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: A tissue retractor device for retracting tissue is disclosed. The device includes a base connected to a plurality of blades distributed around the base. Each of the blades is outwardly movable from the base. A pusher is engaged to the base. The pusher is movable in a longitudinal direction to move the blades to angularly displace each of the blades from a respective closed position to an open position. At least one biasing device is engaged with the base that biases the respective ones of the blades toward a closed position. The closed position is where the blades are relatively close together with respect to the open position.

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 surgical device is disclosed which may advantageously perform the functions of both a retractor and a distractor. The device has two retractor blades facing each other and held in a common frame, the retractor blades are insertable into a surgical incision in a patient and moveable away from each other along a main axis (x) so as to widen the surgical incision; and a connecting pin attached at a distal end of each retractor blade. Each connecting pin is attachable to a pedicle screw anchored to respective vertebrae of the patient, so that moving away the two retractor blades along the main axis (x) determines a distraction of the vertebrae.

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

Abstract: A surgical 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: 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: Minimally invasive surgical retractors and methods of using the retractors are provided. This retractor may be introduced through a sealed port, controlled by a robotic system, have full articulation, and need not require assembly within the patient's body. As a result, fully endoscopic mitral valve surgery may be performed.

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 retractor assembly for defining a working channel to a surgical site for conducting minimally invasive spinal surgery includes a plurality of relatively articulable components. Temporary interconnections are formed between adjacent sidewalls of the components to hold the components in a desired configuration, such as in a closed triangular form. The components are articulable relative to each other for adjusting the working channel or for performing surgical functions.

Abstract: The present invention is directed to a device including an inner cannula having one or more wings or leaflets attached to one end thereof. The wings or leaflets can be cut to length or shaped to facilitate holding the operative field open for optimal visualization and the use of surgical instruments. A shorter, outer cannula is fitted over the inner cannula and a flange attached to the outer cannula is moved from a closed position in which the wings are covered by the inner surface of the cannula or to an open, deployed position in which the wings are opened. The outer cannula may be textured or shaped to aid in holding the desired position. The device also includes a dam or barrier at the end or other convenient location in the inner cannula to control the flow of air or fluids in the cannula as to make it useful in arthroscopic or endoscopic surgery of all types.

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 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: 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: 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: The present invention is directed to a device including an inner cannula having one or more wings or leaflets attached to one end thereof. The wings or leaflets can be cut to length or shaped to facilitate holding the operative field open for optimal visualization and the use of surgical instruments. A shorter, outer cannula is fitted over the inner cannula and a flange attached to the outer cannula is moved from a closed position in which the wings are covered by the inner surface of the cannula or to an open, deployed position in which the wings are opened. The outer cannula may be textured or shaped to aid in holding the desired position. The device also includes a dam or barrier at the end or other convenient location in the inner cannula to control the flow of air or fluids in the cannula as to make it useful in arthroscopic or endoscopic surgery of all types.

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: 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 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 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: The present invention provides apparatus and methods for facilitating entry through a bodily opening comprising a spreader having a plurality of arms, each of the arms being formed of a resilient material and shaped so that the distal ends tend to be spaced apart from each other when the spreader is in an open position. At least one of the arms has an engaging member having a sharpness adapted to grasp tissue. When the spreader is radially deployed to the open position, the engaging member grasps tissue adjacent the bodily opening and urges the tissue away from the opening to facilitate visualization of the opening and/or access into the opening. A catheter or other device may subsequently be inserted between one or more arms of the spreader and through the bodily opening while the spreader holds the tissue in a spread position.

Abstract: A surgical retractor comprises a support comprising a first mating part comprising a shaft, which defines a longitudinal axis, extending therefrom. At least one tissue engaging member extends between a first end defining a first axis and a second end defining a second axis and having a tissue engaging surface disposed along the second axis. The first end comprises a second mating part comprising a wall that defines an elongated cavity disposed along the first axis and being configured to receive the shaft such that the first axis and the longitudinal axis are co-axial. The wall is engageable with the shaft to align the second mating part with the first mating part such that the second axis intersects the longitudinal axis. Methods of use are disclosed.

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 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 method for accessing a spinal disc of a lumbar spine of a patient using a surgical access system including a tissue distraction assembly and a tissue retraction assembly. The method can include maintaining an operative corridor along a lateral, trans-psoas path using the retraction assembly.

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: Novel ergonomically designed hand held surgical tissue Z-shaped retractors. The retractors include retractor plates which are angulated and deviated from the main axis along the handle of the retractor. The retractors may be applicable for general, cosmetic and reconstructive surgeries, cardio, vascular, obstetrics/gynecology applications, and veterinary practices.

Abstract: The retractor system for use in spinal surgery and other types of surgical procedures that is a simple and efficient solution for minimally invasive access to thoracolumbar spine is disclosed. The fully customizable design allows the surgeon to independently angle the retractor blades and expand the retractor in both cephalad-caudal and medial-lateral directions. With an offering of a range of blade lengths, access can be tailored to the patient's anatomy. Auxiliary instruments such as the retractor inserter, universal hex driver and blade removal instrument allow quick and controlled access to the surgical site. The retractor system provides versatility and control ensuring minimal tissue trauma.

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: Provided are crosslinked polymer compositions that include a first synthetic polymer containing multiple nucleophilic groups covalently bound to a second synthetic polymer containing multiple electrophilic groups. The first synthetic polymer is preferably a synthetic polypeptide or a polyethylene glycol that has been modified to contain multiple nucleophilic groups, such as primary amino (—NH2) or thiol (—SH) groups. The second synthetic polymer may be a hydrophilic or hydrophobic synthetic polymer, which contains or has been derivatized to contain, two or more electrophilic groups, such as succinimidyl groups. The compositions may further include other components, such as naturally occurring polysaccharides or proteins (such as glycosaminoglycans or collagen) and/or biologically active agents.

