Abstract: Bone screws have heads which are provided with a hex socket as well as a threaded portion. A screw driver system includes a hex driver and a threaded driver. The screw driver system permits driving the screw through a plate system into a bone until desired compression is obtained. Then the screw is locked to the plate while maintaining the imparted compression.

Abstract: Bone screws have heads which are provided with a hex socket as well as a threaded portion. A screw driver system includes a hex driver and a threaded driver. The screw driver system permits driving the screw through a plate system into a bone until desired compression is obtained. Then the screw is locked to the plate while maintaining the imparted compression.

Abstract: A fixation system (10) includes a device having a nail portion (12) and a plate portion (14), preferably horizontally and vertically offset relative to the nail portion by a neck portion (16). The nail portion (12) includes preferably threaded screw holes (24, 26), and the plate portion (14) includes longitudinally displaced peg holes (50, 52, 54), each of which is adapted to orient a peg (56, 58, 60) in a different orientation from the others. The system (10) also includes unicortical screws (28) having a reasonably large head (36) adapted to seat against the outer surface of the bone and a threaded shaft (32) adapted to engage in the screw holes (24, 26), and pegs (56, 58, 60) adapted to engage in the peg holes (50, 52, 54). Where threaded screw holes (24, 26) are used, bone is clamped between the nail portion (12) and the head (36) of the unicortical screws (28, 30). The pegs (56, 58, 60) provide stabilization and support for subchondral fragments.

Abstract: The system includes a plate with a screw hole and a bone screw wherein the screw and plate cooperate such that the screw is inhibited from back out from the plate after inserted into bone. Described embodiments include a pawl, with and without ratchet, an interfering clip about the screw head, and a snap-fit engagement between the screw and screw hole. The screw hole is preferably provided with openings at at least one of two diametric sides which provide dynamic compression functionality and access under the screw for an instrument to facilitate screw release.

Abstract: A fracture fixation system includes a device with a plate portion intended to be positioned against an exterior surface of bone and an intramedullary portion. The plate portion includes a plurality of fixed angle holes defining a respective number of axes which are divergent. Fasteners coupled within the fixed angle holes extend to follow the contour of subchondral bone and provide a framework for support for fracture healing.

Abstract: A device for holding a blood vessel (and corresponding method of operation) includes a mandrel having a proximal end opposite a distal end. A tube houses a portion of the mandrel. A tip assembly, which is operably coupled to the distal end of the mandrel, comprises a sheath having a tapered portion and a cylindrical portion. The sheath is adapted to be inserted into a lumen of a blood vessel such that an end of the blood vessel is supported by the tapered portion. The elastic nature of the blood vessel holds the end of the blood vessel in place with respect to the tip assembly. The tapered portion includes an exterior surface with a plurality of needle-guide-grooves that extend along such exterior surface. A needle is driven through the blood vessel while being guided by a needle-guide groove such that the needle is driven through the blood vessel near the end of the blood vessel.

Abstract: A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also adapted to be deployed into an open configuration and then manipulated by actuation of a proximal control and actuation handle into a selected orientation.

Abstract: A port device includes a tubular body sized to be inserted through a pair of ribs in a chest wall of a patient, a ball provided about the body, and a base defining a socket in which the ball is provided. Detent structure permits but limits longitudinal movement of the body relative to the ball. The base includes a clamping system which compresses the ball to lock the ball at a selected orientation within the socket and also immobilizes the port body relative to the ball. The distal end of the body includes a pair of swivels rotatably attached thereto. An obturator is extendable within the body maneuvers the swivels between a closed position (in which the swivels are oriented substantially parallel to the axis of the body), and an open position (in which the swivels are directed outward from the port).

Abstract: An instrument stabilizer minimizes unwanted motion at the distal end of a surgical instrument by applying a damping force to the instrument. According to one embodiment, the instrument stabilizer preferably includes a cannula through which an instrument can extend, and a distal bushing adapted to contact the instrument. The instrument stabilizer also includes a proximal housing which includes a mechanism which applies a stabilizing or damping force to the proximal portion of the cannula. The mechanism which applies the force may be, by way of example, one or more of elastic bands, springs, struts, etc. When a surgical instrument is extended through the cannula and contacts the bushing, movement of the cannula and consequently the surgical instrument is damped by the stabilization force on the proximal portion of the cannula. In addition, a swivel device for angularly orienting the instrument stabilizer relative to a body of patient is also provided.

Abstract: A system for performing through port off-pump coronary artery bypass surgery includes a port insertable between ribs into a chest wall of a patient, a heart stabilizer extendable through and stably couplable to the port, and an instrument stabilizer adapted to dampen extraneous movement to which a surgical instrument extending through the stabilizer is subject.

Abstract: A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.

Abstract: A port device is insertable between the ribs of a patient and functions as an entryway for surgical instruments. The port device includes a tubular body having proximal and distal portions. The distal portion of the tubular body is coupled to a swivel adapted to be moved between a first orientation in which the swivel extends in substantially a same direction as the body, and a second orientation at an angle relative to, and preferably substantially perpendicular to, the first orientation. In the second orientation, the swivel engages the inside of the chest wall. The proximal portion of the tubular body has a clamping assembly which clamps the chest wall against the swivels to secure the port in its location. The port body can be anchored in a various angular positions.

Abstract: A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to provide a stabilized area sufficiently large to allow an accurate anastomosis to be performed. According to preferred aspects of the invention, the stabilizer is particularly adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also preferably adapted to be automatically deployed into its final configuration by release of a lock actuated at a proximal portion of stabilizer extending outside the port. In addition, the stabilizer is adapted to automatically fold when being pulled back through the port.

Abstract: A port device includes tubular body with a distal swivel, a platform movable along the length of the port body, and preferably three legs movable relative to the platform. The tubular body is inserted through the chest wall, and the platform is then positioned over the proximal end of the tubular body and adjusted such that feet on the legs contact the chest wall and clamp the chest wall between the feet and the swivel. The legs may be individually adjusted to provide the tubular body at a desired angle relative to the chest wall. According to preferred aspects of the port device, the platform may be ratcheted relative to the port body and the feet may be ratcheted relative to the platform to permit rapid adjustment of the port relative to the patient.