Abstract: An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and a sternal pad interconnected to a blade. The superior blade is preferably pivotally coupled to the spreader member such that it naturally rises as the blades are separated. Alternatively, a vertical displacement member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected superior blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor is interconnected to the blades to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: A medical punch includes a longitudinally dividable anvil with a reduced cross-sectional dimension facilitating insertion of the anvil into the vessel wall to achieve a clean aperture in the vessel wall by cooperative shearing action of a cutting edge and an anvil edge. In another embodiment, the instrument incorporates a measuring device for determining the thickness of a vessel wall between an anvil and a distal end of a cylindrical structure which together form a caliper, and the measuring device can also constitute a medical punch by cooperative shearing action of a cutting edge and an anvil to achieve a clean aperture in the vessel wall.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor assembly having a pair of opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount may hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

Abstract: An ablation assembly capable of ablating tissues inside the cavity of an organ is disclosed. The ablation assembly generally includes an ablative energy source and an ablative energy delivery device coupled to the ablative energy source. The ablative energy delivery device is configured for delivering ablative energy sufficiently strong to cause tissue ablation. The ablative energy delivery device generally includes a penetration end adapted to penetrate through a wall of an organ and an angular component that is used to position the device inside the organ after the device has penetrated through the wall of the organ.

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: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor apparatus having one or more opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount preferably is configured to hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

Abstract: The invention comprises a method for performing a coronary artery bypass graft on a beating heart under thoracoscopic visualization without opening the chest wall. At least one small opening is formed in the patient's chest, a target artery for an arterial blood supply is located, instruments are introduced through one or more small openings formed in the patient's chest to prepare the target artery for fluid connection to the coronary artery, and instruments are introduced through one or more small openings formed in the patient's chest to connect the target artery to the coronary artery distal from a stenosis. In a preferred embodiment, a minimal left anterior intercostal thoracotomy provides access to form an anastomosis between the left internal mammary artery (LIMA) and the left anterior descending artery (LAD) while thoracoscopic viewing facilitates harvesting the LIMA.

Abstract: A multifunction, retractable sun shielding apparatus. A retractable screen, a housing configured to receive and contain the retractable screen upon retracting the screen, and a drive mechanism attached to longitudinal edges of the screen, and configured to drive the screen in directions of retraction and deployment. A power switch may be provided that is actuatable by an operator to drive the drive mechanism to deploy or retract the retractable screen. An interlock automatically stops deployment of the retractable screen at a first predefined position where the screen functions as a visor with regard to an adjacent windshield, and a second predefined position where the screen fully covers the adjacent windshield.

Abstract: A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be used in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

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: Systems and methods for remote access of network-enabled devices that provide seamless, firewall-compliant connectivity between multiple users and multiple devices, that allow collaborative operations by multiple users of remote devices, that allow point to multipoint control of multiple devices and which allow rapid, secure transmission of data between remote users and devices. In general terms, the system includes at least one connection server, and at least two computers operatively coupled to the connection server via a public or global network. In an example where at least one client computer is operatively connected to at least one network-enabled device through a connection server via the public or global network, the connection server is configured to route control instructions from the client to the network-enabled device, and route data from the network-enabled device to the client.

Abstract: Systems, methods and computer readable media for graphically identifying properties of files represented on a user interface, such as a computer display. File properties such as file permissions, file ages and relative file sizes may be graphically represented using color encoding of icons in part or in total, color encoding of text associated with icons representative of files, unique icon shapes and relatively sized icons, as well as combinations of these features.

Abstract: Devices for stabilizing tissue during a surgical procedure. The beating heart may be stabilized during a surgical procedure on the heart, using a described stabilizing device. In one example, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles id effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all.

Abstract: A large capacity animal feeding and watering device having a serving tray (52) and a removable storage container (48) seated axially within the tray so as to deliver food or water to a serving dish (60). The tray has a number of removable wheels mounted thereunder which enables the device to be highly moveable by the user even when heavy and filled to capacity. The top of the container has a filling aperture (34) of sufficient size to enable access by an adult human hand to the interior of the container to fill or to clean. The same manufacturing molds are used in the production of both the feeding and watering device thereby reducing production costs. The container and the tray are designed to nest closely within other like components thereby decreasing the volume occupied in shipping and storage thus reducing costs.

Abstract: A method and potential embodiment for processing streaming data records is described which provides facilities for defining and naming multiple input and output data streams (along with their related transformation, filtering, aggregation and other processing operations) using relational processing definitions, abstractions and techniques similar to those found in relational database management systems (RDBMS) and which is embodied as a set of communicating stream processing nodes. Whereas RDBMS process queries on a centralized processing node against historical stored data records, DDSMS process queries on distributed processing nodes against future flowing data records. The result is a Distributed Data Stream Management System (DDSMS) comprising a set of relational stream processing nodes that work and communicate together in concert to perform useful distributed data processing for a variety of applications such as service monitoring, alerting, message brokering and other applications.

Abstract: A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be used in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

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: The invention is devices and techniques which use a negative (suction) pressure or vacuum, applied through a surgical instrument, to fix the position of a portion of the surface of a beating heart so that a surgical procedure can be more easily performed. The devices apply a negative pressure at several points on the outer surface of the heart such that a portion of the heart is fixed in place by the suction imposed through the surgical instrument. Because the instrument fixes the position of the tissue, and because the instruments remain at a constant distance from the particular portion of the heart where the surgery is being performed, the device may also serve as a support or platform so that other surgical instruments or devices can be advantageously used at the site.

Abstract: Anastomosis devices, methods and apparatus for installing the devices in the performance of an anastomosis. One example of a device includes a central ring portion from which malleable tines and optionally also fastener elements extend. Each tine may have a weakened section at which it preferentially folds or buckles when subjected to bending force. Each tine can grab and evert tissue around an orifice in which it is installed, as it is moved from an initial to a final configuration. To install a device, the tines are advanced against an anvil to cause them to grab tissue around the orifice and curl radially. The anvil is then retracted to fold the tines so their curled ends move radially outward.

Abstract: An anastomosis is performed using a flexible mounting structure mounted on the outside of at least one vessel. Fasteners extend through the vessel and are bent towards the incision to attach the flexible mounting structure to the vessel in a manner that controls the edge of the vessel adjacent to the incision. The mounting structures are oriented on each vessel so fasteners on one mounting structure interdigitate with fasteners on the other mounting structure at the location of contact between the vessels when the two vessels are brought together. This creates two complementary sinusoidal-shaped vessel edges with peaks of one edge being accommodated in the valleys of the other edge. The peak-to-valley orientation forms a sinusoidal-shaped joint which is leak free. The fasteners are spaced so proper pressure is applied to the tissue to promote healing without leaking. Furthermore, the fasteners are sized and shaped to properly engage the tissue and bend in a desired manner.