Abstract: A method of delivering a fusion cage to an intervertebral disc space bounded by adjacent vertebral endplates, comprising the step of delivering the fusion cage into the disc space without contacting its teeth to the vertebral endplates during delivery, wherein a sheath is interposed between a cage surface and the endplates to prevent contact therebetween during delivery.

Abstract: A physical retractor apparatus and method for retracting anatomy during surgery wherein the apparatus includes a handle rod, a body portion, a retractor blade and a mechanism which allows the retractor blade to be angularly adjusted, and secured, to one of any number of angular positions. The retractor blade may be first manually positioned to a gross angular position and thereafter fine tuned in angular position. The adjustment mechanism includes a pair of arms forced together to contract about a pivot pin to set an angular position and a threaded screw device which is rotatable to adjust further the angular position.

Abstract: A self supporting apparatus (10) for trays (40) includes a groove plate (20), and a plurality of pivotally mounted trays (40) wherein each tray (40) is pivotally moveable relative to the groove plate (20) between a first position (46) and a second position (48). The groove plate (20) includes a plurality of flexible tabs (70) facing the plurality of trays (40). An edge (50) of each tray (40) includes a rounded surface (52) and a rib (56), wherein each one of the ribs (56) engages one of the flexible tabs (70) to hold the trays (40) in one of the first or second positions (46, 48). The rib (56) flexes the tab (70) as each tray (40) is pivoted between the first and second positions. The tab (70) and rib (56) maintain the trays (40) in the selected positions until the trays (40) are moved.

Abstract: A tissue retractor comprising an outer ring, an inner ring, and a flexible, metal sheath extending therebetween is described. Embodiments of the outer ring comprise an outer ring rotatable around an annular axis thereof, thereby rolling the sheath therearound when retracting an incision or opening in a body wall. Embodiments of the sheath comprise a plurality of linked loops, a plurality of loops joined by a wire extending through adjacent loops, a braided wire, and a plurality of chains. Also described are kits comprising outer rings, inner rings, and sheaths, some or all of varying dimensions, which may be selected and assembled by the user for their intended use. Some or all of the kit components may be resterilized for reuse.

Abstract: Provided are methods for maintaining the viability of photoreceptor cells following retinal detachment. The viability of photoreceptor cells can be preserved by administering a hydrophilic bile acid (e.g., UDCA or TUDCA) to a mammal having an eye with a detached retina. Administration of the hydrophilic bile acid maintains the viability of the photoreceptor cells until such time that the retina becomes reattached to the underlying retinal pigment epithelium and choroid, thereby minimizing the loss of vision or visual acuity, which otherwise may occur as a result of the retinal detachment.

Abstract: An articulating surgical instrument includes a case having a trigger handle, a sheath coupled to the case, a flexible bending section coupled to the sheath, an end effector removably attachable to the bending section, a set of cables that control position of the bending section, at least two motors coupled to the cables, and a user control module configured to control position of the bending section and the end effector. The instrument further includes a pushrod disposed within the sheath and within the bending section that is configured for axial motion relative to the sheath and the bending section and rotational motion within the sheath and the bending section. The pushrod is coupled to the trigger handle and removably coupled to the end effector, so that rotational motion of the pushrod effectuates rotation of the end effector and axial motion of the pushrod is controllable by the trigger handle.

Abstract: An assembly for surgically treating a chest-wall deformity may include an implantable stabilizer member, an implantable pectus bar and an implantable stopping member. The implantable stabilizer member may include first and second base parts and a channel defined by the first and second base parts. The stabilizer member may include first and second retaining bars extending between the first and second base parts and traversing the channel. The first and second base parts may be adapted to be secured to tissue of the chest wall. The implantable pectus bar may be receivable within the channel of the stabilizer member. The implantable stopping member may be adapted to be engaged with the pectus bar between the first and second retaining bars after the pectus bar is inserted into the channel to restrict movement of the pectus bar relative to the tissue.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity adapts to tissue tracts of different widths. The surgical instrument includes a proximal member, a distal member, and a sleeve extending between the proximal member and the distal member and defining a longitudinal passage therein. The proximal member includes an inflatable member that selectively adjusts the radial dimension of the proximal member. A ring member may be separately insertable by a user during a surgical procedure into the space directly adjacent to the radially-inner surface of the inflatable member, so as to selectively provide rigidity to the proximal member.

