Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezius muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: Methods and apparatus are provided for affecting an appearance of skin by harvesting small portions of tissue from a donor (first) site and applying them at a recipient (second) site. A plurality of micrografts can be formed from a piece of graft tissue and attached to a dressing material. The dressing material can then be expanded to increase a separation distance between the micrografts, and the dressing material having spaced-apart micrografts attached thereto can be applied to a prepared recipient site. An apparatus can be provided that expands the dressing material using a pressurized fluid. A further method can include providing a suspension of small portions of graft tissue in a solution. The solution can be injected into blisters formed at a recipient (second) site and the tissue portions allowed to attach and proliferate. A method and apparatus can also be provided for forming corresponding blisters at a donor site and at a recipient site.

Abstract: A system for performing minimally invasive procedures in a working space within a body lumen of a patient including a flexible catheter configured to receive a working instrument therethrough. The flexible catheter has a working space expanding system positioned at the distal portion, the working space expanding system including first and second flexible elements movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body. The first and second flexible elements are connected at a distal region by a coupling structure. A stabilizing member stabilizes the distal portion of the flexible catheter.

Abstract: Retractor blades for a retractor system are disclosed. The blades are designed for use in preparing an area of the body for a surgical procedure. The retractor blades are configured with different lengths and with different blade tip geometries to facilitate engagement with vertebrae for the oblique lateral interbody fusion surgical approach.

Abstract: A speculum includes a first blade member and a second blade member. Each of the first and second blade members extend from a proximal end to a distal end. A speculum control includes a control nut threadingly engaged with a threaded shaft. Internal threads of the control nut are oversized relative external threads of the threaded shaft such that the control nut freely spins upon the threaded shaft.

Abstract: A surgical device includes at least one retractor blade. Each retractor blade includes a blade body having a lateral side, a medial side opposite the lateral side and a bottom end. The bottom end has an inverted-arch curvature. The inverted-arch curvature includes a lowest point in proximity to a midline of the blade body. Each retractor blade includes a connector integrated into a mid-section on the medial side of the blade body and a leg interface configured to mate and/or pair with a leg of a distractor. The at least one retractor blade may include two retractor blades configured as mirror images of each other. Each blade is configured to pair with a respective one distractor.

Abstract: A retractor system includes first and second fixation pins and a retractor assembly including first and second retractor bodies. Each of the first and second retractor bodies includes a main panel and extension panels extending from the main panel. Each of the first and second retractor bodies is transitionable between a first configuration, in which, each of the first and second retractor bodies is substantially flat, and a second configuration, in which, each of the first and second retractor bodies has a substantially U-shaped profile such that the extension panels oppose each other. The extension panels of the first retractor body are configured to selectively overlap the respective extension panels of the second retractor body when the first and second retractor bodies are in the second configuration.

Abstract: A tissue containment device (10) for isolating tissue from surrounding tissue during a surgical procedure to remove the tissue includes a bag (12) formed by one or more walls (14) defining a containment compartment (16) and an opening (18) for accessing the containment compartment. Each wall (14) is formed from at least two layers including an inner layer (20) facing the containment compartment and an outer layer (22) facing outwards from bag (12). The layers define between them one or more inflatable volumes (24). Layers (20) and (22) are interconnected at spaced-apart connection regions (28) that are arranged such that, when a fluid is introduced into the inflatable volumes (24), regions of the at least two layers between the connection regions form wall cavity regions surrounding an internal volume of the containment compartment.

Abstract: Surgical retractors and methods thereof for retracting body tissue in a therapeutic procedure. The surgical retractor may include retractor blades have openings or channels configured to receive bone pins while maintaining accessibility and visibility of the operative window.

Abstract: A closed loop granular jamming apparatus is disclosed including a three-dimensional membrane structure filled with granular material. Fluid is evacuated from the structure which induces a jamming effect, whereas the viscosity of the granular media increases with increasing particle density. The thin membrane conforms to the shape of the granular material. Decreasing enclosed volume and increasing packing density prevents particles from distributing within the confined space, inducing the aggregate to behave as a solid. In the jammed state, the apparatus is resistive to force and change of shape. The apparatus is returned to the unjammed state by releasing the vacuum. The size and shape of the apparatus may be repeatedly adjusted by alternating between the jammed and unjammed states. The closed loop granular jamming apparatus may include toroidal and cylindrical shapes with articulating inserts and compliant spines.

