Multiportal surgical dilator systems and associated devices and methods

Abstract

Multiportal surgical dilator systems and associated devices and methods are disclosed herein. In some embodiments, a dilator system includes a first dilator, a second dilator, and a lock. The first dilator can include a receiving portion. The second dilator can include an interlocking portion. The receiving portion can be configured to receive the interlocking portion. The lock can be configured to releasably secure the interlocking portion in the receiving portion, thereby interlocking the first dilator and the second dilator. The first dilator can be configured to be inserted into a patient through a first port, and the second dilator can be configured to be inserted into the patient through a second port spaced apart from the first port. When the lock interlocks the first and second dilators, an angle between the first dilator and the second dilator can be adjustable to define a variable working space in the patient.

Description

MULTIPORTAL SURGICAL DILATOR SYSTEMS AND ASSOCIATEDDEVICES AND METHODSCROSS-REFERENCE TO RELATED APPLICATION

[0001] The present application claims the benefit of U.S. Provisional Patent Application No.: 63 / 673,239, filed July 19, 2024, the disclosure of which is incorporated herein by reference in its entirety.TECHNICAL FIELD

[0002] The present technology relates generally to medical systems and, more particularly, to multiportal surgical dilator systems and associated devices and methods for use during surgical procedures.BACKGROUND

[0003] Individuals often suffer from damaged or displaced spinal discs and / or vertebral bodies due to trauma, disease, degenerative defects, or wear over an extended period of time. One result of this displacement or damage to a spinal disc or vertebral body may be chronic back pain. A common procedure for treating damage or disease of the spinal disc or vertebral body may involve partial or complete removal of an intervertebral disc. An intervertebral implant (commonly referred to as an interbody spacer or cage) can be inserted into the cavity created where the intervertebral disc was removed to help maintain height of the spine and / or restore stability to the spine. An interbody spacer may also provide a lordotic correction to the curvature of the spine. An example of an interbody spacer that has been commonly used is a fixed dimension cage, which typically is filled with bone and / or bone growth-inducing materials. Unfortunately, it may be difficult to prepare a suitable working space for insertion of endoscopes and other surgical instruments. Additionally, conventional surgical techniques can cause a significant amount of trauma at or near the implantation site (e.g., injury to nerve tissue), which can significantly increase recovery time and / or lead to patient discomfort. Accordingly, there is a need for improved dilator systems for preparing working space for delivering a spinal implant, performing decompression procedures, and / or other surgical procedures.BRIEF DESCRIPTION OF THE DRAWINGS

[0004] FIG. 1 is an isometric view of a spinal surgical system in accordance with at least some embodiments of the present technology.

[0005] FIG. 2 is an isometric, partially exploded view of a dilator system in accordance with embodiments of the present technology.

[0006] FIG. 3 is an isometric view of a first dilator of the dilator system of FIG. 2.

[0007] FIG. 4 is an enlarged isometric view of a portion of the first dilator of FIG. 3.

[0008] FIG. 5 is an enlarged, cross-sectional side view of the first dilator of FIG. 3 taken along line 5-5 of FIG. 4.

[0009] FIG. 6 is an isometric view of a second dilator of the dilator system of FIG. 2.

[0010] FIG. 7 is an enlarged isometric view of the second dilator of FIG. 6.

[0011] FIG. 8 is an isometric view of a lock of the dilator system of FIG. 2.

[0012] FIG. 9 is an enlarged, cross-sectional side view of a portion of the dilator system of FIG.2 in an unlocked state.

[0013] FIG. 10 is an enlarged, cross-sectional side view of the portion of the dilator system of FIG. 2 in a locked state.

[0014] FIG. 11 is an isometric view of a dilator system configured in accordance with some embodiments of the present technology.

[0015] FIGS. 12A and 12B are enlarged isometric views of the dilator system of FIG. 11 in an interlocked state and a separated state, respectively.

[0016] FIG. 13 is an enlarged, cross-sectional side view of the dilator system of FIG. 1 1 .

[0017] FIG. 14 is a flowchart illustrating a method for creating a working space in a patient during a surgical procedure in accordance with embodiments of the present technology.DETAILED DESCRIPTIONI. Overview

[0018] Embodiments of the present technology relate to surgical dilator systems and associated devices and methods. The systems can be used to safely and effectively prepare suitable working spaces in a patient for insertion of endoscopes and other surgical instruments. The systems can also be conveniently adjustable to adapt to different working space demands. For example, a dilator system can include a first dilator, a second dilator, and a lock. The distal end portions of the first and second dilators can be interlocked via, for example, a ball-and-socket mechanism such that the first dilator can be rotated relative to the second dilator, thus defining a variable working space. The lock can automatically secure the first and second dilators in the interlocked state in response to a user pushing the first dilator and the second dilator together. The interlocked first and second dilators can be moved within the patient to create a desired working space inside the patient. The lock can also automatically release the first and second dilators from the interlocked state in response to the user pulling the first and second dilators apart. The dilator system can also include mechanisms that can selectively fix the angle between the first and second dilators. Fixing the angle advantageously maintains the dimensions of the working space, allowing the user to perform surgical maneuvers without accidentally changing the working space. The working space can be created while the first and second dilators remain positioned within access ports. After creating the working space, the first and second dilators can be removed from the patient. Instruments can then be inserted through the access ports to perform surgical steps within or near the working space.

[0019] In some embodiments, a dilator system for providing a working space for a surgical procedure includes a first dilator, a second dilator, and a lock. The first dilator can include a first insertion portion and a receiving portion coupled to a distal end of the first insertion portion. The second dilator can include a second insertion portion and an interlocking portion coupled to a distal end of the second insertion portion. The receiving portion of the first dilator can be configured to receive the interlocking portion of the second dilator. The lock can be configured to releasably secure the interlocking portion of the second dilator in the receiving portion of the first dilator, thereby interlocking the first dilator and the second dilator. The first dilator can be configured to be inserted into a patient through a first port, and the second dilator can be configured to be inserted into the patient through a second port spaced apart from the first port. When the lock interlocks the firstdilator and the second dilator, an angle between the first dilator and the second dilator can be adjustable to define a variable working space in the patient.

[0020] In some embodiments, a dilator system includes a first dilator, a second dilator, and a lock. The first dilator can include a receiving portion defining a socket at a first distal end of the first dilator. The second dilator can include a spherical component at a second distal end of the second dilator. The spherical component can be configured to be inserted in the socket. The lock can be configured to releasably secure the spherical component in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism. The spherical component can be rotatable within the socket to change an angle between the first dilator and the second dilator, and the first dilator and the second dilator define a variable working space inside a patient for a surgical procedure.

