Abstract: Camera position indication systems and methods are disclosed herein for conveying a camera's position to a user and/or adjusting a camera view display to match a user's perspective during a surgical procedure. In one embodiment, an example method can include receiving an output view from a camera placed within a channel of an access device to view a surgical site within a patient, receiving an input of camera position from a user, and showing on a display the output view from the camera and an indication of camera position based on the input of camera position.

Abstract: A visualization tissue retractor includes a handle defining a proximal end portion and a distal end portion, a dock extending from the proximal end portion of the handle and configured to receive a portable display device, a retractor arm extending from the distal end portion of the handle and defining a guide track disposed along at least a portion of a length thereof, and a surgical camera assembly engaged with the guide track and configured to slide therealong.

Abstract: One or more embodiments provide medical tool grip mechanism to which multiple types of medical instruments can be attached. A grip mechanism grips an instrument. The instrument has a shaft extending in a longitudinal direction, a treatment tool arranged at a distal end of the shaft, and a treatment tool control portion that is arranged at a proximal end of the shaft and controls the treatment tool. The grip mechanism has a gripping portion. The gripping portion grips the treatment tool control portion such that the treatment tool control portion is rotatable about a rotational axis extending in the longitudinal direction of the shaft, and movable in the longitudinal direction with respect to the shaft.

Abstract: In one embodiment, an expander set includes a first and second expander. The first expander includes an outer surface having a first engagement feature and a groove and the second expander includes an inside surface having a second engagement feature adapted to engage with the first engagement feature. The inside surface of the second expander is shaped to correspond to a portion of the outer surface of the first expander. Additionally, the groove on the outer surface of the first expander is sized and shaped to accommodate a rod of a retraction system such that when the first expander is advanced within the retraction system, the rod remains within the groove. When the first and second expanders are engaged with one another, they define an oblong cross-section.

Abstract: An osteotome is provided that is designed for implanting and extracting medical device implants. The osteotome includes a handle, a blade attachment assembly about a first end of the handle for receiving a blade, and a wing assembly about a second end of the handle opposite the first end. The wing assembly further includes a wing extending outwardly from the handle.

Abstract: A lateral retractor system for forming a pathway to a patient's intervertebral disc space includes a single dilator and a retractable dual-tapered-blade assembly. The dilator may feature a narrow rectangular body for insertion at an insertion orientation parallel to the fibers of the patient's psoas muscle, at an approximate 45-degree angle to the patient's spine. The retractable dual-tapered-blade assembly consists of only two blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-tapered-blade assembly may be passed over the single dilator at the insertion orientation and rotated approximately 45-50 degrees to a final rotated orientation parallel to the intervertebral disc space before the two blade subassemblies are retracted away from one another to create the surgical pathway, while simultaneously and continuously assessing for encroachment upon one or more nerve structures within 360-degrees of the instrument.

Abstract: The invention relates to a surgical apparatus, in particular a navigation probe for localizing and treating lesions in a brain, comprising: a body member (10) having an anterior end (20), a posterior end (30) and at least one groove (60, 62) extending for a particular length in a longitudinal direction of the body member (10) between said anterior end (20) and said posterior end (30); a saddle (70) adapted to securely hold a medical device, the saddle (70) being placed on said body member (10) and having at least one grip (74, 75, 76) that extends into said at least one groove (60, 62) so as to mount the saddle (70) on the body member (10) moveable in said longitudinal direction; and a means for maneuvering said body member (10).

Abstract: A retractor system with a closed loop control includes a retractor having one or more sensors, which measure parameters associated with a retracted tissue. The system further includes a positioning mechanism connected to the retractor and a controller which receives feedback signals from the sensors. Based on the feedback signals from the sensors, the retractor is actuated by the positioning mechanism so that the tissue can be retracted while maintaining the parameters associated with the retracted tissue above a threshold level or within a desired range. Another retractor system includes a retractor with a force sensor and at least one additional sensor, which can be used without a closed loop control arrangement.

Abstract: A system and method for using video-synchronized electromyography to improve neuromuscular performance of a target muscle is disclosed. A subject may perform a series of exercises or movements that are candidates for inclusion in an exercise regimen. Video of the subject performing the candidate movements may be combined with electromyogram data from a target muscle and a facilitating muscle. The clips may be analyzed to determine the best exercises for the subject to achieve his or her fitness goals for the target muscle.

