Abstract: The grasping retractor has an arm member and a blade member with a jaw portion at one end and a recurved handle portion at the other end. A clamping bracket is pivotally attached to the blade member, and has a jaw portion located to move into engagement with the jaw portion of the blade member when the clamping bracket is pivoted. A locking mechanism holds the clamping bracket secure, allowing the blade member to function as a retractor without slipping.

Abstract: A device and method are disclosed for dampening the heart motions of a patient's beating heart in a local area of a desired surgical site. The heart motion dampening is provided by a ring-like structure having prongs attached thereto, wherein the prongs engage or penetrate heart tissue in a manner effective for both anchoring the device of the present invention and for transmitting heart motion dampening resistive forces to the area about the surgical site so that the patient's heart is substantially still at the surgical site.

Abstract: A endoscopic device provides improvements in the endoscopic working space by the use of a semi-tubular hood with an arched top wall and self-supporting walls that allow simultaneous manipulations of dissection, cutting, ligation, and retraction, and the like, without requiring constant application of external force; while enhancing visualization and reducing the need for cleaning the endoscopic lens.

Abstract: The present invention relates to a surgical retractor that immobilizes tissue at a surgical site. A preferred embodiment, of the retractor is used during minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. Tape or thread can be used to connect the artery to the retractor with a holder.

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: A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be used in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

Abstract: Devices and methods for performing percutaneous spinal surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30). The fixture (30) includes a housing (31) attachable to the proximal end (22) of the cannula (20) that defines a working channel opening (35) which is in communication with the working channel (25). The housing (31) also defines an optics bore (60) adjacent the working channel opening (35).

Abstract: A surgical instrument includes a frame structure defining proximal and distal portions. The proximal portion has an articulating arm for repositionably mounting to a base and the distal portion supporting a stabilizing member. An attachment mounts on the stabilizing member, the attachment being configured and dimensioned such that upon contact with the heart the engaged heart tissue bulges outward. A method of surgery using the attachment includes providing a frame structure defining proximal and distal portions, the proximal portion being repositionably mountable to a base, supporting an attachment on the stabilizing member and engaging heart tissue with the attachment such that the tissue bulges outward to better present the tissue for surgery.

Abstract: A surgical retractor, particularly suitable for soft tissue surgery such as plastic surgical procedures. The retractor has an elongate planar portion with a proximal end and a distal end, a main body portion therebetween, an upper surface and a bottom surface. The distal end of the retractor has a generally semi-circular shape, and has teeth extending from the perimeter thereof which extend above the upper surface of the retractor. The plurality of teeth are generally triangular in shape with apexes extending upwardly from the plane of the upper surface of the retractor and the teeth are smooth along their edges and apexes. The retractor is formed of generally rigid, yet malleable material, such as metal or plastic.

Abstract: A surgical retractor for use in performing surgery upon a patient at a surgical siting includes an annular frame conformed to fit the surface of the patient's body at the site, the frame having a plurality of notches, each having a width. A plurality of stays are provided each including an elongated elastic member having a length, a width, and proximal and distal end portions. The width of each elastic member is preferably greater than the width of the notches so that the stay forms a connection with the annular frame by engaging a selected portion of the elastic member into a notch. At least a portion of one of the elastic members includes a section of hollow elastic tubing having a bore surrounded by a tubing wall. A tissue holding member includes a handle plate forming a first plane, the plate having a thickness, a length, and a height. A wide section of the tissue holding member is much wider than the diameter of the tubing.

Abstract: Devices and methods for minimally invasive harvesting of a vessel or vascular conduit, especially the saphenous vein for coronary artery bypass grafting, are disclosed. Generally, an instrument is provided which has one or more specially designed end effectors which are permanently or detachably mounted to a harvesting implement, and may also be interchangeable with each other. The end effectors have features or elements which facilitate separation of connective tissue from the vessel and/or engagement of side branches to be separated from the vessel. In various embodiments, the instrument also provides means for quickly and easily attaching and detaching the end effectors as well as means for engaging with an endoscope, if desired. The harvesting methods provide for use of the instruments through one or more minimally invasive incisions.

