Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Method, and the associated device, for examining a biological tissue, in particular dental tissue or tooth enamel of one or several teeth, the method including the steps of taking into account at least the fluorescence of the tissue detected in a first wavelength range and the fluorescence of the tissue detected in a second wavelength range. The device can be a surgery microscope with one or several filters. The filters can be swiveled into or out the illumination beam path or the optical path of the light source of the device.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: A hand-held tool is provided for retraction of internal organs during transhiatal mediastinal surgery. The tool includes a handle and a blade extending forwardly from the handle. The blade has an acute end extending rearwardly and then curves forwardly and upwardly to form an open mouth for receiving the organ.

Abstract: A robotic surgical instrument including: a shaft; an end effector element; an articulation connecting the end effector element to the shaft, the articulation including: joints permitting the end effector element to adopt a range of orientations relative to a longitudinal axis of the shaft; pairs of driving elements configured to drive the joints; a supporting body having a bevelled surface; and are directing pulley mounted on the bevelled surface such that the redirecting pulley rotates about a redirecting pulley axis transverse to the bevelled surface.

Abstract: A retractor system and related methods for use in spinal surgery procedures, including but not limited to fusing or repairing damaged or deteriorated intervertebral discs or vertebral bodies in the lower lumbar levels. The retractor system includes a plurality of blade assemblies coupled to a handle assembly, wherein each of the blade assemblies may be independently adjusted (e.g. length blade and/or blade angulation and/or blade rotation relative to the handle assembly) to provide unprecedented customization of an operative corridor extending to the surgical target site of the patient such that any number of spinal surgery procedures may be undertaken by a surgeon, including but not limited to spinal fusion procedures at the L5-S1 disc space.

Abstract: Described herein are devices and methods for fusion of adjacent vertebral bones using distractor platforms for exposure and resection of at least a portion of a facet joint, such as in performance of a TLiF procedure. In one embodiment, the distractor platform contains at least a first receptacle and/or extension adapted to couple to the implanted screw/bone marker, and the method includes advancing a threaded segment of a bone fastener assembly into the identified first pedicle of the first vertebral bone, the bone fastener assembly further comprises a second segment adapted to couple with a distraction platform, which is adapted to concurrently attach onto at least one tissue retention blade, and retain the tissue retention blade in the displaced position. Stabilization of a spinal segment is also provided by advancing a substantially concave orthopedic implant through an opening made in a posterior aspect of a disc space.

Abstract: Described herein are devices and methods for fusion of adjacent vertebral bones using distractor platforms for exposure and resection of at least a portion of the facet joint, such as in performance of a TLiF procedure. In one embodiment, the distractor platform contains at least a first receptacle and/or extension adapted to couple to the implanted screw/bone marker and the method includes advancing a threaded segment of a bone fastener assembly into the identified first pedicle of the first vertebral bone, the first bone fastener assembly further comprises a second segment adapted to couple with a distraction platform adapted to concurrently attach onto at least one tissue retention blade and adapted to retain the tissue retention blade in the displaced position. Stabilization of a spinal segment is also provided by advancing a substantially concave orthopedic implant through an opening made in a posterior aspect of a disc space.

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 in accordance with embodiments of the invention includes an adapter and an arm that can be releasably connected to the adapter. An end portion of the arm includes first and second legs and a lock well between the legs. The adapter includes a tubular channel having side walls configured to receive the end portion of the arm, and a lock having a cam in the channel that is rotatable between a release position and a lock position. The lock is configured such that (1) when the lock is in the release position the end portion of the arm can be inserted into the channel and removed from the channel with the cam passing to and from the lock well between the legs, and (2) when the lock is in the lock position the cam is in the lock well and engages the legs to urge the legs into engagement with the side walls of the channel.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: A surgical instrument includes a first member defining a passageway defining a first axis. A second member is positioned in the passageway and includes a lip extending at an angle relative to a second axis defined by the second member that engages a flange of the first member. A third member engages an outer surface of the first member. The third member includes an end surface. A fourth member defines a pathway having the first and second members disposed therein. The fourth member includes a first locking element. A fifth member includes a body including an inner surface that engages the third member. The fifth member includes a plurality of straps extending outwardly from the body. At least one of the straps includes a second locking element that engages the first locking element to fix the fourth member relative to the fifth member. Systems and methods are disclosed.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: A medical device for tissue resection and related methods of use are disclosed. The device may include an elongate member having a proximal end and a distal end. The distal end of the elongate member may include a distal portion defining an end face and a cavity extending distally therefrom. The distal portion may further include multiple sections configured to transition between a first position and a second position different from the first position. The medical device may further include a mechanism configured to adjust a volume of the cavity by moving at least one of the multiple sections from the first position to the second position.

