Abstract: A surgical apparatus includes a seal anchor member. The seal anchor member includes a leading end, a trailing end, and at least one longitudinal port extending between the two ends. The at least one longitudinal port is dimensioned for reception of a surgical object. One end of the at least one longitudinal port is closed by a membrane, which can be pierced through by a sharp-pointed device. The at least one longitudinal port further includes at least one lip therein. The at least one lip is configured to establish a substantially sealed relation with the surgical object entered therethrough, thereby inhibiting the loss of insufflation gas between the at least one longitudinal port and the surgical object.

Abstract: An instrument for spinal surgery for retracting soft tissue and mounting between a superior spinous process and an inferior spinous process includes a relatively rigid frame, a first retractor blade mounted to the frame and a distractor element movably mounted to the frame. The distractor element has a body, a proximal end and a distal end. The distractor element has a thickness and a length. The distractor element is configured for mounting between the superior and inferior spinous processes in a working configuration. The distractor element is generally tapered at the distal end in an insertion configuration. The instrument also includes an insertion shaft attached to the proximal end and a first shaft joint mounted between the frame and the insertion shaft.

Abstract: A tool introducer is configured for introduction in an elongated body including a straight tube, wherein the tube encloses a tube lumen opened at its distal end with a tube opening. The tool introducer includes locking means to selectively lock or unlock an interchangeable surgical tool to the tube from displacing axially and/or rotationally in the tube lumen, the locking means being configured such that, at the locking, a tool connector of the tool projects towards the tube opening and is distanced therefrom by at least 3 cm. A method includes positioning the surgical tool introducer such that a distal portion thereof projects in a body cavity, manipulating and/or extending the tool introducer to reach and engage an elongated shaft introduced percutaneously into the body cavity; and inserting the elongated shaft into the tube lumen via the tube opening and connecting the tool to the elongated shaft.

Abstract: A surgical access device includes a seal assembly having a seal housing and a gimbal mount disposed within the seal housing, the seal housing defining a central longitudinal axis and having a longitudinal passage for receiving at least one surgical object therethrough and the gimbal mount adapted for angular movement relative to the central longitudinal axis. The seal assembly also includes a bellows configured to engage at least a portion of the gimbal mount, the bellows dimensioned and adapted to establish a biasing relationship with the gimbal mount, such that the bellows biases the gimbal mount to align with the central longitudinal axis of the seal housing. The bellows is configured to be attached to a proximal wall of the seal housing.

Abstract: In a pericardioscopic procedure, without providing an endoscope or surgical instrument with special space ensuring means and without unnecessarily dilating the pericardial space, a space necessary for operation of the endoscope or surgical instrument is ensured, so that maneuverability is improved while suppressing complications. Provided is a space ensuring device comprising: a pericardium pressing part for pressing a pericardium from the pericardial space side; a heart pressing part for pressing the surface of a heart from the pericardial space side; and an interconnecting part interconnecting the pericardium pressing part and the heart pressing part, wherein the interconnecting part generates the resilient force enabling expansion against a pressure applied by a pericardium and a heart so as to ensure a space between the pericardium pressing part and the heart pressing part.

Abstract: A method for laterally accessing a lumbosacral intervertebral disc space of a patient includes positioning the patient laterally and making an incision to provide lateral access to the patient's iliac crest. A bracket (24) may be placed on the iliac crest and a retractor (28) may be attached to the bracket such that a distal end of the retractor is positioned over the lumbosacral intervertebral disc space while a proximal end of the retractor provides an entry space for a surgeon to insert at least one tool (90). The surgeon may perform a surgical procedure on the lumbosacral intervertebral disc space through a channel (49) defined by the retractor.

Abstract: A method for creating a sequence of access channels to provide access for performing surgery on a lumbar spine; through positioning a patient to facilitate surgical access to the lumbar spine; docking a retractor device against a proximal surface of the psoas muscle and maintaining the pre-psoas access channel with the retractor device docked at the proximal surface of the psoas muscle. Making a direct visual inspection of the psoas muscle before splitting the psoas muscle to create and maintain a psoas access channel that extends from the pre-psoas access channel to the spine. Holding open the psoas access channel with a pair of retractor blades. After completing a surgical process on the spine removing the pair of retractor blades from the psoas access channel.

