Abstract: According to some embodiments, the process includes the steps of: a) taking a sagittal preoperative x-ray of the vertebral column of the patient to be treated, extending from the cervical vertebrae to the femoral heads; b) on that x-ray, identifying points on S1, S2, T12 et C7; c) depicting, on the said x-ray, curved segments beginning at the center of the plate of S1 et going to the center of the plate of C7; e) identifying, on that x-ray, the correction(s) to be made to the vertebral column, including the identification of posterior osteotomies to make; f) pivoting portions of said x-ray relative to other portions of that x-ray, according to osteotomies to be made; g) performing, on said x-ray, a displacement of the sagittal curvature segment extending over the vertebral segment to be corrected; h) from a straight vertebral rod (TV), producing the curvature of that rod according to the shape of said sagittal curvature segment in said displacement position.

Abstract: A positioning device for positioning an orthopedic implant in a patient during a surgical procedure includes a first orthopedic fastener and a device body. The orthopedic fastener penetrates into a bone of the patient to secure the orthopedic implant to the bone. The device body is removably positionable at least partially subcutaneously within the patient. The device body can retract tissue of the patient and includes a first fastener guide that guides positioning of the first orthopedic fastener relative to the bone of the patient. The device body releasably secures the orthopedic implant during positioning of the orthopedic implant. The positioning device can also include an implant attacher that removably secures the orthopedic implant to the device body. The implant attacher movably extends through the device body along an attacher axis.

Abstract: Trocar retractor apparatus and methods for use are described where an apparatus for positioning an instrument may generally include a substrate having a first surface and a second surface opposite to the first surface, an instrument positioning guide projecting from the first surface of the substrate, and one or more suction assemblies positioned along the second surface and in fluid communication with an interior of the substrate. The one or more suction assemblies may be attachable to a tissue region via a vacuum force applied through the one or more suction assemblies. The apparatus may also have the substrate configured to maintain a predetermined configuration when the vacuum force is applied.

Abstract: An end effector for a surgical robotic system, comprising a main body, one or members, and an adjustment mechanism. The main body has an interior sidewall and an opening extending through the main body. The one or more members are located within the main body and extend into and retract from the opening to vary a diameter of the opening through which a tool may be inserted. The adjustment mechanism coupled to the one or more members for varying the diameter of the opening, and comprises a collar coupled to the one or more members such that rotation of the collar in a first direction causes the one or more members to move away from the interior sidewall to reduce the diameter of the opening, and rotation in a second direction causes the one or more members to move towards the interior sidewall to increase the diameter of the opening.

Abstract: A surgical access device and methods for facilitating access through an incision or wound to a surgical site in a patient's body comprising an inferior retention member, a superior retention member, and a pliable membrane therebetween. The pliable membrane includes a base layer, a permeable membrane attached to the base layer, and a fluid delivery region disposed between the layers. The fluid delivery region is fluidly coupled to a fluid source. The fluid is delivered to the surgical site via the permeable membrane. The inferior retention member provides for fluid removal from the surgical site. Methods are provided for use of the surgical access device to retract tissue and deliver fluid to the tissue from the pliable membrane.

Abstract: In a surgical method, an access sheath is provided by a tube of a braided material. A first end of the sheath may be folded. The first end, folded or unfolded, is grasped with a distal end of a tool, which is then inserted into the nose of a patient. Advancing the tool pulls the distal end of the sheath into the nose of the patient. The sheath is then released from the tool and the tool is withdrawn. A portion of the sheath may be optionally cut off to shorten the sheath to a desired length. Typically the sheath has a total length of 70 to 180 mm and an outside diameter of 12 to 50 mm. The sheath may have a constant outside diameter along its length. The sheath may comprise silicone on the braided material.

Abstract: The invention provides a pneumatic sealing system device which allows sealing a working channel, a surgery multichannel device comprising a pneumatic sealing system and a method for installing said pneumatic sealing system on a multichannel device. The device is a mentioned instruments simultaneously.