Abstract: A method and system for managing information in an on-line community is described.

Abstract: A trocar has an elongate body and a tissue-penetrating tip. One or more radially extending blade(s) are provided near the tissue-penetrating tip of the trocar body so that they automatically open as the trocar is advanced through tissue. The blades will enlarge the penetration which was formed by the tip of the trocar.

Abstract: A vaginal speculum, conical in shape made out of clear plastic resin or metal that when closed can easily and gently be inserted into the introitus (vaginal opening). In certain embodiments, an obturator is used to introduce and/or expand the speculum. Various mechanisms are disclosed for dilating the speculum, after it has been inserted, so as to allow inspection of the patient's cervix. Such dilation can be effected relative to multiple axes, or even in substantially continuous, radial fashion about the periphery of the speculum, for improved visualization. In addition, this speculum has a handle that is oriented such that a vaginal exam can be performed on a standard exam table. The handle also includes a receptacle that receives a standard pen light. A light pipe directs light from the pen light to illuminate the cervix.

Abstract: The present application relates to a double blade for a surgical retractor having a base body with a substantially cylindrical mounting mandrel for mounting the double blade on a surgical retractor, and at least two blade elements that are so mounted on the base body as to be rotatable and/or displaceable through at least a certain angular range with respect to the base body. Moreover, the present application relates to a blade arrangement in which a double blade is connected to a connecting element of a further double blade, or a single blade. In this case, the at least one double blade or, optionally, the single blade is rotatable with respect to the connecting element. In addition, the application relates to a retractor with a double blade, a blade arrangement or a blade assembly comprising double blades and a blade arrangement.

Abstract: A multiple piece tongue blade is described. The multiple piece tongue blade is provided with a step and a tip. The stem is adapted to be inserted into a handle of a surgical retractor. The tip is adapted to be selectively attached to the stem. The tip is insertable into a mouth of a patient such that the tip applies pressure onto a tongue of the patient.

Abstract: A supplementary blade for a speculum is disclosed, the speculum having a plurality of primary blades movable relative to each other for opening and closing, wherein the supplementary blade comprises an anchor portion attachable to the speculum and a blade portion movable with respect to the anchor portion, and the blade portion is shaped to interact with at least one of the primary blades to move into an extended position in response to opening of the primary blades. A speculum is disclosed having a plurality of primary blades movable relative to each other for opening and closing, wherein at least one of the blades comprises a means for attaching a supplementary blade thereto to increase the functional length of the at least one blade.

Abstract: A vaginal speculum comprises upper and lower blades arranged to pivot relative to each other about coupling elements each associated with a respective blade. The upper blade is detachable from the lower blade, when the speculum is in situ in the vaginal cavity, upon pulling the upper blade generally proximally. This decouples the coupling elements from each other or detaches at least one of the coupling elements from the associated blade. The speculum has optional side blades.

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

Abstract: Various embodiments of the present invention provide a surgical retractor having two blade-supporting arms, which are mounted to be laterally slideable towards and apart from each other by a toothed rack. Each arm supports a respective retractor blade. In some embodiments, the retractor blades are curved in the same direction as each other so that the first blade is concave in the first direction, and a second blade is also concave in the same direction. Alternatively or additionally, in some embodiments, a cushioned material or cushioned sleeve is present on the blades where the blades contact the anatomy. The cushioned material or sleeve may be made of a soft silicone. Further, the cushioned material or sleeve may be coated or molded onto the blade structure, or may be a removable sleeve that is manually slid onto or off of the blade structure. Also, alternatively or in addition in some embodiments, blade-mounted lighting may be provided.

