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: The invention relates to a surgical retraction device which comprises at least two support arms which are moveable relative to each other and are held directly or indirectly upon one another and upon which at least one surgical restraining element for restraining bones or body tissue is or can be arranged, and which also comprises a support arm positioning mechanism for moving and changing a position of the at least two support arms relative to each other, it is proposed that the support arm positioning mechanism should comprise a coarse adjustment mechanism and at least one fine adjustment mechanism with which a position of the at least two support arms relative to each other can be changed mutually independently.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes a housing coupled to a retractor. The housing can be have one or more sealing ports for receiving surgical instruments. Each sealing port can include one or more sealing elements therein for sealing the port and/or forming a seal around a surgical instrument disposed therethrough. Each sealing port can be in a fixed position relative to the housing and can be rotatable with the housing relative to the retractor. A plurality of safety shields can extend from the housing into the retractor to protect the retractor from instruments inserted through the sealing ports and into the retractor.

Abstract: A ligament protector for use in protecting a ligament during an orthopedic procedure is disclosed. The ligament protector includes at least two wings and bone mounting elements. A handle may be removably coupled to the ligament protector.

Abstract: A retractor is disclosed. The retractor includes a housing, at least one blade holder slidably coupled to the housing, and an actuator handle to control sliding movement of the blade holder. The blade holder and the actuator handle hold at least one blade.

Abstract: Embodiments of the invention include devices and methods for implanting a vertebral body spacer. A lateral surgical approach is contemplated with some disclosed procedures. Instruments of some embodiments are insertable into a disc space to achieve distraction, to determine a desired disc space height, and to select a corresponding implant.

Abstract: Retractor cannula systems may be used for accessing and visualizing the spine and related methods of treatment, including a forward-looking retractor cannula system for creating a working space and the retractor cannula system having atraumatic dissection capability to allow visualization in spine. The devices and methods described may be used, for example, to perform annulus repair, herniated disc excision, and denervation of neurological tissue; to dispense pharmacological agents and/or cell or tissue therapy agents; to diagnose disc degeneration and bony degeneration, spinal stenosis, and nucleus decompression, and to perform disc augmentation.

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 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 three-prong retractor is disclosed which is inserted into an incision in a patient in order to create an area for surgery. The retractor opens such that two blades move away from a first blade to create an elongated opening. The two blades may then move away from each other in a direction that intersects the direction of the movement of the first blade away from the two blades. The ends of the two blades remote from the retractor body may then move away from the end of the first blade remote from the retractor body to further open the incision. The retractor may also have an elastomeric sheath surrounding the blades in order to create a barrier between the surgical area and the patient's skin.

Abstract: A device, system and method for orthopedic spine surgery using a screw-based retractor are disclosed herein and allows for access to the spine through a minimally or less invasive approach. The retractor device is designed to be coupled to a pedicle screw and then to have opposed arms of the retractor spread apart to open the wound proximally. The retractor is removed by pulling it out of the wound whereby the retractor is separated along an asymmetric stress riser to pass over the pedicle screw head. The retractor is intended to be made of a flexible metal material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

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: 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 supplementary blade for a speculum, 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 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. A speculum comprising first and second blades whose opening and closing is controlled by manipulating respective handles, wherein at least one of the handles comprises ratchet means engageable by the other of said handles.

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 retractor with multiple blades for use in surgery. The retractor may comprise first and second elongated portions which are pivotally connected to each other. A first blade may be connected to the first elongated portion and a second blade may be connected to the second elongated portion. The retractor may also comprise a sliding bar having a third blade. The sliding bar may be associated with the first and second elongated portions such that movement of the elongated portions relative to each other may result in movement of the sliding bar and, consequently, movement of the third blade relative to the first and second blades. In one embodiment, the retractor may comprise a tension limiting device so that the third blade may remain relatively stationary as the first and second blades are moved. The retractor may also comprise a fourth blade operatively connected to the first and second elongated portions. The fourth blade may be moved independently of the other blades or may move with the other blades.

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: A vaginal speculum arrangement includes a blade system for opening the vagina having a first blade (1) and a second blade (2) physically separable from one another, and an injection mechanism for dispensing a diagnostic marker onto the surface of the examined tissue having an injection probe (7). The direction of application of the diagnostic marker by the injection probe is not influenced by separation of the first and second blades and thus the injection probe (7) allows for a substantially homogeneous application of the diagnostic marker on a desired area in the examined vaginal or cervical tissue, irrespective of the degree of separation of the blades (1,2). The probe may be a nozzle generating a desirable injection pattern. The probe may be affixed to an extension rod, which may be mechanically coupled with the speculum blades.