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 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 retractor for use in surgical operations comprises a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis. The retractor further comprises a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In operation, 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, thereby 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.) The retractor thus forms an aperture for passage of surgical instruments and viewing of the surgical field by surgical personnel.

Abstract: A speculum having first and second arms beginning at a proximal point and ending at a distal end and having a cup positioned at the distal end, an attachment portion positioned on the first arm and proximal to the cup, and a user manipulation element positioned within the attachment portion. In another embodiment the speculum has a generally U-shaped frame having a proximal point and pair of distal ends, a pair of cups attached to the distal ends, a pair of user manipulation elements attached to the frame and positioned between the cups and the proximal point so that the user manipulation elements can rotate relative to the frame.

Abstract: A method is disclosed for introducing a spinal disc implant into an intervertebral space of a subject. The subject is placed in a lateral position, and the anterior face of the spinal disc intervertebral space is accessed, between the L5 and S1 vertebrae, from an anterior and lateral retroperitoneal approach. An operative corridor to the anterior face of the spinal disc space is established by introducing a retractor instrument anterolaterally to the spinal disc space between the anterior superior iliac spine and the anterior inferior iliac spine. The damaged spinal disc contents are removed from the intervertebral space through the operative corridor, and the implant is advanced into the intervertebral space at an oblique angle and pivoted to position the implant substantially laterally within the intervertebral space. Elongated retractor and insertion instruments, as well as a modified disc implant, are also disclosed for carrying out the method.

Abstract: A method of preventing tissue creep using a surgical retractor apparatus having one or more independent, removable extension members adapted to be mounted at the distal end of the retractor, or between the blades of a spreadable retractor, after the retractor has been positioned in the patient, such that a significant portion of the extension member extends beyond the distal end of the retractor to preclude or minimize intrusion of tissue into the access area created by the retractor. The extension members may vary in size and shape so that the most appropriate extension member can be chosen to address the intrusion problem, and the extension members may be mounted at various fixed locations, using clips, mechanical interlocking structures or the like.

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: A hand-held, surgical instrument to manipulate a patient's tissues having a grip, a first blade, a second blade, a blade actuator, at least one blade rib, a light, and a power source. The first blade and the second blade each extend from the base end of the grip. The second blade is divided longitudinally into a left segment and a right segment, which are each pivotable about a common axis. Movement of the blade actuator causes the segments of the second blade to pivot about the common axis. The light illuminates the patient's tissues proximate the blades. The device may include suction ports on the underside of the first blade to provide aspiration. The blade rib may include multiple longitudinal blade ribs extending along the length of the first blade, the second blade, or both. The blade rib may also include multiple transverse blade ribs extending along the width of the first blade, the second blade, or both.

Abstract: A self-retaining retractor is described. The retractor can be sized for small patients, such as young children or infants or some animals. The retractor has two blades that are capable of holding tissue separated during a procedure, such as a tracheotomy.

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. An optional intermediate retractor assembly is positionable between the first and second retractor portions to provide further tissue retraction capabilities.

Abstract: The present disclosure generally relates to a system and method for accessing a spinal disc. In an embodiment, a system for accessing a spinal disc disposed within internal body structures includes a sonar probe. The sonar probe emits sound waves into the internal body structures to create return signals. The system also includes a retractor and a monitoring system. The monitoring system includes an ultrasound imaging screen. The ultrasound imaging screen displays images of the internal body structures from the return signals. The ultrasound imaging screen provides a visual identification of a nerve when disposed in the internal body structures.

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: The present disclosure provides for systems and methods for Nested Cannula configuration. Nested Cannula systems include a plurality of telescoping, pre-shaped tubes configured and dimensioned to reach target locations within a particular anatomical region. A three dimensional image is read for the particular anatomical region and structure in question. A series of arcs are generated between a point of the anatomical region and a target location, ensuring collision-free motion for each of the tubes at each specific diameter. The target location is determined based upon the medical procedure being performed and the location and orientation in six degrees of freedom of the anatomical structure in question. The series of arcs are used to configure and dimension the plurality of tubes. The Nested Cannula system is adapted to reach relatively small and complex target locations, such as to deliver photodynamic therapy, balloon angioplasty or BronchoAlveolar Lavage.

Abstract: Systems and related methods for measuring pelvic organ prolapse are disclosed. A plurality of positioning devices, such as RFID tags, ultrasound reflectors or magnetic field sensors, which may be active or passive, and which are preferably disposable, are set at predetermined positions within the patient and their relative positions recorded with one or more corresponding external receiving devices fixed to the patient while the patient is in a relaxed state. The patient is then instructed to perform an action (such as a valsalva maneuver) that causes the positioning devices to move and their movement relative to their initial recorded positions is measured.

Abstract: A surgical access system includes retractor for creating an access path between an incision site and a surgical site. The retractor includes a frame having a base member and a pair of generally curved rails extending therefrom. A tubular member is coupled to the frame and includes first and second blade portions that are capable of relative movement with respect to each other by movement on the curved rails. A method of inserting the retractor into a patient includes inserting a guide rod over a guide wire, locating an obturator in the retractor, inserting the obturator and retractor over the guide rod, and removing both the guide rod and obturator to leave the retractor in the body to provide the access path.

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: 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 surgical retractor includes a plurality of blade assemblies interconnected by a plurality of racks. One or more of the blade assemblies is movable along a rack to selectively expand the retractor. At least one of the blade assemblies includes a blade that is rotatably connected to the blade assembly and that is rotatable independent of other blades of the retractor.