Abstract: Surgical tissue retraction systems and methods are described herein. Such systems and methods can be employed in some embodiments to provide medial-lateral tissue retraction to increase access to a surgical site. In one embodiment, a surgical instrument can include a body configured to couple to an implantable anchor, a first tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto, and a second tissue manipulating implement coupled to the body and capable of polyaxial movement relative thereto. Further, the first and second tissue manipulating implements can be opposed to one another such that they can move any of toward and away from one another.

Abstract: A retractor system includes a retractor blade and a retractor arm having a side-load connector. The side-load connector includes a port that passes through an upper surface and a lower surface of the side-load connector. A sidewall opening in the side-load connector permits lateral passage of the attachment post through a sidewall to the port. The side-load connector includes a cam pivotably coupled between the lower surface and the upper surface and a spring that applies a biasing force on the cam. The biasing force biases the cam to a closed position in which the cam extends into the opening and prevents unloading the attachment post from the port via the opening. The cam selectively engages either a first groove or a second groove of the attachment post sidewall. The side-load connector further includes teeth that engage teeth of the retractor body when the cam engages the first groove.

Abstract: A retractor system for use in preparing an area of the body for a surgical procedure is disclosed. The retractor system includes retractor blades that can be independently inserted and positioned within the body. The system also includes articulating arms that can be used to secure the retractor blades to one another and to rigidly fix the retractor blades in place relative to an operating table or other fixed structure.

Abstract: A system and method of positioning a spinal implant into an intervertebral space comprises the steps of: cutting an incision through the skin toward an intervertebral space between a L5 and S1 vertebra; inserting an uncoupled first, second and third retractor blade into the incision to pre-position the retractor blades prior to retraction; coupling the pre-positioned first retractor blade to a connector arm to connect the first retractor blade to a table arm; attaching a blade to blade connector and mini flex arm to couple the second blade to either the first blade or third blade; and wherein the three uncoupled blades, once pre-positioned and then coupled, the blades are retracted to open the incision and expose the vertebral bodies.

Abstract: Disclosed is a method of unilateral biportal endoscopy and a surgical instrument set used in the same. More particularly, the present invention relates to a method of unilateral biportal endoscopy which separately secures a working portal for surgical instruments and an endoscopic portal for an endoscope, thereby providing a more accurate spinal surgery, and to a surgical instrument set which can be effectively applied to the method.

Abstract: A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

Abstract: A swivel distractor includes a blade portion, a flange, and a distraction portion. The flange extends at an angle from a first end of the blade portion. The distraction portion is pivotally coupled to a second end of the blade portion opposite the first end. The distraction portion may include a first foot that is configured to be received in a head of a first pedicle screw and a second foot that is configured to be received in a head of a second pedicle screw. The second foot may be movable relative to the first foot.

Abstract: Embodiments of a corpectomy method, comprising the steps of: providing a distractor unit comprising at least a first hydraulic cylinder configured to removably receive a piston of a predetermined length during a surgical procedure; providing the piston; providing a plurality of bone screws; affixing a first bone screw of the plurality of bone screws to a first vertebrae of a spine and a second bone screw of the plurality of bone screws to a second vertebrae of the spine; mounting the distractor unit onto the first bone screw and the second bone screw; and extending the hydraulic piston of the distractor unit to cause the first vertebrae and the second vertebrae to move away from each other are disclosed.

Abstract: A surgical retractor for illuminating a surgical field includes an ergonomic handle, a retractor blade coupled with the handle, a quick release mechanism, and an illuminator blade. The retractor blade is adapted to engage and retract tissue, and the quick release mechanism is adapted to couple the handle with the retractor blade. The illuminator blade acts as a waveguide to transmit light by total internal reflection. Light is extracted from the illuminator to illuminate the surgical field. The retractor blade is releasable from the handle without requiring uncoupling of the illuminator blade from the handle and also without requiring optical uncoupling of the illuminator blade from a light source. The retractor may also be adapted to evacuate smoke from the surgical field.