[0021] In some embodiments, a dilator system includes a plurality of dilators configured to be selectively coupled together to enable creation of one or more working spaces. The dilators can have enlarged distal tips that can be moved back and forth to create open volumes around or adjacent targeted tissue, implantation sites, etc. In some procedures, distal ends of two or more dilators can be coupled together such that the triangulated dilators can be manually manipulated (e.g., translated, rotated, etc.) to create, enlarge, and / or shape a working space inside the patient. For example, the dilators can be moved distally into a patient to tear, separate, and / or move tissue (e.g., fat, soft tissue ligaments, cartilage, bone, etc.), move anatomical elements (e.g., vertebrae, organs, etc.), and / or the like. In some embodiments, the dilators can be in an atraumatic triangulated configuration that prevents the locked dilators from being inserted too deep into the patient. For example, the dilators can angle away from each other such that the dilators contact bone (e.g., vertebral bodies, spinous processes, etc.) prior to the dilators contacting the non-targeted tissue, such as nerve tissue of the spinal cord. The atraumatic triangulated configuration can be, for example, a V-shaped configuration defining an included angle equal to or greater than, for example, 20°, 30°, 40°, 50°, 60°, or 70°. The dilators can be repeatedly locked and unlocked to create the working space(s). In some locked arrangements, the dilators are rotationally and translationally fixed to each other. In some locked arrangements, the dilators can be pivotally coupled together.

[0022] In some embodiments, a dilator system includes a plurality of dilators configured to be selectively coupled together by, for example, one or more locking elements. The locking elementscan include one or more magnets, snap fittings, actuatable locks, threaded connections, clamps, pins, etc. In some embodiments, the locking elements can be operated to selectively lock the dilators. For example, dilators can automatically lock upon physical engagement with one another. The number and configuration of locking elements can be selected based on the desired convenience of locking. For example, dilators can include one or more magnets to allow portions of the dilators to be conveniently coupled and separated.

[0023] In some embodiments, all or a portion of dilators are made of a radiopaque material for viewing via fluoroscopy. A user can manually grip a pair of triangulated dilators. A user can manually move the triangulated dilators downwardly and upwardly to increase a height of a working space. A user can sweep the triangulated dilators sideways to expand a length of a working space. The triangulated dilators can increase the leverage provided to the user for pushing, tearing, and repositioning tissue around or near the surgical site.

[0024] In some embodiments, a dilator system includes a plurality of dilators that engage one another to form connections, such as joints, friction fits, etc. Joints can be, for example, ball joints (e.g., ball and socket joints), hinges, joints, and other type of joints. The joints allow triangulated dilators to be moved relative to one another to reposition, adjust angular positions, and otherwise manipulate the dilator system. In some embodiments, each dilator defines a portion of a joint. In other embodiments, a dilator can be coupled to a joint of another dilator. The configuration of the joint can be selected based on a desired range of motion.

[0025] In some embodiments, a method for creating a working space during a surgical procedure on a patient includes the steps of (i) inserting a first dilator into the patient through a first port, (ii) inserting a second dilator into the patient through a second port, (iii) interlocking a receiving portion of the first dilator with an interlocking portion of the second dilator within the patient such that the first dilator and the second dilator are oriented at an angle relative to one another, thereby defining, for example, delivery paths and / or the working space, and (iv) rotating the second dilator relative to the first dilator while the receiving portion and the interlocking portion are interlocked to adjust the angle, thereby adjusting the delivery paths and / or working space. The angle can be selected based on a desired amount of dilation, a maximum amount of dilation, a minimum amount of dilation, or the like. For example, a kit can include sets of dilators with pairs of dilators configured to allow a maximum angle of dilation (e.g., 90°, 80°, 70°, 60°) to limit or prevent injury to non-targeted tissue,excessive dilation, or the like. During surgical procedure, different dilation steps can be performed using different sets of dilators.

[0026] In some embodiments, the dilator system is used in a spinal surgical system that also includes a visualization instrument and / or other devices to assist the surgical procedure, including instrument holders, pillows, etc. Surgical techniques described herein can include a spinal implant delivery procedure, a decompression procedure, an oblique lumbar interbody fusion (OLIF) procedure, a lateral lumbar interbody fusion (LLIF) procedure, a posterior lumbar interbody fusion (PLIF) procedure, a transforaminal lumbar interbody fusion (TLIF) procedure, an anterior lumbar interbody fusion (ALIF) procedure, or combinations thereof.

[0027] In some embodiments, a dilator system includes dilators configured to interlock, lock, or unlock by, for example, by predefined relative movement. For example, axial rotation of a first dilator relative to a second dilator can interlock, lock, and / or unlock the first and second dilators. In some embodiments, axial translation between the first and second dilators can interlock, lock, and / or unlock the first and second dilators. When interlocked, the dilators can form a joint and move relative to each other via non-axial rotation or other desired movement. In some embodiments, a locking mechanism can unlock (e.g., actuating a button of the locking mechanism) the relative orientations of dilators, thereby configuring the dilator system from a fixed state to a pivotable state. This can allow for easy adjustment of the angle therebetween, enhancing surgical adaptability, flexibility, and precision. In some embodiments, the dilators can be separated by pulling the first dilator away from the second dilator with sufficient, but not excessive, force.

[0028] Embodiments of the present technology can simplify triangulation during surgical procedures and optimize the surgical field for intricate procedures. The two dilators of the dilator system can be easily connected together, providing a clear and unified working space. The dilator system includes an intuitive mechanism for interlocking and unlocking the two dilators, and allows for easy adjustment of the angle therebetween, enhancing surgical adaptability, flexibility, and precision. The dilators also include blunt, smooth, and / or curved surfaces and edges, minimizing risk of injury to, for example, non-targeted tissue and / or the patient and ensuring safety during insertion and manipulation. Overall, dilator systems configured in accordance with embodiments of the present technology enable the creation of secure working spaces crucial for precise and intricate surgical maneuvers.

[0029] Embodiments of the present disclosure will be described more fully hereinafter with reference to the accompanying drawings in which like numerals represent like elements throughout the several figures, and in which example embodiments are shown. Embodiments of the claims may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. The examples set forth herein are non-limiting examples and are merely examples among other possible examples.II. Spinal Surgical Systems

[0030] FIG. 1 is an isometric view of a spinal surgical system 100 (“the system 100”) positioned along a human patient’s spine 102 in accordance with embodiments of the present technology. The system can include a dilator system 110 and a cannula 160. The dilator system 110 can include a first dilator 120 and a second dilator 140, each having a generally narrow, elongate form factor. The first dilator 120 and the second dilator 140 can be inserted into separate surgical incisions and / or ports. The cannula 160 can have a half-cylindrical shape defining an open channel in which the first dilator 120 can be positioned, and the cannula 160 can be used to assist with proper insertion of the first dilator 120. In some embodiments, the cannula 160 or a different cannula can be used to assist with proper insertion of the second dilator 140.