Abstract: Methods and devices are provided to allow for easy customization of a surgical access device by an end user. In one exemplary embodiment a surgical access device is provided that includes a plurality of elongate seal elements that are configured to form a sealed configuration between a surgical site and an outside environment. The seal elements can be disposed in a surgical opening and can mate directly to each other with the outermost seal elements mating directly to tissue of the opening. The seal elements can include one or more mating elements to provide the desired mating. The seal elements can also include sealable openings that are configured to receive surgical instruments for use at the surgical site. The sealable openings maintain the desired seal throughout the course of a surgical procedure. Exemplary methods for providing custom configurations on location are also provided.

Abstract: A fornix manipulator includes a collar and stabilizer. The collar has a first end and a second end, the second end having an opening and diameter greater than the first end and the first end having an opening to receive a cervix into the collar. The stabilizer has a base portion defining a guide hole and a plurality of prongs extending from the base portion to contact the first end of the collar.

Abstract: A retractor includes a handle portion, a blade portion coupled to the handle portion. The blade portion is configured for insertion into an internal region of a patient. The blade portion includes a first portion configured to manipulate tissue of the patient. In an embodiment, a locator element is configured to highlight an external region of the patient to indicate to a user the location of the first portion in the internal region. In an embodiment, a signal-transmission medium is coupled to the blade portion and has a port. An overmolded camera unit has a lens and is configured to couple with the port. When the camera unit is coupled with the port, the lens is oriented to capture images of the internal region.

Abstract: Systems and methods for using a trocar system are disclosed. The system generally includes a handle having a first end a second end, a trocar disposed adjacent the first end of the handle, a plurality of cannulas disposed on the trocar simultaneously, and a drive system. The drive system is disposed for forward movement of the cannulas in a longitudinal direction away from the first end of the handle.

Abstract: A surgical access device including a lower portion having a central opening spaced from a lower portion outer wall, an upper portion adjacent to the lower portion and having a central opening spaced from an upper portion outer wall, and at least one flange portion extending outwardly from the upper and lower portions. The device can further include a gap extending from the central openings of the lower and upper portions and through their outer walls.

Abstract: Embodiments include a method of performing a medical procedure in a patient. The method includes creating an incision in an abdominal wall of the patient, inserting a flexible guide tube into the incision, and advancing a flexible instrument through the guide tube. The method also includes positioning a distal tip of the guide tube adjacent to a gastroesophageal junction and passing the instrument through an esophageal hiatus.

Abstract: A surgical access system includes an access device having a tubular shape and a channel extending through the device that is sized to receive a surgical instrument. The outer surface of the device defines a support section and access section having an aperture extending through the wall of the device. The aperture has a wider distal portion and a narrower proximal portion and the surgical instrument may be inserted through the aperture. The access device simultaneously retracts soft tissue and distracts bone when inserted into the surgical site while allowing a surgeon access to the surgical site.

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. The retractor system provides versatility and control ensuring minimal tissue trauma.

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 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 posterior retractor is provided, including a handle section; and, a retraction section having an anchoring element. The handle section has 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. A use of the posterior retractor in a hip arthroplasty procedure is described.

Abstract: A surgical port feature may include a funnel portion, a tongue, a waist portion, and surgical instrument channels. The waist portion may be located between the funnel portion and the tongue. The surgical instrument channels may extend from the funnel portion through the waist portion. The surgical port feature may further include a second tongue, with the wait portion being located between the funnel portion, the tongue, and the second tongue.

Abstract: A surgical kit for operations on the spinal column includes a surgical instrument having a handle body, the handle body having a substantially flat portion blended with the body, wherein the substantially flat portion is shaped to urge the gauze for draining a wound.

Abstract: An instrument access device comprises first, second and third instrument seals for sealing around instruments extended through the device. The seals have respective connector sleeves. Each sleeve connects a base to one of the instrument seals. The device also comprises two insufflation/desufflation ports. Each of the ports comprises a connector extending from the base, a tube extending from the connector, a luer connector and a removable cap. The luer connector is used for connection to any suitable supply line for insufflation gas or for discharge if insufflation gas. In use, the insufflation/desufflation ports facilitate independent control of insufflation and desufflation as may be required during a surgical procedure. Access sleeve at the proximal end is cut-off, folded over the inner proximal ring and is held in place between the base and the inner proximal ring when the base is fitted.

