Abstract: A circumferential retractor apparatus including a first retractor paddle having a grasping surface and a body portion supporting the grasping surface, a second retractor paddle having a grasping surface and a body portion supporting the grasping surface and an elastic member having one end received by the first retractor paddle and an opposite end received by the second retractor paddle. Each of the paddles has a hole formed therein of a size suitable for allowing the elastic member to pass therethrough. A slot is formed in the body portion so as to open to the hole. The slot is of a tapered configuration so as to have a wide end opening to the hole and a narrow end away from the hole. The grasping surface includes a plurality of fingers extending outwardly of the body portion. Each of the plurality of fingers are arranged in parallel spaced relationship to each other. The elastic member is a length of surgical tubing.

Abstract: The present disclosure relates to methods and devices for stanching the effusion of blood from the exposed ends of the sternal halves of an incised sternum during cardiac and/or thoracic surgical procedures. According to an aspect, there is provided a device for stanching the effusion of blood from an exposed sternal half of a sternum formed during a sternotomy. The device includes an end wall having a size and a dimension to at least partially cover the exposed end of a sternal half. The device may include an upper wall; a lower wall spaced from the upper wall; and an end wall interconnecting the upper and lower walls. The upper wall, the lower wall and end wall bound a space while the upper wall and the lower wall define an opening through which an exposed end of a sternal half is receivable into the space of the device.

Abstract: A suture deflector for retracting a body tissue by deflecting a surgical suture that is simultaneously attached to a body tissue and a surgical retractor. The suture deflector imparts a deflecting force on the surgical suture to retract a body tissue between a first and second retracted position. The suture deflector consists of a securing mechanism for attaching the suture deflector to a surgical retractor and a deflection member extending from the securing mechanism. The deflection member includes a suture contacting section that is configured so as to prevent the severing of the surgical suture when it is deflected by the suture deflector. In certain embodiments, the deflection member includes a connecting section that extends between the securing mechanism and the suture contacting section and that is also movable relative to the securing mechanism in order to impart a deflecting force on the surgical suture.

Abstract: A surgical retractor assembly for providing a generally constant retracting force at a fixation site on a patient despite possible movements of the fixation site during application of the retracting force. The retractor assembly comprises a support structure engaging element for providing communication between the surgical retractor assembly and a support structure; a retractor guide for receiving a first end of a retracting member, the retractor guide being coupled to the support structure engaging element, wherein the retractor guide is displaceable relative to the support structure engaging element; and a biasing structure that provides the retracting force.

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: To avoid traditional muscle dissection required in the placement of a screw for a pedicle screw fixation, a retractor is provided having a guide of an appropriate length to provide access from the skin surface to the dorsal aspect of the vertebra over the pedicle. The retractor has a handle to provide appropriate holding leverage and to maintain the guide so as to stabilize the guide against the lateral aspects of the facet with the paraspinous musculature. The retractor has a channel of an appropriate size to accommodate a variety of tools, including a drill bit or a tap. The channel also provides a pathway for a probe or feeler to inspect the placement of the screw.

Abstract: Methods and devices retract tissue for minimally invasive surgery in a patient. A retractor includes a working channel formed by a first portion and a second portion. The first and second portions are movable relative to one another from a first configuration for insertion that minimizes trauma to skin and tissue to an enlarged configuration after insertion to further retract skin and tissue in a minimally invasive manner. Instruments are engageable to the first and second portions and operable to move the first and second portions relative to one another.

Abstract: An access device particularly adapted for use in laparoscopic surgery facilitates access with instruments, such as the hand of the surgeon, across a body wall and into a body cavity. The device can be formed of a gel material having properties for forming a zero seal, or an instrument seal with a wide range of instrument diameters. The gel material can be translucent facilitating illumination and visualization of the surgical site through the access device.

Abstract: A multipurpose retractor is disclosed for use in surgical operations. The retractor can also be used as a speculum. The retractor is made from metal plates, springs, strings, hinges, rods and a worm gear system. The retractor can expand from having a very small diameter to a very large diameter. And at the same time it can produce substantial force or pressure to keep any orifice, birth canal, surgical incision open steadily and stably. The retractor can be easily collapsed after use within seconds using a worm gear system. The worm gear system provides considerable mechanical advantage and allows for the contraction of the retractor with little applied force by the hand. It also allows for control of the retractor to remain in a certain diameter size. A locking mechanism applied to the gear system prevents the retractor from unfolding and therefore the retractor remains stable. The spring system provides the retractor to open completely with great force and remain open.