[0031] As shown in FIG. 1, the first dilator 120 and the second dilator 140 can be inserted through the separate ports at different angles such that the distal ends of the first dilator 120 and the second dilator 140 meet at a position at or adjacent the patient’s spine 102. As discussed in further detail below, the distal ends of the first dilator 120 and the second dilator 140 can be maneuvered by the user to engage one another and interlock, thereby defining an angle a therebetween and forming a generally sector-shaped working space. By interlocking, the first dilator 120 and the second dilator 140 can provide a clear and unified working space for subsequent surgical procedures. The first dilator 120 and the second dilator 140 can also be easily unlocked, disconnected, or separated by the user for adjustment and / or removal of the dilator system 100. In some embodiments, the cannula 160 can maintain an orientation of the first dilator 120 relative to the patient during the surgical procedure.

[0032] In some embodiments, the first dilator 120 and / or the second dilator 140 include fixation features that can maintain the first dilator 120 and the second dilator 140 at a predetermined angle a. In some embodiments, the first dilator 120 and / or the second dilator 140 include adjustment featuresthat can be actuated to allow the user to adjust the angle a while the distal ends of the first dilator 120 and the second dilator 140 remain engaged. For example, the angle a can be adjusted between 10- 90°. By allowing the user to adjust the angle a, the dilator system 110 provides a high degree of adaptability, flexibility, and precision during surgical procedures. Therefore, the dilator system 110 enables the creation of a secure working space crucial for precise and intricate surgical maneuvers.III. Select Embodiments of Dilator Systems

[0033] FIG. 2 is an isometric, partially exploded view of the dilator system 110 in accordance with embodiments of the present technology. As aforementioned, the dilator system 110 can include the first dilator 120 and the second dilator 140, and can further include a lock 270. As discussed further herein, the lock 270 can removably couple, or lock, the first dilator 120 to the second dilator 140.

[0034] FIG. 3 is an isometric view of the first dilator 120 in accordance with embodiments of the present technology. The first dilator 120 has a generally narrow, elongate shaft that extends between a proximal end portion 322a and a distal end portion 322b. The length of the first dilator 120 can be between 100-300 mm, such as 150 mm, 200 mm, 250 mm, etc. The first dilator 120 can include a handle portion 324, a collar 326, an insertion portion 328, and a receiving portion 330.

[0035] The handle portion 324, at the proximal end portion 322a, can comprise a generally narrow, elongate cylinder. The handle portion 324 can include grooves 325 and / or other features that assist a user in gripping onto the handle portion 324. The collar 326, coupled to the handle portion 324, can have a smaller diameter than the handle portion 324. The collar 326 can serve as an indicator and / or stopper for how deep the first dilator 120 should be inserted into a patient via an incision, a port, etc. The insertion portion 328 can comprise a generally narrow, elongate, and tapered cylinder extending between the collar 326 and the receiving portion 330. For example, the insertion portion 328 can have a first diameter of about 3 mm, 3.5 mm, 4 mm, 4.5 mm adjacent the collar 326, and a second diameter of about 1mm, 1.5 mm, 2 mm, or 2.5 mm adjacent the receiving portion 330. In some embodiments, a ratio of the first diameter of the insertion portion 328 to the second diameter of the receiving portion 330 can be in the range of about 1, 2, 3, or 4. The configuration and sizes of the components can be selected based on the size of insertion ports, delivery paths into the patient, size of the working space, and / or the like. The receiving portion 330, at the distal end portion 322b, canbe shaped and size to removably receive the second dilator 140, as discussed in further detail herein. The collar 326, the insertion portion 328, and the receiving portion 330 can be made of metal (e.g., medical-grade stainless steel), durable composite material, and / or other material suitable for insertion in a patient.

[0036] FIG. 4 is an enlarged isometric view of the receiving portion 330 of the first dilator 120. In the illustrated embodiment, the receiving portion 330 comprises a generally teardrop-shaped component having a first inner surface 432, a second inner surface 434, a lip 436 between the first and second inner surfaces 432, 434, and an outer surface 438. The first inner surface 432 comprises a generally elongate, curved surface extending from the lip 436 towards the insertion portion 328. The second inner surface 434 comprises a semispherical surface defining a socket 433 for receiving the second dilator 140, as discussed in further detail herein. The receiving portion 330 can also include a receptacle or aperture 437 extending from the second inner surface 434 to the outer surface 438. The aperture 437 can be concentric with the lip 436, as shown. The lip 436 can extend into the thickness of the receiving portion 330, defining an annular recess 435 therein. The outer surface 438 can have an atraumatic configuration. For example, the outer surface 438 can have an atraumatic semispherical portion around the second inner surface 434, and an elongate portion extending on the other side of the first inner surface 432. The semispherical portion of the outer surface 438 provides a smooth, curved surface suitable for insertion into a patient without causing damage to distal tissue, such as non-targeted tissue (e.g., nerve tissue). The curved outer surface 438 allows the dilators to be slid along bone, through tissue, and / or the like. The configuration, curvature, and size of the tissuecontacting portions of the dilators can be selected based on the surgical site, characteristics of nontargeted tissue, delivery paths, and / or working space.

[0037] FIG. 5 is an enlarged, cross-sectional side view of the receiving portion 330 taken along line 5-5 of FIG. 4. As shown, the annular recess 435 can have a diameter DI of about 4.5mm, 5 mm, 5.5 mm, or 6 mm. The semispherical portion of the outer surface 438 can have a diameter D2 of about 5 mm, 5.5 mm, 6 mm, or 6.5 mm (e.g., greater than DI). The second inner surface 434 can have a diameter D3 of about 3.5 mm, 4 mm, 4.5 mm, or 5 mm (e.g., smaller than each of DI and D2). The aperture 437 can have a diameter D4 of about 0.5-2 mm or 1-1 .5 mm. It is appreciated that the diameters given herein are merely example dimensions, and that the receiving portion 330 can have other relative dimensions.

[0038] FIG. 6 is an isometric view of the second dilator 140 in accordance with embodiments of the present technology. The second dilator 140 has a generally narrow, elongate form factor that extends between a proximal end portion 642a and a distal end portion 642b. The length of the second dilator 140 can be between 100-300 mm, such as 150 mm, 200 mm, 250 mm, etc. The second dilator 140 can include a handle portion 644, a collar 646, an insertion portion 648, and an interlocking portion 650.

[0039] The handle portion 644, at the proximal end portion 642a, can comprise a generally narrow, elongate cylinder. The handle portion 644 can include grooves 645 and / or other features that assist a user in gripping onto the handle portion 644. The handle portion 644 can also include a release mechanism 647 (e.g., a button) that, when actuated, configures the second dilator 140 in a pivotable state as described further herein. The handle portion 644 can include one or more wires, rods, tethers, and other components connecting the release mechanism 647 to moveable components, locks, and other features. The collar 646, coupled to the handle portion 644, can have a smaller diameter than the handle portion 644. The collar 646 can serve as an indicator and / or stopper for how deep the second dilator 140 should be inserted into a patient via an incision, a port, etc. The insertion portion 648 can comprise a generally narrow, elongate, and tapered cylinder extending between the collar 646 and the receiving portion 330. For example, the insertion portion 648 can have a first diameter of about 3.5 mm adjacent the collar 646, and a second diameter of about 1.3 mm adjacent the receiving portion 330. The interlocking portion 650, at the distal end portion 642b, can be shaped and sized to removably interlock with the first dilator 120, as discussed in further detail herein. The collar 646, the insertion portion 648, and the interlocking portion 650 can be made of metal (e.g., medical-grade stainless steel), durable composite material, and / or other material suitable for insertion in a patient.

