Abstract: A vaginal lateral walls retractor for use with a vaginal speculum to retract the vaginal lateral walls during vaginal/cervical examinations includes a generally tubular sleeve having cross-sectional dimensions that allow the sleeve to fit in between blades of the speculum while the blades are inserted and opened within a vagina. The sleeve retracts the vaginal lateral walls that have pushed in under the inserted and opened speculum blades. The cross-sectional dimension also provides an inside working area for examination and sampling of the vagina and cervix area.

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 are currently implanted in patients to treat pain and other conditions including incontinence by delivering stimulants to the nervous system. Surgical methods are improved for implanting the devices. The soft tissues of the body are dilated above the site of device implantation, for example, above the sacrum, to create an annulus of dilated soft tissues. The tissues are dilated by introducing into the soft tissue sequentially larger cannulated dilating devices. A tubular retractor is then passed over the largest introduced dilating device and at least a number of the dilating devices are retracted. This establishes a tubular device insertion corridor through the dilated soft tissues to the site of implantation, for example, the foramen of the sacrum. The device to be implanted, such as an electrical lead, is then inserted through the corridor. The device is tested in situ. Finally, such other method steps are performed, including closing the corridor, as implantation requires.

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.

Abstract: The present invention is directed to a new and useful device and method for stabilizing cardiac tissue at a surgical site during heart surgery, and specifically useful during beating heart surgery. The device includes a foot for contacting a heart tissue and two arms movably connected together for selective movement to vary and adjust the position of the foot on the heart. The foot and the arm assembly are designed to optimize stability of the foot in contact with heart tissue, and therefore, to optimize stability of the heart during surgical procedure. The device is capable of being mounted on a chest spreader. The foot has a bottom surface which is angled for better stabilization and engagement with the heart.

Abstract: A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired. A special suction cup is used which accommodates multiplanar movement of the heart and the myocardium while also preventing heart tissue from interrupting the suction being applied to the heart. One form of the system can be used in minimally invasive surgery.

Abstract: A system for manipulating a heart during cardiac surgery 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 system for manipulating a heart during cardiac surgery of the present invention. The system is an improvement on the retractor disclosed in parent application Ser. No. 08/936,184 filed on Sep. 17, 1997 and locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired.

Abstract: A swinger clamp is clamped onto a horizontal guide rail and supports a vertical bar to hold various devices during surgical procedures. The clamp has a damper jaw that abuts a rim. To prevent the rim from drifting in its rotational position relative to the clamping jaw, a groove is formed in the rim to engage with the damper jaw.

Abstract: A tissue compression shield can help minimize trauma to tissue during surgical retraction. One such shield has a shell having a rigid outer surface adapted to abut a surgical retractor and a concave inner surface defining an elongate tissue-receiving channel. The concave inner surface is adapted to deform under localized pressure to increase surface area in contact with tissue within the channel, thereby more widely distributing pressure across the tissue. If so desired, the shield can include a compressible inner pad that contacts the tissue. In an alternative design, a shield employs a shell including a central body and a pair of opposed legs defining therebetween an elongate tissue-receiving channel. An upper one of the legs has a notch along an outer edge thereof which defines a bone-seating recess which is smaller than the tissue-receiving channel.

Abstract: A surgical instrument includes a frame structure defining proximal and distal portions. The proximal portion has an articulating arm for repositionably mounting to a base and the distal portion supporting a stabilizing member. An attachment mounts on the stabilizing member, the attachment being configured and dimensioned such that upon contact with the heart the engaged heart tissue bulges outward. A method of surgery using the attachment includes providing a frame structure defining proximal and distal portions, the proximal portion being repositionably mountable to a base, supporting an attachment on the stabilizng member and engaging heart tissue with the attachment such that the tissue bulges outward to better present the tissue for surgery.

Abstract: The invention provides devices and methods for endoscopically cannulating the aorta, right atrium, and other body tissues to establish cardiopulmonary bypass for minimally invasive coronary artery bypass grafting surgery, and for other surgeries. After inserting the suction support through a minimal access port, the suction support having an arcuate member with suction ports provides countertraction to the aorta by creating a vacuum seal between its suction ports and the aorta, therefore facilitating aortic incision and cannulation. In one embodiment, the suction support allows aorta stabilization, incision, and insertion with an introducer to be achieved sequentially. Methods for using the devices herein are also disclosed.