Abstract: A system and method to virtually simulate maintenance of a medical device located in a defined space by a user is provided. The system can include a main interactive touchscreen; and a central controller connected in communication with the touchscreen monitor. The central controller can execute a series of computer-readable program instructions to perform comparing a detection of contact by the user at the touchscreen relative to a graphic representation of a virtual view of the component of the medical device relative to one of a series of predefined tasks associated with a maintenance procedure of the medical device stored in a database, and generating a display illustrative of a completion of the maintenance procedure upon calculating a completion of each of the plurality of predefined tasks.

Abstract: A catheter having a selectively variable degree of flexibility includes an elongate tubular outer member and an elongate tubular inner member disposed within the outer member. The catheter further includes a cavity disposed in between the outer and inner members. A tubular braid of filaments may be disposed within the cavity. The outer and inner members are movable relative to each other along intermediate portions thereof when in a first configuration, and are not movable relative to each other when in a second configuration. When the inner and outer members are in the first configuration, the tubular braid of filaments is movably disposed relative to at least one of the outer member and the inner member. When the inner and outer members are in the second configuration, the inner and outer members clamp the tubular braid of filaments in a fixed position relative to the inner and outer members.

Abstract: A single-arm stabilizer having suction capability includes a single, small leg through which suction can be applied. The leg has an upper surface and a lower surface that are spaced apart to define a chamber. The lower surface includes a plurality of openings that are disposed adjacent each other. A support arm is connected to the leg in order to position the leg as desired. A suction line is in fluid communication with the chamber in order to create a vacuum within the chamber. The stabilizer can be used to stabilize any desired portion of a patient's body, but is particularly effective at stabilizing the septum of a patient's heart. Such stabilization can be accomplished by inserting the leg into the patient's heart through the aorta.

Abstract: A self supporting apparatus (10) for trays (40) includes a groove plate (20), and a plurality of pivotally mounted trays (40) wherein each tray (40) is pivotally moveable relative to the groove plate (20) between a first position (46) and a second position (48). The groove plate (20) includes a plurality of flexible tabs (70) facing the plurality of trays (40). An edge (50) of each tray (40) includes a rounded surface (52) and a rib (56), wherein each one of the ribs (56) engages one of the flexible tabs (70) to hold the trays (40) in one of the first or second positions (46, 48). The rib (56) flexes the tab (70) as each tray (40) is pivoted between the first and second positions. The tab (70) and rib (56) maintain the trays (40) in the selected positions until the trays (40) are moved.

Abstract: An implant (300) for repair of a spinal inter-vertebral disc, constituted of a first section and a second section, each having: a support member section (110); a proximal support member secured to the proximal end of the support member section and arranged to extend proximally thereof, the proximal support member (170) arranged in a deployed configuration to distend in the direction of the first face (130) of the support member section (110); and a pair of one inter-annulus support members (170), each of the pair of inter-annulus support members optionally exhibiting a plurality of stacked layers, arranged so as to cooperating under ejection forces to act as a single layer, the support member section of the first section secured to the support member section of the second section such that the second face of the first section faces the second face of the second section.

Abstract: A laparoscopic surgical device comprising an anchor element comprising a pair of jaws defining a mouth within which at least a portion of an organ or tissue may be grasped is described. The jaws are biased towards one another so as to normally adopt a closed configuration. The anchor element is coupled to a support member, the support member being moveable about the anchor element. The device is dimensioned to be operably passed fully through a trocar into the abdominal cavity wherein it may be manipulated by a surgeon or other operator to grasp the desired target organ or tissue.

Abstract: A die-cuttable retractor/stabilizer comprising a top layer having an adhesive applied one side thereof and a backing layer which covers the adhesive and which is removable from the top. The retractor/stabilizer includes a dividing cut in the backing layer which extends the width of the backing layer to separate the backing layer into an upper panel and a lower panel. A first lower panel back cut in the backing layer lower panel extends from the bottom edge of the backing layer to a point proximate the dividing cut to divide the lower panel in to at least a lower panel positioning portion and a lower panel second portion.