[0040] FIG. 7 is an enlarged isometric view of the distal end portion 642b of the second dilator 140. In the illustrated embodiment, the interlocking portion 650 has a spherical geometry with the insertion portion 648 extending from one end of the interlocking portion 650 and a protrusion or distal tip 752 extending from an opposite end of the interlocking portion 650. The sphere or ball of the interlocking portion 650 can have a diameter D5 of about 4 mm. The distal tip 752 can have a cylindrical portion and a semispherical portion thereon. The cylindrical portion can be tapered in the shape of a frustum of a cone. In some embodiments, the insertion portion 648 and the distal tip 752are aligned along a longitudinal axis of the second dilator 140. The spherical geometry of the interlocking portion 650, the semispherical portion of the distal tip 752, and the tapered geometry of the cylindrical portion of the distal tip 752 provide smooth, curved surfaces suitable for insertion into a patient without causing damage. In some embodiments, the user can actuate the release mechanism 647 (e.g., press on the button) to withdraw the distal tip 752 into the interlocking portion 650.

[0041] FIG. 8 is an isometric view of the lock 270 in accordance with embodiments of the present technology. In the illustrated embodiment, the lock 270 comprises an annular ring with a cross-sectional diameter D6 of about 0.5 mm. Also, the lock 270 does not extend all the way around, but instead includes a gap 872. Therefore, the lock 270 can be an expandable ring configurable between a neutral state and an expanded state in which the lock 270 is biased toward the neutral state, and can have a variable inner diameter D7. When the lock 270 is in the neutral state, the inner diameter D7 can be less than about 4 mm. In other embodiments, the lock 270 can comprise an expandable component of other configurations, such as a coil, an elastic band, a snap ring, a split ring, etc. The lock 270 can be made of metal (e.g., medical-grade stainless steel), a durable composite material, and / or other material suitable for insertion in a patient, and of sufficient elasticity for expansion and compression.

[0042] FIG. 9 is an enlarged, cross-sectional side view of the dilator system 110 in an unlocked state. The lock 270 can be inserted into the annular recess 435 of the receiving portion 330 by, for example, pushing the lock 270 downward and towards the lip 436. As the lock 270 moves downward, the first inner surface 432, which can be tapered as shown, can push against and compress the lock 270 such that the gap 872 decreases in size, effectively reducing the overall diameter of the lock 270. Once the lock 270 reaches the lip 436, the lock 270 can snap into position in the annular recess 435. As shown, when the lock 270 is in the neutral state, the lock 270 can extend inward of the lip 436. The first dilator 120 (e.g., with the lock 270) and the second dilator 140 (not shown in FIG. 9) can then be inserted into the patient independently through different incisions, ports, etc.

[0043] FIG. 10 is an enlarged, cross-sectional side view of the dilator system 110 in a locked state. To lock the dilator system 110, the user can move the first dilator 120 and / or the second dilator 140 towards one another until the interlocking portion 650 of the second dilator 140 contacts the first inner surface 432 of the receiving portion 330. As the user pushes the interlocking portion 650 further into the socket 433, the interlocking portion 650 can push against and thereby expand the lock 270deeper into the annular recess 435. When the interlocking portion 650 is positioned to be generally flush against the second inner surface 434, the first dilator 120 and the second dilator 140 are interlocked in a ball-and-socket arrangement. The biasing force of the lock 270 tending to return the lock 270 from the expanded state (FIG. 10) to the neutral state (FIG. 9) can apply a force on the interlocking component 650. The applied force can be large enough to prevent unintended separation between the first dilator 120 and the second dilator 140, but small enough to be easily overcome by the user such that the user can separate the first dilator 120 and the second dilator 140 by pulling them apart without using excessive force.

[0044] When the interlocking portion 650 is coupled to the receiving portion 330, the dilator system 110 can be configurable between different states (e.g., a fixed state, a pivoting state, articulating state, etc.). For example, as the interlocking portion 650 is positioned in the socket 433, the distal tip 752 can be inserted into and through the aperture 437 such that the distal tip 752 extends beyond the first dilator 120. By being positioned in the aperture 437, the distal tip 752 can at least temporarily fix the orientation of the second dilator 140 to the first dilator 120, keeping the angle a therebetween (FIG. 1) constant and defining the fixed state of the dilator system 110. As aforementioned, in some embodiments, the user can actuate the release mechanism 647 (e.g., press on the button) to withdraw the distal tip 752 into the interlocking portion 650. This can configure the second dilator 140 to the pivotable state in which the user can change the angle a. Advantageously, fixing the angle a via the distal tip 752 (e.g., the fixed state) allows the user to easily maintain a specific working space using the dilator system 110, while adjusting the angle a (e.g., the pivotable state) allows the user to change the working space as desired during, for example, a surgical procedure. In some embodiments, the receiving portion 330 includes multiple apertures 437 such that the distal tip 752 can be inserted through the multiple apertures 437, thereby orienting the second dilator 140 relative to the first dilator 120 at various predefined angles.

[0045] In other embodiments, the dilator system can include additional or alternative mechanisms for interlocking the first dilator and the second dilator. For example, FIG. 11 is an isometric view of another dilator system 1100 configured in accordance with embodiments of the present technology. The dilator system 1100 includes a first dilator 1 110 and a second dilator 1120. The first dilator 1110 can include a receiving portion 1112 and the second dilator 1120 can include an interlocking portion 1122 configured to be inserted at least partially in the receiving portion 1112.The second dilator 1120 can also include a button 1124 at or near a proximal end portion of the second dilator 1120. As discussed further herein, the receiving portion 1112 and the interlocking portion 1122 can include features that lock the relative orientations of the first dilator 1110 and the second dilator 1120. For example, the first dilator 1110 and the second dilator 1120 can be oriented at a first angle Al as illustrated in FIG. 11 with solid lines. Actuating the button 1124 (e.g., depressing the button 1124 by a user) can unlock the relative orientations of the first dilator 1110 and the second dilator 1120, thereby configuring the dilator system 1100 from a fixed state to a pivotable state. As illustrated in FIG. 11 with phantom lines, while the dilator system 1100 is in the pivotable state, the second dilator 1120 can be rotated to a different orientation at which the first dilator 1110 and the second dilator 1120 are oriented at a second angle A2.