Abstract: A dilation system for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a wedge assembly and an actuating mechanism. The wedge assembly comprises includes a base and a plurality of blades extending from the base so that the distal end of the blades extend away from the base. The mechanism is operably associated with the blades so as to cause the distal end of the blades to move from a closed condition to an expanded condition.

Abstract: A lateral retractor system for forming a surgical pathway to a patient's intervertebral disc space includes a single dilator and a retractable dual-tapered-blade assembly. The single dilator may feature a narrow rectangular body for insertion at an insertion orientation parallel to the fibers of the patient's psoas muscle and at an approximate 45-degree angle to the patient's spine. The retractable dual-tapered-blade assembly consists of only two blade subassemblies, each having a blade bordered by adjustable wings, along with built-in lighting and video capabilities. The dual-tapered-blade assembly may be passed over the single dilator at the insertion orientation and rotated approximately 45-50 degrees from the insertion orientation to a final rotated orientation parallel to the intervertebral disc space before the two blade subassemblies are retracted away from one another to create the surgical pathway. Other embodiments are also disclosed.

Abstract: The present disclosure relates to methods and devices for surgically manipulating tissue. In general, the methods and devices can include an elongate retractor shaft having a distal retractor tip that is configured to manipulate tissue, for example the tip can be configured to separate muscle and nerve fibers surrounding a vertebra. The elongate retractor shaft can include an illumination source such that at least a portion of the surgical field is illuminated by the device when the device is used in the body. A sensor can also or alternatively be included on the elongate retractor shaft, for example on the blunt retraction tip, such that the sensor can monitor physiological parameters of the tissue in or adjacent to the surgical field.

Abstract: Methods and devices are disclosed to reduce tissue trauma when a physician retracts a patient's tissues for surgery. A device includes a tissue engager adapted to engage a patient's tissue, a control system adapted to control the tissue engager to deform the patient's tissue, and a sensor adapted to produce a first signal based on the deformation. The control system is further adapted to receive the first signal, perform a plurality of measurements based on the first signal over time; and compare a substantially instantaneous measurement of the first signal to a variance in the plurality of measurements over an interval of time preceding the instantaneous measurement, and detect a state of the patient's tissue based on the comparison.

Abstract: Provided are devices, systems, and methods for targeted administration of therapeutic agents to a subject. For example, provided are devices, systems, and methods for targeting the administration of peri-urethral bulking agents.

Abstract: A dilation system and method for accessing a surgical target site to perform surgical procedures. In one version, the dilation system includes a dilation assembly and an actuating mechanism. The dilation assembly comprises plurality of dilator segments. The actuating mechanism is operably associated with the dilator segments so as to cause the dilator segments to move from a collapsed state to an expanded state.

Abstract: A surgical access system comprising a tissue retraction assembly equipped with two or more electrodes for use in monitoring the status of nearby neural structures, including the localized depth of neural structures relative to one or more components of the tissue retraction assembly. Additional neurological testing may be performed to monitor the health and status of the neural structures during the portions of the surgical procedure in which the tissue retraction assembly is used to maintain the operative corridor.

Abstract: This disclosure describes example an surgical fixation system and example methods for implanting the surgical fixation system on the spine. The surgical fixation system can be applied minimally invasively to the anterior column for both single level and multi-level constructs. The surgical system can be applied to the anterior column via lateral access approaches. The lateral access approach may traverse the psoas muscle. The fixation system includes a plurality of anchor assemblies connected by a spinal rod. The anchor assemblies each include a fixation body, bone anchor, rod-receiving member, anchor lock and rod lock. The rod-receiving member may be moveably coupled to the fixation body to facilitate rod insertion.

Abstract: A surgical access system comprising a tissue dilation assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures. A retractor assembly for creating an operative corridor to a spinal surgical target site is disclosed, comprising: a retractor body and a plurality retractor blades extending generally perpendicularly to the retractor body, the retractor body being operable to separate the at plurality of retractor blades relative to each; and a supplemental retractor blade assembly attachable to at least two of the plurality of retractor blades, the supplemental retractor blade assembly comprising an elongated supplemental retractor blade and a crossbar connector, the crossbar connector configured to be attached to said at least two retractor blades while engaging the supplemental retractor blade.