Abstract: Deflectable implants, systems and methods for implanting deflectable implants are disclosed. The deflectable implant includes at least one sequence of segments, the sequence includes at least two segments, the segments being interconnected at effective hinges, the sequence assuming a straightened or low curvature insertion state for insertion into the body, the sequence being deflectable to a fully deflected state defined by abutment of abutment features of adjacent of the segments.

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 system and method for performing surgical procedures within a body cavity, e.g. abdomen, uses a magnetized device is utilized to allow a surgeon to control intra-abdominal organs and objects. The system and method allows a surgeon to perform an intra-abdominal procedure without the need to position surgical tools inside of the body cavity. Additional surgical ports are not necessary as the magnetized device allows the surgeon to retract or position various objects within the abdomen.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site.

Abstract: Minimally-invasive portal systems and methods for performing lumbar decompression, instrumented fusion/stabilization, and the like. In some implementations, an access tube defining a depth may be disposed at least partially within the body of a patient. A cross-sectional area of the access tube may be adjusted in one or more dimensions. One or more retractor devices may be positioned at least substantially concentrically within the access tube and then secured to the access tube in a fixed position.

Abstract: An osteotome suitable for cutting through cancellous bone that is holding an orthopaedic implant requiring revision within a cavity of a bone, includes a cylindrical waveguide connectable to a source of ultrasonic vibrations at its proximal end and a blade having a hollow part-cylindrical cross-section and a cutting edge at its distal tip. The respective longitudinal axes of the waveguide and the blade cross at an angle of about 30°, and the waveguide and blade taper and curve smoothly together where they meet. The osteotome is dimensioned such that a first antinode of the ultrasonic vibrations is located at a proximal end of the waveguide, a second antinode is located at the distal tip of the blade and a node is located where the waveguide and blade meet. The osteotome cuts readily through cancellous bone when ultrasonically energized.

Abstract: Embodiments described herein provide devices, systems, and methods that reduce the distance between two locations in tissue, often for treatment of congestive heart failure. For example, an anchor of an implant system may, when the implant system is fully deployed, reside within the right ventricle in engagement with the ventricular septum. The anchor may be deployed into the heart through a working lumen of a minimally invasive access tool. The minimally invasive access tool may have a plurality of grippers near a distal end of the working lumen. The grippers may engage epicardial tissue of the heart and may be moved radially inwardly relative so as to provide stabilization of the epicardial tissue and/or hemostasis near an access site where the anchor is inserted through the epicardium. The minimally invasive access tool may minimize blood loss from the access site and improve anchor implant processes.

Abstract: A retractor instrument for minimally invasive surgery may include a housing with a longitudinal axis, an arm extending from a distal end of the housing, and an actuation mechanism, wherein actuation of the actuation mechanism causes radial expansion of the arm relative to the longitudinal axis. The device may be adapted for use with an endoscope or arthroscope or may be an integral part of one such scope. A method of performing surgery in constrained areas within the body is also included and may be applicable to the carpal tunnel of a wrist and palm or the cubital tunnel of an elbow.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: A surgical sheath for use in endoscopic trans-nasal or intra-ocular surgery has an angle section joined to a conical section, with the conical section having a central axis not parallel to a central axis of the angle section. A body section is joined to the angle section, with the body section having a length at least twice the length of the angle section. The conical section, the angle section and the body section may be a flexible or compliant material. The sheath reduces collateral trauma to the tissues in the surgical pathway.

Abstract: Described here are methods and devices for forming tracts in tissue. Some of the devices feature an elongate member, a suction member coupled to a distal portion of the elongate member, and a tissue-piercing member slidably housed within the elongate member for forming a tract in tissue. Other devices feature more than one suction member. Methods for forming tracts in tissue are also described here. In some methods, a device is advanced adjacent tissue, where the device features one or more suction members and a tissue-piercing member. Suction is applied so that the tissue is drawn against the one or more suction members, and a tissue-piercing member is advanced in a first direction through the drawn tissue to form a tract in or through the tissue. Kits incorporating one or more of the devices described here, in conjunction with one or more tools or the like, are also described here.