Abstract: A tissue retractor with particular use in spinal surgery comprises a pair of pivotally linked arms, each with a blade mounted thereto by a ball and socket joint to allow the blades free movement relative to the arms. The blades have anchoring end to anchor to bone, which preferably are sharp piercing tips. The balls and the sockets are preferably detachable from each other. The retractor is operable by placing the blades in a wound opening; securing the anchoring ends to a portion of bone at positions a distance apart from each other to define a desired surgical field; and operating the retractor to cause the blades to separate and to retract tissues surrounding said wound opening by outward pivoting of the blades relative to the position of the anchoring ends. A supplemental retractor blade or blades may be provided by a linking armature for additional retraction generally perpendicularly to a retraction action provided by the main retractor blades.

Abstract: A method for removing a vessel from a patient's body comprises the steps of identifying the vessel to be removing and providing an incision in the patient's body near the identified vessel. An optical dissector is inserted through the incision and tissue is optically dissected away from the surface of the vessel with the optical dissector. The optical dissector is then withdrawn from the body through the incision. An optical retractor is inserted into the body through the incision and is used to retract the dissected tissue away from the surface of the vessel thereby providing space between the dissected vessel and the retracted tissue. The vessel and its side branches are then dissected, ligated and transected and the vessel is then removed from the body through the incision.

Abstract: A method for removing a vessel from a patient's body comprises the steps of identifying the vessel to be removing and providing an incision in the patient's body near the identified vessel. An optical dissector is inserted through the incision and tissue is optically dissected away from the surface of the vessel with the optical dissector. The optical dissector is then withdrawn from the body through the incision. An optical retractor is inserted into the body through the incision and is used to retract the dissected tissue away from the surface of the vessel thereby providing space between the dissected vessel and the retracted tissue. The vessel and its side branches are then dissected, ligated and transected and the vessel is then removed from the body through the incision.

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: A surgical device for dissecting and retracting tissue includes a scope holder for holding an endoscope therein and a transparent concave head connected to the scope holder. The concave head defines a working space therein. A fluid carrying system is operatively connected to and communicates with the concave head and the working space for clearing particulate from the working space.

Abstract: Apparatus and method for endoscopically harvesting an elongate structure such as a blood vessel or nerve from a patient's body. A harvesting head defines a channel for receiving a blood vessel or the like and an outer surface for dissecting and retracting connective tissue surrounding a vessel received in the channel. The head may have a substantially ovate shape and may depend from an extended handle. The head has at least one slot that extends between the outer surface and channel for receiving side branches of the vessel. The slot contains a blade for cutting the side branches and electrocauterizing plates for sealing the cut ends of the side branches. An opening may be provided for application of a ligation device to the side branch. The apparatus may be inserted into an incision in a patient's body and advanced along the length of a vessel to endoscopically dissect, ligate and transect the side branches to harvest the main trunk of the vessel to support subsequent surgical procedures.

Abstract: A surgical retractor assembly includes a handle and a retractor blade connected to the handle by a connecting pin. The connecting pin has a handle-connecting portion that extends through an aperture in the handle and a blade-connecting portion with spaced-apart flanges separated by a blade engaging portion that engages a slot in the retractor blade.

Abstract: A nonabsorbent holding member adapted for use within an abdominal cavity of a patient defined by an anterior wall, a posterior wall and two lateral walls to keep the patient's bowels out of the operative field during open pelvic surgery. The holding member is a substantially U-shaped planar member having a peripheral edge formed of a resiliently deformable material sized to be received within the abdominal cavity. The resilient deformation of at least a portion of the peripheral edge of the holding member results in a residual reactive force against the abdominal cavity to assist in positioning the holding member in the abdominal cavity. The peripheral edge includes a continuous groove lying in the plane of the holding member which circumscribes the elastically deformable peripheral edge to facilitate secure positioning of the holding member within the abdominal cavity.

Abstract: A laparoscopic elevator to simultaneously lift the four quadrants of an abdominal cavity for laparoscopic surgery, comprising al least a lifting member for each quadrant, each of which is individually introduced into the abdominal cavity of a patient and including; a horizontal lifting portion in order to lift the abdominal wall of a the abdominal cavity of the patient; a vertical flat holding portion, at approximately 90.degree. regarding the horizontal portion; and an elbow portion which has an angular torsion to place the horizontal portion oriented towards one of the quadrants regarding the vertical portion of the first lifting member; and a holding handle which receives and holds each of the vertical portions of the lifting members.

Abstract: A surgical retractor made of polymeric material is provided for use especially with electric scalpels.