Abstract: A system for a mapping and ablation catheter. The catheter includes a MOSFET sensor array that provides better fidelity of the signal measurements as well as data collection and reduces the error generated by spatial distribution of the isotropic and anisotropic wave fronts and error associated with near and far field's signal averages. The system maps the change in bioelectric potential in the vicinity of an activation wave front. During measurement, the manifold carrying the sensor array translates and rotates so as to achieve a measure of high potential employing an impedance value. The system of guiding and controlling the movement of the catheter distal end is able to deliver energy for ablating the renal artery nerve and thereby providing a safe and efficient method and apparatus for neuromodulation.

Abstract: According to some embodiments, a retractor device for selectively moving (e.g., retracting) anatomical tissue of a subject during a minimally invasive procedure (e.g., accessing the lumbar or other portion of a spine during a spinal fusion procedure) comprises a main body comprising at least three sides (e.g., three, four, five sides, more than five sides, etc.). In some embodiments, the main body defines or otherwise forms a central opening, which comprises a center-point positioned along a centerline of the central opening. In some embodiments, the retractor device further comprises a plurality of movable members secured to the main body.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Systems, methods, and kits for performing endoscopic fusion with neuromonitoring. The endoscopic fusion may be performed, for example, through a cannula providing a portal to the disc space. Throughout various steps in the procedure, neuromonitoring may occur to minimize the possibility of injuring or contacting a nerve.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site.

Abstract: A retractor device has an oximeter sensor at its tip, which allows measuring of oxygen saturation of a tissue being retracted by the retractor. The retractor device also has a force sensor which can measure an amount of force that is applied to the retracted tissue by the tip of the retractor device. The tip includes one or more openings for at least one source and detector. A specific implementation is a spinal nerve root retractor with an oximeter sensor and a force sensor.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: The present invention provides various systems, a kit, and a method for accessing, sampling within, and visualization of areas within the mediastinal cavity for assisting a surgeon in performing a mediastinoscopy procedure. The access system includes one or more preferably toroidal balloons that can be expanded to dilate and protect the inner walls of a bodily conduit. Instruments pass through hollow spaces within the expanded toroidal balloons. The proximally positioned balloons are expanded first and the unexpanded balloons to be positioned distally are passed through them and subsequently expanded. The sampling system includes an instrument with a rounded head having two or more jaws and a slit therein at the distal end of an elongated tubular body. The visualization system includes a 360° camera that can be positioned from proximal to distal a target site and can also do a U-turn about its axis of extension.

Abstract: A surgical device includes one or more cameras integrated therein. The view of each of the one or more cameras can be integrated together and provided to a surgeon display and/or an assistant display. 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 images generated by the one or more 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 at least partially transparent. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: The use of a memory metal mesh stent as a retractor in a lateral approach to the spine. The expanded stent is used as a conduit through which an implant can pass. This advance is predicated upon the appreciation that modern stent implants have diameters that are large enough to accommodate passage of an intervertebral spinal implant therethrough.

Abstract: A protective tissue cover having a sleeve configuration to slide onto the working portion of a surgical instrument, such as a retractor. At least the contact side of the protective tissue cover is constructed from smooth antimicrobial material that minimizes contact irritation with tissue. Alternative embodiments include various multiple-ply constructions that incorporate an antimicrobial layer, an absorbent layer, and other medical layers to assist in surgical procedures.

Abstract: The protective tissue cover includes a sleeve configured to slide onto the working portion of a surgical retractor. At least the contact side of the protective tissue cover is constructed from smooth antimicrobial material that minimizes contact irritation with tissue. Alternative embodiments include various multiple-ply constructions that incorporate an antimicrobial layer, an absorbent layer, and other medical layers to assist in surgical procedures.

