Abstract: A retractor for use in laparoscopic procedures includes an upper retractor ring, a lower retractor ring, and a retractor sheath extending between the upper retractor ring and the lower retractor ring to form a tubular passageway through which instruments or a medical practitioner's hands may pass during a medical procedure. The retractor sheath includes an elliptical passageway extending between lower retractor ring and the upper retractor ring.

Abstract: Device for supporting the abdominal wall away from organs positioned thereunder for freeing up a surgical space in minimally invasive surgery, having multiple tube-shaped hollow bodies, which are fillable via a hose line (6, 16), and which are connected to each other in circumferential direction to form a preferably conical toroidal shape. The elongated hollow bodies (2, 10) are each supported at their ends (4, 12) on a tube-shaped, thin-walled, foldable hollow body (8, 14), which forms a ring, and which can be filled via a hose line (6, 16), extending along the two edges of the toroidal shape. The diameters of the two annular hollow bodies (8, 14) may be the same, or different, thus forming a cylindrical or frustoconical wall (18) serving for support.

Abstract: A surgical retractor positioning device is provided to create a surgical working field in a minimally invasive and flexible manner. In one embodiment, the device can include a frame and an arm connected to the frame. The arm can include a proximal end, a distal end having a distal end axis, and a major axis, wherein the distal end axis is movable relative to the proximal end, whereby the distal end axis can intersect the major axis at an angle. The device can include at least one blade connected to the distal end of the arm, wherein the blade is fixably rotatable about the major axis. The device can include at least two arms.

Abstract: The teachings provided herein are generally directed to a posterior retractor comprising a handle section; and, a retraction section having an anchoring element. In most embodiments, the handle section comprises a proximal region, a mid-region, and a distal region. And, the length of the handle section can be sufficient to position a hand-held portion of the proximal region of the handle section outside of a surgical site during use of the posterior retractor in a hip arthroplasty procedure. The teachings include the use of the posterior retractor in a hip arthroplasty procedure.

Abstract: A grasper for a surgical retractor is provided. The grasper has a grasper body, a push-button activator and a holder to releasably retain a connector head of, for example, a retractor blade. The holder is configured to move from a first position, located at least partially in the opening to provide for selectively retaining the connector head in the opening, to a second position wherein the connector head may be removed. The push-button activator is operably connected to the holder to move the holder from the first position to the second position. In one embodiment the holder is gear driven by the activator.

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 retractor is provided for maintaining substantially parallel blade alignment with the longitudinal axis of the retractor during opening and closing the retractor blades. The retractor includes rotatable blade receptacles and hinged blade arms interconnected to rotatable arms for maintaining the alignment of the blades during opening and closing. In addition, the retractor may include interchangeable blades, means for locking the blade position, and means for securing the retractor to a mechanical arm.

Abstract: Embodiments of the invention include endoscopic guide tubes having a retractor and a stabilizing assembly for use with the guide tube and related methods of use.

Abstract: The invention describes a disposable device for operations on the arteria haemorroidalis, which comprises a retractor tube (1), closed and rounded on the end (101) which is inserted in the anal cavity, and open and diverging on the external end (201) to which is connected a griping handle (M) which removable houses a luminous source (F). In the connection zone of the handle to the external mouth of the retractor there is provided a channel (C) which contains a parabola (5) which reflects the light supplied from said luminous source (F) and which sends the reflected light inside of the same retractor, to illuminate a lateral window (8) through which appears the rectal mucosa upon which the operation must be made for the ligature of the arteria haemorroidalis.

Abstract: The present invention provides a system and method of retracting tissue during medical procedures. In one embodiment, the present invention provides a blade portion for retracting tissue and a shaft portion coupled thereto. In one embodiment, the shaft portion of the surgical retractor is adapted to engage at least one retaining member. The retaining member may have one or more channels through which the shaft portion may be slidably inserted. In one embodiment, the retaining member provides one or more securing members for receiving at least one elastic member.

Abstract: The retractor system for use in spinal surgery and other types of surgical procedures that is a simple and efficient solution for minimally invasive access to thoracolumbar spine is disclosed. The fully customizable design allows the surgeon to independently angle the retractor blades and expand the retractor in both cephalad-caudal and medial-lateral directions. With an offering of a range of blade lengths, access can be tailored to the patient's anatomy. Auxiliary instruments such as the retractor inserter, universal hex driver and blade removal instrument allow quick and controlled access to the surgical site. The retractor system provides versatility and control ensuring minimal tissue trauma.