Abstract: A hand-held retractor that is adapted for endoscopic use at a predetermined area of a patient. The retractor is comprised of a longitudinally-extending blade with a proximal end, a distal end, and a top surface. A handle is connected to the proximal end of the blade by a separating member, which is preferably arcuate. The separating member is configured to allow a surgeon direct access to and visualization of the area adjacent the top surface and distal end of the blade after positioning the distal end of the blade at the predetermined area. Also provided is a method of endoscopic retrosternal adhesiolysis which utilizes a retractor to provide access to and visualization of adhesions adjacent the cranial portion of a patient's sternum while retracting away and protecting underlying tissue.

Abstract: A nonabsorbent holding member adapted for use within an abdominal cavity of a patient defined by an anterior wall, a posterior wall and two lateral walls to keep the patient's bowels out of the operative field during open pelvic surgery. The holding member has a peripheral edge formed of a resiliently deformable material sized to be received within the abdominal cavity. The resilient deformation of at least a portion of the peripheral edge of the holding member results in a residual reactive force against the abdominal cavity to assist in positioning the holding member in the abdominal cavity.

Abstract: A surgical retractor comprising a base adapted to lie on the patient's skin, a handle slidably mounted with respect to the base, a tissue retracting blade extending from the handle, and a locking member movable from at least a first position to a second position to retain the tissue retracting blade in a selected position. A method for accessing the saphenous vein to facilitate harvesting the vein is also disclosed comprising the steps of making a small incision in the leg of a patient, positioning a retractor on a patient's leg such that a retractor blade extends into the incision and a base lies on the surface of the patient's leg and pulling the retractor blade away from the patient to lift the tissue away from the underlying saphenous vein.

Abstract: A retractor for placement proximate an incision for holding back the edges of the incision, the retractor comprising a pair of substantially elongate retractor portions having outer substantially irregular edges formed along substantially the entire length thereof for engaging and holding back the opposing edges of an incision, and an expansion assembly coupled to the retractor portions for moving the retractor portions between a collapsed position and an expanded position.

Abstract: A handle carries a dry cell battery which supplies current to a microprocessor which receives signals from a sensor on the end of a bill carried by a staff which projects from the handle. The signal to the microprocessor is converted to a display on the handle. The display has alarms to indicate when the retractor applies too much force to a spinal cord or when the force has been applied for too long a time.

Abstract: Abdominal wall retractors is made of a plurality of extension arms to define a plane when expanded. The device is inserted through a small opening in the patient's abdomen, after which it is expanded by manipulation upon the portion remaining exterior to the patient. The retractor then elevates the abdominal wall to facilitate laparoscopic surgery, thus avoiding the need for creation of a pneumoperitoneum or the use of general anesthetic.

Abstract: A surgical drill guide and retractor for treating mandibular fractures includes an adjustable length sleeve having an inner segment slidably mounted within an outer segment. The adjustable length sleeve also has a through-going lumen which connects a first opening at an end of the outer segment with a second opening at an end of the inner segment. The lumen is dimensioned for slidably receiving a drill bit or other instrument therein. A handle slidably retracts the inner segment into the outer segment to expose a preselected length of a drill bit or other instrument inserted through the lumen of the sleeve. A proximal end of the drill guide includes a mandibular retractor which is inserted intraorally or extraorally and has a retractor blade shaped to retract the cutaneous region laterally away from the bone. The retracting blade also has an aperture which allows surgical instruments to be inserted through the aperture to the bone.

Abstract: An apparatus for use in surgery includes an instrument body having a middle portion and first and second ends. The instrument body is S-shaped along its length, with the middle portion being straight. At least one of the first or second ends is serrated for use in dissection of tissue.

Abstract: In a surgical retractor having a frame on which at least two retractor elements are mounted, if desired, so as to be displaceable, to enable individual adjustment of the forces exerted by the retractor elements on the surrounding tissue, it is proposed that the frame have at least one support foot which carries attachment means for fixing on a bone.

Abstract: A method for removing a vessel from a patient's body comprises the steps of identifying the vessel to be removing and providing an incision in the patient's body near the identified vessel. An optical dissector is inserted through the incision and tissue is optically dissected away from the surface of the vessel with the optical dissector. The optical dissector is then withdrawn from the body through the incision. An optical retractor is inserted into the body through the incision and is used to retract the dissected tissue away from the surface of the vessel thereby providing space between the dissected vessel and the retracted tissue. The vessel and its side branches are then dissected, ligated and transected and the vessel is then removed from the body through the incision.