Abstract: Surgical devices permitting a surgeon to access repeatedly tissue at a particular surgical site in a patient to perform multiple surgeries over time. The devices have two substantially planar and parallel leaves that are sterile, nonresorbable, and biocompatible. Each leaf forms a continuous structure and defines the entire longitudinal length of the device to accommodate the size and location of the surgical site. A base member is located in situ and adjacent the surgical site. An anchoring surface secures the device to the tissue of the patient at the surgical site. The leaves have a conjoined portion such that a manual force is required to separate the leaves, thereby expeditiously creating a pathway through which access to the tissue at the surgical site is realized with minimal tissue dissection, and the proximal ends of the leaves are not conjoined to facilitate separation of the leaves and creation of the pathway.

Abstract: The invention relates to a hand access laparoscopy device having a gelcap, a retainer, a sleeve and a retention ring. The gelcap includes gel that is bonded to a cap. The cap includes an inner cylindrical wall to which the gel in bonded, thereby providing a sealing area between the device and the wound in a body wall. By securing the gel to the inner cylindrical wall, the thickness of the gel and corresponding cap is minimized along with the overall footprint of the device. With the gel thickness reduced and able to be substantially flush, the “doming” phenomenon produced by insufflation of a patient's abdomen is reduced.

Abstract: An introducer includes a housing and a flexible seal. The housing includes a hub, a cap, and a lumen. The flexible seal is positioned across the lumen and retained between the hub and the cap. The seal includes a top surface and a bottom surface, a bottom slit formed in the bottom surface, and a top slit formed in the top surface. The top slit crosses the bottom slit. The seal member is biased by an interface between the hub and the cap to at least partially close the top slit and at least partially open the bottom slit.

Abstract: A laparoscopic seal assembly includes a seal cap having a seal with an access opening. The seal cap also includes a manifold connection for attachment of a functional apparatus. The seal assembly further includes a retractor. The functional apparatus may be a finger mounted tether or an insufflations passageway. The functional apparatus may be combined or provided separately.

Abstract: A surgical retractor includes an outer ring unit, a tubular retraction membrane made of a resilient material and including an inner surface defining a passageway, and a lighting unit. The tubular retraction membrane has an outer tubular end connected to the outer ring unit and rollable about the outer ring unit. The lighting unit is connected to an inner tubular end of the retraction membrane and includes a light-emitting ring, and a heat-dissipation ring in contact with the light-emitting ring.

Abstract: Tissue retraction devices and methods include a tissue retractor with a radiolucent portion to permit imaging through the radiolucent portion with X-ray, fluoroscopic or other suitable imaging system. The tissue retractor also includes one or more radio-opaque elements that define at least a portion of a perimeter of the radiolucent portion to provide an indication of the retractor location in the patient via the imaging system.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: Devices and methods are disclosed herein for accessing the hip joint. A first device can be securely attached to the capsule of a joint. The first device can tent the capsule to increase the volume of the peripheral compartment. A second device can be biased against the first device to pierce the tented capsule and create a portal. Devices and methods are also disclosed herein for distending the capsule of a joint. A distention device may access a portal established within the capsule. The distention device can expand the capsule by applying an expansive force within the peripheral compartment. The distention device can maintain distention of the peripheral compartment while other devices access the joint.

Abstract: A system and method for performing surgical procedures within a body cavity, e.g. abdomen, uses a magnetized device is utilized to allow a surgeon to control intra-abdominal organs and objects. The system and method allows a surgeon to perform an intra-abdominal procedure without the need to position surgical tools inside of the body cavity. Additional surgical ports are not necessary as the magnetized device allows the surgeon to retract or position various objects within the abdomen.

Abstract: A transparent surgical pelvic retractor includes a transparent, generally semicircular retractor body having a retractor interior; a concave inner surface facing the retractor interior; and a convex outer surface opposite the inner surface. A surgical retractor method is also disclosed.