Abstract: A medical instrument assembly including a handle assembly having a first handle portion and a second handle portion proximate the second end, wherein the second handle portion is slidably engaged with the first handle portion. A first localization element is attached to the first handle portion and a second localization element is attached to the second handle portion. A medical instrument is mechanically coupled to the second handle portion and a translation of the second handle portion with respect to the first handle portion causes a coincident and coextensive translation of the medical instrument. The amount of translation of the medical instrument is adapted to be determined by calculating the distance between the first localization element and the second localization element. The first and second localization elements may be electromagnetic sensors which positions may be determined by a navigation system.

Abstract: The invention is directed to a method of operating an ophthalmosurgical system which includes a console for accommodating an irrigation fluid vessel containing irrigation fluid and a cassette, insertable into the console, for directing the irrigation fluid to a surgical instrument for an eye to be treated. An irrigation fluid flow path leads from the irrigation fluid vessel to the cassette and to the surgical instrument. A first fluid pump includes a first pump chamber having a first volume and a first drive chamber separated therefrom by a first elastic partition and having a second volume. A second fluid pump is arranged in parallel to the first fluid pump and includes a second pump chamber having a third volume and a second drive chamber separated therefrom by a second elastic partition and having a fourth volume.

Abstract: A lighting device for attachment to a handheld electrosurgical instrument is disclosed, which includes an elongated housing having opposed proximal and distal end portions and defining an interior chamber containing a battery powered light assembly for illuminating a surgical site, the housing having at least one smoke evacuation passage that extends from an inlet located adjacent to or near the distal end portion of the housing to an outlet located adjacent to or near the proximal end portion of the housing for removing smoke generated at the surgical site.

Abstract: A method for retracting tissue in a surgical procedure includes inserting a first blade of a retractor system into an incision in a body of a patient. The retractor system includes a first articulating arm and a second articulating arm. The first articulating arm is coupled to a retractor assembly blade. The retractor assembly blade has a handle portion and the first blade. The second articulating arm is coupled to a bracket securing a second blade. The method includes retracting tissue using the first blade, inserting the second blade into the incision in the body of the patient and retracting tissue using the second blade.

Abstract: Methods and apparatus for compressing and/or distracting bones are described herein. In one such method, a tap marker is engaged with a bone and a compressor/distractor device. The tap marker can be removed after moving the bone and a bone screw can be inserted into the space previously occupied by the tap marker. A rod or other fixation element can then be attached to the bone screw.

Abstract: A retractor-distractor system comprising a frame with slidably coupled superior and inferior arms extending therefrom. The superior arm comprises a superior clamp arm pivotally coupled to a lateral end of the superior arm, a superior ball joint received between the superior clamp arm and the superior arm, and a superior ball joint lock operable to pivot the superior clamp arm proximate to the superior arm, thereby locking the orientation of the superior ball joint. The inferior arm comprises an inferior clamp arm pivotally coupled to a lateral end of the inferior arm, an inferior ball joint received between the inferior clamp arm and the inferior arm, and an inferior ball joint lock operable to pivot the inferior clamp arm proximate to the inferior arm, thereby locking the orientation of the inferior ball joint. The superior and inferior arms are operable to receive a modular blade to retract and distract tissue.

Abstract: A surgical instrument includes a first member having an inner surface and an outer surface. A second member has an inner surface and an outer surface. At least one of the inner surfaces defines at least one mating element and the outer surfaces are engageable with tissue. The members are relatively movable between a first configuration and a second configuration to space the tissue and define an opening between the members. At least one third member defines at least one mating element engageable with the at least one mating element of the inner surface such that the at least one third member is disposed within the opening. Systems and methods are disclosed.

Abstract: The present application is generally directed to improved instruments and instrument features for distraction and tissue retraction. In particular, the present application is directed to distraction blades and wide blocking blades that can be used together, or individually, to assist in the distraction of bone and the retraction of tissue during a surgical procedure, such as a spinal fusion procedure.

Abstract: The present disclosure describes a surgical retractor system and method. The surgical retractor includes an elongate element defining an operational axis, a first blade secured to the elongate element and comprising a blade face, a second blade moveably secured to the elongate element, wherein the second blade defines a reference point located thereon, and wherein a movement of the second blade moves the reference point in a linear direction parallel to the operational axis and orthogonal to the blade face. A guide element may be removably located within an opening located on either the first blade or the second blade.

