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: The Lorentz-Active Sheath (LAS) serves as a conduit for other medical devices such as catheters, balloons, biopsy needles, etc. The sheath is inserted through a vein or other body orifice and is guided into the area of the patient where the operation is to be performed. The position and orientation of the LAS is tracked via an industry standard position detection system which senses electrical signals that are emitted from several electrodes coupled to the LAS. The signals received from the LAS are used to calculate an accurate and reliable assessment of the actual position of the LAS within the patient. The electrode signals also serve to create a reference frame which is then used to act as a motion compensation filter and fiducial alignment system for the movement of the LAS-hosted medical tool.

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.

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: Methods and devices are disclosed to reduce tissue trauma when a physician retracts a patient's tissues for surgery. In one part, methods and devices are disclosed for controlling retraction force and pace. In another part, methods and devices are disclosed for oscillating force when opening. In another part, methods and devices are disclosed for detecting trauma during retraction. In another part, methods and devices are disclosed for balancing forces on multiple retraction elements. In another part, methods and devices are disclosed for reducing forces in multiple dimensions. In another part, methods and devices are disclosed for engaging ribs. In another part, methods and devices are disclosed to compensate for deformation of a retractor under load. In another part, methods and devices are disclosed that combine these methods and devices. In another part, methods and devices are disclosed for controlling pressure inside inflatable devices used for deforming biological tissues.

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 retractor comprises an arm having a first end and a second end. A blade has an outer surface and a contact surface. The blade is fixed to at least one of the first end and the second end of the arm. A transducer is disposed on the contact surface of the blade. A Doppler ultrasound sensor is in electrical communication with the transducer. The transducer transmits signals to the Doppler ultrasound sensor that can be used to calculate blood flow rate proximate to a surgical site where the surgical retractor is being used.

Abstract: A method for dynamic cerebral autoregulation (CA) assessment includes acquiring a blood pressure (BP) signal having a first oscillatory pattern from a first individual, acquiring a blood flow velocity (BFV) signal having a second oscillatory pattern from the first individual, decomposing the BP signal into a first group of intrinsic mode functions (IMFs), decomposing the BFV signal into a second group of IMFs, determining dominant oscillatory frequencies in the first group of IMFs, automatically selecting a first characteristic IMF from the first group of IMFs that has its associated dominant oscillatory frequency in a predetermined frequency range, automatically selecting a second characteristic IMF from the second group of IMFs, calculating a time sequence of instantaneous phase difference between the first characteristic IMF and the second characteristic IMF, computing an average of the instantaneous phase difference in the time sequence, and identifying a pathological condition in the first individual.

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: 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: An improved radial expansible retractor and a method of minimally invasive surgery, by opening a channel in the brain or other soft tissue of a patient, by inserting the radial expansible retractor into the body of the patient, and by widening the channel at a continuous and gentle rate. The use of the improved radial expansible retractor renders surgical procedures, including neurosurgical procedures, shorter, less traumatic, and more reliable, reducing risk and the need for subsequent surgery and reducing recovery time. Procedures are carried out with real time monitoring of the retracted brain perfusion pressure. A plurality of improved radial expansible retractors may be used in a single operation. The improved radial expansible retractor allows access to areas of the brain previously almost impossible to access.

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: Described is a surgical system for monitoring a patient's condition during surgery. One aspect is a non-contact EEG sensor. The non-contact EEG sensor can be used to predict the onset of physiological disorders. Another aspect includes the use of a plurality of pressure sensors to determine the pressure applied by retractors on the patient, including the brain and other organs.

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 reconfigurable modular retractor system including a set of interchangeable body modules, the body modules including mechanisms for forming retractors and slot mechanisms for connecting blades, and blades including locking mechanisms for locking inside the slot mechanisms. A method of using the retractor system by forming a retractor by using at least one body module, attaching blades to the body module, inserting the retractor into a surgical area, retracting tissue, removing retraction from the tissue, and removing the retractor.

Abstract: Devices and methods that may be employed to detect and/or prevent intraoperative full thickness penetration of anatomic walls, and to provide delineation of anatomic structures during surgery.

Abstract: A first magnetic field can be produced across a tissue region using a first magnetic field source, providing a magnetic coupling force between the first magnetic field source and a first object, wherein the first object provides a magnetic field or a magnetic susceptibility to obtain the magnetic coupling force. The magnetic coupling force can be sensed using a force sensor and a resulting sensed force signal can be provided to a controller. The controller can provide an output signal to control the magnetic coupling force using the sensed forced signal to obtain a constant or desired magnetic coupling force.