Abstract: To avoid traditional muscle dissection required in the placement of a screw for a pedicle screw fixation, a retractor is provided having a guide of an appropriate length to provide access from the skin surface to the dorsal aspect of the vertebra over the pedicle. The retractor has a handle to provide appropriate holding leverage and to maintain the guide so as to stabilize the guide against the lateral aspects of the facet with the paraspinous musculature. The retractor has a channel of an appropriate size to accommodate a variety of tools, including a drill bit or a tap. The channel also provides a pathway for a probe or feeler to inspect the placement of the screw. A tool groove may be provided in the channel to support the shaft of a tool, such as a tap.

Abstract: A laminectomy suction and retraction device has a body with an offset probe extending therefrom. The tip of the probe has a retraction blade having a pair of suction ports lying above a pair of ports in the distal end surface of the probe. A rectangular port is formed by the end surface of the probe, adjacent the blade surface.

Abstract: A speculum system with four blades is provided. The blades project in approximately the same direction, and each blade is connected to a handle linearly or at an angle. The handles are coupled together. In one embodiment, the distance between the blades is changeable so that a field of view defined as the viewable area between the blades can be increased or decreased. In another embodiment, the blades include texture, such as ribs, holes or teeth to grip onto surrounding muscle fiber. In yet another embodiment, a stabilizing arm attaches to a stabilizing object, such as a table or heavy or immovable object, and to one of the handles to stabilize the speculum system.

Abstract: A connector head for a retractor blade provides connector head adapted to cooperate with a first and a second side loading socket. The connector head includes a first and a second loading portion, the second loading portion located above the first loading portion. A cap is preferably located between the first and second loading portions to separate the first and second loading portions from one another. The first loading portion includes a base which rests on a ledge surface of the retractor blade. The base and the cap may have sloped edges to assist in locating a socket between shoulders of the cap and base. The first loading portion has a diameter which is less than the diameter of the base an cap to define a first channel. The second loading portion has a smaller diameter than the diameter of the cap and top to provide a second channel. Two sockets from separate retractor instruments may connect to the connector head at the same time.

Abstract: A method and apparatus for performing minimally invasive hip surgery for implanting a prosthetic acetabular component into a natural acetabulum. The method and apparatus include a posterior retractor having handle and retracting sections. The retracting section retracts soft tissue in the posterior section of the surgical site and includes a paddle with a curved flare and an elongated curved prong extending outwardly.

Abstract: An organ-stabilizing element is covered with a layer of textile material such as cloth to enhance slip-free engagement with an organ such as a beating heart during surgery thereon. The organ-stabilizing element is supported on a stacked structure of successive ball elements and rings that can be selectively flexible or rigid in response to tensioning of a flexible cable within a central bore of the structure.

Abstract: A suction device for applying vacuum to a tissue surface is provided. The suction device including: a suction cup portion having a wall defining a cavity and an engagement surface for engaging the tissue surface; a vacuum inlet portion connected to the suction cup portion, the vacuum inlet portion having an inlet for connection to a vacuum source and a conduit in fluid communication with the vacuum inlet and the cavity such that a vacuum applied to the inlet is transferred to the cavity; and a valve disposed in the bore for selectively venting the vacuum in the cavity.

Abstract: A surgical tool for retracting body tissue during surgery consisting of two pivoting arms each provided with a finger, a translating actuation member also provided with a finger, and a single actuator mechanically coupled to either one of the pivoting arms or the translating actuation member. The two pivoting arms and the actuation member are operatively connected together for simultaneous movement between a closed configuration having the three fingers close together, and an open configuration having the three fingers spaced apart. The surgical tool is adaptable to suit the specific patient anatomy and desired degree of tissue retraction.

Abstract: A surgical stay-grip assembly includes a pair of jaws pivotally connected to one another and a jaw closing member, preferably a spring, for urging a first end of the jaws together. An elongated member, preferably elastic, is connected to one of the jaws. One jaw includes a receiver for securing the elongated member to the jaw. The other jaw preferably includes a receptacle adapted to secure an elongated member to this other jaw. When securing to the receptacle, the elongated member includes an enlarged end portion and the receptacle includes an opening adapted to retain the enlarged end portion within the receptacle. Preferably, the surgical stay-grip assembly includes a retractor hook assembly connected to the distal end of the elongated member.

