Abstract: A retractor for use in surgical operations comprises a pair of blade assemblies. In operation, the blade assemblies are initially in a closed position to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The retractor is adapted to rotate a first blade about a first axis and a second blade about a second axis. The retractor is adapted to move the pair of blade assemblies apart along a third axis. The retractor is adapted to pivot the first blade about a fourth axis and the second blade about a fifth axis. In some embodiments, a method of performing an operation, e.g. a spinal operation, on a patient using the disclosed retractor is provided.

Abstract: A retractor for use in surgical operations comprises a pair of blade assemblies. In operation, the blade assemblies are initially in a closed position to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The retractor is adapted to rotate a first blade about a first axis and a second blade about a second axis. The retractor is adapted to move the pair of blade assemblies apart along a third axis. The retractor is adapted to pivot the first blade about a fourth axis and the second blade about a fifth axis. In some embodiments, a method of performing an operation, e.g. a spinal operation, on a patient using the disclosed retractor is provided.

Abstract: Devices, systems, and methods for measuring a force applied to a joint during a surgical procedure are disclosed. The device includes an insertion tool, a handle, and one or more force indicators. The insertion tool includes an insertion end and a base end. The one or more force indicators may be attached to the insertion tool and the handle. The insertion end of the device may be inserted into a joint during a surgical procedure and used to apply a force to the joint and/or measure the force using the one or more force indicators when the force is applied.

Abstract: A retraction device, e.g., a programmable stiffness state tissue displacement device, for providing increased visibility during an operation is provided. The device includes one or more strips of compliant jammable layer components connected in parallel, and encapsulated within a flexible envelope such that each of the one or more strips of compliant jammable layer components are pneumatically connected. The device further includes a negative pressure pump coupled to the flexible envelope, such that the application of negative pressure to the flexible envelope by the negative pressure pump causes the one or more strips of compliant jammable layer components to jam and thereby transition the retraction device from a malleable state to a rigid state.

Abstract: Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.

Abstract: A retractor includes a body, a first handle pivotally coupled to the body, a first attachment assembly comprising a first button configured to allow detachment of a second handle portion from the first handle, a first arm assembly attached to the first handle, a first blade attached to the first arm assembly, wherein the first handle is configured to control distraction of the first blade in response to pivotal motion of the first handle, a second handle pivotally coupled to the body, a second attachment assembly comprising a second button configured to allow detachment of a fourth handle portion from the second handle, a second arm assembly attached to the second handle, and a second blade attached to the second arm assembly, wherein the second handle is configured to control distraction of the second blade in response to pivotal motion of the second handle.

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: A delicate tissue retraction system for use with a navigation probe having a probe shaft and a probe tip at a distal end of the probe shaft. The delicate tissue retraction system includes a retractor and an introducer that is removably installed within the retractor. The introducer has a wall forming a hollow channel extending from a proximal introducer end to a distal introducer end. A mount is integrally formed with the introducer and extends from the distal introducer end into the channel. The mount is positioned to surround the probe tip when the navigation probe is at a fully inserted position within the introducer with the probe tip at the distal introducer end.

Abstract: The present disclosure can include a system including a surgical arm, a retractor connected to the surgical arm, a force sensor mounted on the surgical arm, the force sensor configured to receive sensor data indicating force on the retractor from the force sensor, and a magnetorheological fluid actuator for actuating the surgical arm, the actuator configured to actuate according to the received sensor data, and adjust the surgical arm according to the received sensor data so as to maintain a constant retraction force. The present disclosure can additionally include a method for retracting tissue including applying force to the tissue with a magnetorheological fluid actuator to induce a retraction force, sensing a change in force applied to the tissue using a force sensor, and maintaining the retraction force by adjusting the force applied to the tissue.

Abstract: The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.

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: A 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: A surgical retractor includes a first member defining a longitudinal axis. The first member includes a blade disposed in spaced apart relation relative to the longitudinal axis and a grip surface. A second member has a blade disposed in spaced apart relation relative to the longitudinal axis and a grip surface. The grip surfaces are configured to be drawn together along the longitudinal axis such that the blades are engageable with tissue and connected with the grip surfaces such that the grip surfaces provide a tactile feedback of the tissue engagement. Systems and methods of use are disclosed.

