Abstract: Devices, methods, and systems for treating an ulcer or skin defect are disclosed. First and second base panels of a closure device are adhered to first and second sides of the ulcer or skin defect, respectively. Lateral ties couple the first and second base panels together and provide a predetermined separation distance or lateral gap between the inner edges of the panel. The predetermined separation distance or lateral gap is sufficient to treat the most common sized ulcers or skin defects, for example, accommodating an ulcer or skin defect with a minor axis of at most 50 mm. The lateral ties have their ends fixed to one panel and their opposite ends adjustably and reversibly attached to the other panel so that the separation distance can be reduced or adjusted to provide a lateral compressive force to the ulcer or skin defect, thereby promoting healing.

Abstract: In a device for stretching the skin, particularly for closing a wound, anchoring elements are anchored in the skin. The anchoring elements are movable on a guide device. First anchoring elements are anchored in the skin of the edge of the wound. Second anchoring elements are adjustable on the guide device in the stretching direction behind the first anchoring elements in relation to and independently of said first anchoring elements.

Abstract: Devices, bandages, kits and methods are described that can control or regulate the mechanical environment of a wound to ameliorate scar and/or keloid formation. The mechanical environment of a wound includes stress, strain, and any combination of stress and strain. The control of a wound's mechanical environment can be active, passive, dynamic, or static. The devices are configured to be removably secured to a skin surface in proximity to the wound site and shield the wound from endogenous and/or exogenous stress.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: The invention relates to a surgical retractor, particularly for the retraction of a separated sternum, with a holding device and two spreader arms, wherein the spreader arms are mounted with one end on the holding device, at a distance from each other that is adjustable in a spreading plane, and at least two retaining elements for retention of bone material, for example of the separated sternum, are arranged on each of the spreader arms. To develop this retractor for sternotomy in such a way as to permit gentler opening of the separated sternum, it is proposed that at least one of the retaining elements is mounted such that its position can be modified in the retraction direction with respect to that end of the spreader arm mounted on the holding device.

Abstract: A surgical retractor designed for wounds and incisions located on curved areas of the body. The clamp assembly comprising the present surgical retractor comprises multiple hinges and other types of movable joints allowing it to be adjusted to any number of positions in order to conform to various areas of the body as well as wounds or incisions of different sizes. In particular, the clamp assembly can comprise hinges located in the middle of at least two of its sides allowing it to be bent into multiple angles both above and below the flat horizontal position allowed by nearly all existing surgical retractors. Multiple retracting hook assemblies can be mounted at various positions along the sides of the clamp assembly allowing the hook comprising each to hold tissue in a variety of positions as needed.

Abstract: Methods and devices are provided for providing access through tissue to a surgical site. Generally, the methods and devices allow adjustment of a surgical access port's longitudinal length. In one embodiment, a surgical access port is provided that includes a housing having a cannula distally extending therefrom. The housing can be configured to cut a proximal portion of the cannula to adjust a longitudinal length of the cannula and hence of the surgical access port. In another embodiment, a surgical access port is provided that includes a cannula formed of a plurality of modular segments removably coupled together. One or more of the segments can be configured to be removable from the cannula to change the cannula's longitudinal length.

Abstract: Methods and devices are provided for providing access through tissue to a surgical site. Generally, the methods and devices allow adjustment of a surgical access port's longitudinal length. In one embodiment, a surgical access port is provided that includes a housing having a cannula distally extending therefrom. The housing can be configured to cut a proximal portion of the cannula to adjust a longitudinal length of the cannula and hence of the surgical access port. In another embodiment, a surgical access port is provided that includes a cannula formed of a plurality of modular segments removably coupled together. One or more of the segments can be configured to be removable from the cannula to change the cannula's longitudinal length.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. In general, the methods and devices allow a surgical access device to be securely positioned within an opening in tissue to provide access to a body cavity underlying the tissue. An actuator can be rotatably disposed on or in a housing of a surgical access device such that rotation of the actuator relative to the housing is effective to move a cannula of the surgical access device between an insertion configuration in which the cannula has a reduced profile enabling it to easily be inserted into a tissue opening, and an expanded profile enabling it to form an anchor against and/or within the tissue opening.