Abstract: Devices for performing medical procedures such as laparoscopic surgery are provided herein. For example, this document provides laparoscopic retractor devices. In some embodiments, the laparoscopic retractor devices provided herein include two retractor blades that can be expanded or contracted. Further, in some embodiments an elastic covering is included, and the retractor blades are disposed within the elastic covering.

Abstract: An insertion tongue of the retractor device may be pushed into the subject through the trocar incision, along one side of the organ. The tip of the insertion tongue pushes the impacted organ and its endoscopic recovery bag slightly away from the cavity wall. A scalpel is passed through the insertion guide with the tip of the scalpel blade in the retention guide on the back of the insertion tongue, and with the sharp side of the scalpel blade facing away from the organ and from the tongue of the retractor device. The scalpel is then passed down through the cavity wall, with its tip in the retention guide, while tension on the retractor device handle away from the organ, and gentle outward traction on the organ (and bag) permits removal of the organ (and bag) as soon as the opening is just large enough to allow it.

Abstract: Medical instruments, particularly structurally-adjustable speculums and retractors for obstetrical and gynecological operations, procedures, and examinations, including a minimally obstructive compact speculum or retractor. The compact speculum may comprise a first wing and a second wing; and a hinge comprising at least one hinge component. The compact speculum may further comprise a ratchet that releasably holds the wings in an open position. The hinge component may comprise the ratchet, an illumination source, a fluid handler, a light guide, a lubrication source, or a combination thereof. The compact speculum may be a vaginal speculum.

Abstract: Embodiments of a circumferential retractor having an attached supporting, manipulating or positioning tool are described. The retractor optionally includes a sealing member associated with an external member of the retractor and an external support structure that may be used with the retractor and positioning tool as needed.

Abstract: A suction elevator with suction capability includes a handle having a first end and a second end. The first end of the handle includes a connector for attaching the surgical elevator to a suction source. An arm extends from the second end of the handle, the arm having a blade portion at the end opposite that which extends from the handle. A continuous bore runs through the connector, handle, and arm, ending where the blade defines an opening in fluid communication with the bore.

Abstract: An apparatus for the efficient provision of directed illumination to a subdermal surgical field that is attachable to or completely forms a surgical retractor blade. This illuminated surgical retractor system may include a retractor and a light guide disposed over the retractor. The retractor has a front surface facing a surgical field, a rear surface adapted to engage tissue, a distal end, and a proximal end. The light guide conforms to the shape of the retractor and is removably secured to the retractor and conducts light through the front or rear surface of the retractor. The light guide has an input adaptor and one or more light emitting surfaces.

Abstract: A medical device and a method for preparing a patient's body to receive a bodily implant are provided. The medical device includes a needle member configured to be inserted into a tissue layer. The needle member has a proximal end portion and a distal end portion. An adjustment member is coupled to the proximal end portion of the needle member. The adjustment member includes an adjustment screw and a nut for setting a predetermined depth of insertion of the needle member within the tissue layer. The adjustment member further includes an adjustment member support configured to provide a support to the adjustment screw and the nut. The adjustment member is configured to move between a first position and a second position with respect to the adjustment member support to limit insertion of the needle member within the tissue layer to the predetermined depth.

Abstract: A surgical instrument includes a first member having an inner surface and an outer surface. A second member has an inner surface and an outer surface. The outer surfaces are engageable with tissue adjacent a spine that defines a longitudinal axis. The members are relatively movable between a first configuration and a second configuration to space the tissue. In the first configuration, the members are disposable between a first position such that the inner surfaces define a substantially oval cavity that defines a major axis substantially aligned with the longitudinal axis and a second position such that the major axis is rotated relative to the longitudinal axis to space psoas tissue. Systems and methods are disclosed.

Abstract: A surgical retractor for illuminating a surgical field includes an ergonomic handle, a retractor blade coupled with the handle, a quick release mechanism, and an illuminator blade. The retractor blade is adapted to engage and retract tissue, and the quick release mechanism is adapted to couple the handle with the retractor blade. The illuminator blade acts as a waveguide to transmit light by total internal reflection. Light is extracted from the illuminator to illuminate the surgical field. The retractor blade is releasable from the handle without requiring uncoupling of the illuminator blade from the handle and also without requiring optical uncoupling of the illuminator blade from a light source. The retractor may also be adapted to evacuate smoke from the surgical field.