Abstract: A surgical access assembly for positioning within an opening in tissue including an outer member positionable outside a patient and defining an opening therein to receive a surgical instrument. The outer member has a first portion and a second portion wherein at least one of the first and second portions is movable with respect to the other portion. The assembly also includes an inner member positionable within a patient and a flexible member extending between the inner member and outer member, wherein movement of one of the first and second portions of the outer member adjusts tension on the flexible member to retract tissue. A locking mechanism locks the outer member in a plurality of select expanded positions. The locking mechanism includes first engagement structure on the first portion engageable with the second portion and a slidable member movable to a locking position to retain the first and second portions in the select expanded position.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: The present invention provides a minimally-invasive portal system for performing lumbar decompression, instrumented fusion/stabilization, and the like. The minimally-invasive portal system utilizes an access tube having an adjustable cross-sectional area and one or more retractor devices each having a first portion and a second portion aligned at a predetermined angle relative to the first portion, wherein the first portion of each of the one or more retractor devices is disposed substantially concentrically with the access tube, and wherein the second portion of each of the one or more retractor devices protrudes substantially beyond a bottom portion of the access tube. The minimally-invasive portal system also utilizes a plurality of adjustment mechanisms for selectively adjusting the cross-sectional area of the access tube and one or more retaining clips for securing the one or more retractor devices to the access tube in a fixed position.

Abstract: A scaffold assembly includes an instrument pod and a plurality of actuable movers. The instrument pod may include one or more instruments operably coupled thereto. The instrument pod is inserted through a tissue tract into the body cavity. Each actuatable mover includes an insertion member extending therefrom therefrom for insertion within tissue. Each mover has one or more lines removably attachable to the instrument pod that are configured to move the instrument pod between different positions relative to each mover upon the actuation of one or more of the movers to move the instrument pod within the body cavity.

Abstract: Embodiments of the present invention provide a nastogastric tube for deflecting an esophagus during an ablation procedure. According to one embodiment, the nasogastric tube includes a flexible tube comprising at least one lumen having proximal and distal ends, and an esophageal deflector positioned within the at least one lumen and configured to be mechanically actuated to assume a curved profile so as to deflect a portion of the tube between the proximal and distal ends. The esophageal deflector is configured to deflect the portion of the tube proximate to a retrocardiac portion of the esophagus such that the retrocardiac portion of the esophagus is deflected away from an ablation site.

Abstract: Methods and devices are provided for performing surgical procedures using tissue retractors. In general, a surgical retractor device is provided that includes a flexible fabric tissue retractor configured to support tissue. At least one grasping element can be coupled to a perimeter of the flexible fabric, and the grasping elements can be manipulated to couple the flexible fabric to a surgical port, e.g., a trocar, inserted through a body wall and extending into a body cavity. The grasping element can also be configured to move the flexible fabric and thereby move the tissue.

Abstract: A surgical portal apparatus includes a portal housing, a portal sleeve, and a seal. The portal housing defines a central housing axis and a central housing channel. The portal sleeve extends from the portal housing and is dimensioned to pass through tissue to provide access to underlying tissue via a longitudinal opening. The central housing channel of the portal housing and the longitudinal opening of the portal sleeve define a passageway for reception and passage of a surgical object. The seal has inner surfaces defining a seal passage for establishing a general sealed relation about the surgical object. The seal passage is radially offset with respect to the central housing axis. The seal is adapted to rotate about the central housing axis to vary positioning of the seal passage to substantially maintain the substantial sealed relation upon manipulation of the surgical object within the portal housing.

Abstract: A Perineal elasticity meter having a circular central stem marked with millimeter markings and a sleeve portion surrounding the circular stem. Hinges connect the sleeve to expanders that extend from the circular stem. The perineal elasticity meter is configured to be inserted into the vagina of a patient in order to measure the elasticity of the perineal area. The sleeve includes an opening that shows a circumferential measurement achieved by the expansion of the expanders, as the sleeve moves along the central stem. Another perineal elasticity meter includes two stems connected via a hinge at a proximal portion of the stems. The proximal portions of the stems are configured to be inserted into the vagina of a patient and a measurement is taken of a distance between the expanded distal portion of the stems, thereby measuring the elasticity of the perineal area.