Abstract: A surgical access device assembly that allows access to a pathology being treated while significantly reducing the risk of damaging anatomical structures proximate the pathology. The access device assembly includes a base portion having a central bore extending therethrough, and retractor blades pivotably mounted to the base portion. An insertion handle is coupled to the base portion to thread the retractor blades into the patient. The insertion handle is removed from the base portion, and a core hollow screw is threaded into the base portion to separate the retractor blades to gain access to the pathology through the hollow screw.

Abstract: A surgical instrument to manipulate a patient's tissues, comprising a handle, a first blade, a second blade, and a blade actuator, and may further comprise a light and a power source. The first blade and the second blade each extend from the handle. The second blade is divided into at least two segments. The segments are each pivotable in relation to each other along a common axis. Movement of the blade actuator causes the segments of the second blade to pivot radially toward and away from each other.

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 instrument to manipulate a patient's tissues, comprising a handle, a first blade, a second blade, and a blade actuator, and may further comprise a light and a power source. The first blade and the second blade each extend from the handle. The second blade is divided into at least two segments. The segments are each pivotable in relation to each other along a common axis. Movement of the blade actuator causes the segments of the second blade to pivot radially toward and away from each other.

Abstract: Minimaily 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 compact, low-profile surgical retractor (100) avoids the need for a bulky frame. The retractor includes retractor blade components (110, 120, 130, 140, 150, 160) joined pivotally. A cable (170) is guided by each retractor blade component. A winding mechanism (180), such as a spool, is carried by one of the retractor blade components (120) for winding up the cable to cause the retractor blade components to transition from a closed position to an open position. The winding mechanism may be actuated by a detachable handle (200). The retractor blade components may be unitary, injection-molded pieces. The retractor blade components may be fixed pivotally, such as by pins, or pivotally joined by living hinges. A less-invasive surgical method is also provided in which the retractor is inserted into the body through an incision.

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: 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 method and apparatus for closing a vascular wound includes a guidewire and/or other surgical implement extending from the wound. A hemostatic material is advanced over the surgical implement and into contact with an area of the blood vessel surrounding the wound. The surgical implement is removed. Blood soaks the hemostatic material, and blood clotting is facilitated by the hemostatic agent within the material. A sealing layer of adhesive can be applied to the hemostatic material, confining the blood flow to the material. Thus, the vascular puncture wound is sealed by natural blood clot formation.

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 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: An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and support pads interconnected to a blade. A torsional member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor interconnected to the blades and is used to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: A surgical retraction and positioning device comprises a stable platform and a flexible tape attached thereto for easier retraction and manipulation of a heart during cardiac surgery. The stable platform has an elongate body having a curved handle extending into an organ contacting base. The base is formed at the distal end of the handle and is at least partially concave to conform to the contours of the outer surface of the heart. A portion of a flexible element, such as umbilical tape, is secured to the base, leaving at least one free end to enable the surgeon to wrap, or secure, the heart against the organ contacting base.

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: A lid retractor for use, for example, in transconjuntival blepharoplasty electrosurgery on eyelids which avoids having to move the retractor during the procedure. The lid retractor comprises an elongated handle which at one end, the gripper end, divides into several projections each terminating in a hook that can be placed over the lower lid to enable the lower lid to be retracted to access lid or eye regions under the lid retractor. The gripper is dimensioned so that the whole eyelid can be pulled down such that several fat compartments under the eyelid can be accessed, visualized, and surgically treated without having to move the lid retractor position.

Abstract: Disclosed is a spatula dissector (10) presenting a body (12) and a flat distal end (14) comprised of two jaw elements (28, 30) capable of spreading relative to the surface of the spatula.

Abstract: Disclosed is a device for lifting the abdominal wall for laparoscopy, whereby the device can be inserted into the abdominal cavity through an opening in the abdominal wall, having an instrument shaft, which is provided at its distal end region with at least one, preferably two limbs disposed parallel to the axis of the instrument shaft and the can be folded open laterally to the shaft axis. The invention is distinguished by the limbs being joined to the instrument shaft via a folding mechanism, which rotates the limbs at an angle ranging up to 180°.