Abstract: A self-retaining retractor and surgical method of retracting integument at a surgical site comprising a medial arm moveably connected to a first end of an extension arm. The extension arm is connected to a lateral arm. The connection may be made after the medial arm is in the surgical site. The extension arm may be moved from an undeployed position to a deployed position. The medial arm or the lateral arm may include a surgical instrument holder, such as a holder for an endoscope. A locking mechanism may be used to lock the retractor in a deployed position. A strap may also be used to secure the retractor.

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

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

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A formix manipulator includes a collar and stabilizer. The collar has a first end and a second end, the second end having an opening and diameter greater than the first end and the first end having an opening to receive a cervix into the collar. The stabilizer has a base portion defining a guide hole and a plurality of prongs extending from the base portion to contact the first end of the collar.

Abstract: The medical device may include an elongate member having a proximal end and a distal end, and a plurality of legs coupled to the distal end of the elongate member. The medical device may also include a moveable element distal to the distal end of the elongate member, disposed around the plurality of legs. The moveable element may be reciprocally moveable relative to the elongate member and plurality of legs between a first and second position. The plurality of legs may be in a collapsed configuration when the moveable element is in the first position, and may be in an expanded configuration when the moveable element is in the second position.

Abstract: A tissue retractor device for retracting tissue includes a base and a plurality of blades connected to and distributed around said base. Each of the blades is outwardly movable from the base and includes a respective sloped portion on an interior region of the blades. The tissue retractor includes a pusher engaged to the base. A portion of said pusher abuts the sloped portion of each of the blades. Movement of the pusher in a longitudinal direction engages a portion of the pusher against said sloped portion of each of the blades to move the blades and angularly displace the blades between a respective closed position and an open position.

Abstract: Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

Abstract: A retractor for use in spinal surgery comprises a frame including a ring member defining a generally central interior space. A plurality of blades is releasably supported respectively to slidable arms each supported on the ring member for individual translational movement relative to the ring member. The blades define an initial substantially enclosed opening that is expandable for use in a surgical procedure. A clutch mechanism supported on the ring member is associated with each arm to individually selectively engage each such arm with a rotatable main gear such that upon rotation of the main gear by a single actuator any one, all or any desired combination of arms may be translated relative to the ring member to move the blades and expand the opening in one or more selected desired directions.

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

Abstract: Methods and devices are provided for retracting tissue. In one exemplary embodiment, a retractor is provided that includes a base, a plurality of blades extending from the base, and an actuator coupled to the base and operatively connected to the blades. The actuator can be configured to be actuated to move the blades relative to the base, thereby allowing the blades to retract tissue. The actuator can be self-locking so as to allow the blades to be freely movable within their entire range of motion relative to the base through actuation of the actuator without using another mechanism to lock the blades in a fixed position and to unlock the blades from the fixed position. The retractor can be formed from one or more radiolucent materials.

Abstract: The present invention relates to a spreadable retractor, including a rake plate having a pair of laterally separated rake mountings; a pair of rakes, one of the rakes moveably mounted to each of the laterally separated rake mountings, wherein each of the rakes comprises a rake shaft extending away from the rake plate; and a rake spreader mounted to the rake plate at a position between the laterally separated rake mountings, the rake spreader operably linked to and configured to spread the pair of rakes apart from each other. The spreadable retractor of the present invention provides the ability for surgical personnel to use a single device to both lift and spread tissues and bones in the vicinity of a surgical incision.

Abstract: A speculum includes an upper blade, a lower blade, a link member, a handle portion, a curved portion, and a light source. The link member connects the upper blade and the lower blade to allow the upper blade and the lower blade to move between an open state and a close state. The curved portion connects the lower blade and the handle portion. The light source is disposed on the curved portion.