Abstract: An arthroscopic sealing cannula having improved efficiency, access and reduced manufacturing costs is described herein. In particular, the present invention describes arthroscopic sealing cannulae in which the conventional thermal and chemical bonding means are eliminated and replaced with a mechanical joining system that utilizes mating fastener pairs integrally molded into the distal and proximal elements of a cannula so as to thereby provide a strong reliable joining of the elements. Such a mechanical system eliminates the need for costly capital equipment and specializing tooling as well as the material and environmental handling problems associated with conventional bonding techniques. Furthermore, in that the join may be readily confirmed through simple visual examination, the present invention also eliminates the need for complex, costly, and time-consuming validation procedures mandated by regulations in place to ensure proper integrity, strength, and reliability of the bond.

Abstract: A minimally invasive retractor assembly includes a posted screw and one or more retractor blades. Each retractor blade is releasably coupled to the posted screw. The retractor blade or blades are manipulated or flexed relative to the posted screw allowing retraction of tissue surrounding the incision. The retractor is made of a biocompatible material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: A surgical access device includes a seal assembly having an upper housing member, a lower housing member, and a receiving member. The receiving member defines a central longitudinal axis and has a longitudinal passage for receiving a surgical object therethrough. The surgical access device also includes a first seal secured between the upper housing member and the lower housing member and a second seal positioned between the upper housing member and the receiving member. The first seal provides a biasing force to maintain the second seal in contact with the upper housing member to provide a sealing relationship therewith.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: A retraction device comprises a base and at least one retracting blade. The base has at least one tab. The retracting blade has a slotted distal end for receiving the tab of the base.

Abstract: An anoscope kit comprising an anoscope having a plurality of spaced apart fingers having free ends and a dilator removably positionable within the anoscope to aid insertion of the anoscope. The dilator has a proximal region, an intermediate region and a distal region, the distal region including an enlarged distal head. A ramped surface extends from the enlarged distal head toward the intermediate region, the intermediate region having an outer surface to contact the fingers of the dilator.

Abstract: Disclosed herein are devices and methods for introducing a plurality of instruments to a target site through a working channel. The working channel can include a surface adapted to guide one or more instruments into select positions. The working channel can be defined by a portion of a guide tube or tip that may be coupled with an endoscope.

Abstract: Methods and devices are disclosed to reduce the tissue trauma that occurs when a physician retracts or otherwise deforms a patient's tissues for surgery or other medical procedures. In one part, methods and devices are disclosed for cooling the tissue around the incision. In another part, methods and devices are disclosed that elute drugs into the tissues of the tissue margin. In another part, methods and devices are disclosed to engage tissues during retraction to cushion, to sense tissue state, and to modulate tissue state.

Abstract: A spine retractor and distractor device comprises spinal process clamps and a retractor assembly, which may be rotatably coupled with the spinal process clamps. The retractor assembly may include a retractor ring, or frame, and a plurality of retractor blades adjustably coupled to the frame, e.g., by clamps. The spinal process clamps can maintain a grip on the spinal processes of the patient, and distraction pliers may be used to impart a distraction force on the spinal process clamps to distract the spinal segments. Additionally, other components, features, or tools, e.g., a light source and/or a camera, can be mounted on the instrument.

Abstract: A tissue retractor device for retracting tissue includes a base and a plurality of blades connected to and distributed around said base. Each of the blades is outwardly movable from the base and includes a respective sloped portion on an interior region of the blades. The tissue retractor includes a pusher engaged to the base. A portion of said pusher abuts the sloped portion of each of the blades. Movement of the pusher in a longitudinal direction engages a portion of the pusher against said sloped portion of each of the blades to move the blades and angularly displace the blades between a respective closed position and an open position.

Abstract: A spinal surgery retractor with a slotted keyway for integrating a keyed spinal distractor. This retractor and distractor combination slide together to displace a portion of the intervertebral disk space to restore or maintain intervertebral spacing and facilitate retraction of surrounding soft tissues while disk space surgery is performed. The distractor head and mating portion of the retractors have matching profiles that enable the retractor to maintain distraction of the vertebra after removal of the distractor portion of the tool, permitting access to increase at the operating site. The retractor has convex curved surfaces that interface with a majority of retracted soft tissues during progression of the retraction process, which enhance retractor safety. In addition, the retractor portion of the tool has a proximally located section that is laterally flexible, which provides further progression in the retraction process while increasing relative access to the operating site.