Abstract: According to one embodiment, a protective device for use in congestive heart failure treatments, and other treatments, includes a control mechanism, an elongate shaft, and a protective plate. The control mechanism is coupled with a proximal end of the elongate shaft and the protective plate is pivotably coupled with a distal end of the elongate shaft. The elongate shaft enables the protective plate to be inserted within a body and navigated distally of a heart wall. The protective plate has a relatively wide and thin body portion and is pivotable relative to the elongate shaft by operation of the control mechanism. Pivoting and/or navigating of the protective plate within the body allows the protective plate to be positioned adjacent the heart wall to shield body organs or tissue surrounding the heart wall from being damaged by surgical instruments inserted through the heart wall.

Abstract: The use of red or near infrared light upon neurons of the lumbar plexus that are in distress due to retraction-induced ischemia. The surgeon may protect nerves made ischemic in the surgery by: a) making an incision in a patient, b) inserting an access device into the patient through the incision to at least partially create a path to a spine of the patient, and c) irradiating nervous tissue adjacent the path with an amount of NIR or red light effective to provide neuroprotection.

Abstract: A method for retracting tissue in a surgical procedure includes inserting a first blade of a retractor system into an incision in a body of a patient. The retractor system includes a first articulating arm and a second articulating arm. The first articulating arm is coupled to a retractor assembly blade. The retractor assembly blade has a handle portion and the first blade. The second articulating arm is coupled to a bracket securing a second blade. The method includes retracting tissue using the first blade, inserting the second blade into the incision in the body of the patient and retracting tissue using the second blade.

Abstract: The invention provides a retractor having a lighting module which is removeably attached to a paddle of the retractor. The retractor is able to provide improved illumination of a workspace within the body by attaching the light source directly to the paddle. As the light source is removeable from the paddle, it enables the light source to be removed after use and discarded while the retractor can be re-used. Furthermore, as the light source is removeably attached at a distal end of the paddle, the illumination is provided closest to the workspace, regardless of the length of the paddle.

Abstract: A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

Abstract: The self-retaining nasal septum retractor includes two pivotally attached arms having handles on one end and speculum blades on the opposing end. The speculum blades are adjustably connected to the arms through pivoting joints. A user can adjust the vertical displacement and angular relation between the speculum blades and the arms to fit different patient septal/nasal structures. A self-retaining mechanism allows a user to lock the retractor in a retracted position, freeing up a hand of the user for other surgical tasks.

Abstract: Provided is a device of automatic mechanical wound opener for head and neck surgery. The device includes a wound opener including: a fixed unit and a plurality of drawing units, and at least one of the drawing units being movably connected on the fixed unit, wherein each of the drawing units includes a first arm, a second arm, and a blade connected to the second arm; wherein the first arm is connected to the fixed unit by one end thereof and to the second arm by the other end thereof; the second arm can be adjusted to an needed included angle relative to the first arm; and at least one of the blades includes an extension plate connected to an end of a plate part of the blade, and the extension plate is connected to the second arm for shortening the spacing between two blades.

Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

Abstract: A surgical retractor including a retractor body, and a retractor arm, a control assembly configured to control movement of the retractor blade, the control assembly including a base member having an opening, a regulating member configured to control rotation of a first portion of the retractor arm and move through the opening of the base member, a connecting member cooperatively connected to the regulating member, and a barrel assembly in operative slidable engagement with the opening formed in the base member, wherein rotation of the regulating member in a selected direction moves a stem of the regulating member through the opening thereby forcing the barrel assembly to slide along the opening and the base member to pivot relative to a second portion of the retractor arm between a first position and second position.