Abstract: A surgical elevator device that can be used in the reduction of bone fractures, particularly facial bone fractures, and even more particularly zygomatic arch fractures. The elevator device enables accurate measurement of the depth of insertion of the device into tissue space and provides tactile control of fracture location and reduction. In one embodiment, the elevator device comprises a groove on an elevator element for receiving a bone structure. The groove can be formed by a pair of parallel ridges. A projection extending from the elevator provides a pivot point for applying a controlled force to the bone to reduce the fracture. A preferred embodiment further comprises a method of reducing a bone fracture, such as a zygomatic arch fracture.

Abstract: A tissue retraction system comprising a drive gear coupled to a shaft. The tissue retraction system includes a first plurality of linking members located along a second axis and configured to rotate along the second axis based on contact with the drive gear as the drive gear is rotated. The tissue retraction system includes a linking member selector configured to rotate along the first axis, wherein the linking member selector comprises a cylindrical body integrally formed with a handle. The tissue retraction system includes a right arm assembly configured to move along a first trajectory. The tissue retraction system includes a first retractor blade coupled to the right arm assembly. The tissue retraction system includes a left arm assembly configured to move along a second trajectory. The tissue retraction system includes a second retractor blade coupled to the left arm assembly.

Abstract: Systems are provided that allow improved instrumentation and access during a surgical procedure including for instance a lateral approach minimally invasive spinal fusion.

Abstract: A retractor, distractor, and camera system with the camera system and/or distractor configured to provide releasable attachment of the camera system to the distractor, and also provide for rotation of the camera assembly relative to the distractor to allow for adjusting the aim of the camera viewing axis to obtain an image of the surgical workspace established by the retractor.

Abstract: A cardiac retractor is disclosed. The cardiac retractor has an outer tube. The cardiac retractor also has a fixed collar fixedly coupled to a proximal end of the outer tube. The cardiac retractor further has a fixed link fixedly coupled to a distal end of the outer tube. The cardiac retractor also has an inner tube rotatable within the outer tube. The cardiac retractor further has a fixed key coupled to a proximal end of the inner tube and configured to rotate the inner tube relative to the outer tube. The cardiac retractor also has a keyed link coupled to a distal end of the outer tube.

Abstract: An access system for spinal surgery through a lateral approach comprises a tissue retractor including a center body supporting a centering guide having an elongate opening defining an alignment axis. A pair of retractor blades are movably supported by the center body one blade each on either side of said the centering guide, each retractor blade having a proximal end and a distal end, the distal ends of each retractor blade being configured for placement adjacent a spinal column of a patient. A plurality of elongate disc anchors is provided, each disc anchor being sized for individual removable receipt through the centering guide opening. Each disc anchor has a length such that the distal end of each disc anchor extends distally beyond the distal ends of the retractor blades when each disc anchor is respectively disposed in the centering guide opening.

Abstract: A technique for correcting a bone deformity, such as a bunion, may be performed using a fulcrum. In some examples, the technique involves inserting a fulcrum between a first metatarsal that is anatomically misaligned with respect to a second metatarsal. The technique further includes preparing an end of the first metatarsal and preparing an end of a medial cuneiform opposing the end of the first metatarsal. In addition, a distal portion of the first metatarsal is moved toward the second metatarsal in a transverse plane, thereby pivoting a proximal portion of the first metatarsal about the fulcrum and reducing an intermetatarsal angle between the first metatarsal and the second metatarsal.

Abstract: In one embodiment, the present disclosure relates to an instrument adapted for use in an anterior to psoas spinal access procedure. The instrument includes a body, a first arm and a second arm. A first rod extends from the first arm at an angle thereto while a second rod extends from the second arm at an angle thereto. Each of the first rod and the second rod include a length with a first portion and a second portion, the first portion having a convex surface perimeter and the second portion having a perimeter different from the first portion and being convex in part. In some embodiments, a kit includes the instrument and a blade adapted for use in conjunction with the instrument in an anterior to psoas spinal access procedure.