[0046] FIGS. 12A and 12B are enlarged isometric views of the dilator system 1100 in an interlocked state and a separated state, respectively. In the illustrated embodiment, the receiving portion 1112 defines a socket, and the interlocking portion 1122 comprises a ball or spherical component that can be inserted into the socket. Therefore, the first dilator 1110 and the second dilator 1120 can be interlocked in a ball-and-socket mechanism that allows rotation of one dilator relative to the other dilator.

[0047] FIG. 13 is an enlarged, cross-sectional side view of the dilator system 1100. As shown, the receiving portion 1112 of the first dilator 1110 defines a receptacle 1312, and the second dilator 1120 further includes a protrusion or snap latch 1322 extending from a bottom end of the interlocking portion 1122. The snap latch 1322 can be snapped into the receptacle 1312 to releasably but securely couple the first dilator 1110 to the second dilator 1120. The snap latch 1322 and the receptacle 1312, when engaged, can also fix the angle between the first dilator 1110 to the second dilator 1120, advantageously configuring the first dilator 1110 to the second dilator 1120 to define a fixed working space (e.g., the fixed state). In some embodiments, the button 1124 (FIG. 11) can be actuated (e.g., depressed) to withdraw the snap latch 1322 at least partially into the interlocking portion 1122, thereby enabling the spherical component of the interlocking portion 1122 to freely rotate within the socket of the receiving portion 1112 (e.g., the pivotable state).

[0048] In some embodiments, the receiving portion 1112 includes multiple receptacles 1312 such that the snap latch 1322 can be snapped into the multiple receptacles 1312, thereby orienting the second dilator 1120 relative to the first dilator 1110 at various predefined angles. It is appreciatedthat the snap latch 1322 and the receptacle 1312 can have geometries different from the illustrated embodiment to achieve a snap-fitting mechanism. In other embodiments, the first dilator 1110 and the second dilator 1120 can have additional or alternative features that allow the first dilator 1110 and the second dilator 1120 to interlock via a twist-lock mechanism, a slide-lock mechanism, etc.

[0049] Embodiments of the present technology can simplify triangulation during surgical procedures and optimize the surgical field for intricate procedures. The two dilators of the dilator system can be easily connected together, providing a clear and unified working space. The dilator system includes an intuitive mechanism for interlocking and unlocking the two dilators, and allows for easy adjustment of the angle therebetween, enhancing surgical adaptability, flexibility, and precision. The dilators also include blunt, smooth, and / or curved surfaces and edges, minimizing risk of injury to the patient and ensuring safety during insertion and manipulation. Overall, dilator systems configured in accordance with embodiments of the present technology enable the creation of secure working spaces crucial for precise and intricate surgical maneuvers.IV. Methods for Creating a Working Space

[0050] FIG. 14 is a flowchart illustrating a method 1400 for creating a working space in a patient during a surgical procedure in accordance with embodiments of the present technology. While the method 1400 is described below with reference to the embodiments illustrated in FIGS. 1-13, the method 1400 can be performed using other embodiments of the present technology. Also, while the method 1400 is described below in a particular order, one or more steps can be performed in a different order or omitted entirely. The method 1400 can also include additional or alternative steps.

[0051] At block 1402, the method 1400 begins by inserting a first dilator (e.g., the first dilator 120, the first dilator 1110) into the patient through a first port. The first port can comprise a surgical incision in the patient and / or a medical port positioned therein. In some embodiments, the first dilator is inserted along a cannula (e g., the cannula 160) extending through the first port. The cannula can be configured to maintain an orientation of the first dilator relative to the patient during the surgical procedure.

[0052] The method 1400 continues at block 1404 by inserting a second dilator (e.g., the second dilator 140, the second dilator 1120) into the patient through a second port. Like the first port, thesecond port can comprise a surgical incision in the patient and / or a medical port positioned therein. The first port and the second port can be spaced apart along the patient’s skin.

[0053] The method 1400 continues at block 1406 by interlocking a receiving portion (e.g., the receiving portion 330, the receiving portion 1112) of the first dilator with an interlocking portion (e.g., the interlocking portion 650, the interlocking portion 1122) of the second dilator within the patient such that the first dilator and the second dilator are oriented at an angle relative to one another, thereby defining the working space. In some embodiments, interlocking the receiving portion with the interlocking portion comprises expanding an expandable ring (e.g., the lock 270) into an annular recess (e.g., the annular recess 435) of the receiving portion. The expandable ring, when expanded, can be configured to apply a biasing force on the interlocking portion to releasably secure the interlocking portion in the receiving portion.

[0054] The method 1400 continues at block 1408 by rotating the second dilator relative to the first dilator while the receiving portion and the interlocking portion are interlocked to adjust the angle, thereby adjusting the working space. In some embodiments, the receiving portion defines a socket, the interlocking portion includes a spherical component, and rotating the second dilator relative to the first dilator comprises rotating the spherical component within the socket.

[0055] In some embodiments, the method 1400 further comprises unlocking the interlocking portion from the receiving portion such that the first dilator is separated from the second dilator, pulling the first dilator out of the patient through the first port, and pulling the second dilator out of the patient through the second port. In some embodiments, the method 1400 further comprises inserting a surgical instrument (e.g., an endoscope) in the working space defined by the first dilator and the second dilator.V. Examples

