Abstract: A disposable nasal speculum, which includes a first rod member having an arched tongue at one end and a hand grip at an opposite end, a second rod member having an arched tongue at one end and a hand grip at an opposite end and a 90.degree. bend on the middle, a flexible short rod connected between the bend of the second rod member and a middle part of the first rod member, wherein the second rod member having a projecting strip extended from its inner side and stopped at an inner side of the first rod member to support the rod members in a closed position.

Abstract: A surgical retractor with interchangeable retractor blades allows the retractor blades to be positioned in an incision before being side-loaded into the retractor body and locked in place. The surgical retractor uses a connector head with a circumferential groove that fits in a side-loading socket and is locked in place with a cam that fits in the circumferential groove. A release lever releases the cam and allows the retractor blades to be removed.

Abstract: An instrument is provided for use by a surgeon to separate the nasal septum from the sphenoid sinus wall of a patient, in a procedure which may be performed very rapidly and with significantly reduced trauma to the septum. The instrument may be very usefully employed in connection with endoscopic endonasal pituitary surgery, although it is not limited thereto. The instrument comprises an elongated support member having first and second ends in opposing relationship, and further comprises pivotable and fixed jaw members respectively joined to the first end of the support member. Each of the jaw members has a length dimension measured from the support member, wherein the length of the pivotable jaw member exceeds the length of the fixed jaw member by a specified amount. A handle component joined to the second end of the support member is movable between first and second handle positions, to move the pivotable member in corresponding relationship between closed and open positions.

Abstract: A surgical retractor with interchangeable retractor blades allows the retractor blades to be positioned in an incision before being side-loaded into the retractor body and locked in place. The surgical retractor uses a nipple connector with a conical base and a rounded head which fits into and self-aligns in a corresponding socket.

Abstract: An apparatus and method of use is provided for locally stabilizing an anastomotic site during a beating heart surgical procedure which includes occluding a section of the artery receiving the bypass graft vessel. An apparatus is provided to stabilize the epicardium and the operational field, and includes a platform that can be compressed onto the epicardium or tensioned by pulling the epicardium upwardly, thereby providing a stabilized operational field. At least one occluding member provides means to occlude the section of artery receiving the bypass graft vessel. An adjustable stabilizing arm can be used in conjunction with the platform to further provide stability to the epicardium during the beating heart bypass graft procedure.

Abstract: A surgical access device (10 or 10') includes a frame defining an access port and a pair of flanges are carried on the lower surface of the frame. The flanges are pivotable between an insertion position, where their leading edges are optimally placed adjacent one another to assist in inserting the device in an incision, and a retracting position, where both flanges optimally urge upwardly against the internal surface of the patient's tissue to seat the access port. A method of the invention involves making an incision at least as long as the leading edge of such a device and inserting the leading edge of the device into the incision. The flanges are moved laterally away from one another to expand the opening in the tissue and center the access port laterally within the opening.

Abstract: A mechanical lifting retractor is provided which increases working space in the chest for cardiac surgery by temporarily expanding the space between the rib cage and the pericardium. The lifting device has a pair of parallel right-angled retractors. Distal portions of the retractors are insertable in side-by-side parallel relation between a pair of adjacent ribs in the rib cage and into the mediastinal space between the ribs and sternum and the pericardium beneath them. The distal portions are pivotable into a lifting position in which they are separated by a rotational angle of approximately 180.degree.. Following insertion of the distal portions into the mediastinal space, the distal portions are rotated into the lifting position and oriented in the sagittal plane such that each distal portion extends beneath one of the ribs. A lifting force is applied to the lifting retractor, causing the distal portions to engage the ribs and to lift the rib cage and thereby enlarging the mediastinal space.