Abstract: An improved bone retractor tool includes a pair of arms pivotably connected to one in a pliers-like configuration and a pair of tissue engagement plates each having forward and rearward portions, each of the pair of tissue engagement plates mounted on the upper end of one of the pair of arms and extending generally parallel with one another when the pair of arms are in closed position. Forward bone engagement spikes are mounted on and extend forwards from the forward portions of the tissue engagement plates. A releasable securement mechanism is mounted on the pair of arms for releasably retaining the pair of arms in a selected position relative to one another, and a tensioning device is mounted on the pair of arms for tensioning the lower ends away from one another thereby forcing the pair of tissue engagement plates towards one another upon the securement mechanism being released.

Abstract: Devices and methods for moving tissue and/or moving the devices relative to the tissue during a surgical procedure are disclosed. The devices and methods disclosed herein can be used in conventional, open surgical procedures, or in minimally invasive surgical procedures, such as laparoscopic and endoscopic procedures. In one aspect, the method can be used to provide an enlarged opening in the stomach wall for transgastric access.

Abstract: Methods and devices for minimally invasive surgery in a patient. A tubular body is disclosed which includes in its side wall a plurality of longitudinal passages. Elongated blocking members are also disclosed which are inserted into the passages. The elongated blocking members block deflected interfering tissue during the surgery.

Abstract: A minimally invasive surgical access device that allows access to a pathology being treated while significantly reducing the risk of damaging anatomical structures proximate the pathology. The access device includes a base portion having a central bore extending therethrough, and retractor blades pivotably mounted to the base portion. An insertion handle is coupled to the base portion to thread the retractor blades into the patient. The insertion handle is removed from the base portion, and a core hollow screw is threaded into the base portion to separate the retractor blades to gain access to the pathology through the hollow screw.

Abstract: A retractor device for cervical spinal fusion surgery. The retractor device includes a first post assembly having a first pin for mounting the first post assembly to a first vertebral body and a first rod coupled thereto in a multi-axial manner so that the first rod can be pivoted relative to the first pin. The retractor device also includes a second post assembly having a second pin for mounting the second post assembly to a second vertebral body and a second rod coupled thereto in a multi-axial manner so that the second rod can be pivoted relative to the second pin. The retractor device also includes a first retractor blade having a first retractor blade arm slideably engageable to the first rod, and a second retractor blade having a second retractor blade arm slideably engageable to the second rod. The first retractor blade is slid down the first rod and the second retractor blade is slid down the second rod to be positioned and separate the anatomical structures.

Abstract: A device for providing suction to tissue is disclosed. A method of suctioning tissue is also disclosed.

Abstract: A retractor configured for anchorage to the acetabular area of the hip bone via a bendable pin, such that the bent pin retains the retractor in a selected position. The retractor includes a site anchor portion, with a spacer portion extending upward from a leading end of the site anchor portion. At least one retainer track is affixed to the spacer portion, the track being configured to closely receive the bendable pin. The leading end of the site anchor portion is preferably angled and serrated. The site anchor portion preferably has a curved configuration for use in resting the leading end of the site anchor portion substantially along an outer portion of a rim of the acetabulum. The retractor may be provided with an extension portion. The extension portion is preferably angled and serrated.

Abstract: An expandable surgical retractor for use in minimal incision surgery is disclosed. The retractor consists of a fiber optic central rod surrounded by flexible wires designed to create an open space for visualization and surgical work within an illuminated surgical field. The flexible wires are disposed via selective pressure of the surgeon and are variable in number. The configuration will allow for both forward and back illumination of the surgical field. The expandable surgical retractor allows for surgical visualization in anatomical areas heretofore too complicated for surgical consideration. Other embodiments of the expandable surgical retractor are contemplated wherein a handle with an aperture may replace the central rod. The flexible wires may fit in openings around the aperture. The handle, in this embodiment, may have a light source and may be adapted to be used in select areas of anatomy. Further, the handle may be transparent.

Abstract: A minimal incision maximal access system allows for maximum desirable exposure along with maximum access to the operative field utilizing a minimum incision as small as the METRx and Endius systems. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing hinged bi-hemispherical or oval working tubes applied over an introducer obturator which is controllably dilated to slowly separate muscle tissue. Deeper end working and visualization areas with maximum proximal access and work dimensions are provided to makes the operative procedure safer in application and shorten the surgeons's learning curve because it most closely approximates the ability to use open microdiskectomy techniques.