Abstract: A method for tensioning incisions made in a target vessel during an anastomosis procedure is provided. After an incision is made in a target vessel, incision tensioners are placed within the incision in order to tension the incision. The incision is tensioned when the incision tensioners are pulled taut in order to stretch the incision to a predetermined length or a predetermined force. The tensioners allow for proper grafting of a graft vessel to the target vessel in an end to side anastomosis. In addition, the incision tensioners allow the incision to have a known geometry, thereby allowing precise grafting of the graft vessel to the target vessel during the anastomosis procedure. After the incision is tensioned, the graft vessel is grafted to the target vessel using clips, sutures, staples or other anastomosis devices. One example of anastomosis clips are configured to capture the graft vessel and the target vessel such that the graft vessel grafts with the target vessel.

Abstract: A system for performing vascular surgery includes a first retractor blade and a second retractor blade and a fulcrum device. The first retractor blade includes a first grasping bar, and the second retractor blade comprises a second grasping bar. The first retractor blade and the second retractor blade are adapted to engage opposing edges of a subcostal incision in a patient. The fulcrum device includes a first fulcrum slot and a second fulcrum slot formed through opposing edges of the fulcrum device. The first fulcrum slot is adapted to receive the first grasping bar and the second fulcrum slot is adapted to receive the second grasping bar, such that the fulcrum device is adapted to apply leverage from the first retractor blade and the second retractor blade to spread the edges of the incision and to allow access to a chest cavity of the patient.

Abstract: Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

Abstract: A cooled stabilizer is provided for use in coronary bypass grafting surgical procedures. The cooled stabilizer can be attached to a surgical retractor for providing localized traction, stabilization and/or hemostasis to a predetermined area of body tissue. The stabilizer includes cooling channels and/or pads forming a continuous bottom surface for providing a chilled surface to contact body tissue. In one example, the cooled stabilizer can be shaped as a horseshoe with chilled surfaces over horseshoe sections and optionally over a heel.

Abstract: An illuminated surgical retractor for defining and illuminating a subcutaneous surgical field in the space near a vessel (such as the radial artery or the basilic vein) during a procedure for harvesting the vessel, wherein the illuminated surgical retractor includes a handle member pivotally connected at an acute angle to a first elongate section that has a non-liner shape, and includes a second elongate section releasably connected to the first elongate section, wherein a portion of the second elongate section defines an illumination input end portion, which is optically coupled to a light source to substantially illuminate the second elongate section, and further including an insertion area positioned on the proximal end portion of the first elongate section to allow the second elongate section to be inserted into the first elongate section.

Abstract: A tissue retractor includes a body having proximal and distal ends. The retractor also includes a retraction device having a head connected to the distal end of the body and defining two opposing openings, a connector movably disposed in the body, and two flexible needles of a shape memory material having a memory shape. The needles are fixedly connected to the connector for traveling through a respective one of the openings. The memory shape of the needles includes a portion with an arcuate shape. A one-handed actuation device is connected to the proximal end of the body and is operatively connected to the connector through the body. Upon actuation of the actuation device, the connector can be moved to selectively extend the needles out of the head and withdraw the needles into the head. Methods for using the tissue retractor, in particular for the treatment of Gastroesophageal Reflux Disease, are also provided.

Abstract: A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto.

Abstract: An illuminated surgical retractor for defining and illuminating a subcutaneous surgical field in the space near a vessel (such as the saphenous vein or radial artery) during a procedure for harvesting the vessel, wherein the illuminated surgical retractor includes a handle member pivotally connected at an acute angle to a first elongate section that has an at least partially tapered width, and includes a second elongate section releasably connected to the first elongate section, wherein a portion of the second elongate section defines an illumination input end portion, which is optically coupled to a light source to substantially illuminate the second elongate section, and further including an insertion area positioned on the proximal end portion of the first elongate section to allow the second elongate section to be inserted into the first elongate section.

Abstract: A system, method and apparatus for regulating vacuum applied to surgical suction devices allowing the use of a single vacuum regulator and associated canister to provide vacuum to two suction devices, such as a suction stabilizer and a suction retractor. Vacuum controllers may be placed in the vacuum lines provided to each of two or more suction devices, or may be placed only in the vacuum line of the suction device believed most likely to detach during the procedure. Each vacuum controller is provided with a primary vacuum line, coupling its associated suction device to the output of the vacuum regulator and a pilot passage, also coupling the suction device to the vacuum regulator. The controller closes a valve in the main vacuum line in response to loss of vacuum attachment, which valve remains closed until attachment is reestablished. Closure of the valve results in substantial or complete blockage of the main vacuum line.

