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: An expandable acetabular reaming system for use in hip replacement surgery comprises a reamer head having a convex forward surface attached to a base plate that defines an interior space therebetween. The forward surface includes a plurality of apertures therethrough. The base plate includes a central aperture over which a flexible bladder is mounted within the interior space. The reaming system further includes a plurality of cutting blades mounted to the bladder and positioned so as to correspond with respective apertures. An air cylinder is coupled to the underside of the base plate and includes an open top in communication with the bladder through the central aperture of the base plate. A threaded shaft extends through a threaded aperture in a bottom wall of the air cylinder and is coupled to a thimble-type knob. As a user turns the knob, the shaft rotates to force air through the base plate aperture so as to inflate the bladder.

Abstract: A bottom-loading multi-axial bone anchor apparatus is disclosed. The apparatus includes a receiver member, a crown member, a bone anchor and a retaining member. The receiver member defines an upper opening and a lower opening, which may form part of the same opening, a channel, and a groove. The crown member and bone anchor are loaded into the lower opening of the receiver member, and the retaining member fits around the bone anchor and into the groove in the receiver member. The bone anchor is capable of multi-axial positioning with respect to the receiver member. An elongated member is placed in the channel of the receiver member, contacting the crown member, and a compression member is applied via the upper opening. The compression member presses down on the elongated member, which presses down on the crown member and locks the bone anchor between the crown member and the retaining member.

Abstract: A nozzle with an abrasion chamber for removal of the outermost layer of skin and the skin treatment system for use therewith. The abrasive material flows across a slot formed in the abrasion chamber. The path of the abrasive material may be generally helical. In the preferred helical embodiments, the paths are either vertically or horizontally oriented within the abrasion nozzle. To promote the spiral path of the material, some embodiments feed the abrasive material into the abrasion chamber at an angle causing the material to flow down the curved sidewall of a generally cylindrical abrasion chamber, thereby encouraging the spiral path.

Abstract: The present invention provides an improved orthopedic method and system for incremental adjustment of the bone segments on either side of a bone repair site. The apparatus includes a ratchet assembly which may be subcutaneously implanted, and an adjustment assembly which may be inserted percutaneously for releasable engagement with the adjustment assembly. The ratchet assembly includes a first piece having a tongue with ratcheting serrations, and a second piece having a cavity to receive the tongue and also including ratcheting pawls to engage the serrations. The serrations and the pawl cooperate to act as a uni-directional ratchet; depending on the geometry of the serrations, the ratchet assembly may operate as an incremental distractor or reducer. The adjustment assembly may be a simple threaded shaft which engages with a threaded bore on one of the pieces of the ratchet assembly; in this embodiment as the shaft is rotated, its end will provide a force to the other piece of the ratchet assembly.

Abstract: A method and portable apparatus for the visual examination and grading of cervical epithelium by means of a hand-held colposcopy assembly capable of producing a digital image of the cervix. The present invention enables real-time imaging and archiving of images of the entire cervix for the purpose of detecting cancerous and pre-cancerous tissue and by virtue of computerized image processing suggests an objective diagnosis of the cervical epithelium by means of a low cost, portable, hand-held digital colposcope.

Abstract: An apparatus and method for releasably positively gripping and manipulating an implant within the eye. A preferred embodiment includes a vacuum cannula apparatus.

Abstract: Surgical apparatus for coronary surgery of a patient comprising contacting means being capable of providing a mechanical force against at least a portion of the patient's coronary organs according to its positioning with regard to said organs, positioning means to set said contacting means in a given substantially stable spatial position and orientation within a given volume, said contacting means being pivotally connected to a sternum retractor via said positioning means. The surgical apparatus according to the invention allows to perform coronary artery revascularization without the need for extra-corporeal circulation.

Abstract: A shape-memory alloy coupling system for connecting two or more members and selectively preventing premature locking. The coupling system includes a coupling device adapted for connection to a member and being at least partially formed of a shape-memory material. The coupling device has a first configuration that allows relative movement between the member and the coupling device, and a second configuration that limits relative movement between the member and the coupling device. A blocking element co-acts with the coupling device to selectively prevent the coupling device from assuming the second configuration.

Abstract: An implant-type chemical supply device includes: a supply tube for supplying chemicals from a chemical tank; a pump unit having an actuating lever which is rotated by a step motor and has rollers on both ends thereof so that the rollers are arranged in contact with the halfway of the supply tube, for extruding the chemicals within the supply tube by the rollers to supply the chemicals; a waveform synthesizing circuit for producing drive pulse groups each having a different effective power; a drive circuit for supplying any one of the drive pulse groups to the step motor in synchronism with a time signal; a detection circuit for generating a non-rotation signal when an induced voltage developed in the drive coil within the step motor by free oscillations of the step motor is equal to or less than a given value after the drive pulse is supplied to the step motor; and a control circuit for controlling the drive circuit so that the drive pulse having an effective power larger by one in magnitude than that of the

Abstract: Bone anchor implantation devices and methods for their use are disclosed. The bone anchor implantation devices and methods find particular application in maintaining or improving urinary continence by suspending or stabilizing the bladder neck. Protective sheaths for covering a bone anchor on a bone anchor implantation device are disclosed. The protective sheaths protect the bone anchor from contacting tissue during insertion and prevent contamination of the bone anchor.