[0056] The present technology is illustrated, for example, according to various aspects described below as numbered examples (1, 2, 3, etc.) for convenience. These are provided as examples and do not limit the present technology. It is noted that any of the dependent examples may be combined in any combination, and placed into a respective independent example. The other examples can be presented in a similar manner.1. A dilator system for providing a working space for a surgical procedure, the dilator system comprising: a first dilator including a first insertion portion and a receiving portion coupled to a distal end of the first insertion portion, wherein the first dilator is configured to be inserted into a patient through a first port; a second dilator including a second insertion portion and an interlocking portion coupled to a distal end of the second insertion portion, wherein the receiving portion of the first dilator is configured to receive the interlocking portion of the second dilator, wherein the second dilator is configured to be inserted into the patient through a second port spaced apart from the first port; and a lock configured to releasably secure the interlocking portion of the second dilator in the receiving portion of the first dilator, thereby interlocking the first dilator and the second dilator, wherein, when the lock interlocks the first dilator and the second dilator, an angle between the first dilator and the second dilator is adjustable to define a variable working space in the patient.2. The dilator system of example 1, wherein the interlocking portion comprises a spherical component, and wherein the receiving portion and the spherical component engage one another to define a ball joint.3. The dilator system of example 1 or example 2, wherein the receiving portion of the first dilator is configured lock onto the interlocking portion when the interlocking portion is inserted into the receiving portion.4. The dilator system of any of examples 1-3, wherein the lock is configured to keep the first and second dilators interlocked while the first dilator and the second dilator tear tissue.5. The dilator system of any of examples 1-4, wherein the receiving portion includes a semispherical shell defining a socket, and wherein the interlocking portion includes a sphericalcomponent configured to be at least partially inserted in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.6. The dilator system of example 5, wherein the semispherical shell has an outer diameter between 5-6.5 mm and an inner diameter between 3.5-5 mm, and wherein the spherical component has a diameter between 3.5-5 mm.7. The dilator system of any of examples 1-6, wherein the receiving portion defines a receptacle, and wherein the interlocking portion includes a snap latch configured to be inserted in the receptacle, thereby fixing the angle between the first dilator and the second dilator.8. The dilator system of any of examples 1-7, wherein the receiving portion includes an aperture, wherein the second dilator further includes a distal tip extending from and distal to the interlocking portion, and wherein the distal tip is configured to be inserted through the aperture of the receiving portion, thereby fixing the angle between the first dilator and the second dilator.9. The dilator system of example 8, wherein the second dilator further includes a release mechanism configured to selectively withdraw the distal tip at least partially into the interlocking portion such that the angle between the first dilator and the second dilator is adjustable.10. The dilator system of any of examples 1-9, wherein the lock comprises an expandable ring configurable between a neutral state and an expanded state, wherein, when the interlocking portion is located in the receiving portion, the lock is configured to be in the expanded state, and wherein, when the lock is in the expanded state, the lock is biased toward the neutral state to releasably secure the interlocking portion in the receiving portion.11. The dilator system of example 10, wherein the receiving portion includes an annular lip defining an annular recess configured to receive the expandable ring, and wherein, when the interlocking portion is located in the receiving portion, the expandable ring extends around the interlocking portion and along the annular recess.12. The dilator system of example 11, wherein the expandable ring has a cross-sectional diameter of about 0.5 mm, wherein, when the expandable ring is in the neutral state, the expandable ring has an inner diameter of less than about 4 mm, and wherein the annular recess has a diameter of about 5 mm.13. The dilator system of any of examples 1-12, wherein each of the first insertion portion and the second insertion portion is tapered, and wherein each of the receiving portion and the interlocking portion includes a smooth, curved outer surface.14. A dilator system, comprising: a first dilator including a receiving portion defining a socket at a first distal end of the first dilator; a second dilator including a spherical component at a second distal end of the second dilator, wherein the spherical component is configured to be inserted into the socket such that the spherical component is releasably coupled to the socket to form a ball joint configured to allow adjustments of an angle between the first dilator and the second dilator that are together within a patient to define a working space inside the patient for a surgical procedure.15. The dilator system of example 14, further comprising a lock configured to releasably secure the spherical component in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.16. The dilator system of example 14 or example 15, wherein the receiving portion further defines a receptacle extending from the socket, wherein the second dilator further includes a protrusion extending from and distal to the spherical component, and wherein the protrusion is configured to be inserted in the receptacle to fix the angle between the first dilator and the second dilator.17. The dilator system of example 16, wherein the protrusion and the receptacle are configured to fix the angle between the first dilator and the second dilator via at least one of a twistlock mechanism, a snap-fit mechanism, or a slide-lock mechanism.18. The dilator system of example 16, wherein the second dilator further includes a handle portion extending proximal to the spherical component and a button on the handle portion, wherein depressing the button causes the protrusion to retract at least partially into the spherical component such that the angle between the first dilator and the second dilator can be adjusted.19. A dilator system comprising: a first dilator including a first shaft and a receiving portion; and a second dilator including a second shaft and an interlocking portion configured to releasably couple to the receiving portion while the first shaft is positioned in a first access port in a patient and the second shaft is positioned in a second access port in the patient, wherein, when the first dilator and the second dilator are releasably coupled together, the dilator system has a rounded distal portion configured to be moved within the patient to form a working space.20. The dilator system of example 19, wherein, when the interlocking portion is coupled to the receiving portion, the dilator system is configurable between: a fixed state for rotationally fixing the first dilator relative to the second dilator, and a pivoting state for allowing rotation of the first dilator relative to the second dilator about the interlocking portion and the receiving portion as a pivot.21. The dilator system of example 19 or example 20, wherein the interlocking portion is configured to snap lock to the receiving portion upon insertion into the receiving portion.22. The dilator system of any of examples 19-21, wherein the interlocking portion and the receiving portion are configured to define a ball joint.23. The dilator system of any of examples 19-22, wherein the interlocking portion comprises a spherical component, and wherein the receiving portion and the spherical component are configured to slidably engage one another.24. The dilator system of any of examples 19-23, wherein the receiving portion of the first dilator is configured lock onto the interlocking portion when the interlocking portion is inserted into the receiving portion.25. The dilator system of any of examples 19-24, wherein the first dilator and the second dilator are configured to remain interlocked while the first dilator and the second dilator tear tissue.26. The dilator system of any of examples 19-25, wherein the receiving portion includes a semispherical shell defining a socket, and wherein the interlocking portion includes a spherical component configured to be at least partially inserted in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.27. The dilator system of example 26, wherein the semispherical shell has an outer diameter between 5-6.5 mm and an inner diameter between 3.5-5 mm, and wherein the spherical component has a diameter between 3.5-5 mm.28. The dilator system of any of examples 19-27, wherein the receiving portion defines a receptacle, and wherein the interlocking portion includes a snap latch configured to be inserted in the receptacle, thereby fixing an angle between the first dilator and the second dilator.29. The dilator system of any of examples 19-28, wherein the receiving portion includes an aperture, wherein the second dilator further includes a distal tip extending from and distal to the interlocking portion, and wherein the distal tip is configured to be inserted through the aperture of the receiving portion, thereby fixing an angle between the first dilator and the second dilator.30. The dilator system of example 29, wherein the second dilator further includes a release mechanism configured to selectively withdraw the distal tip at least partially into the interlocking portion such that the angle between the first dilator and the second dilator is adjustable.31. The dilator system of any of examples 19-30, further comprising a lock including an expandable ring configurable between a neutral state and an expanded state, wherein, when the interlocking portion is located in the receiving portion, the lock is configured to be in the expanded state, and wherein, when the lock is in the expanded state, the lock is biased toward the neutral state to releasably secure the interlocking portion in the receiving portion.32. The dilator system of example 31, wherein the receiving portion includes an annular lip defining an annular recess configured to receive the expandable ring, and wherein, when the interlocking portion is located in the receiving portion, the expandable ring extends around the interlocking portion and along the annular recess.33. The dilator system of example 32, wherein the expandable ring has a cross-sectional diameter of about 0.5 mm, wherein, when the expandable ring is in the neutral state, the expandable ring has an inner diameter of less than about 4 mm, and wherein the annular recess has a diameter of about 5 mm.34. The dilator system of any of examples 19-33, wherein each of the receiving portion and the interlocking portion includes a smooth, curved outer surface.35. A method for creating a working space during a surgical procedure on a patient, the method comprising: inserting a first dilator into the patient through a first port; inserting a second dilator into the patient through a second port; interlocking a receiving portion of the first dilator with an interlocking portion of the second dilator within the patient such that the first dilator and the second dilator are oriented at an angle relative to one another, thereby defining the working space; androtating the second dilator relative to the first dilator while the receiving portion and the interlocking portion are interlocked to adjust the angle, thereby adjusting the working space.36. The method of example 35, wherein interlocking the receiving portion with the interlocking portion comprises expanding an expandable ring into an annular recess of the receiving portion, wherein the expandable ring, when expanded, is configured to apply a biasing force on the interlocking portion to releasably secure the interlocking portion in the receiving portion.37. The method of example 35 or example 36, wherein the receiving portion defines a socket, wherein the interlocking portion includes a spherical component, and wherein rotating the second dilator relative to the first dilator comprises rotating the spherical component within the socket.38. The method of any of examples 35-37, wherein inserting the first dilator comprises inserting the first dilator along a cannula extending through the first port, wherein the cannula is configured to maintain an orientation of the first dilator relative to the patient during the surgical procedure.39. The method of any of examples 35-38, further comprising: unlocking the interlocking portion from the receiving portion such that the first dilator is separated from the second dilator; pulling the first dilator out of the patient through the first port; and pulling the second dilator out of the patient through the second port.40. The method of any of examples 35-39, further comprising inserting a surgical instrument in the working space defined by the first dilator and the second dilator.V. Conclusion