Abstract: A surgical access port configured and dimensioned for positioning within an opening in tissue for providing access to an internal surgical site includes a body portion defining a passageway therethrough. The body portion includes an outer surface. A pressure feedback indicator is disposed on at least a portion of the outer surface of the body portion. The pressure feedback indicator is configured for providing a visual indication to a user where an applied pressure is greater than a predetermined threshold.

Abstract: A surgical portal apparatus for use during a minimally invasive procedure includes a housing and a portal member extending distally from the housing. The housing and portal member combination defines a longitudinal axis. The portal member is sized to be positioned within tissue and has an opening at the distal end. The apparatus also has a pliable seal and a plurality of concentrically arranged piston members, disposed within the housing. The pistons are engageable with the pliable seal and are adapted for moving relative to the housing to control the diameter of a passage through the inner portion of the seal in response to the insertion of a surgical object.

Abstract: Systems and methods employing a small gauge steerable catheter (30) including a locatable guide (32) with a sheath (40), particularly as an enhancement to a bronchoscope (14). A typical procedure is as follows. The location of a target in a reference coordinate system is detected or imported. The catheter (30) is navigated to the target which tracking the distal tip (34) of the guide (32) in the reference coordinate system. Insertion of the catheter is typically via a working channel of a convention bronchoscope. Once the tip of the catheter is positioned at the target, the guide (32) is withdrawn, leaving the sheath (40) secured in place. The sheath (40) is then used as a guide channel to direct a medical tool to target.

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.

Abstract: A retractor system for percutaneous surgery in a patient includes first and second retractor portions positionable opposite one another in an incision of the patient. The system also includes at least one actuating member operable to provide an oscillating motion to at least one of the first and second retractor portions. The actuating member is in communication with a controller and is responsive to the controller to move and adjust at least one of the first and second retractor portions between a first position and a second position. The system also includes at least one pressure sensor and display and at least one timing circuit with display. In another form, a method is directed to retracting tissue for percutaneous access to a surgical site in a patient using the pressure sensors and display as will as the timing circuit and display to assure that the amount of pressure applied and the duration does not exceed pre-determined values.

Abstract: An apparatus for monitoring the characteristics of tissue adjacent a surgical site and communicating that information to a health care provider includes a retractor, a sensor, and a processing system. The sensor is disposed on the retractor and is configured to measure a parameter indicative of at least one characteristic of the tissue adjacent the first or the second blade. The processing system is in communication with the sensor and configured and arranged to receive information from the sensor indicative of the measured parameter. It includes a threshold stored therein indicative of excessive trauma to the tissue and it is configured in a manner such that it compares the received information to the stored threshold and communicates information to the health care provider regarding the comparison.

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 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: For minimally invasive surgical applications, an expandable surgical retractor is inserted in a surgical corridor and expanded to a desired size and shape. Cooling allows the retractor to maintain the expanded characteristic. Following surgery, the retractor can be removed in a manner that minimizes bleeding and tissue damage.

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.

Abstract: A device for gynecological examination has an imaging unit, which may include an illumination source, an imaging unit and an optical system, positioned within a speculum type device, typically between the blades thereof. The imaging unit is positioned at the end of an elongated rod that is positioned within a guide tube, both of which pass from between the blades down through the speculum handle, where they can be manipulated by a user to push the unit upward and forward for better viewing. A transmitter for transmitting sensed data to an external or remote receiver may be part of or may be separate from the device. The device may have non-imaging sensors, such as a pH sensor, a sensor to sense electrical impedance of tissues, a temperature sensor, etc., either by itself or in addition to an imager. A system may further include a remote receiver, a processor for processing data and a monitor for presenting images to the user in real time.

Abstract: Septic barriers interposed between a target tissue such as an oral or vaginal cavity, exposed epidermis, or wound or surgical site, and a user and his/her optical interrogation instruments to reduce cross-infection and/or contamination. In certain embodiments, the septic barrier is substantially transparent for viewing purposes and is typically effectively non-fluorescent, particularly when used for investigating autofluorescence or other fluorescence emanating from a target, so as to have little or no effect on the measurements and observations being made. The sepsis barrier can comprises a window through which the user sees the tissue, a frame holding the window, and an attachment structure, such as threads or bayonet attachment, configured to connect the barrier to the instrument. If desired, the system can also have an optional attachment mechanism for permanent or temporary connection of a further instrument to the frame, such as a tissue retractor configured to aid manipulation of the target tissue.