Abstract: A surgical method of operating on the spinal column includes the steps of making a slit in the back of a patient proximate to the spinal column, such to divide a first muscle portion around the spinal column into a pair of separate side muscle portions, and detaching at least one of the separate side muscle portions from the spinal column by force-fitting an elongate gauze member into the slit and compressing the gauze member between the spinal column and the at least one of the side muscle portion, such to controllably detach an additional separate muscle portion of the side muscle portions from the spinal column.

Abstract: A retractor device for spearing the body tissue apart is provided. The retractor includes a housing configured to include a plurality of sections, wherein each section is configured to accommodate placement of at least one blade, a blade holding mechanism configured to secure the at least one blade within the housing, a translation mechanism configured to provide translation movement of at least one of the sections, and a rotation mechanism configured to provide rotation movement of at least one blade.

Abstract: A suspension system for supporting surgical devices inside a patient's body cavity comprising an external frame, a plurality of elongated members extending from the external frame and through the patient's skin into the body cavity, and an internal platform located inside the body cavity. The internal platform includes a plurality of links reconfigurable from a first elongated position wherein the links are substantially aligned along a longitudinal axis for insertion to a second position wherein the links are angled with respect to one another to form a non-linear configuration.

Abstract: A method of accessing an internal portion of a patient including the steps of providing an access assembly including an outer frame, an inner member and a flexible member, inserting the inner member through an opening in tissue into a body of a patient with the flexible member extending proximally through the opening in tissue, moving at least a first portion or second portion of the outer member to a select unlocked spread position to enlarge the opening in tissue and the passageway through the flexible member, and subsequently moving the locking member to move the first and second engagement structures into a locking position to lock the first portion in the select spread position.

Abstract: Medical retractors including light guides made of cyclo olefin polymer.

Abstract: The present application relates to a biological tissue transfer method for transferring a biological target tissue within the body, the method comprising: (a) attaching part of a first traction member to a first position which is different from a connecting position at which the target tissue is connected to other biological tissue; (b) attaching part of a second traction member to a second position which serves as the apex of a triangle formed together with the connecting position and the first position that surrounds the target site; (c) extending the first traction member in the direction from the connecting position to the first position, and extending the second traction member in the direction from the connecting position to the second position; and (d) transferring the target tissue within the body by applying traction on the first traction member and the second traction member respectively.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity. The apparatus may include a seal anchor member comprising a compressible material. The seal anchor member may be adapted to transition between a first condition for insertion of at least a portion of the seal anchor member within a tissue tract and a second condition to facilitate a securing of the seal anchor member within a tissue tract and in substantial scaled relation with tissue surfaces defining a tissue tract. The seal anchor member may have proximal and distal ends and may define at least one port extending between the proximal and distal ends, the at least one port being adapted for the reception of an object whereby compressible material defining the at least one port is adapted to deform to establish a substantial scaled relation with the object. The seal anchor member may have a non-circular cross-section.

Abstract: A surgical device including a seal anchor that includes leading and trailing portions. A plurality of ports longitudinally extends between the leading and trailing portions. The ports are adapted and configured to receive surgical objects therein. At least one of the surgical objects is a viewing instrument including a viewing portion. During a surgical procedure, surgical objects inserted in the other ports are selectively positionable with respect to the viewing instrument.

Abstract: Methods and devices are disclosed to reduce the tissue trauma that occurs when a physician retracts or otherwise deforms a patient's tissues for surgery or other medical procedures. In one part, methods and devices are disclosed for controlling the force and pace of retraction to reduce tissue trauma. In another part, methods and devices are disclosed for applying an oscillating load when opening. In another part, pads that cool the tissue around the incision are disclosed. In another part, pads that elute drugs into the tissues of the tissue margin are disclosed. In another part, methods and devices are disclosed that self-align components of the retractor and engage hard tissues directly to avoid soft tissue damage. In another part, pads that engage tissues to cushion, to sense tissue state, and to modulate tissue state are disclosed.

Abstract: In accordance with aspects of the present invention, a door mechanism is provided. A door mechanism according to some embodiments of the present invention includes a door that includes a sealing part, an arm connected to the sealing part, and a pivot part connected to the arm, the door rotating around a pivot axis at the pivot part; and a lever, the lever engaging the door at the pivot part such that the lever opens the door when engaged but is not affected when the door is opened without the lever.

Abstract: Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.

Abstract: Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.