Abstract: A surgical retractor including a blade molded from a polymer having at least a predetermined flexural strength, a handle, and a deepened portion connecting a proximal end of the blade to the handle, wherein the deepened portion increases in depth from the proximal end of the blade toward the handle, and wherein the blade, being molded from the polymer, and the deepened portion are configured such that the blade deforms less than 10 mm under 15 lbs of force applied thereto.

Abstract: A minimally invasive dilation device includes a plurality of rigid arms radially arrayed about a center and a dilating member positioned between the arms. A stylus may occupy the center. An outer flexible sleeve may be circumferentially secured to the arms, lying within or without the plurality of arms. An inner mesh may surround the stylus and dilating member. The device may be introduced into tissue toward a targeted area, while in a closed configuration. The dilating member may be a balloon, wherein upon inflation of the balloon, the arms are pushed radially outward, expanding the device and dilating the surrounding tissue. The dilating member may be a tube, wherein upon insertion of the tube, the arms are pushed radially outward. A cannula may be inserted inside the plurality of arms to keep the arms in an open configuration, and the dilating member may be withdrawn, providing an open passageway through the device to the targeted area. The device may be used with a neural monitoring system.

Abstract: A retractor member is configured for insertion through a channel of an access member and for moving soft tissue at a treatment site that is accessible through the channel. The retractor includes a body having a proximal end and a distal end and spaced from each other along a longitudinal direction. The distal end defines a retractor blade and the body defines a first surface and a second surface opposite each other along a transverse direction substantially perpendicular to the longitudinal direction. The retractor includes an attachment device configured to selectively attach the body to a portion of the access member such that the body is extendable through the working channel while the body is attached to the portion of the access member.

Abstract: A surgical retractor, comprising a blade having a top surface and a bottom surface, and a handle extending at an angle from a proximal end of the blade, wherein the blade and the handle are molded from a glass-fiber reinforced polymer having a flexural strength of at least 300 Mpa, and wherein the blade, being molded from the glass-fiber reinforced polymer, deforms less than 10 mm under 15 lbs of force applied thereto.

Abstract: A retractor assembly includes a base, a first side assembly, a second side assembly, and a medial arm assembly. The first side assembly is coupled to a first side of the base and translates relative to the base along a first direction. The second side assembly is coupled to a second side of the base and configured to translate relative to the base along the first direction. The medial arm assembly is coupled to the base and can extend in an extension direction and retract in a retraction direction. The extension direction is opposite the retraction direction. The extension direction and the retraction direction are perpendicular to the first direction. The medial arm assembly includes a body, and a blade assembly. The blade assembly includes a receiving portion and a medial blade. The receiving portion and the medial blade are rotatably interfaced via a ball and a socket.

Abstract: A surgical access system comprising a tissue dilation 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.

Abstract: This disclosure provides a retractor for use in repairing vaginal tears following birth. The retractor is formed as a sheet of soft rubber, plastic or silicone and is rolled or folded for vaginal insertion; the retractor is resilient so as to provide a spring force which urges the vaginal canal open to a degree that facilities visualization and obstetric repair while avoiding unnecessary strain on the tissues being repaired. An optional flange structure can be provided so as to provide a structure for the surgeon/OB to reposition the retractor in-situ, and also to serve as a stop or retainer to hold the retractor in place. The disclosed retractor is self-retaining, such that both of a surgeon's hands can be freed for other tasks.

Abstract: A vaginal speculum and side wall retractor allows clinicians to visualize the cervix and upper vagina by retracting vaginal walls simultaneously. This device is comprised of a handle, a mobile introducer allowing the device to comfortably be inserted vaginally, and a lower blade capable of stabilizing the cervix and a body containing the side wall retractor. This retractor is comprised of a rolled-up sheet of transparent plastic which can be opened through a rotating shaft countersunk in the body of the base. A friction or sprocket gear allows the rotating shaft to open and close the plastic side wall retractor as well as completely unwinding the transparent plastic sheet so that the device can be removed while leaving surgical instruments in the vagina. The rotating shaft serves as a light guide and brings light from the knob, which contains an LED, into the rolled-up sheet during examinations.

Abstract: In an optical fiber scanning apparatus, an optical fiber to which a permanent magnet is disposed and which is configured to emit illumination light from a distal end portion is arranged in a hollow portion where a magnetic field generation unit is disposed of a frame body, the frame body for which a cross section of the hollow portion is a square includes a first frame body for which planar coils are disposed respectively on a first surface and a second surface that are orthogonal to each other, and a second frame body for which planar coils are disposed respectively on a third surface and a fourth surface that are orthogonal to each other, and which is bonded with the first frame body, and the first surface to the fourth surface configure inner surfaces of the hollow portion.