Abstract: The present disclosure can include a system including a surgical arm, a retractor connected to the surgical arm, a force sensor mounted on the surgical arm, the force sensor configured to receive sensor data indicating force on the retractor from the force sensor, and a magnetorheological fluid actuator for actuating the surgical arm, the actuator configured to actuate according to the received sensor data, and adjust the surgical arm according to the received sensor data so as to maintain a constant retraction force. The present disclosure can additionally include a method for retracting tissue including applying force to the tissue with a magnetorheological fluid actuator to induce a retraction force, sensing a change in force applied to the tissue using a force sensor, and maintaining the retraction force by adjusting the force applied to the tissue.

Abstract: An illuminated medical system comprises a medical instrument and a light transmitting waveguide. The waveguide projects lights from a distal portion of the waveguide toward a target area. The waveguide is formed primarily of a cyclic olefin copolymer or a cyclic olefin polymer.

Abstract: An introducer set for a microwave ablation probe is disclosed. The introducer set includes a cannula that is at least partially transparent to microwave energy, and a stylet sized to be received by the lumen of the cannula. Other examples provide a microwave ablation system including a microwave ablation probe having a radiating portion and a cannula that is at least partially transparent to microwave energy. The radiating portion of the probe aligns with the transparent portion of the cannula when the probe is inserted into the cannula lumen. The technology provides a method including introducing a microwave ablation probe into the lumen of a cannula having a cannula body that is at least partially transparent to microwave energy, aligning the transparent portion of the cannula with the radiating portion of the probe, and causing microwave energy to be emitted from the radiating portion of the probe.

Abstract: A device for applying a compressive force to the uterus, the device comprising a contact portion for contacting the uterus and providing a compressive force thereto, and at least two elongate handles each extending from the contact portion along a respective longitudinal axis. The at least two elongate handles are configured to facilitate insertion of the device into the body and handling of the device from outside the body when inserted. At least a part of the contact portion is configured to be radially moveable relative to the longitudinal axes between a first radial position and a second radial position where the second radial position is radially outward of the first radial position.

Abstract: Configurations are described for conducting minimally invasive medical interventions utilizing elongate instruments and assemblies thereof to stabilize and/or fixate a sacro-iliac joint. In one embodiment, a tool assembly may be advanced from a posterior approach into the SI junction and configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly. After a defect is created, the tool assembly may be retracted and a prosthesis deployed into the defect.

Abstract: An illuminated medical system comprises a medical instrument and a light transmitting waveguide. The waveguide projects lights from a distal portion of the waveguide toward a target area. The waveguide is formed primarily of a cyclic olefin copolymer or a cyclic olefin polymer.

Abstract: The invention comprises an apparatus for covering an exposed end of a severed sternum, comprising a strip operative to cover the exposed end and pliable portions which are able to be manually deformed over sides of the exposed end so as to retain the strip against the exposed end to stop or at least reduce flow of blood from the exposed end.

Abstract: Intra-abdominal liver retraction devices and methods of use. One device includes a body, a stabilizing member, and a lifting filament. The stabilizing member is configured to be swiveled so that the device can be introduced through a trocar into the abdomen of a patient. The filament pulls the stabilizing member into engagement with the abdominal wall while a foot section lifts the liver. Another device includes first, second and third sections coupled together by a filament. The first and second sections are pivotably connected by a first pivotable joint. The second and third sections are pivotably connected by a second pivotable joint including the flexible filament. The second and third sections are pivoted with respect to each other to form a support surface to lift the liver by pulling the filament. The second pivotable joint separates to enable the device to be removed.