Abstract: This application presents minimally-obstructive and structurally-adjustable retractors for vaginal repairs, which afford an open work area of desirable size and enhanced visualization for a surgeon about the perineum and the posterior vaginal wall of the patient. The retractors may be lightweight and compact, and also configured and dimensioned to minimize slippage during use. The retractors may have occluders that may partially or substantially block or absorb fluids, for example, from or around the cervix. The retractors may incorporate built-in light sources. The retractors may retract the engorged labia of the postpartum patient as well as the vaginal walls. The retractor may also be used as a speculum.

Abstract: Embodiments herein are generally directed to surgical retractor systems. In some embodiments, these retractor systems may be used in spinal fusion or other procedures that utilize a transforaminal approach.

Abstract: A retractor blade assembly includes an arm member, blade connector and a retractor blade having stem member provided at the top of the blade. The stem member includes a first pin member, provided at an upper portion of the stem member. The first pin member has at least one abutment extending outward from the stem member, a first groove provided below the first pin member, a second groove provided below the first groove, provided about the circumference of the stem member, a second pin member having at least one abutment extending from the second groove. The blade connector cooperatively engages the stem member permitting the retractor blade to operate in a rotatable mode and a locked mode.

Abstract: The gripping device (1) enables the introduction and attachment of a set screw (101) within a U-shaped link connector (102) of a polyaxial or monoaxial pedicle screw (103) to immobilize a connecting rod (104) of a osteosynthesis device (100), and includes a locking element (2) which is supported against the link connector (102) making it possible to ensure concentricity between the principal axes of the gripping device (1) and those of the link connector (102) and to ensure that the connecting rod (104) is kept on the inside of the link connector (102); and an element for releasing (3) the gripping device (1) after establishing and screwing the set screws (101) inside the link connector (102).

Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

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: The present invention relates to a spreadable retractor, including a rake plate having a pair of laterally separated rake mountings; a pair of rakes, one of the rakes moveably mounted to each of the laterally separated rake mountings, wherein each of the rakes comprises a rake shaft extending away from the rake plate; and a rake spreader mounted to the rake plate at a position between the laterally separated rake mountings, the rake spreader operably linked to and configured to spread the pair of rakes apart from each other. The spreadable retractor of the present invention provides the ability for surgical personnel to use a single device to both lift and spread tissues and bones in the vicinity of a surgical incision.

Abstract: An adaptor for removably engaging surgical retractor blades to a retractor frame has a recess with a latch mechanism at its proximal end for removably securing the adaptor to the rail of a retractor frame, and a spring-loaded locking jaw mechanism at its distal end for removably engaging a retractor blade.

Abstract: A trocar surgical seal or surgical access device is provided. The trocar surgical seal comprises first and second supports coupled together by a film passageway. The trocar surgical seal provides an instrument seal for instruments inserted therethrough. The trocar surgical seal occupies minimal surgical space.

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. Some embodiments of the surgical access system may be particularly suited for establishing an operative corridor to a surgical target site in the spine. Such an operative corridor may be established through the retroperitoneal space and the psoas muscle during a direct lateral, retroperitoneal approach to the spine.

Abstract: A tissue retractor generally includes a pair of arms that are pivotally coupled to each other and each have a finger grip portion on a first end and a working portion arranged on an opposite second end. Each of the second ends comprises an elongated shaft that extends along an axis. A pair of paddles each having a planar engagement body and a mounting portion are pivotally coupled to a corresponding elongated shaft. The paddles are selectively rotatable around the respective axes.

Abstract: A quick-release handle is used in positioning a retractor blade in a surgical site and securing the retractor blade to a retractor frame. The retractor blade has a generally cylindrical post for removably engaging a retractor frame, an alignment groove on its top surface, and an annular recess extending around the post. The quick-release handle has a head with a U-shaped flange for sliding engagement with the annular recess and the upper portion of the post. The handle also contains a sliding rod actuated by a thumb-slide mechanism to engage the alignment groove on the retractor blade post. In particular, a locking tongue extending from the distal end of the rod engages the alignment groove, while a protrusion extending from the rod engages the annular recess, thereby maintaining proper rotational alignment between the handle and retractor blade.