Abstract: The present invention provides a combination cannula positioned targeting guide adapted for angular receipt and support of a surgical instrument, the combination including an endoscopic portal having an enlarged membrane chamber having a rear port and an elongated portal cannula extending towards a portal tip, the rear port and the portal cannula being axially aligned; a portal stand extending from a substantially rectangular body towards an arcuate channel in communication with the enlarged membrane chamber; and the endoscopic portal being rotationally secured to the portal stand

Abstract: The Surgical Visual Field Enhancer is used to improve the visual field under a limited skin incision. It includes various parts to make the surgeon's work easier, such as the removable handle, the tunnel opening guide, the tunnel dilator, the lighting tool and the lighting transmitter. Initially, the user holds the surgical tool body of the surgical visual field enhancer and uses the tunnel opening end to create a tunnel through the soft tissue. The tunnel opening end is composed of the tunnel opening tip and the enlargement scalpel for tunnel enlargement. The distance marker and guard are used for depth estimation, in some cases, the tunnel opening guide can be inserted in the soft tissue to guide the tunnel creation. The tunnel dilator will follow the tunnel opening guide to create the tunnel to the operative site. When the tunnel has been created, the visual enhancer end is inserted to enhance the surgical visual field.

Abstract: A surgical instrument for positioning a sleeve is presented. The surgical instrument comprises a shaft, a handle connected to one end of the shaft, a sleeve holder connected to the opposite end of the shaft and defining a space in which the sleeve is to be positioned. The surgical instrument further comprises a locking element adapted to protrude into the space for engagement of the sleeve and a magnet adapted to force the locking element into the space by a magnetic force.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: A retractor assembly for defining a working channel to a surgical site for conducting minimally invasive spinal surgery includes a plurality of relatively articulable components. Temporary interconnections are formed between adjacent sidewalls of the components to hold the components in a desired configuration, such as in a closed triangular form. The components are articulable relative to each other for adjusting the working channel or for performing surgical functions.

Abstract: A new self-service surgical retractor with the characteristics comprising: main post (1), lock sleeve (7), lock operating lever (11), take-up device lock sleeve (15), take-up device (17) and hook plate (22). The lock sleeve (7) is covered on the lower part of the main post (1) to form a dovetail groove; the lock operating lever (11) is spun on the main post (1) through the thread; the take-up device lock sleeve (15) is spun on the upper part of the main post (1) and locks and fixes the inserted link (18) of the take-up device (17) on the upper end of the main post (1); the take-up device (17) is connected with the hook plate (22) through the retraction tape or rope (21). With simple structure and low cost, the present invention is easy to manufacture and use.

Abstract: A retracting eye drape assembly is disclosed for use around a patient's eye to seclude and seal off the operative field during eye surgery. The drape assembly includes a retraction member connected to the drape and configured to engage the patient's eyelid, an extension member connected to the retraction member or to the drape and configured to substantially enclose the patient's eyelid, and a retraction flap configured to secure the patient's eyelid in a substantially retracted position. A method of applying an eye drape assembly is disclosed. After application of the drape to the patient's face, and while the patient's eyelid is closed, the patient's eyelid is engaged by a retraction member connected to the drape and retracted. While retracted, the patient's eyelid is substantially enclosed to seclude the eyelid and eyelashes from the operational area. The secluded eyelid and eyelashes are then secured in a retracted position.

Abstract: A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity. The apparatus may include a seal anchor member comprising a compressible material. The seal anchor member may be adapted to transition between a first condition for insertion of at least a portion of the seal anchor member within a tissue tract and a second condition to facilitate a securing of the seal anchor member within a tissue tract and in substantial sealed relation with tissue surfaces defining a tissue tract. The seal anchor member may have proximal and distal ends and may define at least one port extending between the proximal and distal ends, the at least one port being adapted for the reception of an object whereby compressible material defining the at least one port is adapted to deform to establish a substantial sealed relation with the object. The at least one port may include an undercut to reduce the likelihood of leaks therethrough.