Abstract: An apparatus for stabilizing a predetermined area on a heart of a patient to enable a surgical procedure, the apparatus comprising a bifurcated member having two elongated prongs which can be adjustable as to width and an elongated handle segment attached to the bifurcated member. The handle segment can be either fixably or pivotably attached to the bifurcated member. The apparatus may further comprise an attachment or inlay to prevent lateral movement thereof when being used in the surgical procedure. The apparatus may also include a cleat for securing a portion of the surgical thread used during the surgical process. At least a portion of the prongs (or feet) of the bifurcated member may further be independently rotatable for self-alignment with the surface of the predetermined area of the heart.

Abstract: A surgical tissue retractor for use in small tissue incisions such as heart valve surgery. The retractor is comprised of a plurality of retractor blades that can be operated simultaneously or at least one or more blades can be operated independently. Right and left retractor blades are mounted on an actuator mechanism that spreads or expands the blades as a rotatable primary actuator knob is rotated. A third retractable arm is mounted for simultaneous operation with the right and left retractor blade or independent operation through a secondary rotatable actuator knob that extends or retracts a threaded shaft attached to the center retractor blade. The retractor includes a housing having a hangar for use of the retractor in conjunction with a larger retractor such as a sternum spreader or rib spreader retractor.

Abstract: A speculum for dilating a body cavity with at least three blades, twice as many supporting members, a rachet mechanism between pairs of directly connected supporting members, and a light source receptacle located on one of the blades with a curved plastic track at the base of the receptacle to transmit light from a removable, commercially available, light source into the cavity created by the speculum. Two of the supporting members, besides helping to move the blades from a closed to an open position and back, can also pivot anteriorly.

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 access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and support pads interconnected to a blade. A torsional member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor interconnected to the blades and is used to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and a sternal pad interconnected to a blade. The superior blade is pivotally coupled to the spreader member such that it naturally rises as the blades are separated. Alternatively, a vertical displacement member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected superior blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor is interconnected to the blades to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: A self-retaining hand-held surgical retractor includes a main pair of blades mounted to a pair of fulcrumed levers. The proximal ends of two longitudinally extending bars are mounted to a toggle link carried between the handles. The bars pass through arms projecting from the levers above the plane containing the levers. A pair of supplemental blades are mounted to the bars. Closing the handles directly causes both the main pair of blades and the supplemental pair of blades to recede from each other, and also causes the supplemental pair of blades to move rearwardly from the main pair of blades through the action of the toggle link.

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

Abstract: An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and support pads interconnected to the first blade. A torsional member is operably interconnected to the first blade and the spreader member and is used to vertically displace the first blade in either direction and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor interconnected to the blades is used to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: A surgical retractor retracts tissue from a body cavity in which surgery is to be performed. The retractor has a plurality of fingers or blades which extend laterally from a handle. The fingers pivot about a pivot pin between a retracted position and an extended position. Extension is achieved by rotation of a centered control plate relative to the handle. The pivot pin for the fingers is displaced from the axis of the handle, and moves relative to the handle. Each of the fingers has an arcuate slot, and a guide post within the arcuate slots controls pivoting. Because of the distance separating the pivot pin and the axis of the handle, extension of the fingers occurs a distance away from the incision into which the retractor is inserted, and undue trauma to the incision is avoided. Because the pivot point moves relative to the handle, the fingers extend longitudinally during the pivoting motion.

Abstract: A surgical lifter adapted to engage and lift the skin from the underlying tissue to create a work space in which a surgeon can operate, includes an expandable lifter head comprising at least two blades pivotally connected for relative pivotal movement between a deployed position in which the blades are fanned out, and a collapsed position in which the blades overlap one another; and a lifter shaft adapted to extend through the skin to engage the lifter head inside the body.

Abstract: A retractor apparatus for use in conducting a surgical operation through an incision in a patient. The retractor includes a retractor support, a plurality of surgical retractors, and a stretchable sleeve. The surgical retractors are mounted to the retractor support such that at least two of the surgical retractors are facing each other. The stretchable sleeve encircles the surgical retractors to form a continuous surface around the surgical retractors for engagement of tissue.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patent's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide assess for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tubular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows movement relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.

Abstract: A cylindrical anal retractor for examining the inside of an anus of a living body including an inserting valve portion inside of which a substantially circular-shaped opening is formed, a handle which serves to dilate the opening by gripping it, and an auxiliary appliance for making the insertion of the inserting valve portion into the anus smooth; the trivalve inserting portion has three plate-like members, which are curved inside, and two of the members are connected to the handle so as to be rotatable about axes extended in an inserting direction of the inserting valve portion. In the anal retractor according to the present invention, therefore, the pain which is given to the patient when the anal retractor is inserted into his or her anus is remarkably reduced.