Abstract: A reactor device for simultaneously retracting and viewing bodily tissues during a medical procedure. The retractor includes a blade member for retracting bodily tissues and an imaging device to form an image of the bodily tissues which are exposed by the operation of the blade member. The imaging device is coupled to a display device so that the image of the bodily tissues formed by the imaging device is displayed by the display device. Moreover, a method is provided for endoscopically performing a tissue retracting procedure using a retractor device. The method includes the steps of retracting bodily tissues using a retractor to form a cavity and imaging the cavity using an imaging device mounted on said retractor to form an image of the cavity and to provide the image of the cavity to a display device that is coupled to the imaging device.

Abstract: A guide for a cannula extending through a tissue and into a cavity in which a surgical procedure is to be performed. The guide has first and second plates cooperatively defining a through passageway for a cannula. Structure connects between the first and second plates to allow selective altering of the relative positions of the first and second plates to thereby change the configuration of the through passageway defined cooperatively between the first and second plates. A conversion unit can be used to draw the plates away from each other to enlarge an incision into which the first and second plates extend.

Abstract: A surgical instrument provides a simplified method of inserting sutures in laparoscopic surgery. A suture needle is hollow, and the suture thread extends through the needle. A liquid, such as a saline irrigation fluid, is driven through the hollow needle. This liquid carries the suture thread. The suture needle initially passes through the tissue, and the liquid is then actuated to drive the suture thread through the needle. The needle may then be withdrawn, leaving the suture thread in the tissue. The suture thread can then be tied off to complete the suture. In another aspect of this invention, the suture needle, or any other surgical tool, is connected to the body of the surgical instrument through a universal connection such that the angular orientation of the surgical tool relative to the surgical instrument can be universally adjusted in a three dimensional space.

Abstract: A gynecologic instrument or uterine mobilizer having a tube with one end attached to a journal pivotally mounted and maintained within a channel in the head of the instrument via a pin engaging a groove in the head. The head includes structure, such as an attachment or collar, for manipulating a desired place of a vaginal wall when the instrument is inserted in the vagina. In one embodiment, the structure includes a collar having a concave surface lying over a surface of the head that is substantially crescent-shaped. In another embodiment, the structure includes a substantially disc-shaped element. In one of two related embodiments, the substantially disc-shaped element may be provided with an indentation or notch in a peripheral surface.

Abstract: A handle for a surgical retractor comprises a central, elongated rod member and two gripping and leverage crossbars that intersect the rod member. The handle is useful with a variety of retractor blades for increasing comfort, decreasing fatigue, and improving leverage over a retractor blade.

Abstract: An instrument and method for retracting or repositioning a distal anatomic structure (organ) having a lumen (cavity) by remote manipulation. The method includes advancing the distal end of a flexible variform intraluminal member in a linear shape through a lumen (i.e., the esophagus) in the body to a distal location (the stomach), and deforming the distal end of the instrument to a rigid articulated (arched or curved) shape which retracts tissue surrounding the lumen. Further axial or rotational manipulation of a handle attached to the member correspondingly further retracts the distal anatomic structure to facilitate an endoscopic surgery.

Abstract: In a device for transanal resectate extraction which includes a rectoscope sleeve with a proximal tubular end portion, a connecting piece sealingly mounted onto said tubular proximate end portion for closing the rectoscope sleeve and including a bore axially extending therethrough and a resectate extractor having a tubular portion extending through the bore so as to be axially movable but position-lockable therein. The tubular portion of the extractor has a protector portion at its distal end with an axial passage in alignment with the tubular extractor portion for receiving grasping pincers inserted through the tubular extractor portion. The protector portion has an outer diameter smaller than the inner diameter of the rectoscope sleeve so that it can be retracted into the sleeve.

Abstract: The invention provides an apparatus and method for manipulating parts of the body in surgical procedures, particularly useful for peritoneal distension in laparoscopic surgery. The apparatus comprises a positionable support structure having an extendible horizontal arm rotatably mounted to an extendible vertical post, the post having a clamp at its lower end for mounting to a surgical table. An end segment at the distal end of the horizontal arm has a mount for mounting end-of-arm tooling, for example, peritoneal distension instruments. Locking mechanisms are disposed in the horizontal arm, vertical post and end segment to lock the support structure in a desired position. A motor is disposed within the vertical post for power-assisted extension and retraction of the vertical post. Preferably, the locking mechanisms and motor are controllable using switches mounted on the end segment.

Abstract: A method and apparatus for lifting an abdominal wall during laparoscopic diagnostic and surgical procedures. The surgical lift device includes a gripping portion for contacting and holding an external skin surface adjacent the abdominal wall. The gripping portion is selectively detachable from the skin surface. The device further includes a lifting portion that extends outwardly from the gripping portion. In accordance with alternative embodiments, the gripping portion may comprise an adhesive sheet or a suction member and the lifting portion may comprise a wire member or a portion of a hook and loop-type fastener.