Abstract: A technique for operating a data storage system includes accessing respective absolute expiration times for valid pages in one or more candidate storage blocks. Garbage collection is performed on ones of the candidate storage blocks that include a first predetermined number of the valid pages that do not expire, as indicated by the absolute expiration times, prior to a first predetermined time period. Garbage collection is deferred on ones of the candidate storage blocks that include a second predetermined number of the valid pages that expire, as indicated by the absolute expiration times, prior to a second predetermined time period.

Abstract: Described are various embodiments of surgical procedure systems, devices, tools, and methods, useful for treating pelvic conditions such as vaginal prolapse and other conditions caused by muscle and ligament weakness, the devices and tools being useful for accessing a posterior region of pelvic anatomy, and related methods. Such devices can include retractors, introducers, and other devices for accessing desired areas of a patient's anatomy.

Abstract: This application presents structurally-adjustable vaginal specula, which provides visualization and access to the vagina and the cervix. The specula may be lightweight and compact, and may also be configured and dimensioned to minimize slippage during use. The specula may comprise built-in light sources. The specula may comprise a fluid handler, for example, to remove fluids from the vagina during medical interventions. The specula may retract the labia as well as the vaginal walls. The speculum may also be used as a retractor.

Abstract: It is described a surgical instrument such as a speculum comprising longitudinally extending cups-shaped pivotably mounted blades manufactured from a moldable material, such as plastic or metal. Each blade has an inwardly curved circumferential edge with an edge face which is provided with a parting line resulting from molding the blades. Negative effects such as possible injuries associated with parting lines or steps can be mitigated by inwardly relocating these lines on an edge face of the inwardly curved circumferential edge.

Abstract: A system and method are disclosed which may include a training board including a plank made of wood (or other material such as metal, rubber or plastic) and deformable or non-deformable structures coupled to a bottom thereof, thereby enabling the board to rotate about as many as three rotational axes upon having force applied thereto by a user. The training board may enable a user to use to the board for training purposes or recreational activities using structures having a range of properties.

Abstract: A reusable needle guide suitable for an ultrasonic probe to be use for an endocavity examination of a patient is disclosed. The needle guide basically comprises at least a first and second guide members and a mounting (e.g., clamp) assembly. The clamp assembly serves to releasably mount the needle guide on the probe. The first guide member has a first passageway-forming surface. The second guide member has a second passageway-forming surface. The guide members are connected together to enable them to be pivoted from a closed orientation to an open orientation and vice versa. The first and second passageway-forming surfaces form an elongated passageway to guide a needle therethrough when in the closed orientation. The first and second passageway-forming surfaces are disposed at an angle to each other when they are in the open orientation, whereupon the first and second passageway-forming surfaces can be readily cleaned.

Abstract: A speculum is provided herein which includes first and second arms, connected by a hinge, each having a channel formed thereon adapted to the shape of an eyelid. First and second elements are respectively located on the first and second arms configured to cooperatively retain the first and second arms in select rotational positions. A slot is defined in the second arm to partially separate first and second portions of the second arm with the first portion being displaceable away from the second portion. The second element is located on the first portion. Advantageously, with this arrangement, the first portion acts as a spring-loaded hinge which applies not only biasing force to the second element for retention, but also permits the second element to be separable from the first element. The subject invention provides a mechanical feature beyond the inherent memory of the material for operation of the speculum.

Abstract: The invention relates to a spreadable medical instrument for endoscopic interventions having a base body, a handle positioned on the base body, and at least two spatula blades that are connected with the handle and can be displaced between a closed starting position and at least one working position parallel and/or at an angle to one another by means of an adjustment device, in such a way that the adjustment mechanism is positioned on the handle so that it is possible simultaneously to grip the handle and activate the adjustment mechanism with the same hand. To create a spreadable medical instrument that has the widest possible range of applications and is easy and safe to operate, it is proposed with the invention that the adjustment mechanism is configured as a continuous, adjustable screw-in mechanism.

Abstract: A vaginal dilator having side blades or having upper and lower blades including accessorial blades is described. The vaginal dilator includes an upper blade, a pressing member, a lower blade and a handle. The upper and lower blades are connected by a pin. The pressing member is engaged with the handle by a first dilating fixation device. The vaginal dilator having side blades includes an arc-shaped movable locating sleeve rotationally connected with the upper blade. Each end of the sleeve is provided with a mounting base. The mounting base is provided with a joint cavity for receiving a side blade which can be retracted between the upper and lower blades. The back portion of the side blade is provided with a second dilating fixation device engaged with the back end of the upper blade or a locating buckle of the mounting base.