Abstract: Disclosed are methods, devices, and systems for inducing neuromodulation by focusing a source of stimulation through a skull/brain interface in the form of an aperture formed in the skull, a naturally occurring fenestration in the skull, or a transcranial channel. Further disclosed are methods, devices, and systems for identifying where to locate skull/brain interfaces, accessories that can be used with the interfaces, and features for controlling stimulation delivered through the interfaces. Multiple indications for the skull/brain interfaces are also disclosed, including diagnosis and treatment of neurological disorders and conditions such as epilepsy, movement disorders, depression, Alzheimer's disease, autism, coma, and pain.

Abstract: Methods and devices are disclosed to reduce the tissue trauma that occurs when a physician retracts or otherwise deforms a patient's tissues for surgery or other medical procedures. In one part, methods and devices are disclosed for controlling the force and pace of retraction to reduce tissue trauma. In another part, methods and devices are disclosed for applying an oscillating load when opening. In another part, pads that cool the tissue around the incision are disclosed. In another part, pads that elute drugs into the tissues of the tissue margin are disclosed. In another part, methods and devices are disclosed that self-align components of the retractor and engage hard tissues directly to avoid soft tissue damage. In another part, pads that engage tissues to cushion, to sense tissue state, and to modulate tissue state are disclosed.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: The present disclosure relates to methods and devices for surgically manipulating tissue. In general, the methods and devices can include an elongate retractor shaft having a distal retractor tip that is configured to manipulate tissue, for example the tip can be configured to separate muscle and nerve fibers surrounding a vertebra. The elongate retractor shaft can include an illumination source such that at least a portion of the surgical field is illuminated by the device when the device is used in the body. A sensor can also or alternatively be included on the elongate retractor shaft, for example on the blunt retraction tip, such that the sensor can monitor physiological parameters of the tissue in or adjacent to the surgical field.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site. The tissue retraction assembly has a plurality of blades which may be introduced while in a closed configuration, after which point they may be opened to create an operation corridor to the surgical target site, including pivoting at least one blade to expand the operative corridor adjacent to the operative site. The surgical access system further includes pressure sensing technology to measure the pressure being exerted upon body tissues before, during, and/or after retraction and/or distraction.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Systems and methods are described for accessing and operating on an intervertebral disc at the lumbosacral junction via a trans-iliac approach. The instruments and methods described employ nerve monitoring to direct passage of the instruments through a safe zone between the L5 nerve root lying posterior to the trans-iliac path and the iliac vein (and iliac artery) lying anterior to the trans-iliac path.

Abstract: A surgical access system and method for accessing a surgical target site in order to perform surgical procedures, and particularly suited for establishing an operative corridor to an intervertebral target.

Abstract: Systems and methods for performing neurophysiologic assessments of neural tissue including nerve pathology monitoring which may or may not be augmented by adding the ability to assess or monitor the pressure being exerted upon a nerve or nerve root before, during and/or after retraction.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A medical device for providing direct port-like endoscopic access to the urinary bladder, or other orifice, of a patient and a method of utilizing and inserting the medical device. The medical device can include a hollow tube with a main channel and a separate channel, a cap with an inflation port and a hollow flexible stem fluidly connecting the inflation port and the separate channel. A method can include inserting a needle above the pubic symphysis of a mammal, threading a guide wire through the needle, removing the needle and inserting the medical device. The method can optionally include determining measuring the depth between the skin surface of the patient's suprapubic region and urinary bladder.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: The disclosed embodiments relate to a system and method for assuring validity of monitoring parameters in combination with a therapeutic device. An exemplary embodiment of the present technique comprises perturbing a treatment administered to a patient, measuring at least one parameter of the patient reflecting the underlying physiological state and associated with the treatment, and comparing the perturbations of the treatment to measurements of the at least one parameter to determine if the perturbations to the treatment are reflected by the parameter.

Abstract: A surgical access system comprising a tissue dilation assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures. A retractor assembly for creating an operative corridor to a spinal surgical target site is disclosed, comprising: a retractor body and a plurality retractor blades extending generally perpendicularly to the retractor body, the retractor body being operable to separate the at plurality of retractor blades relative to each; and a supplemental retractor blade assembly attachable to at least two of the plurality of retractor blades, the supplemental retractor blade assembly comprising an elongated supplemental retractor blade and a crossbar connector, the crossbar connector configured to be attached to said at least two retractor blades while engaging the supplemental retractor blade.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.