Abstract: A method for removing a vessel from a patient's body comprises the steps of identifying the vessel to be removing and providing an incision in the patient's body near the identified vessel. An optical dissector is inserted through the incision and tissue is optically dissected away from the surface of the vessel with the optical dissector. The optical dissector is then withdrawn from the body through the incision. An optical retractor is inserted into the body through the incision and is used to retract the dissected tissue away from the surface of the vessel thereby providing space between the dissected vessel and the retracted tissue. The vessel and its side branches are then dissected, ligated and transected and the vessel is then removed from the body through the incision.

Abstract: An expandable speculum is described which may be provided in kit form. The speculum includes a handle with an integral eyepiece. A set of first elongated tubular members, each releasably connectable to the handle adjacent the eyepiece are formed of a substantially rigid material. Each includes an external surface and an internal bore formed along a longitudinal axis. A selected one of the tubular members may be selected and attached to the handle. The elongated tubular members in the set include various lengths and cross-sectional dimension at the external surfaces thereof to permit selection according to use and patient physiology. Elastic tubular sheaths are disposed axially over the external surfaces of the first elongated tubular members and are radially inflatable with respect to the first tubular members and said longitudinal axis in response to application of fluid pressure.

Abstract: The present invention provides endoscopic instrumentation and surgical techniques especially useful for accessing at least a portion of an intervertebral disc. Vertebrae spreading instruments are provided for spreading adjacent vertebrae to facilitate access to the intervertebral disc are. The disclosed surgical method uses an anterior approach to access the intervertebral disc and spreads adjacent vertebrae utilizing an endoscopic vertebrae spreading instrument.

Abstract: A tissue spreading surgical instrument having a handle assembly which includes a moveable handle assembly; an elongated shaft extending distally from said handle assembly which houses an actuating mechanism moveable in response to movement of the handle assembly and a tissue spreading assembly comprising a plurality of fingers operatively associated with the distal end of the shaft and deployable between a closed and open position wherein the fingers are spread in opposite direction by the actuation mechanism in response to movement of the handle assembly is provided.

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 method for removing a vessel from a patient's body comprises the steps of identifying the vessel to be removing and providing an incision in the patient's body near the identified vessel. An optical dissector is inserted through the incision and tissue is optically dissected away from the surface of the vessel with the optical dissector. The optical dissector is then withdrawn from the body through the incision. An optical retractor is inserted into the body through the incision and is used to retract the dissected tissue away from the surface of the vessel thereby providing space between the dissected vessel and the retracted tissue. The vessel and its side branches are then dissected, ligated and transected and the vessel is then removed from the body through the incision.

Abstract: The invention relates to an instrument set for laparoscopic vaginal hysterectomy which comprises a uterine rotator comprising a rod with a uterine end for insertion into the uterus and a control end, and with at least one wing moveable in and out of the uterine end which in a folded-out position makes contact with the inner wall of the uterus and which is connected via coupling means to a control member located at the control end, wherein the rod is preferably provided with two wings, and more preferably the rod is provided with a hinge, and with optionally at least one artery forceps provided with a handle and mutually reciprocating jaws.

Abstract: A surgical retractor is disclosed having a handle portion, an elongated body portion extending distally from the handle portion and including an outer tube, a fixed stabilizing member extending from a distal end of the outer tube and a pair of resilient bands pivotably connected to a distal end portion of the stabilizing member. An actuation mechanism is provided which is associated with the handle portion and proximal end portions of the bands for moving the bands between open and closed position. The surgical retractor further includes a sheath dimensioned to receive at least a portion of the stabilizing member and the bands.

Abstract: A nonabsorbent holding member adapted for use within an abdominal cavity of a patient defined by an anterior wall, a posterior wall and two lateral walls to keep the patient's bowels out of the operative field during open pelvic surgery. The holding member has a peripheral edge formed of a resiliently deformable material sized to be received within the abdominal cavity. The resilient deformation of at least a portion of the peripheral edge of the holding member results in a residual reactive force against the abdominal cavity to assist in positioning the holding member in the abdominal cavity.

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 abdominal lift for use in endoscopic surgery is described. The lift defines a substantial portion of a circle. It has a spoke portion and an upstanding member. Its surface may be mechanically compliant and may be coated with an adhesion prevention agent or a lubricous coating. The described method of use includes use of a starter lift followed by insertion of the abdominal lift. The abdominal lift is elevated to establish a pneumoperitoneum at or near ambient air pressure.