Abstract: Devices and methods that may be employed to detect and/or prevent intraoperative full thickness penetration of anatomic walls, and to provide delineation of anatomic structures during surgery.

Abstract: A retraction device adapted to retract tissue is provided, comprising at least one pair of opposed retraction members, with each retraction member being capable of operably engaging the tissue to be retracted. A drive mechanism is operably engaged with at least one of each pair of retraction members for separating one of each pair of retraction members from the other to retract the tissue. A measuring device is operably engaged with at least one of the drive mechanism and one of each pair of retraction members, for determining and/or controlling a magnitude and/or rate of a force and/or strain imparted to the tissue by the drive mechanism via the retraction members as the tissue is being retracted. Associated devices and methods are also provided.

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.

Abstract: A retraction device including at least one pair of opposed retraction members, with each retraction member being capable of operably engaging the tissue to be retracted. A drive mechanism is operably engaged with at least one of each pair of retraction members for separating one of each pair of retraction members from the other to retract the tissue. A measuring device is operably engaged with at least one of the drive mechanism and one of each pair of retraction members, for determining and/or controlling a magnitude and/or rate of a force and/or strain imparted to the tissue by the drive mechanism via the retraction members as the tissue is being retracted. Associated devices and methods are also provided.

Abstract: In various embodiments of the invention, an electro-vacuum pump can be used either as a stand alone unit to create, monitor and control a vacuum or to maintain, assist or as a back up for a hand operated pump in a variety of surgical procedures. The vacuum pump is controlled by a processor and is automatically activated when the vacuum is below a pre-selected parameter or a parameter selected on the fly by the surgeon. Visual or audio feedback is used to allow the surgeon increased control of the vacuum device while carrying out the surgical procedure.

Abstract: A surgical access device includes a proximal housing having proximal and distal end portions, the distal end portion of the housing being configured and adapted to engage a proximal portion of a flexible wound retractor. The proximal housing can be provided with a plenum chamber being defined therein, the plenum chamber being in fluid communication with at least one nozzle. The nozzle is preferably configured to direct pressurized fluid in an axial direction from the plenum chamber into a central bore of the surgical access device to provide a constant gaseous seal around a surgical instrument inserted therethrough, while inhibiting a loss of pressurized fluid from the body cavity therethrough. The plenum chamber can be adapted and configured to receive pressurized fluid and conduct the pressurized fluid to the at least one nozzle.

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: 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 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: Described is a surgical system for monitoring a patient's condition during surgery. One aspect is a non-contact EEG sensor. The non-contact EEG sensor can be used to predict the onset of physiological disorders. Another aspect includes the use of a plurality of pressure sensors to determine the pressure applied by retractors on the patient, including the brain and other organs.

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 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: Biopsy instruments are integrated with a multi-fiber optical probe adapted to perform diagnostic measurements. In addition to being able to analyze, treat or remove tissue, such integrated devices characterize tissue by measuring the amount of scattering and absorption of light transmitted into the tissue. Each fiberoptic probe has an illuminating fiber that provides a broadband light source for transmission into tissue, and a collecting fiber that collects the light scattered by the tissue and transmits the collected light to a spectrometer. One embodiment is an endoscope-mediated tool with a jaw-type biopsy forceps and a multi-fiber optical probe which is conveyed through a hollow central channel. Another embodiment is an endoscope-mediated tool with a jaw-type biopsy forceps and a plurality of multi-fiber optical probes. Yet another embodiment is an endoscopic polypectomy-type snare catheter with a multi-fiber optical probe located at the tip.

Abstract: A retractor has an oximeter sensor at its tip, which allows measuring of oxygen saturation of a tissue being retracted by the retractor. 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.

Abstract: This patent describes a retractor system for surgical applications of the type used to retract organic tissues not involved in an operation, in an area where such an operation is to be performed, of the type comprising at least one spatula equipped with at least one spatula body (1) and a layer of bio-compatible material (20), as a coating adhering to the spatula body (1). Advantageously according to the invention, the retractor system comprises at least one sensor (2, 3, 4, 27), substantially integrated in such a spatula body (1) and at least partially coated with the layer of bio-compatible material (20) to detect characteristic parameters of the organic tissues at a point of contact with the spatula body (1). A detection system (40) using such retractor system is also described.

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.