An instrument access device (1) comprises a wound protector and retractor (2), a proximal assembly (3) coupled to the wound protector and retractor (2), and an instrument receiver (5) which can be releasably coupled to the proximal assembly (3). The instrument receiver (5) has a valve assembly (6) through which an instrument (7) is passed and a cannula portion (8) which extends in use through an incision which has been retracted and protected by the retractor (2). The instrument receiver (5) has an insufflation/desufflation port (9). The proximal assembly (3) comprises an inner proximal ring member (40) and an outer proximal ring member (41). The proximal end of the retractor sleeve (25) is located between the proximal ring members (40, 41). The inner proximal ring member (40) has a slot (43) for receiving and releasably engaging with an insufflation port section (45) of the instrument receiver (5). Because the cannula portion (8) extends through the retracted and protected incision there is minimal frictional resistance to the insertion of an instrument through the retracted incision. The distal end of the cannula portion 8 may be located close to the inner surface of the abdominal tissue which minimises restriction on movement of an instrument within the abdomen - the cannula provides minimal obstruction to this internal movement. Curved instruments may be readily inserted.