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision.

Abstract: An instrument for operating on anatomical tissue includes a barrel having at least one shaft. An end is offset from the shaft. In an insertion position, the end effector is confined within the diametrical dimension of the barrel at a distal end thereof. After insertion, the end effector can be manipulated to extend beyond the diametrical dimension of the barrel to provide a large working span in which tissue can be manipulated.

Abstract: Disclosed is a device for isolating a cardiac surgical site. The device includes a first finger having a clinging accessory for attaching the first finger to a heart, a second finger having a clinging accessory for attaching the second finger to the heart, a first joint disposed on the first finger so that the first finger may rotate on a surface of the heart such that the rotation stretches a surgical site, a first stopper disposed on the first finger for preventing undesired rotation of the first finger to isolate the surgical site, and a link for coupling the first finger to the second finger. Also disclosed is a method of isolating a cardiac surgical site. The method includes the steps of disposing a first finger on a heart, clinging the first finger to the heart surface, disposing a second finger on a heart, clinging the second finger to the heart surface, and then rotating the first finger for achieving selective isolation of the heart surface.

Abstract: A surgical apparatus is described for performing cardiac surgery on the coronary organs of a patient. It has a contacting means capable of providing a mechanical load on at least a portion of said coronary organ, a positioning means which allows the setting of either or both the contacting means and coronary organ in a large number of positions or orientations within a surgical workspace. The apparatus also has a manipulation means serving as a single point control to position and orient the contacting means onto the coronary organ tissue. An adjustment means serves to bias the range of at least one motion degree of freedom of the surgical apparatus within a the limits of a restricted range that is less than the full range of motion of that degree of freedom of motion that would be otherwise achievable when the bias is not present or overridden.

Abstract: Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

Abstract: Methods and apparatus are described to manipulate the position of the heart to provide surgical access to lateral and posterior portions of the heart. A jack apparatus connected to a surgical retractor can be positioned in the surgical cavity to produce a sideways force on the heart. A tripod apparatus can be used to hold up the heart into a desired position. A band can be attached to the heart to rotate its position. Fingers attached to the bottom of a blade on a surgical retractor can be used to manipulate the heart's position.

Abstract: Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

Abstract: In accordance with the present invention there is provided a device for stabilizing and/or manipulating moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissues. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube is operatively connected to a suction source so as to draw air through the tube from the distal end to the proximal end. The device further includes at least one foot operatively connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue. The distal surface of each foot has an outer perimeter having a substantially spherical profile. This spherical profile helps the device make better contact with the tissue, so the tissue can be more effectively manipulated.

Abstract: A surgical retractor comprising a base adapted to lie on the patient's skin, a handle slidably mounted with respect to the base, a tissue retracting blade extending from the handle, and a locking member movable from at least a first position to a second position to retain the tissue retracting blade in a selected position. A light guide illuminates the surgical site during use. An angle adapter can be mounted to the base to increase the angle of the tissue retracting blade with respect to the tissue. A method for accessing the saphenous vein to facilitate harvesting the vein is also disclosed comprising the steps of making a small incision in the leg of a patient, positioning a retractor on a patient's leg such that a retractor blade extends into the incision and a base lies on the surface of the patient's leg and pulling the retractor blade away from the patient to lift the tissue away from the underlying saphenous vein.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool.

Abstract: The present invention is directed to a device and methods for immobilizing a localized region of a compliant body. A device of the invention includes at least two arms, an elbow region between the arms, and a suction arrangement. During use the region of the compliant material to be immobilized is flanked by the arms and a negative pressure is applied through the suction arrangement to immobilize the flanked region. The device of the invention is suited for use in medical applications, for example, coronary bypass graft surgery.

Abstract: The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration.

Abstract: This invention describes methods and devices for stabilizing and retracting tissue during surgery, in particular internal tissue. Patches of material, preferably biodegradable, are adhered to tissue surfaces. By manipulation of the patches, for example directly with forceps, or via sutures attached to the patches, tissues can be retracted or otherwise manipulated with minimal trauma to the tissues. The method is especially useful in minimally-invasive surgery.