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: Apparatus and methods for creating anastomoses are provided. An incision tool for creating an incision having a controlled length in a side wall of a patient's body tissue conduit is provided. A delivery device for inserting a hollow annular connector into an incision in a side wall of a patient's body tissue conduit is provided. The delivery device may include first and second anvil structures around which the connector may be disposed. By moving the first anvil structure away from the second anvil structure, the connector may expand to a desired configuration (e.g., non-round) within the aperture. In one example, the connector may be inserted into the aperture to hold the aperture open prior to attachment of a graft conduit to the aperture, thereby allowing a physician to inspect the aperture and the surrounding tissue.

Abstract: This invention provides a heart positioning device, method and system for positioning, manipulating, holding, grasping, immobilizing and/or stabilizing a heart. The heart positioning device may include a suction head and a shaft with a means for remotely changing the position of the head from a first position axially aligned with the shaft to a second, unaligned position and a sleeve slideably positioned on the shaft and sized to receive the suction head in a compressed condition.

Abstract: Devices and methods are disclosed for stabilizing tissue within a patient's body during a surgical operation to provide a relatively motionless surgical field, such as during a coronary artery bypass graft procedure. The devices include tissue stabilizers which engage and provide stabilization to a targeted area of tissue and further have the ability to engage and manipulate some portion of tissue within or adjacent the targeted area to improve the surgical presentation of that portion of tissue. The tissue stabilizer typically has one or more stabilizer feet which have a first foot portion configured to provide stabilization to the targeted tissue and a second foot portion moveable relative to the first foot portion for manipulating a portion of tissue to improve the surgical presentation.

Abstract: A surgical access system includes retractor for creating an access path between an incision site and a surgical site. The retractor includes a frame having a base member and a pair of generally curved rails extending therefrom. A tubular member is coupled to the frame and includes first and second blade portions that are capable of relative movement with respect to each other by movement on the curved rails. A method of inserting the retractor into a patient includes inserting a guide rod over a guide wire, locating an obturator in the retractor, inserting the obturator and retractor over the guide rod, and removing both the guide rod and obturator to leave the retractor in the body to provide the access path.

Abstract: A apparatus and method for retracting tissue of a patient during the performance of an orthopaedic surgical procedure includes creating an incision in a tissue of the patient in the presence of a magnetic field. The magnetic field is generated by a computer assisted orthopaedic surgery system. The tissue surrounding the incision is retracted with a nonmagnetic retractor. The method may also include altering the shape of the nonmagnetic retractor.

Abstract: A surgical retractor is configured to provide surgical access in thoracic surgery, for example through an intercostal incision. The surgical retractor includes at least one inflated or inflatable member to cushion the ribs and surrounding tissue from injury or trauma. In one embodiment, the inflatable member is configured as an inflatable ring with a concave outer surface for engaging and spreading apart two adjacent ribs when the ring is inflated. In another embodiment, the inflatable ring can be combined with a substantially rigid inner ring for supporting and rigidifying the retractor. In yet another embodiment, a plurality of substantially rigid retractor blades is mounted on a spreading track or the like. One or more inflatable members or an inflatable ring are used to cushion the tissue from the rigid retractor blades.

Abstract: The present invention relates to a surgical retractor that immobilizes tissue at a surgical site. A preferred embodiment of the retractor is used during minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. Tape or thread can be used to connect the artery to the retractor with a holder.

Abstract: An organ manipulator including at least one suction member or adhesive disk mounted to a joint providing freedom of movement of the at least one suction member or adhesive disk relative to its support. A method for retracting and suspending an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) in at least the vertical direction during both steps.

Abstract: Devices and methods are provided for manipulating and supporting an organ. The subject devices are characterized by having an inflatable annular member having a central opening and an organ contacting surface, a vacuum distribution element configured to create a diffused vacuum space in the central opening, and a positioning element having a lumen coupled to a vacuum source and to the inflatable annular member. The subject devices are suitable for use in a variety of surgical approaches and, as such, may be configured to be inserted into a patient's chest cavity through a sheath. Methods are also provided for using the subject devices, where the order of the methods may be altered. Also provided are systems and kits for manipulating and positioning an organ.

Abstract: Apparatus and methods for stabilizing and/or positioning tissues or organs during surgical procedures. One feature of the positioners of the invention includes the use of one or more suction elements used to grip the organ or tissue. The main body of the suction element comprises body defining a polyhedral shaped chamber, an elliptical ring structure and a vacuum port. The invention further includes structures to support the suction element and hold the suction element and attached tissue in a fixed position including catheters, lockable flexible arms, and retractors.

Abstract: A method and device for performing endoluminal fundoplication are described. A device is inserted in the patient's stomach through the esophagus, including an unit adapted to grasp and pull a portion of the gastroesophageal junction into the stomach, and an unit adapted to move a portion of the fundus towards the esophagus. The device also can place fasteners to hold the gastric wall and the esophageal wall secured together, thus forming a valve between esophagus and stomach. An adhesive compound can be used to stabilize the juncture of the two walls.