Abstract: A tissue retractor with particular use in spinal surgery comprises a pair of pivotally linked arms, each with a blade mounted thereto by a ball and socket joint to allow the blades free movement relative to the arms. The blades have anchoring end to anchor to bone, which preferably are sharp piercing tips. The balls and the sockets are preferably detachable from each other. The retractor is operable by placing the blades in a wound opening; securing the anchoring ends to a portion of bone at positions a distance apart from each other to define a desired surgical field; and operating the retractor to cause the blades to separate and to retract tissues surrounding said wound opening by outward pivoting of the blades relative to the position of the anchoring ends. A supplemental retractor blade or blades may be provided by a linking armature for additional retraction generally perpendicularly to a retraction action provided by the main retractor blades.

Abstract: The present invention provides a speculum having two half-beaks each linked to an elongated lever member. The speculum includes one or more pivot devices which cause the distal end of the two half-beaks to rotate away from each other when the proximal ends of the lever members are rotated towards each other. The present invention also provides a method for inserting an elongated instrument into an animal's body comprising the steps of: making an incision in an animal's skin; inserting a speculum having two half-beaks through the incision into the animal's body; opening the two half-beaks to permit an elongated instrument to be inserted therethrough; and inserting an elongated instrument through the two-half beaks and into the animal's body.

Abstract: The present invention is directed to new and useful methods and apparatus for isolating and immobilizing tissue for improved presentation in a surgical site, preferably in coronary bypass on a beating heart. At the same time, the present invention also helps avert ischemic damage to tissues downstream. A surgical stabilizer in accordance with the present invention offers physical manipulation of a surgical site, which improves the surgeon's sewing, grasping, and visualizing abilities at the site, and in turn, may increase the confidence and patency of the graft. The stabilizer is used to compress or to suction a region of the heart just below a stenotic coronary artery. The surgeon may selectively articulate the tissue by spreading it apart or pushing it together, as per his or her preference, or per the requirements of the surgical situation. The surgeon may lock in place the handle via a ratchet mechanism to hold the specific open or closed articulation of the surgical stabilizer.

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 speculum includes manually operated scissor arms with keyed shafts at the ends of each arm adapted to receive speculum jaw or blade members supported on the shaft in a desired, adjustable orientation. The speculum blades include a self-contained fiber optic light source. An optional sleeve with shape memory characteristics may be used in combination with the speculum jaw members.

Abstract: A retractor for placement proximate an incision for holding back the edges of the incision, the retractor comprising a pair of substantially elongate retractor portions having outer substantially irregular edges formed along substantially the entire length thereof for engaging and holding back the opposing edges of an incision, and an expansion assembly coupled to the retractor portions for moving the retractor portions between a collapsed position and an expanded position.

Abstract: A nasal speculum having generally arcuate blades movable between a closed position and an open examination position. The speculum includes interconnected parallel arms having cross members at one end. The cross members mount a pair of intermediate members having the arcuate blades at their distal ends. After the blades are inserted in a nasal passageway, the arms are squeezed to move the blades from the normally closed position outwardly to the open examination position. Preferably, the nasal speculum is a one-piece molded plastic having smooth conical blades at the work surfaces.

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: 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: The present invention provides endoscopic instrumentation and surgical techniques especially useful for accessing at least a portion of an intervertebral disc. Vertebrae spreading instruments are provided for spreading adjacent vertebrae to facilitate access to the intervertebral disc are. The disclosed surgical method uses an anterior approach to access the intervertebral disc and spreads adjacent vertebrae utilizing an endoscopic vertebrae spreading instrument.

Abstract: A tissue spreading surgical instrument having a handle assembly which includes a moveable handle assembly; an elongated shaft extending distally from said handle assembly which houses an actuating mechanism moveable in response to movement of the handle assembly and a tissue spreading assembly comprising a plurality of fingers operatively associated with the distal end of the shaft and deployable between a closed and open position wherein the fingers are spread in opposite direction by the actuation mechanism in response to movement of the handle assembly is provided.

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.

Abstract: A four blade medical retractor for holding open a body or surgical cavity. A first blade is fixedly mounted to the first leg of an L-shaped frame. A second blade is slidably mounted to the second leg of the frame and includes a spring biased pawl to control motion of the second blade relative to the first blade. A third blade is slidably mounted to the first leg and also includes a pawl to control motion of the third blade along the first leg. A carrier mounted to the second leg holds a fourth blade which is movable both along the length of the second leg and also to and from the third blade.