Abstract: An expandable multifunctional instrument for creating a space at an obstructed site in the body includes an elongate member having a distal end for being introduced in the body, a proximal end for being disposed externally of the body and an expandable member for being positioned at the obstructed site. The expandable member is movable at the obstructed site from a non-expanded position to an expanded position to displace anatomical tissue to create a space at the obstructed site for performing various operative procedures. A method of creating a space at an obstructed site includes expanding an expandable member at the obstructed site and/or introducing fluid under pressure at the obstructed site to create a space where normally no space exists.

Abstract: An apparatus and method of use is provided for locally stabilizing an anastomotic site during a beating heart surgical procedure which includes occluding a section of the artery receiving the bypass graft vessel. An apparatus is provided to stabilize the epicardium and the operational field, and includes a platform that can be compressed onto the epicardium or tensioned by pulling the epicardium upwardly, thereby providing a stabilized operational field. At least one occluding member provides means to occlude the section of artery receiving the bypass graft vessel. An adjustable stabilizing arm can be used in conjunction with the platform to further provide stability to the epicardium during the beating heart bypass graft procedure.

Abstract: In accordance with the present invention, there is provided a lifting apparatus for pivoting a surgical retractor with respect to a patient it is being used on. The lifting apparatus has a bridge for engaging at least one arm of a surgical retractor. The bridge has a distal end, a proximal end and a longitudinal axis extending therebetween. The bridge further includes a distal coupling attached to the distal end of the bridge for releaseably attaching the bridge to the surgical retractor. The lifting apparatus further comprises an elevator. The elevator is for applying an upward force to the proximal end of the bridge, so that when the apparatus is attached to a surgical retractor, the elevator pivots the retractor upward about the distal coupling. The elevator includes a bridge coupling for attaching to the proximal end of the bridge. A resilient pad is releaseably attached to the base of the lifting assembly and is positioned between the base and the chest of the patient.

Abstract: A mounting assembly for mounting a surgical instrument to a base, which facilitates positioning a surgical instrument relative to the surgical site so that only the minimum portion of the instrument is positioned in the free space available around the surgical site. A surgical instrument is also provided which includes a handle, a tool member, and a segmented flexible articulating arm which operatively connects the handle and the tool member. Also provided is an instrumentation kit having a surgical instrument which includes an end effector connecting assembly disposed at the distal end portion of an articulating arm to facilitate the removal or attachment of and end effector from the distal end of the articulating arm. The surgical instrumentation kit also includes a number of interchangeable surgical tool end effectors each having a uniform connector portion for interchangeable engagement with the end effector connecting assembly of the surgical instrument.

Abstract: An apparatus for stabilizing a predetermined area on a heart of a patient to enable a surgical procedure, the apparatus comprising a bifurcated member having two elongated prongs and an elongated handle segment attached to the bifurcated member. Selected portions of the apparatus can be constructed from a memory metal alloy, such as nitinol, to allow the surgeon to adapt the apparatus to a particular surgical procedure. The bifurcated member can be either fixably or pivotally attached to the handle segment. The apparatus may further comprise an attachment or inlay to prevent lateral movement thereof when being used in the surgical procedure. The apparatus may additionally include a cleat for securing a portion of the surgical thread used during the surgical process. Another aspect of the present invention is a member slidably attached to a portion of the handle segment that is movable between a position compressing an artery to reduce or stop blood flow and a position spaced apart from the artery.

Abstract: The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, 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 is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes only minimal excess motion at the surgery site.

Abstract: A vacuum-actuated tissue-lifting device and method for performing a surgical procedure in an operative space of a patient are disclosed. The preferred device has a shell with a profile configured to surround a tissue surface of the patient, a vacuum port located on the shell for applying a vacuum between the shell and the tissue surface, and an air conduit extending through the shell to permit air to pass into the operative space of the patient when vacuum is applied. In a preferred embodiment, the device has an entry port located on the shell and a perforable membrane located on the entry port to provide a seal when a surgical instrument is inserted through the membrane during the procedure. The device and method of the invention eliminate the need for carbon dioxide insufflation, mechanical lifting devices which create obstructions and high stress zones on tissues within the operative space created, and unwanted displacement of internal organs when the targeted tissue surface is lifted.