Abstract: A retractor system includes a frame and first and second retractor blades. The frame includes first and second securement features. At least one of the first and second securement features is movable with respect to the frame when the first and second securement features is mounted to the frame. Proximal portions of the first and second refractor blades are secured proximate the first and second securement features respectively. In a first position the first and second refractor blades are laterally opposed. Movement of the securement feature adjusts the angle of at least one of the retractor blades so that at least one of the retractor blades may be adjusted between an acute angle and an obtuse angle to horizontal.

Abstract: A multiple piece tongue blade is described. The multiple piece tongue blade is provided with a step and a tip. The stem is adapted to be inserted into a handle of a surgical retractor. The tip is adapted to be selectively attached to the stem. The tip is insertable into a mouth of a patient such that the tip applies pressure onto a tongue of the patient.

Abstract: Devices, systems and methods for minimally open orthopedic spine surgery are disclosed. A first flexible screw-based retractor is designed to be coupled to each pedicle screw inserted into adjacent vertebral bodies. A retractor system is provided in which a first retractor blade is mounted to one of the screws and a second movable retractor blade is moved away from the first blade, in a medial direction, to create a working channel through which the disc space may be accessed for passing instruments and implants. Light may be incorporated into the device to illuminate the surgical field. One or all of the retractor blades may be made of a sterilizable plastic or metal and be disposable or reusable.

Abstract: Embodiments described herein include devices, systems, and methods for reducing the distance between two locations in tissue. In one embodiment, an anchor may reside within the right ventricle in engagement with the septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along a surface of the heart. Perforating the exterior wall and the septum from an epicardial approach can provide control over the reshaping of the ventricular chamber. Guiding deployment of the implant from along the epicardial access path and another access path into and through the right ventricle provides control over the movement of the anchor within the ventricle. The joined epicardial pathway and right atrial pathway allows the tension member to be advanced into the heart through the right atrium and pulled into engagement along the epicardial access path.

Abstract: A vaginal speculum comprises upper and lower blades arranged to pivot relative to each other about coupling elements each associated with a respective blade. The upper blade is detachable from the lower blade, when the speculum is in situ in the vaginal cavity, upon pulling the upper blade generally proximally. This decouples the coupling elements from each other or detaches at least one of the coupling elements from the associated blade. The speculum has optional side blades.

Abstract: A spinal surgery retractor and method of use. The retractor includes a slotted keyway for integrating a keyed spinal distractor. The 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.

Abstract: A blade assembly for a tissue retractor includes a blade, a mount, and a positioner member. The blade includes a length extending from a proximal portion with a coupling to a distal portion for retracting soft tissue. The mount includes a receiving portion that receives the coupling. The positioner member is rotatably coupled to the mount and engages the proximal portion to apply a force that positions the blade relative to the mount.

Abstract: A self-retaining retractor and surgical method of retracting integument at a surgical site comprising a medial arm moveably connected to a first end of an extension arm. The extension arm is connected to a lateral arm. The connection may be made after the medial arm is in the surgical site. The extension arm may be moved from an undeployed position to a deployed position. The medial arm or the lateral arm may include a surgical instrument holder, such as a holder for an endoscope. A locking mechanism may be used to lock the retractor in a deployed position. A strap may also be used to secure the retractor.

Abstract: A surgical retractor for illuminating a surgical field includes an ergonomic handle, a retractor blade coupled with the handle, a quick release mechanism, and an illuminator blade. The retractor blade is adapted to engage and retract tissue, and the quick release mechanism is adapted to couple the handle with the retractor blade. The illuminator blade acts as a waveguide to transmit light by total internal reflection. Light is extracted from the illuminator to illuminate the surgical field. The retractor blade is releasable from the handle without requiring uncoupling of the illuminator blade from the handle and also without requiring optical uncoupling of the illuminator blade from a light source. The retractor may also be adapted to evacuate smoke from the surgical field.