[0057] The above detailed descriptions of embodiments of the technology are not intended to be exhaustive or to limit the technology to the precise form disclosed above. Although specific embodiments of, and examples for, the technology are described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology, as those skilled in the relevant art will recognize. For example, while steps are presented in a given order, alternative embodiments may perform steps in a different order. Features from various systems, methods, kits, and instruments can be combined with features disclosed in U.S. Provisional Patent Application No. 63 / 673,239; U.S. App. No. 15 / 793,950; U.S. App. No. 17 / 902,685; U.S. App. No. 18 / 988,467; U.S. App. No. 18 / 464,949; U.S. App. No. 18 / 470,140; U.S. App. No. 18 / 764,784; U.S. Pat. No. 8,632,594; U.S. Pat. No. 9,308,099; U.S. Pat. No. 10,105,238; U.S. Pat. No. 10,201,431; U.S. Pat. No. 10,898,340; U.S. Pat. No. 9,820,788; U.S. Pat. No. 10,322,009; U.S. Pat. No. 11,464,648; PCT App. No. PCT / US20 / 49982; PCT App. No. PCT / US25 / 14790; and PCT App. No. PCT / US22 / 21193, which are hereby incorporated by reference and made a part of this application. Once used to create a working space, dilator systems in accordance with embodiments of the present technology can be removed from the patient via access ports to allow instruments (e.g., endoscopes) to be inserted through the access ports (or other access ports) to perform surgical steps within or near the working space. Examples of such instruments and methods of operation at a working space are disclosed in U.S. Provisional Patent App. No. 63 / 611,913, which is hereby incorporated by reference and made part of this application. A kit can include one or more dilator systems, instruments, implants, surgical components, other components selected for a surgical procedure. The dilator systems can be configured for a surgical path or approach, level, surgical site, etc. To the extent any material incorporated herein by reference conflicts with the present disclosure, the present disclosure controls.

[0058] Systems, components, and instruments disclosed herein can be disposable or reusable. For example, the dilators, locks, ports, instruments, or cannulas can be disposable to prevent crosscontamination. As used herein, the term “disposable” when applied to a system or component (or combination of components), such as an instrument, a tool, or a distal tip or a head, is a broad termand generally means, without limitation, that the system or component in question is used a finite number of times and is then discarded. Some disposable components are used only once and are then discarded. In other embodiments, the components and instruments are non-disposable and can be used any number of times. In some kits, all of the components can be disposable to prevent crosscontamination. In some other kits, components (e.g., all or some of the components) can be reusable.

[0059] Where the context permits, singular or plural terms may also include the plural or singular term, respectively. Moreover, unless the word “or” is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of “or” in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the term “comprising” is used throughout to mean including at least the recited feature(s) such that any greater number of the same feature and / or additional types of other features are not precluded. Furthermore, the term “about” is used throughout to mean ± 10% of the given value. It will also be appreciated that specific embodiments have been described herein for purposes of illustration, but that various modifications may be made without deviating from the technology. Further, while advantages associated with certain embodiments of the technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the present technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.

Claims

CLAIMSWhat is claimed is:

1. A dilator system for providing a working space for a surgical procedure, the dilator system comprising: a first dilator including a first insertion portion and a receiving portion coupled to a distal end of the first insertion portion, wherein the first dilator is configured to be inserted into a patient through a first port; a second dilator including a second insertion portion and an interlocking portion coupled to a distal end of the second insertion portion, wherein the receiving portion of the first dilator is configured to receive the interlocking portion of the second dilator, wherein the second dilator is configured to be inserted into the patient through a second port spaced apart from the first port; and a lock configured to releasably secure the interlocking portion of the second dilator in the receiving portion of the first dilator, thereby interlocking the first dilator and the second dilator, wherein, when the lock interlocks the first dilator and the second dilator, an angle between the first dilator and the second dilator is adjustable to define a variable working space in the patient.

2. The dilator system of claim 1, wherein the interlocking portion comprises a spherical component, and wherein the receiving portion and the spherical component engage one another to define a ball joint.

3. The dilator system of claim 1, wherein the receiving portion of the first dilator is configured lock onto the interlocking portion when the interlocking portion is inserted into the receiving portion.

4. The dilator system of claim 1, wherein the lock is configured to keep the first and second dilators interlocked while the first dilator and the second dilator tear tissue.

5. The dilator system of claim 1, wherein the receiving portion includes a semispherical shell defining a socket, and wherein the interlocking portion includes a spherical component configured to be at least partially inserted in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.

6. The dilator system of claim 5, wherein the semispherical shell has an outer diameter between 5-6.5 mm and an inner diameter between 3.5-5 mm, and wherein the spherical component has a diameter between 3.5-5 mm.

7. The dilator system of claim 1, wherein the receiving portion defines a receptacle, and wherein the interlocking portion includes a snap latch configured to be inserted in the receptacle, thereby fixing the angle between the first dilator and the second dilator.

8. The dilator system of claim 1, wherein the receiving portion includes an aperture, wherein the second dilator further includes a distal tip extending from and distal to the interlocking portion, and wherein the distal tip is configured to be inserted through the aperture of the receiving portion, thereby fixing the angle between the first dilator and the second dilator.

9. The dilator system of claim 8, wherein the second dilator further includes a release mechanism configured to selectively withdraw the distal tip at least partially into the interlocking portion such that the angle between the first dilator and the second dilator is adjustable.

10. The dilator system of claim 1, wherein the lock comprises an expandable ring configurable between a neutral state and an expanded state, wherein, when the interlocking portion is located in the receiving portion, the lock is configured to be in the expanded state, and wherein, when the lock is in the expanded state, the lock is biased toward the neutral state to releasably secure the interlocking portion in the receiving portion.