Abstract: A uterine manipulator and associated tip are provided for laparoscopic examinations. The manipulator hereof includes a handle pivotally connected to one end of an elongated frame and a drum positioned at the other end of the frame. The handle is connected to the drum to provide movement of the drum in a plane substantially parallel to the pivot axis of the handle. The handle may be locked relative to the frame in a plurality of desired positions by engagement of a pawl shiftable with the handle in one of a plurality of notches on the frame. The frame is provided with ports along the sides to facilitate cleaning and sterilization. The tip is mounted exclusively remotely to the frame of the uterine manipulator and includes a unique mounting system which maintains the proper orientation of the tip on the drum.

Abstract: A retractor blade having a generally "S" shaped configuration in cross section. The blade is pivotally attached to a rod which may be connected to a table fixed ring retractor. The central portion of the blade moves tissue away from the operative site when the distal end of the blade is placed against a bone and the rod is moved away from the operative site.

Abstract: A push-type hand-held surgical retractor definable in terms of an xyz Cartesian coordinate system, includes a substantially flat retaining element having a primary surface in a yz plane and a secondary surface, substantially normal thereto, in an xy plane. The retractor also includes a curved elongated rigid shaft having first and second ends and having a gradual x-axis curve in both the xy plane and an accentuated y-axis curve in the xy and yz planes, the curved shaft having, at the first end, an arched portion having the y-axis curve, in which the first end integrally depends from an upper side of the secondary surface of the retaining element. The retractor further includes an ellipsoidal loop-like gripping element integrally depending from the second end of the curved elongate shaft.

Abstract: A surgical device includes a frame member having a distal end and a proximal end and a pair of tissue holding mechanisms movably mounted to the frame member at the distal end thereof for securing holds on spaced organic tissues of a patient. Actuators mounted to the frame member at the proximal end thereof are operatively connected to the holding mechanisms for controlling the operation thereof. Another actuator, also mounted to the frame member, is operatively connected to the holding mechanisms for moving the holding mechanisms relative to one another, thereby stretching organic tissues between the held tissues and facilitating access to the stretched tissues. The instrument assembly is particularly useful during laparoscopic surgery.

Abstract: A percutaneous surgical retractor is provided for performing examinations or surgical procedures through the skin. The retractor has an outer sleeve structure with a proximal and an open beveled distal end. A blade is slidable within the outer sleeve and moveable between at least a deployed position and a retracted position. The retracting blade substantially closes the open beveled distal end of the outer sleeve when the blade is in the retracted position to inhibit the coring of tissue by the outer sleeve during percutaneous insertion. The retractor has structure for deploying the retracting blade relative to the outer sleeve.

Abstract: The heart retractor for use in coronary bypass operations consists of a pair of long tapes, a short tape having an opening or a pair of short tapes and a couple of rings freely mounted thereon for forming an opening, and a longitudinal tape for connecting the long tapes and short tape or tapes in parallel with each other.

Abstract: A retractor endoscope for less invasive, direct access endoscopic surgery includes a rigid frame capable of supporting applied loads required to perform retraction of an incision site. The rigid frame includes a handle at one end and a lower blade mount rotatably connected to the opposite end. A translation frame is slidably connected to the rigid frame and includes an upper blade mount rotatably connected thereto. Lower and upper blades are removably mounted to the lower and upper blade mounts respectively, with at least one of the blades including pivot mounts for high intensity fiberoptics. The angle of the lower blade along the lower blade mount rotatable connection and the angle of the upper blade along the upper blade mount rotatable connection are independently adjustable. The size of an operating window is determined by the distance between the lower and upper blade mounts and the angles of the lower and upper blades.

Abstract: A surgical instrument is provided for use in endoscopic or laparoscopic procedures. The instrument includes a handle portion, an endoscopic portion extending from the handle portion, an articulating section pivotably connected to a distal end of the endoscopic portion, and a retractor assembly operatively associated with the articulating section. Structure is provided for progressively manipulating the articulating section of the instrument relative to the longitudinal axis of the endoscopic portion within an angular sector of rotation.

Abstract: A surgical instrument includes a plurality of segments which can be moved relative to each other from a first position in which the segments extend in a straight direction and can be inserted through an opening in a body to a second position in which segments are brought tight against each other to cause the instrument to go round a bend. The segments are brought tight against each other by pulling a flexible element extending through the segments from a part of the instrument located outside of the body. Scissors or gripping means may be located at the free end of the instrument within the body, and these scissors or gripping means may be operated from outside of the body.

Abstract: Disclosed is a self-retaining surgical retractor suitable for use in small surgical incisions or punctures, able to expand the incision or puncture to one or more enlarged cross-sectional areas and designed to protect the edges of the incision or puncture. The surgical retractor comprises a radially expandable tubular body having a control at the proximal end. Pull wires couple the control to the tubular body such that force applied to the control is transmitted to the tubular body as axially compressive force.

Abstract: An apparatus and method for retracting the infrapatellar fat pad during arthroscopic knee surgery. The apparatus includes a silicone retractor strap for supporting the fat pad, a device for threading the strap into the arthroscopic operating compartment, and a segment of suture or other frangible connector for connecting the retractor strap to the threading device.