Abstract: The present disclosure relates to methods and devices for stanching the effusion of blood from the exposed ends of the sternal halves of an incised sternum during cardiac and/or thoracic surgical procedures. According to an aspect, there is provided a device for stanching the effusion of blood from an exposed sternal half of a sternum formed during a sternotomy. The device includes an end wall having a size and a dimension to at least partially cover the exposed end of a sternal half. The device may include an upper wall; a lower wall spaced from the upper wall; and an end wall interconnecting the upper and lower walls. The upper wall, the lower wall and end wall bound a space while the upper wall and the lower wall define an opening through which an exposed end of a sternal half is receivable into the space of the device.

Abstract: Methods and devices retract tissue for minimally invasive surgery in a patient. A retractor includes a working channel formed by a first portion and a second portion. The first and second portions are movable relative to one another from a first configuration for insertion that minimizes trauma to skin and tissue to an enlarged configuration after insertion to further retract skin and tissue in a minimally invasive manner. Instruments are engageable to the first and second portions and operable to move the first and second portions relative to one another.

Abstract: A diagnostic system may include a carrier having at least one well, an upper surface, and a cavity extending downwardly from the upper surface. A specimen-handling tool may be configured to be positioned within the cavity and may include an elongated body having a longitudinal axis that extends along the length of the elongated body, a first end comprising an outermost portion adapted to skewer a tissue biopsy specimen.

Abstract: The present invention provides a surgical device for decreasing the trauma imposed on soft tissue by extended contact with a surgical device during a surgical procedure by thermally treating the tissue. To thermally treat the tissue, the surgical device can be configured to include a structure for enveloping and receiving at least a portion of the surgical device, where the structure is configured to control thermal energy transfer between the structure and the tissue.

Abstract: Minimally invasive spinal surgery techniques include expanding an incision with an expanding cannula, inserting a retractor for retracting a nerve root, and inserting a thermal probe for repairing the annulus. A light absorbing dye may be applied to the annulus for localized heating.

Abstract: A laminectomy suction and retraction device has a body with an offset probe extending therefrom. The tip of the probe has a retraction blade having a pair of suction ports lying above a pair of ports in the distal end surface of the probe. A rectangular port is formed by the end surface of the probe, adjacent the blade surface.

Abstract: An instrument useful in performing lumbar arthrodesis with a minimal approach which spares the lumbar muscles from surgical disruption and includes one of two retractor designs having blades angled approximately 90° with respect to each respective retractor handle. One blade is bent at an end portion thereof in a direction away from the handle portion. The other blade has first and second blade faces, with the second face having at least two toothed structures located thereon.

Abstract: A speculum according to the invention comprises two parts, an outer member (1) and an inner member (2). The outer member (1) comprises a tubular body (3) having an anterior end (4) with an opening (6) and a posterior end (5) with an opening (7). An elongate slot (11) is formed in the side wall (12) of the tubular body (3), extending from the opening (7) at the posterior end (5) towards the anterior end (4). The inner member (2) of the speculum comprises a cup-shaped body (13) having an anterior end (14) formed as a plug (16) and a posterior end (15) with an opening (17). An elongate key member (18) is formed in the side wall (19) of the cup-shaped body (13), extending from the opening (17) at the posterior end (15) towards the anterior end (14). The speculum is assembled by inserting the inner member (2) within the outer member (3) and aligning the key member (18) with the elongate slot (11).

Abstract: An improved stabilizer or retractor or other surgical tool having an elongated distal arm carrying a tissue-contacting mechanism at its distal end and a tensioning mechanism at its proximal end for locking functional components of the tool in a desired position or configuration. The tensioning mechanism is mounted to a turret or other structure attaching the distal arm to a base by means of a shorter, proximally extending flexible arm. The flexible proximal arm allows the tensioning mechanism to be moved relative to the base so that it can be placed more conveniently in the operative field.

Abstract: The present invention provides methods and apparatus in which a surgical retractor comprises a plurality of mechanically coupled tissue retaining walls that are guided into position along one or more guides previously implanted into the patient. The walls are preferably coupled by pivots, so that separating some of the walls from one another opens an operating space. There are preferably two guides, which are driven or screwed into the pedicles of vertebrae, or other bone. Since practical considerations will usually mean that the guides are completely parallel to one another, the retractor has oversized channels to receive the guides. The channels are best disposed in a frame, which also serves to hold lock the walls apart. Various convenience features are contemplated including a web disposed between the walls, which expands as the walls are separated.

Abstract: The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes orgy minimal excess motion at the surgery site.