Abstract: Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

Abstract: Instrumentation for retracting tissue comprising a retractor member including a sidewall defining an axial passage extending along a length thereof and a lateral opening in transverse communication with the passage. A pin member is disposed within the passage and includes a distal end portion positionable adjacent the distal end of the retractor member, with at least a portion of the pin member positioned adjacent and visible through the lateral opening. In another embodiment, the retractor member includes a sidewall having a main sidewall portion defining a first wall thickness, and an enlarged sidewall portion extending axially along a length of the sidewall and defining a second wall thickness greater than the first wall thickness, with the sidewall defining an axial passage extending through the enlarged sidewall portion. A pin member is disposed within the passage and includes a distal end portion positionable adjacent the distal end of the retractor member.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access system including an access port device. The port device has a port member, a plurality of blades, and an articulation mechanism. The blades are circumferentially arranged about a longitudinal axis of the port member to collectively define an access region. The articulation mechanism defines a pivot point along a length of each blade, and is operable to articulate the blades between collapsed and expanded states. The blade tips collectively define a diameter in the collapsed state that is less than that in the expanded state. The blades rotate about the corresponding pivot point, and the pivot points move longitudinally relative to the port member, in transitioning between the contracted and expanded states. Light source(s) can be integrated with the blades or separately provided to enhance surgical field visibility.

Abstract: A method of performing an operation, e.g. a spinal operation, on a patient using a retractor comprising a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis, and further comprising a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In the method, the blade assemblies are closed 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 blade assemblies are then opened by rotating the blades about the set of axes, stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision.

Abstract: Methods and devices are provided for retracting tissue. In one exemplary embodiment, a retractor is provided that includes a base, a plurality of blades extending from the base, and an actuator coupled to the base and operatively connected to the blades. The actuator can be configured to be actuated to move the blades relative to the base, thereby allowing the blades to retract tissue. The actuator can be self-locking so as to allow the blades to be freely movable within their entire range of motion relative to the base through actuation of the actuator without using another mechanism to lock the blades in a fixed position and to unlock the blades from the fixed position. The retractor can be formed from one or more radiolucent materials.

Abstract: Provided is a muscle retractor for spine surgery including: first and second retractors having blades configured to support a spine and muscles, and insertion blocks extending from the blades and having facing open surfaces; an expander having expansion arms slidably inserted into the insertion blocks of the first and second retractors, a gear rack movably installed at both of the expansion arms and having a gear section formed at one surface thereof, and a ratchet installed at the expansion arm moving along the gear rack and locked to or released from the gear section of the gear rack; a slider accessibly inserted into the blade of the first retractor or the second retractor in a projected state; and an auxiliary plate pivotally installed at a lower portion of the blade of the first retractor of the first and second retractors supporting the muscles.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Hernia repair using a mesh patch and a placement tool is described. The placement tool includes a plurality of adjustable blades and a control to move the adjustable blades between a clustered position that allows the blades to be inserted in an opening in a ply of the mesh patch and an expanded position to spread the mesh patch out in a planar fashion. Repair of a hernia includes compressing the mesh patch, inserting the adjustable blades of a placement tool into the opening in the mesh patch, inserting the mesh patch and tool into a patient, moving the adjustable blades from the clustered position to the expanded position, affixing the mesh patch to the patient, moving the adjustable blades from the expanded position to the clustered position, and removing the placement tool from the mesh patch and the patient.

Abstract: A method of performing an operation, e.g. a spinal operation, on a patient using a retractor comprising a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis, and further comprising a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In the method, the blade assemblies are closed 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 blade assemblies are then opened by rotating the blades about the set of axes, stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision).

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access system includes an access device having a tubular shape and a channel extending through the device that is sized to receive a surgical instrument. The outer surface of the device defines a support section and access section having an aperture extending through the wall of the device. The aperture has a wider distal portion and a narrower proximal portion and the surgical instrument may be inserted through the aperture. The access device simultaneously retracts soft tissue and distracts bone when inserted into the surgical site while allowing a surgeon access to the surgical site.