Abstract: An anterior cervical retractor comprises a retractor body having a base arm and a moving arm and a pair of retractor blades having a side loading blade and a top loading blade. The base arm includes a first track and a side loading connector. The first track extends perpendicularly from a proximal end of the base arm and the first track includes an articulating arm post and a gear teeth. The moving arm is located opposite to the base arm and includes a first track receptacle and a top loading connector. The moving arm is advanced along the first track by means of a knob extending from the base arm. The side loading blade includes a first blade portion and a first connection post and the top loading blade includes a second blade portion and a second connection post.

Abstract: A surgical retractor includes a retractor blade and a gripping element releasably coupled to the retractor blade. The gripping element has a textured surface for engaging and gripping tissue. The gripping element may be released from the retractor blade intraoperatively. The surgical retractor may also have an optical illumination element such as an optical waveguide that is magnetically and releasably coupled to the retractor.

Abstract: A system for interchangeable retractor blades includes a shell, a first retractor blade, and a second retractor blade. The shell includes a rigid proximal end configured to attach to a surgical retractor and an opening, a distal closed end, and a pliable portion including a pocket in communication with the opening and extending along a length of the shell to the distal closed end. The first retractor blade includes a first geometry received through the opening into the pocket and that shapes the pliable portion to configure the shell in a first configuration. The second retractor blade includes a second geometry received through the opening into the pocket and that shapes the pliable portion to configure the shell in a second configuration.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction 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.

Abstract: An assembly allowing retraction of soft tissue away from a reference plane; the assembly including at least one retracting element each having a distal end with a formation allowing anchorage of the at least one retracting element. The assembly also includes a proximal end of the at least one retracting element capable of movement through at least one degree of freedom relative to the anchorage.

Abstract: A surgical access system comprising a tissue dilation 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. A retractor assembly for creating an operative corridor to a spinal surgical target site is disclosed, comprising: a retractor body and a plurality retractor blades extending generally perpendicularly to the retractor body, the retractor body being operable to separate the at plurality of retractor blades relative to each; and a supplemental retractor blade assembly attachable to at least two of the plurality of retractor blades, the supplemental retractor blade assembly comprising an elongated supplemental retractor blade and a crossbar connector, the crossbar connector configured to be attached to said at least two retractor blades while engaging the supplemental retractor blade.

Abstract: The use of red or near infrared light upon neurons of the lumbar plexus that are in distress due to retraction-induced ischemia. The surgeon may protect nerves made ischemic in the surgery by: a) making an incision in a patient, b) inserting an access device into the patient through the incision to at least partially create a path to a spine of the patient, and c) irradiating nervous tissue adjacent the path with an amount of NIR or red light effective to provide neuroprotection.

Abstract: A retractor assembly for positioning tissue during a surgical procedure, having two opposing arms disposed adjacent to one another and sized and configured to be urged substantially laterally away from one another during actuation of the retractor assembly into an open position, and one or more posts, each post being connected to, or integral with, and extending radially outwardly from a respective one of the opposing arms, each of the one or more posts having a length sufficient so that each of the one or more posts will extend through a respective aperture defined by a modular component to be detachably attached to the respective one of the opposing arms. Related methods of positioning tissue during surgery are also described.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction 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.

Abstract: A surgical retractor for illuminating a surgical field includes an ergonomic handle, a retractor blade coupled with the handle, a quick release mechanism, and an illuminator blade. The retractor blade is adapted to engage and retract tissue, and the quick release mechanism is adapted to couple the handle with the retractor blade. The illuminator blade acts as a waveguide to transmit light by total internal reflection. Light is extracted from the illuminator to illuminate the surgical field. The retractor blade is releasable from the handle without requiring uncoupling of the illuminator blade from the handle and also without requiring optical uncoupling of the illuminator blade from a light source. The retractor may also be adapted to evacuate smoke from the surgical field.