Abstract: The present disclosure relates to the field of tissue dissection. Specifically, the present disclosure relates to medical devices that lift and retract tissue during a dissection procedure to improve visualization of the target tissue and mitigate obstructions for dissection tools. In particular, the present disclosure relates to devices that transition from a constrained to an unconstrained bowed configuration to immobilize and retract the dissected portion of target tissue during a dissection procedure.

Abstract: Methods, devices, and systems employ cryolysis of oropharyngeal adipose tissues to selectively remove fat cells from the tissues causing obstructive sleep apnea. In various embodiments, a chilled liquid—e.g., a liquid or air—is applied to the target tissue at a temperature and for a duration sufficient to cause cryolysis.

Abstract: The present disclosure relates to methods and devices for surgically manipulating tissue. In general, the methods and devices can include an elongate retractor shaft having a distal retractor tip that is configured to manipulate tissue, for example the tip can be configured to separate muscle and nerve fibers surrounding a vertebra. The elongate retractor shaft can include an illumination source such that at least a portion of the surgical field is illuminated by the device when the device is used in the body. A sensor can also or alternatively be included on the elongate retractor shaft, for example on the blunt retraction tip, such that the sensor can monitor physiological parameters of the tissue in or adjacent to the surgical field.

Abstract: An apparatus includes a body, a cannula, and a needle. The cannula is flexible and extends distally from the body. The needle is slidably disposed in the cannula. The needle includes a sharp distal tip and a curved portion. The needle is configured to translate relative to the cannula between a proximal position and a distal position. The distal tip is configured to be positioned inside the cannula when the needle is in the proximal position. The distal tip is configured to be positioned outside the cannula when the needle is in the distal position. The needle is resiliently biased to extend along a curve through the curved portion.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: Speckle removal in a pulsed laser mapping imaging system is described. A system includes a coherent light source for emitting pulses of coherent light, a fiber optic bundle connected to the coherent light source, and a vibrating mechanism attached to the fiber optic bundle. The system includes and an image sensor comprising a pixel array for sensing reflected electromagnetic radiation. The system is such that at least a portion of the pulses of coherent light emitted by the coherent light source comprises a laser mapping pattern.

Abstract: A method for comparing videos of a surgical procedure is disclosed. The method comprising selecting a plurality of videos from a surgical video database. Each of the plurality of videos including video data of a first surgical procedure comprising a plurality of surgical steps. The method further including identifying a first surgical step included in the plurality of surgical steps within a first video segment in each of the plurality of videos. The method also including warping the first video segment to standardize a dimension of the first video segment in each of the plurality of videos.

Abstract: Medical devices and methods of using medical devices are disclosed. An example tissue retraction device includes a first engagement member having a first end and a second end, a second engagement member having a first end and a second end, a first elastic member attached to the second end of the first engagement member, and a first alignment member having a first end, a second end and a lumen extending therethrough. Further, the tissue retraction device has a first length, the first alignment member has a second length, the first elastic member extends within the lumen of the first alignment member and the second length of the first alignment member is less than or equal to the first length of the tissue retraction device.

Abstract: A bone anchor includes a shank for anchoring to a bone and a receiving part for coupling a rod to the shank. The receiving part includes a base and two legs each including a first portion extending away from the base, and a second portion extending from the first portion further away from the base, and an elongate extension member extending from the second portion still further away from the base. An internal engagement structure is provided on the first and second portions for engaging a fixation device. A breakaway portion facilitates breaking away of the second portion. The extension members are at least as long as the second portions. The second portions are stiffer than a region of the extension members adjacent the second portions.

Abstract: A portal system for intervertebral surgical fusion procedures includes a longitudinally elongated hollow tubular body comprising a first wall, a second wall opposing the first and a third wall spanning from a first edge of the first wall to a first edge of the second wall. A channel is defined longitudinally through at least one of the first, second and third end walls. The fourth wall of the body is at least partially open or can be completely enclosed.

