Abstract: Variable length blades for use with a retractor or distractor include a fixed upper portion and an adjustable extension that allows adjustment to accommodate a wide range of patients. A variable length retractor blade has a fixed upper portion that can vary in length from 10 to 15 cm. having a telescoping extension that can be adjusted to vary the length of the blade from 12 to as much as 24 cm. The variable blades include conventional flanges with a header for securing the variable blades on the end of retractor/distractor arms. An additional option is the inclusion of tubular guides in the variable length blade extension for placement of plurality of fixation screws and a light pipe to provide intensive illumination for the surgical site. Three tubular guides are provided in the upper and lower ends of the telescoping extension on the variable length blade for use with a distractor.

Abstract: A self-supporting retractor for holding open an anatomic space for performing endoscopic surgical procedures. The retractor includes a substantially rigid elongate member, having proximal and distal ends, and having an arch shape or "C" cross-section, defining a passage and longitudinal working window along the retractor. The distal end is preferably rounded or streamlined to facilitate insertion along a dissected space with minimized tissue trauma, and may include a hooded portion enclosing the passage at the distal end. The elongate member may include radially-cooperating segments or self-retaining edges to maximize the area of the space held open by the retractor. The retractor may include a handle or a pivotable finger grip on the proximal end to manipulate the retractor during use, and/or a curved handle to tent the incision providing access to the dissected space. The retractor may also include a channel member for an endoscope, integrally formed or pivotally attached to the retractor.

Abstract: The present invention is directed to new and useful methods and apparatus for isolating and immobilizing tissue for improved presentation in a surgical site, preferably in coronary bypass on a beating heart. At the same time, the present invention also helps avert ischemic damage to tissues downstream. A surgical stabilizer in accordance with the present invention offers physical manipulation of a surgical site, which improves the surgeon's sewing, grasping, and visualizing abilities at the site, and in turn, may increase the confidence and patency of the graft. The stabilizer is used to compress or to suction a region of the heart just below a stenotic coronary artery. The surgeon may selectively articulate the tissue by spreading it apart or pushing it together, as per his or her preference, or per the requirements of the surgical situation. The surgeon may lock in place the handle via a ratchet mechanism to hold the specific open or closed articulation of the surgical stabilizer.

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

Abstract: A combined eyelid retracting and eye flushing device that permits an operator to retract the upper eyelid of a patient for selective eye flushing or other treatment. The device comprises a frame with spaced apart ends. One end forms an integral handle and the other end defines a peripheral edge that forms an arcuate lip for securing the eyelid to the frame. A plurality of spaced apart orifices penetrate the lip to distribute suction along the entire edge surface. An integral flushing system attached to the frame near the lip comprises an irrigator with a hollow stem protruding outwardly from one side of the frame and an aspirator with a hollow stem protruding oppositely. The irrigation stem terminates in a nozzle that selectively sprays liquids upon the eye and the aspiration stem terminates in a receptive orifice that drains run-off liquids and entrained contaminants therefrom. The lip, irrigator and aspirator all connect to a plurality of channels housed inside the frame.

Abstract: An apparatus and method of performing a cholecystectomy procedure through a 3-centimeter incision in the minimum stress triangle through the falciform ligament which provides for direct vertical view of the biliary ducts during dissection. Special tools are provided for this type and other types of surgical operations including obtuse-angled retractors having optionally fixed thereto lighting devices and/or suction devices.

Abstract: A retractor apparatus for use in conducting a surgical operation through an incision in a patient. The retractor includes a retractor support, a plurality of surgical retractors, and a stretchable sleeve. The surgical retractors are mounted to the retractor support such that at least two of the surgical retractors are facing each other. The stretchable sleeve encircles the surgical retractors to form a continuous surface around the surgical retractors for engagement of tissue.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patent's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide assess for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tubular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows movement relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.

Abstract: A disposable uterine manipulator including a pivotable tip support at the distal end of an elongated insertion rod for carrying a manipulator tip assembly, the tip support being rotatable by a manual drive at the proximal end of the insertion rod via a drive linkage to effectuate a range of rotation of the tip support of at least greater than 90.degree. anteversion and at least greater than 30.degree. retroversion. The manual drive may be an articulated linkage, a belt drive, or an axle drive. Several designs for a manipulator tip assembly including a balloon and a dye injection passage are also disclosed.

Abstract: An instrument for manipulating organs in endoscopic procedures in the interior of the body includes two spreading members at the distal end of the instrument. The spreading members can be swiveled outwardly and actuated by means of a handle at the proximal end of the instrument. A control member displaceably guided in the instrument shaft connects the handle and spreading members. The distal end of the instrument is bent in such a way that the spreading members spread out in a curved plane so that organs can be reliably guided with the manipulator.

Abstract: An improved vaginal speculum includes a lower blade member having a straight segment, a curved portion, and a hollow leg portion. The speculum also includes a slide member, an upper blade member rotatably and slidably movable relative to lower blade member, and a light pipe extending from the hollow leg toward the straight segment of the lower blade. The light pipe is adapted to direct light from a light source positionable within the leg, into a region under examination. The upper blade is provided with a smoke evacuation passage formed by a U-shaped channel member positioned adjacent a contoured interior surface of the upper blade member. The U-shaped channel member is provided with a forward end, a rearward end, a bottom surface, and a pair of opposed side walls each having a top edge shaped to fit snugly against the contours of the interior surface or retaining walls formed thereon.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patient's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide access for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tabular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows swinging relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.

Abstract: A mechanically expandable retractor for use in arthroscopic surgery. The retractor has an expanding portion at its distal end for expanding against sub-surface tissues when the retractor is in use. The expanding portion includes a plurality of radially expanding The radially outermost surface of each arm when expanded is longitudinally disposed approximately at the distal end of the retractor. The expanding arms can be disposed irregularly circumferentially around the retractor to expand the tissues to provide a working space between adjacent arms. The retractor is inserted through a small percutaneous opening, expanded in sub-surface tissues without significantly damaging the tissue, then collapsed after use for removal. The retractor has a projecting portion at a proximal end of the retractor for manipulating the retractor, to allow the surgeon to push or pull or lever on tissue.