Abstract: A minimal incision maximal access system allows for maximum desirable work space exposure within the incision along with maximum access to the operative field utilizing a minimum incision as small as the width of the working tube. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing retractors depending from a bi-hinged frame having internal or external controls to control the angle and separation of the retractors. Interchangeable retractor blades can be attached to the frame. At least one retractor blade is independently controlled.

Abstract: In an organ retractor including a shaft defining a longitudinal axis and a longitudinal plane, and at least one organ support assembly operatively coupled to the shaft. The organ support assembly includes a plurality of ribs having a first position, in which each of the plurality of ribs is parallel with one another, and a second position, in which a first rib of the plurality of ribs is transverse with respect to a second rib of the plurality of ribs. The at least one organ support assembly is pivotable from a first orientation, in which each of the plurality of ribs is disposed in the longitudinal plane of the shaft, to a second orientation, in which each of the plurality of ribs is disposed at an angle relative to the longitudinal plane of the shaft, and a support extending between and connected to each of the plurality of two ribs.

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: The invention relates to a retractor for use in endoscopic surgery, comprising a shaft having a hand piece arranged on the proximal end thereof and whose distal end can be moved out of an initially extended and straight position, whereby the adjustable distal end consists of several link elements that can be moved into a ring-shaped structure and the ring-shaped structure can be bent in relation to the shaft. In order to produce a retractor which can be used atraumatically and can be handled in a highly hygienic manner, it is also proposed in accordance with this invention that the distal end of the shaft should be moved into the closed ring structure and the closed ring structure be bent in a continuous manner at an angle of up to 90 degrees. The invention also relates to a medical instrument for introducing a retractor into a human or animal body and to a method for the use of a retractor in endoscopic surgery.

Abstract: A system and method of moving and stretching plastic tissue using dynamic force. A preferably non-reactive force applying component is adjustably attachable to one or more tissue attachment structures for securing the force applying component to the plastic tissue, providing a self adjusting system that is capable of exerting relatively constant tension over a certain distance.

Abstract: An improved organ retractor includes an elongate handle and a rigid stem extending from one end of the elongate handle. A hollow sleeve is positioned around the stem and is axially slidable along the stem from a retracted position partly inside of said handle to an extended position. The sleeve is bifurcated or divided axially in half adjacent a distal end thereof to define two opposed elongate resilient fingers. The distal ends of each of the fingers are movable from a closed position wherein those distal ends are substantially adjacent each other surrounding the rigid stem to an open position wherein the distal ends are spaced from each other. A connector arm is positioned between each of the fingers and the rigid stem. The connector arms move the fingers to an open position when the stem is in one of the retracted and extended positions and move the fingers to a closed position when the stem is in the other of the retracted and extended positions.

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

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

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

Abstract: A method and apparatus for creating a surgical work space by lifting the abdominal wall and retracting abdominal organs during surgery utilizes a pair of lifting rods each hinged at their distal ends to opposite ends of an elongate cross-member. One of the lifting rods is slidable within a strap fastened to the proximal end of the other of the rods. The hinged relation of the lifting rods to the cross members and the sliding relation of the lifting rods to each other allow the apparatus to be pivoted into a streamlined configuration to facilitate insertion into a puncture opening in an abdominal cavity, and then to be pivoted into a triangular frame for defining an area of the abdominal wall to be lifted. After insertion the apparatus is locked into the triangular configuration, connected to a lifting arm, and lifted to cause the retraction rods to lift and support the abdominal wall.

Abstract: A tissue spreading forceps for gripping and spreading tissue include two gripping members which are secured to each other by a spring and are rotatable in relation to each other about a pivot. Initial pressure to the spring causes the gripping members to close and grip tissue at two locations. Additional pressure applied to the spring causes the gripping members to spread apart in relation to each other, thereby spreading the tissue.