11. The dilator system of claim 10, wherein the receiving portion includes an annular lip defining an annular recess configured to receive the expandable ring, and wherein, when theinterlocking portion is located in the receiving portion, the expandable ring extends around the interlocking portion and along the annular recess.

12. The dilator system of claim 11, wherein the expandable ring has a cross-sectional diameter of about 0.5 mm, wherein, when the expandable ring is in the neutral state, the expandable ring has an inner diameter of less than about 4 mm, and wherein the annular recess has a diameter of about 5 mm.

13. The dilator system of claim 1 , wherein each of the first insertion portion and the second insertion portion is tapered, and wherein each of the receiving portion and the interlocking portion includes a smooth, curved outer surface.

14. A dilator system, comprising: a first dilator including a receiving portion defining a socket at a first distal end of the first dilator; a second dilator including a spherical component at a second distal end of the second dilator, wherein the spherical component is configured to be inserted into the socket such that the spherical component is releasably coupled to the socket to form a ball joint configured to allow adjustments of an angle between the first dilator and the second dilator that are together within a patient to define a working space inside the patient for a surgical procedure.

15. The dilator system of claim 14, further comprising a lock configured to releasably secure the spherical component in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.

16. The dilator system of claim 14, wherein the receiving portion further defines a receptacle extending from the socket, wherein the second dilator further includes a protrusion extending from and distal to the spherical component, and wherein the protrusion is configured to be inserted in the receptacle to fix the angle between the first dilator and the second dilator.

17. The dilator system of claim 16, wherein the protrusion and the receptacle are configured to fix the angle between the first dilator and the second dilator via at least one of a twistlock mechanism, a snap-fit mechanism, or a slide-lock mechanism.

18. The dilator system of claim 16, wherein the second dilator further includes a handle portion extending proximal to the spherical component and a button on the handle portion, wherein depressing the button causes the protrusion to retract at least partially into the spherical component such that the angle between the first dilator and the second dilator can be adjusted.

19. A dilator system comprising: a first dilator including a first shaft and a receiving portion; and a second dilator including a second shaft and an interlocking portion configured to releasably couple to the receiving portion while the first shaft is positioned in a first access port in a patient and the second shaft is positioned in a second access port in the patient, wherein, when the first dilator and the second dilator are releasably coupled together, the dilator system has a rounded distal portion configured to be moved within the patient to form a working space.

20. The dilator system of claim 19, wherein, when the interlocking portion is coupled to the receiving portion, the dilator system is configurable between: a fixed state for rotationally fixing the first dilator relative to the second dilator, and a pivoting state for allowing rotation of the first dilator relative to the second dilator about the interlocking portion and the receiving portion as a pivot.

21. The dilator system of claim 19, wherein the interlocking portion is configured to snap lock to the receiving portion upon insertion into the receiving portion.

22. The dilator system of claim 19, wherein the interlocking portion and the receiving portion are configured to define a ball joint.

23. The dilator system of claim 19, wherein the interlocking portion comprises a spherical component, and wherein the receiving portion and the spherical component are configured to slidably engage one another.

24. The dilator system of claim 19, wherein the receiving portion of the first dilator is configured lock onto the interlocking portion when the interlocking portion is inserted into the receiving portion.

25. The dilator system of claim 19, wherein the first dilator and the second dilator are configured to remain interlocked while the first dilator and the second dilator tear tissue.

26. The dilator system of claim 19, wherein the receiving portion includes a semispherical shell defining a socket, and wherein the interlocking portion includes a spherical component configured to be at least partially inserted in the socket, thereby interlocking the first dilator and the second dilator in a ball-and-socket mechanism.

27. The dilator system of claim 26, wherein the semispherical shell has an outer diameter between 5-6.5 mm and an inner diameter between 3.5-5 mm, and wherein the spherical component has a diameter between 3.5-5 mm.

28. The dilator system of claim 19, wherein the receiving portion defines a receptacle, and wherein the interlocking portion includes a snap latch configured to be inserted in the receptacle, thereby fixing an angle between the first dilator and the second dilator.

29. The dilator system of claim 19, wherein the receiving portion includes an aperture, wherein the second dilator further includes a distal tip extending from and distal to the interlocking portion, and wherein the distal tip is configured to be inserted through the aperture of the receiving portion, thereby fixing an angle between the first dilator and the second dilator.

30. The dilator system of claim 29, wherein the second dilator further includes a release mechanism configured to selectively withdraw the distal tip at least partially into the interlocking portion such that the angle between the first dilator and the second dilator is adjustable.

31. The dilator system of claim 19, further comprising a lock including an expandable ring configurable between a neutral state and an expanded state, wherein, when the interlocking portion is located in the receiving portion, the lock is configured to be in the expanded state, and wherein, when the lock is in the expanded state, the lock is biased toward the neutral state to releasably secure the interlocking portion in the receiving portion.

32. The dilator system of claim 31, wherein the receiving portion includes an annular lip defining an annular recess configured to receive the expandable ring, and wherein, when the interlocking portion is located in the receiving portion, the expandable ring extends around the interlocking portion and along the annular recess.

33. The dilator system of claim 32, wherein the expandable ring has a cross-sectional diameter of about 0.5 mm, wherein, when the expandable ring is in the neutral state, the expandable ring has an inner diameter of less than about 4 mm, and wherein the annular recess has a diameter of about 5 mm.

34. The dilator system of claim 19, wherein each of the receiving portion and the interlocking portion includes a smooth, curved outer surface.

35. A method for creating a working space during a surgical procedure on a patient, the method comprising: inserting a first dilator into the patient through a first port; inserting a second dilator into the patient through a second port; interlocking a receiving portion of the first dilator with an interlocking portion of the second dilator within the patient such that the first dilator and the second dilator are oriented at an angle relative to one another, thereby defining the working space; androtating the second dilator relative to the first dilator while the receiving portion and the interlocking portion are interlocked to adjust the angle, thereby adjusting the working space.

36. The method of claim 35, wherein interlocking the receiving portion with the interlocking portion comprises expanding an expandable ring into an annular recess of the receiving portion, wherein the expandable ring, when expanded, is configured to apply a biasing force on the interlocking portion to releasably secure the interlocking portion in the receiving portion.

37. The method of claim 35, wherein the receiving portion defines a socket, wherein the interlocking portion includes a spherical component, and wherein rotating the second dilator relative to the first dilator comprises rotating the spherical component within the socket.

38. The method of claim 35, wherein inserting the first dilator comprises inserting the first dilator along a cannula extending through the first port, wherein the cannula is configured to maintain an orientation of the first dilator relative to the patient during the surgical procedure.

39. The method of claim 35, further comprising: unlocking the interlocking portion from the receiving portion such that the first dilator is separated from the second dilator; pulling the first dilator out of the patient through the first port; and pulling the second dilator out of the patient through the second port.

40. The method of claim 35, further comprising inserting a surgical instrument in the working space defined by the first dilator and the second dilator.

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