Abstract: A process of injecting a thermoplastic material (20) within an annulus fibrosus of a selected intervertebral disk. The thermoplastic material (20) is heated by an injection device to a predetermined high temperature to provide flow of the thermoplastic material from a needle into the annulus fibrosus of the disk upon injection. After injection, the thermoplastic material is cooled by the body temperature of the patient for setting of the thermoplastic material in a non-flowing state while retaining a suitable resilience to provide desired cushioning. The thermoplastic material (20) may also be injected into an abnormal curvature of the spine to correct the abnormal curvature. The preferred thermoplastic material is gutta percha or a gutta percha compound.

Abstract: In a surgical instrument for the mechanical removal of bone cement (2), comprising a longitudinal housing (4) with a cylinder (6) in which a piston element can be reciprocated by a drive means (14), wherein the piston element on the distal end (18) of the cylinder (6) exerts an impact on a chisel tool supported axially in the housing (4), it is provided that the piston element (10) comprises a projectile (10) adapted to be accelerated to a high final speed and inducing a shock wave into the chisel tool comprising a metallic shock wave transmission probe (22), the probe tip (26) of the chisel tool transmitting the shock wave to the bone cement (2) at a low movement amplitude of the probe tip (26).

Abstract: The artificial blood vessel A comprises a front end wire ring 101, a rear end wire ring 102 arranged facing to the front end wire ring 101, a tubular cover 7 which connects the end wire rings 101, 102, and a plurality of intermediate wire rings 12 arranged spaced apart from each other between the front end wire ring 101 and the rear end wire ring 102. Each of the front end wire ring 101, the rear end wire ring 102 and the intermediate wire rings 12 are given flexibly foldable elasticity. The circumference of the front end wire ring 101 is equally divided into four by dividing points 411, 421, 431, 441. Hooking means 13 are formed for a front pull string to be passed through at the dividing points 411, 431.

Abstract: An apparatus for bracing a plurality of vertebrae of the human spine has at least two pedicle screws, each having an annular head with an opening therewithin and including a slot therewithin. Each slot extends into the corresponding opening and includes internal threaded portions. A securing screw to be screwed in each slot is provided. A relatively stiff threaded rod is also provided and is to be inserted into the opening in the head of each of the pedicle screws and to be secured by the securing screws. Adjusting nuts are screwed on the rod and at least one cooperates with each head.

Abstract: An anterior cervical plate is disclosed, along with threaded fasteners for securing the plate to vertebrae or other osseous material. The cervical plate has several pockets or apertures, preferably at least four, to receive a corresponding number of the fasteners. The pockets have spherical surfaces, and the fasteners have heads with similarly sized spherical surfaces, which when engaged permit each of the fasteners to be oriented at a variety of projection angles with respect to the plate. In connection with each pocket, the cervical plate incorporates a fastener retaining feature. The feature can take the form of a cantilevered tab or a beam supported at its opposite ends, in each case plastically deformable between an open position for admitting the fastener and a closed position for preventing retraction.

Abstract: The invention provides a cutter head that reduces the cutting force and number of reamers required by increasing the depth of cut or cutting length. The cutting head uses at least one tooth placed along the length of flutes formed within the body of the cutting head. The grooves forming the flutes can follow a first helical path along the body length, maintaining a substantially constant path over a major portion of the entire length in relation to the axes or, alternatively, have a constantly changing path. A second pattern can follow a second, contiguous helical path that has a second radial orientation to the axis. The teeth can be formed from a sinusoidal wave form comprised of a continuous radius going from convex to concave, with each of the teeth having a predetermined pitch from the crest to the base. In another embodiment the crest of the teeth on the first flute is offset axially by a predetermined distance from the teeth on the adjacent flutes.

Abstract: An orthopaedic instrument for comparing post-surgical joint geometry to pre-surgical joint geometry. The instrument has a head chuck which can be secured to the ball of a ball joint, and an arm having reference indicia thereon. Markings indicative of the pre-surgical joint geometry are made on the bone with reference to the center of the ball. After replacement with a prosthetic ball, the post-operative geometry is verified by securing the head chuck to the prosthetic ball, and comparing the location of the bone markings against the reference indicia on the arm. As needed, adjustments are made in the prosthetic components.

Abstract: An apparatus and method for the therapeutic treatment of an elongated protruding body part. An inner liner and an outer liner, joined together at a proximate end form a cavity there between which is filled with a thermal reservoir material. The inner liner and outer liner are permanently sealed together and shaped to accommodate the body part which is to be thermally treated. The method includes chilling or heating the body part by chilling or heating the apparatus prior to placement over the body part. Preferred embodiments include a sterile inner pocket protected by a removable seal element and self-adhesive straps to secure the device more firmly in place.

Abstract: A retractor (101) for retracting the margins of a wound opening (103) comprises an inner anchoring O-ring (105) attached to a cylindrical sleeve (106) at a distal end and a reinforcing O-ring (109) attached to a proximal end of the sleeve (106). The sleeve (106) is led between an inner ring part (110) and a corresponding recess (116) in an outer ring part (111). The outer ring part (111) has anchor formations (120) over which the proximal end of the sleeve (106) is attached to anchor the sleeve (106). To retract the wound opening (103) the sleeve (106) is pulled while the guide rings (110, 111) are moved against the tissue surrounding the wound opening (103). This pulls the inner O-ring (105) against the inside of the tissue adjacent the wound opening (103), and retracts the wound opening (103). The sleeve (106) is manipulated locally for maximum retraction efficiency.