Abstract: A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can be pre-formed by a stretch blow molding process then advanced over the cannula. The sleeve includes an inflatable balloon and an annular ring distal the inflatable balloon. The cannula includes an annular recess. The annular ring is sized to have an interference fit with the annular recess.

Abstract: An end effector includes a first and second jaw member each comprising a first and second electrode. The first and second jaw members are movable relative to the other between an open position and a closed position. An electrically conductive member is located at the distal end of the first jaw member. The electrically conductive member is sized and configured to define a minimum distance between the first and second electrodes along the length of the first and second electrodes. An electrically insulative member is located on one of the first jaw member or the second jaw member. The electrically insulative member is sized and configured to engage tissue and has a dimension extending from one of the first jaw member or the second jaw member. The dimension is less than the minimum distance.

Abstract: Embodiments of an actuated cannula seal are disclosed In some embodiments, a cannula seal includes a base portion that engages with a cannula; and a seal portion integrally formed with the base portion, the sealing portion capable of engaging with an instrument shaft, the sealing portion capable of being actuated by an actuator so that the sealing portion is continually in motion relative to the instrument shaft. The actuation of the sealing portion can be accomplished by rotation or vibration of the sealing portion relative to the instrument shaft.

Abstract: A surgical fastener apparatus includes a handle, a flexible elongate segment and an end effector having a fastener cartridge with a plurality of fasteners and an anvil, an approximator member movable relative to the longitudinal axis to cause relative movement of the fastener cartridge and the anvil between an open condition and an approximated condition, a fastener drive to deploy the fasteners from the fastener cartridge for crimping by the anvil, at least one tissue grasper at least partially extending along the end effector and movable to engage tissue and draw the tissue between the fastener cartridge and the anvil when in the open condition, and at least one manual actuator to actuate at least one of the approximator member, the fastener drive or the at least one tissue grasper.

Abstract: A device for simultaneous fixation of medical instruments is disclosed, the device comprising a holding portion, a coupling element and a pushing element, wherein the coupling element is configured for the holding portion to be pivoted about a pivot axis, and the pushing element is configured, in a first position, not to exert a force or a first force on the holding portion so that the holding portion can be pivoted, and, in a second position, to exert a second force, which is greater than the first force, on the holding portion so that the holding portion can be pivoted with respect to the first force. is fixed with respect to rotation about the pivot axis. A system with such a device is also disclosed.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to a tissue traction device for endoscopic procedures such as tissue dissection. For example, a tissue traction device may include first and second attachment members pivotably attached by first and second swivels to opposite ends of a stretchable traction band comprising a compliant or semi-compliant material.

Abstract: Embodiments of an actuated cannula seal are disclosed In some embodiments, a cannula seal includes a base portion that engages with a cannula; and a seal portion integrally formed with the base portion, the sealing portion capable of engaging with an instrument shaft, the sealing portion capable of being actuated by an actuator so that the sealing portion is continually in motion relative to the instrument shaft. The actuation of the sealing portion can be accomplished by rotation or vibration of the sealing portion relative to the instrument shaft.

Abstract: A lateral retractor system for forming a surgical pathway to a patient's intervertebral disc space includes a single dilator and a retractable dual-tapered-blade assembly. The single dilator may feature a narrow rectangular body for insertion at an insertion orientation parallel to the fibers of the patient's psoas muscle and at an approximate 45-degree angle to the patient's spine. The retractable dual-tapered-blade assembly consists of only two blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-tapered-blade assembly may be passed over the single dilator at the insertion orientation and rotated approximately 45-50 degrees from the insertion orientation to a final rotated orientation parallel to the intervertebral disc space before the two blade subassemblies are retracted away from one another to create the surgical pathway. Other embodiments are also disclosed.