Abstract: An adjustable retractor is disclosed comprising an inner ring, an outer ring spaced from the inner ring, and an elongate sleeve open at opposite ends. The sleeve is provided and extends between the inner and outer rings and is connected at the opposite ends to the rings. The outer ring is provided with a pre-loaded rotational torque to assist with rotation of the outer ring about its central axis to roll the sleeve about the outer ring to adjust sleeve length. An obstetrics version of the retractor may be used for caesarean sections. A hydraulically controlled retractor includes fluid channels in the inner and outer rings that may be dilated by injection of an appropriate fluid.

Abstract: A circumferential retractor apparatus including a first retractor paddle having a grasping surface and a body portion supporting the grasping surface, a second retractor paddle having a grasping surface and a body portion supporting the grasping surface and an elastic member having one end received by the first retractor paddle and an opposite end received by the second retractor paddle. Each of the paddles has a hole formed therein of a size suitable for allowing the elastic member to pass therethrough. A slot is formed in the body portion so as to open to the hole. The slot is of a tapered configuration so as to have a wide end opening to the hole and a narrow end away from the hole. The grasping surface includes a plurality of fingers extending outwardly of the body portion. Each of the plurality of fingers are arranged in parallel spaced relationship to each other. The elastic member is a length of surgical tubing.

Abstract: The present invention provides methods and apparatus in which a surgical retractor comprises a plurality of mechanically coupled tissue retaining walls that are guided into position along one or more guides previously implanted into the patient. The walls are preferably coupled by pivots, so that separating some of the walls from one another opens an operating space. There are preferably two guides, which are driven or screwed into the pedicles of vertebrae, or other bone. Since practical considerations will usually mean that the guides are not generally parallel to one another, the guides are capable of polyaxial movement with respect to the pedicles, and retractor is provided with oversized channels to receive the guides. The channels may be conveniently disposed in a frame, which also serves to hold lock the walls apart. Various convenience features are contemplated including a web disposed between the walls, which expands as the walls are separated.

Abstract: A manipulation mechanism that can be attached to the heart and other organs of the body so that the organs can be positioned, lifted, turned and held in place during diagnosis, testing, treatment and surgical procedures on the organs.

Abstract: A surgical retractor having a lateral rack with two longitudinal arms extending therefrom. At least one of the arms has a curved segment. It is preferable that the curved segment extend at least one third the length of the arm and be concavely oriented toward the opposing arm.

Abstract: An apparatus for facilitating the locating, everting, and closing of an opening in a blood vessel. The apparatus can include a closure instrument having an elongated member defining a longitudinal axis and proximal and distal ends. The elongated member has a vacuum lumen extending at least a portion of the length thereof for conveying a vacuum and terminating in a vacuum port adjacent the distal end of the elongated member. The distal end of the elongated member is dimensioned to be positioned proximal a vessel opening in a blood vessel whereby vessel edge portions defining the vessel opening are at least partially drawn toward the vacuum port in response to a vacuum conveyed through the vacuum lumen. At least one surgical clip is mounted adjacent the distal end of the elongated member and is adapted to be formed to an at least partially formed condition thereof.

Abstract: This invention describes novel methods and devices for stabilizing and retracting tissue during surgery, in particular internal tissue. Patches of material, preferably biodegradable, are adhered to tissue surfaces. By manipulation of the patches, for example directly with forceps, or via sutures attached to the patches, tissues can be retracted or otherwise manipulated with minimal trauma to the tissues. The method is especially useful in minimally-invasive surgery.

Abstract: A heart stabilizer that may include a wrist which couples an end effector to a first linkage. The end effector and wrist may be inserted through an incision in the chest of a patient to assist in performing a minimally invasive coronary procedure. The wrist provides dexterity so that the end effector can be placed on the heart to stabilize the same.

Abstract: To avoid traditional muscle dissection required in the placement of a screw for a pedicle screw fixation, a retractor is provided having a guide of an appropriate length to provide access from the skin surface to the dorsal aspect of the vertebra over the pedicle. The retractor has a handle to provide appropriate holding leverage and to maintain the guide so as to stabilize the guide against the lateral aspects of the facet with the paraspinous musculature. The retractor has a channel of an appropriate size to accommodate a variety of tools, including a drill bit or a tap. The channel also provides a pathway for a probe or feeler to inspect the placement of the screw. A tool groove may be provided in the channel to support the shaft of a tool, such as a tap.