Abstract: A method and apparatus for dissecting a first layer of tissue from a second layer of tissue and thereafter holding open an anatomic space for the performance of a surgical procedure. The method includes steps of making an incision in a body, introducing a deflated balloon dissector into the incision, inflating the balloon dissector to effect dissection of the first layer of tissue from the second layer of tissue, deploying a retractor within the anatomic space in order to hold open the anatomic space, and optionally deflating or evacuating the balloon dissector to open a cavity for surgical manipulations. The apparatus includes a combined dissector-retractor having a balloon retractor disposed upon the surface of the balloon dissector and integrated therewith.

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: The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration.

Abstract: A method is described for stabilizing moving tissue within the body. The method comprises creating a first opening for primary surgical access into the body, and a second opening spaced apart from the first opening in the body. An elongated stem having a proximal end and a distal end is inserted into the second opening. A foot having an upper and a lower surface is inserted into the first opening. The lower surface of the foot is engaged with the moving tissue within the body. The distal end of the stem is releaseably attached to the foot. The proximal end of the stem may be held so as to stabilize the moving tissue within the body.

Abstract: In accordance with the present invention there is provided a device for stabilizing moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissue. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube has a flexible hose extending through the lumen of the tube between its distal and proximal ends. The hose having a proximal end connected to a suction source so as to draw air through the tube from its distal end to its proximal end. The tube is made up of a plurality of segments which are detachable from one another. The device further includes at least one foot connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue.

Abstract: The invention provides devices and methods for endoscopically cannulating the aorta, right atrium, and other body tissues to establish cardiopulmonary bypass for minimally invasive coronary artery bypass grafting surgery, and for other surgeries. After inserting the suction support through a minimal access port, the suction support having an arcuate member with suction ports provides countertraction to the aorta by creating a vacuum seal between its suction ports and the aorta, therefore facilitating aortic incision and cannulation. In one embodiment, the suction support allows aorta stabilization, incision, and insertion with an introducer to be achieved sequentially. Methods for using the devices herein are also disclosed.

Abstract: In accordance with the present invention there is provided a device for stabilizing moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissue. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube is connected to a suction source so as to draw air through the tube from the distal end to the proximal end. The device further includes at least one foot connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue. In one preferred embodiment the device includes a filter on said distal surface of each foot whereby particulate material is substantially prevented from entering said lumen of said tube.

Abstract: A method for manipulating a tissue structure within a body cavity provides for retracting and supporting the heart wall to provide access into the heart during a cardiac surgical procedure. In one embodiment of the present invention, a surgical tool support apparatus comprises a base having an atraumatic tissue-engaging surface and an aperture for receiving an elongate tool. The apparatus also has a clamp assembly aligned with the aperture and spaced-apart from a surface of the base opposite to the tissue-engaging surface. The apparatus is particularly useful in maintaining a retracting force on a surgical tool used to manipulate tissue within a body cavity such as the thoracic cavity.

Abstract: A surgical instrument includes a frame structure defining proximal and distal portions. The proximal portion has an articulating arm for repositionably mounting to a base and the distal portion supporting a stabilizing member. An attachment mounts on the stabilizing member, the attachment being configured and dimensioned such that upon contact with the heart the engaged heart tissue bulges outward. A method of surgery using the attachment includes providing a frame structure defining proximal and distal portions, the proximal portion being repositionably mountable to a base, supporting an attachment on the stabilizing member and engaging heart tissue with the attachment such that the tissue bulges outward to better present the tissue for surgery.

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 support pads interconnected to a blade. A torsional member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor interconnected to the blades and is used to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: A retractor for use in various types of surgical procedures such as harvesting mammary arteries, coronary bypass surgery, heart valve repairs, mitral valve replacement, partial sternotomies, and other types of surgery includes a toothed crossbar to which a pair of small grips are attached. The first grip is attached to an arm which is removably connected to a first block. The first block is movable along the crossbar, thereby permitting the first grip to be moved toward or away from the second grip. The second grip is attached to an arm which is removably connected to a second block. The second block can be fixed or movably connected to the crossbar. The crossbar includes a hinge that enables the grips to be pivoted relative to each other. Pivoting is accomplished by a pair of vertically extending brackets that are connected to the blocks and which are connected to each other by an adjustable connector.