Abstract: A spine retractor provides lateral access to the spine for distracting soft tissue and psoas muscle for spinal fusion procedures utilizing position controllable blades. The retractor allows concerted linear distraction of two lateral blades and separate linear distraction of one medial blade. Individual angulation assemblies associated with each blade provides separately controllable angulation. Handles attached to the two lateral blades control their distraction while a medial knob controls medial blade distraction. An expansion knob associated with each handle provides individually precise distraction of its associated blade. Each angulation assembly comprises an angulation knob that threads into a distal arm of a blade holder assembly and is received into a spherical ball seated in a spherical pocket in a mating proximal arm of the blade holder assembly. Torque applied to the spherical ball by the angulation knob causes distal arm angulation relative to the proximal.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios 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: A mounting clamp is disclosed for an illuminated surgical retractor system having a handle that supports an illuminated surgical retractor blade. The mounting clamp is attached to and depends from the handle. The mounting clamp includes a receptacle for receiving a slide bar or other fixed component of an operating room table. The clamp further includes a fastener that is selectively tightened to secure the retractor assembly to the fixed component of the table. The fastener is selectively loosened to disengage the retractor assembly from the fixed component of the table.

Abstract: Devices, systems and methods for minimally open orthopedic spine surgery are disclosed. A first flexible screw-based retractor is designed to be coupled to each pedicle screw inserted into adjacent vertebral bodies. A retractor system is provided in which a first retractor blade is mounted to one of the screws and a second movable retractor blade is moved away from the first blade, in a medial direction, to create a working channel through which the disc space may be accessed for passing instruments and implants. Light may be incorporated into the device to illuminate the surgical field. One or all of the retractor blades may be made of a sterilizable plastic or metal and be disposable or reusable.

Abstract: A cardiac retractor is disclosed. The cardiac retractor has an outer tube. The cardiac retractor also has a fixed collar fixedly coupled to a proximal end of the outer tube. The cardiac retractor further has a fixed link fixedly coupled to a distal end of the outer tube. The cardiac retractor also has an inner tube rotatable within the outer tube. The cardiac retractor further has a fixed key coupled to a proximal end of the inner tube and configured to rotate the inner tube relative to the outer tube. The cardiac retractor also has a keyed link coupled to a distal end of the outer tube.

Abstract: Methods and surgical tools for treating back pain use a spinal facet debridement tool with cautery and denuding action and minimally invasive protocol that can denude and cauterize soft tissue associated with a synovial capsule of the spinal facet joint whereby the synovial capsule between the spinal facet joint is removed by rotating the head of the combination debrider tool at a low rotation speed to scrape and cauterize the end plate receptor region so as to denude and denervate the joint preventing regeneration, and thereby treating back pain.

Abstract: An illumination element has a light input section, a light transmitting section, and a light output section. The light input section is optically coupled to a proximal section of the light transmitting section and inputs light into the illumination element. The light transmitting section transmits the light by total internal reflection or by other transmission means. The light output section is adjacent a distal section of the light transmitting section which has a light extraction area from which the light exits with an energy density. The light extraction area comprises a bore extending at least partially inward into a distal end of the light output section. A plurality of optical structures is disposed on an inner wall of the bore. The optical structures are configured to extract light from the light output section and direct it toward the surgical field.

Abstract: A surgical retractor includes a part defining a longitudinal axis. A first radiolucent blade is connected with the part. A second radiolucent blade is connected with the part. The blades are independently translatable relative to the part. At least one of the blades includes spaced apart arms that are connected via a member. The member and the arms are relatively disposed in a configuration to guide at least one surgical instrument in a selected orientation relative to a surgical site. Surgical systems, instruments, constructs, implants and methods are disclosed.

Abstract: Medical devices and methods of using medical devices are disclosed. An example tissue retraction device includes a first tissue engagement member coupled to an elastic member by a coupling assembly. The coupling assembly including a first coupler body having a first end region and a first compression member. Further, the first end region of the first coupler body is configured to extend into a portion of a lumen of the elastic member and the compression member is designed to compress the elastic member onto the first coupler body such that the elastic member is fixedly engaged with the coupler body.

Abstract: A joint distraction lever for measuring a distraction force is disclosed. The joint distraction lever includes a lever body having a handle portion and a working portion. The lever body has a fulcrum extending from a bottom surface of the working portion of the lever body and a distal tip, wherein the distal tip is raised above a top surface of the working portion of the lever body. The joint distraction lever is configured to measure a distraction force applied at the distal tip during a distraction procedure when a torque is applied by an external force applied on the handle portion of the lever body. The joint distraction lever further includes an indicator configured to provide feedback related to the distraction force applied at the distal tip, as measured by the joint distraction lever.