Abstract: A forceps is provided that includes a housing defining an internal passageway and a longitudinal axis, first and second jaws slidably and pivotably connected to the housing, a first connection member having a first end pivotably attached to the first jaw, a second connection member having a first end pivotably attached to the second jaw; and a driver pivotably connected to the other ends of the first connection member and the second connection member, wherein the jaws have an open configuration and a closed configuration, wherein longitudinal movement of the driver in a first direction rotates the first and second jaws relative to the housing from the open configuration towards the closed configuration, wherein longitudinal movement of the driver in the first direction also moves the first and second jaws longitudinally along the longitudinal axis of the housing from the open configuration towards the closed configuration.

Abstract: An end effector for a robotic-assisted surgical system having an adjustable inner diameter. In embodiments, the end effector includes a main body having an opening extending through the main body, one or more members located within the main body that extend into and retract from the opening to vary a diameter of the opening through which a tool may be inserted, and an adjustment mechanism on the end effector and coupled to the one or more members for varying the diameter of the opening.

Abstract: A die-cuttable retractor/stabilizer for repositioning and stabilizing excessive and/or redundant tissue comprises a top layer and a backing layer. An adhesive on the top layer is exposed when the backing layer is separated from the top layer to enable the top layer to be applied to a surface. The retractor/stabilizer comprises a body having a top edge, side edges and a bottom edge. A tab portion is associated with the removable panel, such that the backing layer remains with the tab portion and the tab portion can be used to remove at least a portion of the backing layer from the retractor/stabilizer body. The retractor/stabilizer additionally includes at least one protected grasping/holding area located at an edge or corner of said retractor/holding area as the backing layer is removed from the body to provide a protected holding area once the backing layer has been removed from the body.

Abstract: An adapter assembly includes a base member, a housing, and a locking mechanism. The base member defines a longitudinal axis. The housing is rotatably secured to the base member and is rotatable in relation to the base member between a plurality of positions. The locking mechanism is supported on the housing and includes a locking member and a button. The locking member is moveable from a locked position in which a lock of the locking member is engaged with the base member to secure the housing in one of the plurality of positions to an unlocked position in which the housing is rotatable in relation to the base member. The button is positioned on the base member and is depressible to translate the locking member in a direction parallel to the longitudinal axis from the locked position to the unlocked position.

Abstract: A holder for a heart valve prosthesis, the holder including a hub portion having a longitudinal axis, an engagement portion coupled to the hub portion and including plural finger members variably positionable relative to the hub portion between a collapsed condition wherein the finger members are closed onto the hub portion and an expanded condition wherein the finger members radially protrude with respect to the hub portion to engage a heart valve prosthesis.

Abstract: A camera and expandable bladed retractor system. The system includes a camera, with a distal-most optical element disposed over the proximal end of the lumen or surgical channel established by the retractor blades. The camera may be fixed to the retractor, either to the proximal end of a blade or to a frame member.

Abstract: An imaging device including a support, a dental retractor fastened to the support and defining a retractor opening, a mirror fastened to at least one of the support and the retractor, and structure for fastening an image acquisition apparatus to the support in a position in which the acquisition apparatus is oriented so as to receive a composite image including a direct image of the retractor opening and an image of the retractor opening reflected by the mirror.

Abstract: In at least one embodiment, a medical device can comprise an elongate outer sheath that extends along a sheath longitudinal axis and defines a central lumen extending therethrough, the elongate outer sheath can comprise a proximal sheath portion and a distal sheath portion. A first guidewire can comprise a first guidewire end and a second guidewire end, the first guidewire can extend from the first and second guidewire ends through the central lumen and can form a distal looped portion. An occlusion device can be disposed at a distal end of an elongate flexible shaft. The elongate flexible shaft can extend from the proximal sheath portion through the central lumen. The occlusion device can include a guide lumen through which the first guide wire passes.

Abstract: A retractor having a pair of blades is disclosed. A ring having an opening is attached to one end of the blades. The blades define a channel therebetween. The blades may be pivotally coupled to the ring. The retractor may have at least two conditions. In a first condition, the retractor is insertable through an incision in a patient's skin to an operative site. In a second condition, the retractor may be manipulated for retracting tissue surrounding the operative site. Instruments, prostheses, or tissue may be inserted or removed through the channel of the retractor.