Abstract: Minimaily invasive surgical retractors and methods of using the retractors are provided. This retractor may be introduced through a sealed port, controlled by a robotic system, have full articulation, and need not require assembly within the patient's body. As a result, fully endoscopic mitral valve surgery may be performed.

Abstract: A surgical instrument includes a first member having an inner surface and an outer surface. A second member has an inner surface and an outer surface. At least one of the inner surfaces defines at least one mating element and the outer surfaces are engageable with tissue. The members are relatively movable between a first configuration and a second configuration to space the tissue and define an opening between the members. At least one third member defines at least one mating element engageable with the at least one mating element of the inner surface such that the at least one third member is disposed within the opening. Systems and methods are disclosed.

Abstract: A laparoscopic retractor and suction device includes a shaft including a distal end and an opposed proximal end. The shaft defines an internal suction channel extending from the distal end to the proximal end. The device includes a head attached to the distal end of the shaft and in fluid communication with the suction channel. The head is movable from a collapsed configuration to a deployed configuration.

Abstract: A surgical access assembly includes an access port and a seal anchor. The access port includes a proximal ring, an intermediate ring, a distal ring, and a sleeve defining a passage therethrough. In particular, the proximal, intermediate and distal rings are concentrically arranged with the passage of the sleeve, and the sleeve extends between the proximal and distal rings. The seal anchor is adapted to be at least partially disposed in the access port, and defines a lumen therethrough. At least one of the proximal, intermediate, and distal rings is configured and dimensioned to engage the seal anchor in a sealing relation therewith.

Abstract: An illuminated suction apparatus including a hand-held surgical device combining a high-performance non-fiber optic optical waveguide with suction. This device is useful in a wide array of surgical procedures including open and minimally invasive orthopedics.

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

Abstract: Medical instruments, particularly structurally-adjustable speculums and retractors for obstetrical and gynecological operations, procedures, and examinations, including a minimally obstructive compact speculum or retractor. The compact speculum may comprise a first wing and a second wing; and a hinge comprising at least one hinge component. The compact speculum may further comprise a ratchet that releasably holds the wings in an open position. The hinge component may comprise the ratchet, an illumination source, a fluid handler, a light guide, a lubrication source, or a combination thereof. The compact speculum may be a vaginal speculum.

Abstract: A surgical apparatus includes a housing member and an inner member. The housing member includes an expandable material that is adapted to transition between a compressed condition and an expanded condition. In the expanded condition, an outer surface of the housing member is adapted for a substantial sealing relationship with tissue upon insertion of the housing member within the tissue for accessing an underlying tissue site. The housing member has leading and trailing ends that define a longitudinal axis. The inner member is operably associated with the housing member and includes one or more longitudinal portals extending therethrough adapted for substantially sealed reception of a surgical object. The inner member may be less compliant than the housing member. The inner member may rotate about the longitudinal axis of the housing member.

Abstract: A suction tip for a surgical instrument includes a hollow housing having a top flat wall and a bottom flat wall and including a proximal end and a distal end. The distal end has a widened tip portion that is wider than the proximal end. The distal end may have a plurality of suction ports located at its front, top, right side and left side of the widened tip portion. Furthermore a ledge portion may protrude outwardly past a terminal end of the top flat wall to provide a clear space between the suction ports and tissue for evacuation of fluid in the clear space. Furthermore, the ledge portion which protrude outwardly may have bended tip in desire degrees and shapes.

Abstract: A surgical retractor for illuminating a surgical field includes an ergonomic handle, a retractor blade coupled with the handle, a quick release mechanism, and an illuminator blade. The retractor blade is adapted to engage and retract tissue, and the quick release mechanism is adapted to couple the handle with the retractor blade. The illuminator blade acts as a waveguide to transmit light by total internal reflection. Light is extracted from the illuminator to illuminate the surgical field. The retractor blade is releasable from the handle without requiring uncoupling of the illuminator blade from the handle and also without requiring optical uncoupling of the illuminator blade from a light source. The retractor may also be adapted to evacuate smoke from the surgical field.

Abstract: A laminoplasty plate for securing a separated lamina portion of a desired cervical vertebra in a relief position and a method of using the same to perform a laminoplasty. In one aspect, a lamina setting tool is presented for positioning the lamina portion of the desired cervical vertebra in the relief position. In one aspect, the tool has a first sidewall section that slides in longitudinal relation to a second sidewall section.