Abstract: A pupil expander insertion system for eye surgery includes a pupil expander insertion tool and an iris retracting glide. The insertion tool includes a housing having forward and rearward ends, a hollow chamber in which a piston is axially movable, and an aperture formed in the forward end that communicates with the hollow chamber. A retractable blade for holding a pupil expander in an elongated condition is journaled within the aperture and connected to the piston for longitudinal movement therewith. The forward end of the blade has a slot extending rearwardly, defining a pair of tines wherebetween the expander can be slidably inserted. A stationary hollow spatula surrounds the blade in the retracted position, contacting the pupil expander to slidingly urge it off the retracting blade. The glide has an elongated tongue with a folded tab on one end slidably inserted through a slot means in the other end.

Abstract: A medical retractor having a support shaft on which is threaded a retractor arm drive that supports a retractor arm. The retractor arm drive includes a worm with threads that engage peripheral gear teeth of a worm gear; and the worm gear is threaded onto the support shaft. Rotating the worm, turns the worm gear and moves the retractor arm drive and retractor arm longitudinally along the support shaft. A stop prevents the support shaft from rotating with the worm gear in response to rotation of the worm.

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: An abdominal wall elevator device including a pair of retractable tabs rotatable to 90.degree. with respect to the vertical axis of the device, and selected of a dimension to enter the port of a Trocar in allowing low pressure pneumoperitoneum laparoscopic surgery. In a preferred embodiment of the invention, a removable push-rod incorporates a flat tip to operate on the tenons of a pair of hinges to swing the retractor tabs to the desired angle, to be locked in place.

Abstract: A surgical instrument is provided for performing surgery to relieve the symptoms of carpal tunnel syndrome. The surgical instrument includes a pair of pivotally connected legs with each leg including a handle portion and a blade portion with the blade portions terminating in a nose. The nose is inserted through an incision in the wrist area and progressively "worked" into an area between the transverse carpal ligament. The surgical instrument is rotated approximately 90 degrees and the handle portions are then squeezed to spread the blade portions to create a surgical area fully exposing the transverse carpal ligament. One of the blade portions carries illuminating means for illuminating the surgical area or arena to assure that only the transverse carpal ligament is severed to prevent damage to the median nerve, tendons and the like passing through the carpal tunnel.

Abstract: A surgical retractor is provided including a handle portion, a tubular portion extending from the handle portion, and a collapsible retractor assembly connected to a distal end of the tubular portion. The handle portion includes an actuating structure for manipulating the collapsible retractor assembly through the tubular portion. The retractor assembly includes a plurality of retractor blades, a camming assembly connected to the retractor blades and structure for connecting the retractor blades to the actuating structure.

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: The surgical instrument of the invention consists of a pair of arms hinged together at an intermediate point for relative pivoting movement. The arms are provided with obliquely oriented handles at one end thereof. The opposite ends of the arms support removable posts having means for removably securing a plurality of different retractor or compressor heads thereto. The posts are pivotably connected to the arms to allow the posts to achieve a variety of orientations relative to the arms. A variety of retractor and compressor heads and different shaped posts are provided to allow the instrument to be used in a wide variety of surgical procedures. Separate serrated locking mechanisms are provided to lock the arms in either a retraction or compression position. In one embodiment the posts are secured to one another such that they undergo parallel retraction/compression.

Abstract: An improved dissecting forceps comprises an elongated shaft which fits closely within the lumen of a trocar. A smaller rod extends beyond the distal end of the shaft. A pair of jaws at the distal end of the rod are hinged so that they are movable relative to each other, and meet at a surface when closed. The jaws have bumps at their proximal ends which extend away from the surface at which the jaws meet when closed. A control mechanism located at the proximal end of the shaft causes at least one of the jaws to move relative to the other jaw. Elements of connective tissue are separated when the jaws are spread apart after having been inserted between the tissue. The bumps prevent the tissue from sliding along the jaws in the proximal direction as the jaws are spread apart.