Abstract: A surgical instrument that comprises an elongate shaft assembly that defines a shaft axis. A surgical end effector is pivotally coupled to the elongate shaft assembly for selective pivotal travel about an articulation axis that extends transversely relative to the shaft axis. First and second articulation drivers are supported for selective longitudinal travel relative to the elongate shaft assembly. A first end effector link is movably coupled to the surgical end effector and is coupled to the first articulation driver for axial and pivotal travel relative thereto. A second end effector link is movably coupled to the surgical end effector and is coupled to the second articulation driver for axial and pivotal travel relative thereto.

Abstract: An articulated sensor head includes three different sensor modules. A first of the sensor modules is carried on an extended shank that is mounted in a pivotable fashion from an articulating wrist. A housing carrying a second and a third of the sensor modules is releasably fastened to the extended shank. The second and third sensor modules are carried by the housing in a fixed angular orientation with respect to an orientation of the first sensor module.

Abstract: A sequence of access channels to provide access to a surgical site on a spine using: 1) a first retractor adapted to provide an access channel from outside the patient's body; 2) an inserted second retractor with a set of blades with a set of distal tips for insertion into tissue distal to the distal end of the first retractor; and 3) a retractor inserter for use with the second retractor.

Abstract: Organ manipulation devices for atraumatically grasping the surface of an organ and repositioning the organ to allow access to a location on the organ that would otherwise be substantially inaccessible. Methods of accessing a beating heart, retracting the heart using an organ manipulation apparatus, and stabilizing a surgical target area with a stabilizer. Both the organ manipulator and stabilizer are fixed to a stationary object which may be a sternal retractor. A system for performing beating heart coronary artery bypass grafting includes a sternal retractor, organ manipulator and stabilizer.

Abstract: A surgical retractor assembly is provided having a frame that releasably couples two retractor blades. The retractor blades are coupled to the frame via a pair of mobile carriages that engage a track on the frame. A third retractor blade is configured to be independent of the frame with the first two retractor blades. The independent blade may be fixably positionable in the patient by a direct coupling to a rigid table mount. The retractor assembly may be utilized for creating anterior access to spinal target site while the patient is oriented in the lateral decubitus position.

Abstract: System and methods for transversely displacing structures in the body can include a device for displacing structures in a patient's body, the device having: a handle; a first longitudinal member fixed in position relative to the handle; a second longitudinal member coaxial with the first longitudinal member, the second longitudinal member movable relative to the first longitudinal member between a retracted position and an extended position; and at least one resilient blade extending from a proximal end to a distal end, the proximal end of the at least one resilient blade mechanically fixed in position relative to the second longitudinal member; wherein the distal end of the at least one resilient blade is engaged with the first longitudinal member when the second longitudinal member is in its extended position and disengaged from the first longitudinal member when the second longitudinal member is in its retracted position.

Abstract: A surgical retraction system includes a sternal retractor having a first retractor arm and a second retractor arm. An insert is coupled with the sternal retractor. The insert includes a first section having a first rigid backing, a second section having a second rigid backing that is spaced from the first rigid backing, and a connector section including resilient material interconnecting proximal ends of the first and second sections. The first section of the insert is coupled with the first retractor arm, the second section of the insert is coupled with the second retractor arm, and the connector section extends laterally between the proximal ends of the first and second sections. When the insert is bent, the resilient connector section normally urges the first and second sections of the insert away from one another for returning the insert to a flat configuration.

Abstract: A surgical instrument for use in laparoscopic surgical procedures is disclosed that includes an elongated shaped outer shaft having opposed proximal and distal end portions, and having a non-circular cross-sectional profile, an end effector operatively associated with a distal end portion of the shaped outer shaft and including a pair of cooperating jaw members configured for movement between open and closed positions, a proximal handle assembly operatively associated with a proximal end portion of the shaped outer shaft and including a pivoting actuation handle, and an elongated actuation member extending through the shaped outer shaft from the proximal handle assembly to the end effector, whereby movement of the actuation handle causes corresponding movement of the cooperating jaw members.