Abstract: A method and apparatus for dissecting a first layer of tissue from a second layer of tissue and thereafter holding open an anatomic space for the performance of a surgical procedure. The method includes steps of making an incision in a body, introducing a deflated balloon dissector into the incision, inflating the balloon dissector to effect dissection of the first layer of tissue from the second layer of tissue, deploying a retractor within the anatomic space in order to hold open the anatomic space, and optionally deflating or evacuating the balloon dissector to open a cavity for surgical manipulations. The apparatus includes a combined dissector-retractor having a balloon retractor disposed upon the surface of the balloon dissector and integrated therewith.

Abstract: An organ manipulator including at least one suction member or adhesive disc mounted to a compliant joint, a flexible locking arm for mounting such suction member or compliant joint, and a method for retracting and suspending an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) in at least the vertical direction during both steps. In preferred embodiments, a suction member exerts suction to retract a beating heart and suspend it in a retracted position during surgery. As the retracted heart beats, the compliant joint allows it to expand and contract freely (and otherwise move naturally) at least in the vertical direction so that hemodynamic function is not compromised. The suction member conforms or can be conformed to the organ anatomy, and its inner surface is preferably smooth and lined with absorbent material to improve traction without causing trauma to the organ.

Abstract: A method and apparatus for closing a vascular wound includes a guidewire and/or other surgical implement extending from the wound. A hemostatic material is advanced over the surgical implement and into contact with an area of the blood vessel surrounding the wound. The surgical implement is removed. Blood soaks the hemostatic material, and blood clotting is facilitated by the hemostatic agent within the material. A sealing layer of adhesive can be applied to the hemostatic material, confining the blood flow to the material. Thus, the vascular puncture wound is sealed by natural blood clot formation.

Abstract: A surgical retractor has a body and a socket laterally receiving a connector head. The socket cavity is offset from a loading axis extending to the mouth of the slot. The slot laterally receives the connector head as directed towards the socket cavity where it is retained in a locked configuration. The socket cavity is offset from the loading axis.

Abstract: A laparoscopic surgical extraction port (LSEP) includes a port having a radially-enlarged distal end. A sheath having a plurality of circumferentially-spaced prongs is slidingly mounted onto the port. With the prongs contracted radially-inwardly and the LSEP in its contracted position, a surgeon inserts the LSEP into a patient's abdominal cavity through an incision. The surgeon then expands the LSEP by pulling the port rearwardly such that the radially-enlarged distal end expands the prongs radially-outwardly. The surgeon then positions a specimen and endo-bag in the funnel formed by the expanded prongs. The specimen, endo-bag, and prongs are thereafter simultaneously extracted through the incision. A radially-inward force that is applied to the prongs by the incision substantially prevents the specimen from bunching or rupturing during the extraction process.

Abstract: An apparatus includes a substantially pliable sheet-like member, a surgical retractor, and a substantially elastic coupling extending between the sheet-like member and the retractor. A method for expanding a surgical cavity in a patient includes positioning the patient on a substantially pliable sheet-like member, positioning a surgical retractor in the cavity, extending a substantially elastic coupling between the sheet-like member and the retractor, and tensioning the coupling.

Abstract: A balloon device useful for dissecting tissue or retracting tissue for the purpose of providing access for laparoscopic surgery, the device comprising a balloon which inflates to a shape specially suitable for the surgical procedure and the anatomical region of deployment. The present device, when configured with a tapered dissection balloon, is particularly useful for subfascial endoscopic perforator surgical procedures.

Abstract: A tubular access sleeve and suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart in a minimally invasive manner are disclosed. A suction tool trunk extending through a suction tool lumen of the sleeve is coupled to suction pads at the ends elongated support arms. The suction pads can be retracted into a sleeve working lumen during advancement of the access sleeve through a passage and deployed from the tubular access sleeve lumen and disposed against the an outer tissue layer. Suction can be applied through suction tool lumens to suction ports of the suction pads that fix to the outer tissue layer so as to tension the outer tissue layer and/or pull the outer tissue layer away from an inner tissue layer so that the anatomic space can be accessed by instruments introduced through the working lumen to penetrate the outer tissue layer.

Abstract: Methods and apparatus are disclosed for treating body tissue whereby a section of tissue is drawn into contact with the open distal end of the first passageway of the apparatus. A tissue treatment fluid is introduced into the second passageway for treating the desired section of tissue retained within the first passageway. Methods and apparatus are also disclosed for positioning a medical device at a desired location within the heart. A portion of the apparatus is retained at a desired location of the heart and a medical device is extended through a passageway of the apparatus for contacting the heart at the desired location.