Abstract: An implant insertion instrument provides a guide through tissue (skin, fascia, musculature) and into a vertebral space after a discectomy. The instrument slides onto a guide wire and defines a path for the implant to be delivered to the vertebral space. The guide expands laterally as required to accommodate the implant as the implant slides through a channel defined in the guide, which allows distraction of the vertebral bodies while maintaining a small incision in the patient.

Abstract: The present invention describes a system, devices and methods for percutaneous pedicle screw revision procedures. The present invention utilizes a tulip rod stub/connector adapted to be used to extend pedicle screw/rod constructs with minimal disruption to surrounding soft tissue and without having to remove existing hardware.

Abstract: A system for mounting a retractor tube to a spine without a guidewire is disclosed. The system includes an awl, a first dilator configured to be advanced over the awl, a retractor tube configured to be advanced over the first dilator, wherein an outer surface of the retractor tube defines a plurality of channels, and a plurality of pins adapted to be received within the plurality of channels, wherein the plurality of pins secure the retractor tube to the at least one vertebral body of the spine. A method for selectively mounting a retractor tube to a spine without a guidewire is also disclosed.

Abstract: A retractor holds a surgical incision in a body in an opened state to ensure a surgical field in small-incision endoscopic surgery, and includes a base body that is a thin plate made of tin having a purity of not less than 99.9% and has an elongated rectangular shape in an extended state of the base body. The retractor, in an extended form in a rectangular shape or in a rounded form in a small shape, can be inserted from a small incision wound into the body, and can easily be delivered to the surgical incision in the body by a surgical instrument. The base body is bent and deformed into a desired shape by the surgical instrument and is applied to the surgical incision in the body, so that the surgical incision can be held in an opened state so as to ensure the surgical field.

Abstract: Apparatus and methods for the treatment of abnormal spinal stability and stenosis of the spinal canal. In one embodiment, the apparatus and methods provide treatment via decompression and/or fixation of the spinal canal. One or more implants are used to fixate the posterior column of a spinal segment compromised of the superior and inferior immediately adjacent vertebral bones. In one variant, these disclosed devices are used to fixate the posterior column of a spinal segment while another orthopedic implant is placed into the anterior column of the same spinal segment, thereby providing circumferential decompression.

Abstract: The present disclosure relates to a cannula. The cannula includes a shaft having a distal end and a proximal end and a handle coupled to the proximal end of the shaft. The distal end of the shaft includes a tip having a spherical radius.

Abstract: Systems, devices, and methods of the present application can accelerate and reduce medical complications associated with healing of amputation wounds. The devices and methods utilize a compression structure and negative pressure to cause the amputation wound to preferentially close from the deepest portion of the wound to the shallowest portion.

Abstract: A probe unit includes, a probe configured to treat a bone by ultrasonic vibration, a hollow sheath which surrounds the probe and which has a first portion at a small distance from a central axis, and a second portion at a greater distance from the central axis than the first portion, and a knob configured to rotate the sheath relative to the probe between a first position for insertion between the bone and a living tissue facing the bone so that the first portion is located between the bone and the living tissue and a second position for insertion between the bone and the living tissue so that the second portion is located between the bone and the living tissue.

Abstract: The present invention provides a surgical device comprising: an elongate body with a proximal end and a distal end, the elongate body comprising an abutment portion comprising a pair of integral outwardly flaring elongate wings which between them define a channel adapted for receiving a longitudinally adjacent trocar; and attachment means capable of attaching the elongate body to tubing. Also provided are methods of manufacturing the device of the invention, methods for inserting the device of the invention into an incision in a patient, and methods for delivering suction or fluid to an internally located apparatus using the device of the invention.

Abstract: A ring that can maintain a pupil in an extended position during an ophthalmic procedure. The ring has a plurality of loops that capture iris tissue. The ring is configured to extend the pupil when iris tissue is inserted into each loop. An ophthalmic procedure such as phacoemulsification can then be performed on the patient. The ring has a center opening that provides a wide view of the ocular chamber during the procedure.

Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.