Abstract: A retractor system for use in spinal surgical procedures includes at least two retractor blades, each of the at least two retractor blades, a shim and a shim inserter. The shim has an expansion band and the shim inserter is configured to slide the shim between and along the at least two retractor blades and dispose the shim at a distal end of the at least two retractor blades. The shim spreads the at least two retractor blades away from each other when the shim insert slides the shim between and along the at least two retractor blades and the shim prevents the distal end of each of the at least two retractor blades from closing in on each other due to musculature load when the shim is disposed at the distal end of the at least two retractor blades.

Abstract: Embodiments of the present invention provide a new and improved hands-free mounting apparatus that has at least three rotational degrees of freedom. The apparatus includes a waist belt worn by a user and utilizes a cable and first and second cable housings. Tubular arm segments are positioned between the first and second cable housing assembly. A pivot lock arm allows the user to adjust the position of various components and lock those components and attached device in a fixed position. Other embodiments provide another two rotational degrees of freedom.

Abstract: A trocar sleeve has a hollow shaft having a distal end and a proximal end, the shaft having a rectilinear shaft axis, an external thread rising from an outer surface of the shaft, wherein a first external thread having a shape of a helix has a height, measured from the outer surface up to a vertex of the helix, the height of the helix, seen along the rectilinear shaft axis from distal to proximal increases, and wherein a pitch of the helix, seen along the rectilinear shaft axis from distal to proximal decreases.

Abstract: Various adjustable cannula systems are provided. The systems can include an adjustable cannula capable of expansion and/or contraction having an elongate body with a distal end and a proximal end. The adjustable cannula can be coupled to an upper housing and a lower housing such that rotation of the upper housing results in expansion or contraction of the adjustable cannula. The adjustable cannula can also have a proximal end having a lumen larger than a distal end lumen. A plurality of flanges can be formed in the elongate body by a plurality of slits that span a majority of a length of the cannula, including along or proximate to its proximal end and distal end.

Abstract: An orthopedic implant kit comprising a lockable poly-axial screw, a tissue dilatation sleeve, a screw driver, a screw extender, a rod, rod-reduction device, a set screw driver, a torque limiting device and a screw releasing device.

Abstract: A surgical retractor system having a frame and a plurality of arms connected thereto is disclosed. At least one arm is moveable relative to the frame and the relative movement is constrained to a direction along the longitudinal axis of the arm. At least one retractor blade is removably connected to each of the plurality of arms. The blade is fixably rotatable about an axis normal to the longitudinal axis of the arm to which it is connected.

Abstract: A surgical retractor device for retaining and/or moving internal organs during minimally invasive or laparoscopic surgery is provided. The surgical retractor can be a single continuous structure that includes a shaft. The shaft can branch into a first elongate finger with a first distal end opposite the shaft and a second elongate finger with a second distal end opposite the shaft. The retractor can further include a resilient lattice structure disposed between the first elongate finger and the second elongate finger. The retractor can have an expanded configuration and a collapsed configuration based on relative distance between the first distal end and the second distal end. When the retractor is in the collapsed configuration, spring force energy can be stored in the resilient lattice structure.

Abstract: Systems, devices, and methods for longitudinal closure of a dissected sternum are provided. The system includes first and second reinforcing members, fasteners, and closure members. Each reinforcing member is configured to be placed on an outer surface of a respective sternum portion, such that each reinforcing member is longitudinally disposed on an opposite side of a sternum opening with respect to the other reinforcing member. Fasteners may be placed in holes defined in the reinforcing members to secure a respective reinforcing member to a corresponding sternum portion. The closure members, which may be sternal closing wires, may then be wrapped around the sternum portions and the reinforcing members transversely to close the sternum opening. Because the reinforcing members include extended regions having lateral edges that extend away from a midline of the respective reinforcing member, the closure members are moved away from the edges of the bone.