Abstract: The sliding hook assembly has an integrally formed handle body encapsulating a hook member which can be used to engage a physical restraint in the surgical field in the absence of the use of a slotted surgical retractor frame. The sliding hook assembly further includes an opening with a notch for receiving and securing the elastic member of a surgical retractor stay.

Abstract: An apparatus and method of use is provided for locally stabilizing an anastomotic site during a beating heart surgical procedure which includes occluding a section of the artery receiving the bypass graft vessel. An apparatus is provided to stabilize the epicardium and the operational field, and includes a platform that can be compressed onto the epicardium or tensioned by pulling the epicardium upwardly, thereby providing a stabilized operational field. At least one occluding member provides means to occlude the section of artery receiving the bypass graft vessel. An adjustable stabilizing arm can be used in conjunction with the platform to further provide stability to the epicardium during the beating heart bypass graft procedure.

Abstract: A surgical tool of the type used with a trocar expands the diameter of a puncture opening made in a body cavity so that a linear incision is not needed in certain surgical procedures. An elongate base member of cylindrical construction is divided into a plurality of parts by cuts that extend the longitudinal extent of the base member in circumferentially spaced relation to one another and the parts are bound together and held into a solid cylindrical configuration by a plurality of longitudinally spaced apart bias members such as rubber bands. A plunger has an elongate leading end that drives the base member parts in a radially outward direction, increasing the diameter of the puncture opening, when it is inserted into the base member. The bias members restore the parts of the base member to their position of repose when the leading end of the plunger is withdrawn from the base member.

Abstract: A hand formable rod, band or sheet, consisting of a plurality of elements which are linked together in such a way that the whole can be either very flexible, or semi-rigid, or rigid. In the band, the elements have six degrees of freedom, providing unusual flexibility. This fabrication may be hand formed to a desired shape and then rigidified to a substantial stiffness. In the rigid state, this fabrication is strong enough to retract living tissue, and to perform as a mold, template, or fixator. The rigidity may be varied in very small increments by using a screw or screws acting upon tensioning cables. Tension causes increased friction between sliding surfaces. This friction creates stiffness and strength. Bending the fabrication does not cause material fatigue.

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 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 surgical retracting device includes a body, at least one pivotable finger, and an actuating assembly that moves the finger between open and closed positions. The body defines a passageway and openings that allow suctioning and irrigating through the device. In addition, the device includes a cauterizing assembly for cauterizing tissue of a patient.

Abstract: A splint or overtube device for use in keeping the sigmoid colon in a straightened position during endoscopy to facilitate advancement of the colonoscope or other types of medical endoscopes to the cecum. The present device utilizes an elongated member having a tight distal end or seal to close off the annular space between the endoscope and the elongated member at the distal end of the splint to prevent perforation of the colon. A hydrophilic lubricating substance can be utilized to minimize friction between the tight distal end or seal and the splint. An injection port is provided to allow the endoscope operator to inject fluid to lubricate the distal end or seal, to deflect away the colonic wall in advance of the splint and to remotely lubricate the scope distally. A second sealing member can be utilized at the proximal end of the splint to prevent loss of fluids from the splint.

Abstract: A surgical instrument includes a proximal actuation handle and a flexible guiding catheter having a channeling lumen, a suction lumen, and a control lumen. The guiding catheter has a slit opening into the control lumen at its distal end. A hollow cutting member extends through the channeling lumen and is moveable distally relative to the guiding catheter with a cutting actuation mechanism. The cutting member is preferably a section of thin walled hypodermic tubing having a sharpened distal end and is provided with a first proximal connector for coupling the cutting member to a first pressure regulator. A flexible control wire extends through the control lumen and is movable distally and rotatably relative to the guiding catheter with a control actuation mechanism. The control wire is sufficiently flexible to buckle with each contraction of the heart and has a foot at its distal end located beyond the distal end of the guiding catheter and movable relative thereto by movement of the control wire.