Abstract: A pupil expander insertion system for eye surgery includes a pupil expander insertion tool and an iris retracting glide. The insertion tool includes a housing having forward and rearward ends, a hollow chamber in which a piston is axially movable, and an aperture formed in the forward end that communicates with the hollow chamber. A retractable blade for holding a pupil expander in an elongated condition is journaled within the aperture and connected to the piston for longitudinal movement therewith. The forward end of the blade has a slot extending rearwardly, defining a pair of tines wherebetween the expander can be slidably inserted. A stationary hollow spatula surrounds the blade in the retracted position, contacting the pupil expander to slidingly urge it off the retracting blade. The glide has an elongated tongue with a folded tab on one end slidably inserted through a slot means in the other end.

Abstract: In order to make the covered tissue areas visible in an X-ray picture when using a surgical instrument for the retention of tissue which has at least one valve held on one side, also when using a material impermeable to X-rays, it is suggested that the contact surface of the valves have openings in a distribution which leaves an increasing, non-perforated cross-sectional area from the free end of the contact surface up to its holder.

Abstract: A medical retractor having a support shaft on which is threaded a retractor arm drive that supports a retractor arm. The retractor arm drive includes a worm with threads that engage peripheral gear teeth of a worm gear; and the worm gear is threaded onto the support shaft. Rotating the worm, turns the worm gear and moves the retractor arm drive and retractor arm longitudinally along the support shaft. A stop prevents the support shaft from rotating with the worm gear in response to rotation of the worm.

Abstract: There is provided according to the invention a digital retractor to protect ndex finger, palm and thumb of the non-dominant hand of the surgeon during surgery, where the non-dominant hand is used to retract or position tissue. The retractor comprises a curved base plate which fits against the palmar surface of the index finger and extends toward the thumb, and includes one or two rings attached to the base plate through which the surgeon's index finger, and optionally also the long finger, are poised and positioned.

Abstract: Abdominal wall lift devices and methods are disclosed that extend a lift device through an opening in the abdominal wall in an entry configuration and subsequently transform the device to a deployed configuration within the abdominal cavity. One embodiment includes a plurality of elongated bar members that may be introduced into an abdominal cavity in a separated end-to-end orientation. The bar members are subsequently interconnected into a deployed configuration within the abdominal cavity. Another embodiment includes a device that may be introduced through a small opening in an abdominal wall in a generally L-shaped configuration and subsequently deployed into a generally T-shaped configuration within the abdominal cavity. A further embodiment includes an umbrella-like device that may be introduced in a slender generally cylindrical configuration and subsequently deployed into an open umbrella-type configuration.

Abstract: An elevator device for an abdominal wall in videolaparoscopic surgical operations is provided, which comprises mechanical elements (8) for tensioning an abdominal wall (10) and movement means (2) for the mechanical tensioning elements (8), in which the mechanical tensioning elements (8) are embodied by shaped needles having sharpened ends (14a) adapted to be introduced into the subcutaneous tissue (9) of the abdominal wall (10), and in which the movement means (2) comprises raising members (6) and spacing members (28) to move the shaped needles (8) away from each other, adapted to carry out raising of the abdominal wall (10) and tensioning of same transversally of said raising.

Abstract: A grooved slider forming part of an electrode for use with a resectoscope is shown. The electrode includes an electrode lead member having an elongated conductor member. The elongated conductor member has a first end and a second end with an insulative cover extended therebetween. The first end has a protruding electrode adapted to be electrically connected to an electrosurgical generator and the second end terminates in an active member. An electrode support member is operatively connected to the active member. The electrode support member has an elongated semi-rigid bifurcated arm terminating in a conductive core spaced a predetermined distance from the active member. The bifurcated arm is covered with an insulative material except at the distal end where the grooved slider is located. The electrode support member has a grooved slider having a central opening extending therethrough for fixedly mounting the grooved slider on the conductive core of the support member.

Abstract: A guide for a cannula extending through a tissue and into a cavity in which a surgical procedure is to be performed. The guide has first and second plates cooperatively defining a through passageway for a cannula. Structure connects between the first and second plates to allow selective altering of the relative positions of the first and second plates to thereby change the configuration of the through passageway defined cooperatively between the first and second plates. A conversion unit can be used to draw the plates away from each other to enlarge an incision into which the first and second plates extend.