Abstract: A coupling system includes an applicator tool, an anastomotic prosthesis mounted on the applicator tool, and an engagement device. The applicator tool deploys a securement through the prosthesis and tissue which leaves the prosthesis attached to the tissue. The engagement device selectively engages the applicator tool onto the tissue, with the use of suction, in order to facilitate accurate placement of the prosthesis on the tissue and facilitate deployment of the securement into the tissue. The applicator tool and the tissue are able to move together while the engagement device prevents or inhibits relative movement between the applicator tool and the tissue. A method for securing an anastomotic prosthesis to tissue includes applying of suction to engage an applicator tool to the tissue while a securement is deployed out of the applicator tool and into the prosthesis and the tissue.

Abstract: An oral cavity insertion instrument which is to be attached to a monitor device having a long scope portion is provided. The oral cavity insertion instrument is adapted to be used by being inserted into an oral cavity and has a long cover member having a bore which extends in a longitudinal direction thereof, wherein the scope portion of the monitor is adapted to be inserted into the bore. The oral cavity insertion instrument also has a long tongue depressor in the form of a plate. The tongue depressor is provided adjacent to and in contact with the cover member along the longitudinal direction thereof. The oral cavity insertion instrument includes an attachment unit used to attach the cover member to the monitor device. The tongue depressor includes a tip end having a width greater than that of the cover member. A pharyngoscope apparatus provided with the oral cavity insertion instrument is also provided.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: An access assembly is provided including a tubular member having a proximal end and a distal end, the proximal end in mechanical cooperation with a foldable cap member having a first set of lumens extending the length of the tubular member. The access assembly also includes a first ring secured at the proximal end of the tubular member and a second ring secured at the distal end of the tubular member. The foldable cap member is configured to fold in at least one direction to expose a second set of lumens extending the length of the tubular member.

Abstract: A seal anchor member defines a housing defining a longitudinal axis, the housing having leading and trailing ends, and including a plurality of lumens extending between the leading and trailing ends, each lumen being adapted for substantially sealed reception of an object therein and defining a longitudinal axis, wherein at least two of the lumens define longitudinal axes that are non-parallel to facilitate angled, at-rest placement of multiple instruments within the seal anchor member.

Abstract: Embodiments of the present invention include an insertion aid device with a handle, a tongue depressor, a tracheal suction catheter guide, and a guide with a recess formed by a pair of prongs. The guide may be configured to accommodate the cross-sectional shape of a tracheal suction catheter, a nasogastric tube, or an orogastric tube. The tracheal suction catheter guide may include a connection port configured to couple to an in-line suction catheter. A light source may be included with the insertion aid device.

Abstract: A forceps for use in surgery for dissecting tissue includes a pair of jaw members movable from an open position in spaced relation relative to one another to a closed position. The jaw members each have an outer housing extending along the length thereof to a distal end of the jaw members. The outer housing of one of the jaw members includes a textured surface at a distal end configured to interface with and dissect tissue during the movement of the jaw members from the closed to open positions. A dissecting tip may be selectively extendable from a channel defined in one of the jaw members to engage and separate tissue when in the extended position.

Abstract: A surgical apparatus includes a housing member and an inner member. The housing member includes an expandable material that is adapted to transition between a compressed condition and an expanded condition. In the expanded condition, an outer surface of the housing member is adapted for a substantial sealing relationship with tissue upon insertion of the housing member within the tissue for accessing an underlying tissue site. The housing member has leading and trailing ends that define a longitudinal axis. The inner member is operably associated with the housing member and includes one or more longitudinal portals extending therethrough adapted for substantially sealed reception of a surgical object. The inner member may be less compliant than the housing member. The inner member may rotate about the longitudinal axis of the housing member.

Abstract: An improved access assembly is provided. The access assembly includes a tubular member having a proximal end and a distal end, the tubular member including at least one section extending at least a portion of a length therein. The access assembly further includes a first ring including a plurality of first segments and secured at the proximal end of the tubular member and a second ring including a plurality of second segments and secured at the distal end of the tubular member. At least two segments of the first plurality of segments are independently expandable. At least two sections of the plurality of sections are independently expandable.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: A device for accessing the intra-thoracic space without the need for a thoracotomy or sternotomy includes a cannula having a shaft positionable through a supra-sternal incision into a retrosternal space and a stabilization system for supporting the cannula in a fixed position. The cannula includes illumination features used to illuminate the retrosternal space, giving clear, direct visualization of the retrosternal space during dissection to, and performance of procedures at, the surgical site.