Abstract: A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired. A special suction cup is used which accommodates multiplanar movement of the heart and the myocardium while also preventing heart tissue from interrupting the suction being applied to the heart. One form of the system can be used in minimally invasive surgery.

Abstract: A method and device for endoscopic harvesting of blood vessels from a patient for use in subsequent procedures. The device having a two piece headpiece. A vessel to be removed is inserted into the headpiece and the top and bottom portions of the headpiece are alternatively extended in reciprocating fashion to dissect above and below the vessel. The headpiece having electrodes for ligation of any side branch vessels which are uncovered in the dissection process.

Abstract: A system for manipulating a heart during cardiac surgery 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 system for manipulating a heart during cardiac surgery of the present invention. The system is an improvement on the retractor disclosed in parent application Ser. No. 08/936,184 filed on Sep. 17, 1997 and locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired.

Abstract: A lifting tool for use with a standard rib or chest retractor device where the tool acts to obliquely lift and spread open an incision, the chest wall and ribs, the tool having a pair of extended hook members disposed generally parallel and co-planarly on a mounting flange member.

Abstract: The present invention relates to a retraction plate for displacing soft tissue. The plate includes a window located in between first and second end parts. Each of the end parts has connecting elements for removably securing an elongate element. Coupling of elongate elements to the connecting elements allows lifting of the plate to retract soft tissue, thereby creating a cavity between the soft-tissue mantle and bone to perform a surgical procedure. The retraction plate provides access to a fracture and allows fracture fixation using a minimally invasive surgical technique.

Abstract: Devices and methods are provided for stabilizing tissue, e.g., a beating heart, within a patient's body. In certain embodiments, the subject devices are characterized by having a shaft and at least two contacting members operatively associated with the shaft where the contacting members are capable of assuming a substantial coaxial alignment when in a low profile configuration and also capable of assuming an open, working configuration. In other embodiments, the devices are characterized by having a shaft and at least one tissue contacting member associated with the shaft using a ball and socket mechanism, wherein the at least one tissue contacting member may be caused to pitch and/or roll and/or yaw. In the subject methods, a subject device is advanced to the target site and stabilizes the target tissue using compression, negative pressure or both. The subject invention also includes kits for use in practicing the subject methods.

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: An articulation member for use in a surgical apparatus provides articulation between a surgical tool and a surgical arm configured with a spherical ball. The articulation member includes a pair of opposed clamping members each having a socket portion for receiving the ball end of the surgical arm, and each having a clamp surface for receiving an insertable portion of the surgical tool. The articulation member also includes a locking member moveable between a loosened and a tightened configuration. In the loosened configuration, the orientation of the ball relative to the socket portions is modifiable so as to permit relative pivotal movement between the surgical arm and the surgical tool. In the tightened configuration, the locking member simultaneously urges the socket portions toward the ball, and the clamp surfaces toward the insertable tool portion, thereby frictionally locking the orientation of the surgical tool relative to the surgical arm.

Abstract: An instrument useful in performing lumbar arthrodesis with a minimal approach which spares the lumbar muscles from surgical disruption and includes one of two retractor designs having blades angled approximately 90° with respect to each respective retractor handle. One blade is bent at an end portion thereof in a direction away from the handle portion. The other blade has first and second blade faces, with the second face having at least two toothed structures located thereon.

Abstract: Methods and devices used to stabilize a beating heart during a surgical procedure on the heart and to expose a surgical site are disclosed. The stabilizing device is introduced through an opening through the chest and brought into contact with the beating heart, and by exerting a stabilizing force on the device, the motion of the heart caused by the contractions of the heart muscles is effectively eliminated. Exposure members are actuable to reposition a portion of the surface of the heart to better expose a target artery or other surgical site. Accordingly, the heart is stabilized and movement of the site of the surgery is minimized.

Abstract: Methods and devices retract tissue for minimally invasive surgery in a patient. A retractor includes a working channel formed by a first portion and a second portion. The first and second portions are movable relative to one another from a first configuration for insertion that minimizes trauma to skin and tissue to an enlarged configuration after insertion to further retract skin and tissue in a minimally invasive manner. Instruments are engageable to the first and second portions and operable to move the first and second portions relative to one another.

Abstract: A suction device includes a suction cup having a vacuum inlet for connection to a vacuum source. The suction cup has a wall defining a cavity that is in fluid communication with the vacuum inlet and an engagement surface for engaging a tissue surface. The suction cup is formed of a material that minimizes injury to the tissue surface contacted by the engagement surface and tissue captured when the vacuum is applied and permits the captured tissue to be perfused during use of the suction device.