Abstract: A vaginal speculum is provided that has an upper arm with a handle and jaw. A cross-sectional shape of a longitudinally extending portion may be constant along its entire longitudinal length so that the height of the portion is likewise constant along its length. Right and left side flanges may extend downward from the longitudinally extending portion and a tip of the jaw. The distance between the outer surfaces of the right and left side flanges in the lateral direction may be constant along their entire lengths in the longitudinal direction. A lower arm with a jaw and handle may be included and arranged with the upper arm so that their relative position to one another can be modified.

Abstract: A vaginal manipulator includes a shaft and a head. The head includes a central plate having a distal end connected to the shaft, an expansion plate coupled to and configured to move radially away from the central plate, and a door having a constrained end and a free end. The constrained end of the door is hinged to the central plate and the free end of the door is configured to move away from the central plate. When the vaginal manipulator is inserted into a vagina, the expansion plate is movable relative to the central plate to displace an anterior wall of the vagina and the door is movable relative to the central plate to displace a posterior wall of the vagina into a trans-abdominal line of sight.

Abstract: A vaginal manipulator includes a shaft, a handle connected to a first end of the shaft, and a head connected to a second end of the shaft. The head includes a rigid anterior surface that moves independently from a rigid posterior surface of the head. When the vaginal manipulator is inserted into a vagina, the rigid anterior surface is movable to displace an anterior wall of the vagina and the rigid posterior surface is movable to displace a posterior wall of the vagina. A light source is provided on the head.

Abstract: It is described a surgical instrument such as a speculum comprising longitudinally extending cups-shaped pivotably mounted blades manufactured from a mouldable material, such as plastic or metal. Each blade has an inwardly curved circumferential edge with an edge face which is provided with a parting line resulting from moulding the blades. Negative effects such as possible injuries associated with parting lines or steps can be mitigated by inwardly relocating these lines on an edge face of the inwardly curved circumferential edge.

Abstract: An attachment which can be used with a vaginal speculum. The attachment can be used with a vaginal speculum. The attachment has a pair of arms on one end which will engage the fornix lateral to the cervix of a women's vagina, and a U-shaped curved portion on the other end which will allow a doctor to engage the attachment with a vaginal speculum in order to spread a patient's lateral, as well as vertical, walls at the same time.

Abstract: A surgical device includes a rigid shaft connected between a handle and a head. The head of the surgical device is sized for insertion into an organ such as a vagina, a uterus, a rectum, or an esophagus. The head includes an expansion plate and a door coupled to a central plate. The central plate has a distal end connected to the rigid shaft, an anterior surface, and a recess formed in a posterior side of the central plate that provides a posterior surface opposite the anterior surface. The expansion plate is coupled to and movable relative to the anterior surface of the central plate. The door is coupled disposed within the recess of the central plate and movable relative to the posterior surface of the central plate. The expansion plate is movable independently of the door to allow the head to expand and move the organ.

Abstract: A Perineal elasticity meter having a circular central stem marked with millimeter markings and a sleeve portion surrounding the circular stem. Hinges connect the sleeve to expanders that extend from the circular stem. The perineal elasticity meter is configured to be inserted into the vagina of a patient in order to measure the elasticity of the perineal area. The sleeve includes an opening that shows a circumferential measurement achieved by the expansion of the expanders, as the sleeve moves along the central stem. Another perineal elasticity meter includes two stems connected via a hinge at a proximal portion of the stems. The proximal portions of the stems are configured to be inserted into the vagina of a patient and a measurement is taken of a distance between the expanded distal portion of the stems, thereby measuring the elasticity of the perineal area.

Abstract: A transvaginal ultrasound probe speculum is designed for use with a generally cylindrical elongated ultrasound probe. The speculum has an elongated blade having a proximal end and a distal end, and a connector, such as a collar. The speculum has a lever that cooperates with the collar and the elongated blade for pivoting the blade relative to the ultrasound probe so that the blade and the ultrasound probe serve as the blades of the speculum.

Abstract: A medical instrument serves for creating an access for a minimally invasive intervention and has a body having a longitudinal axis. The body is assembled of at least two parts, each of said parts having edges extending along a direction of said axis. Each of said parts having edges extending along a direction of said axis. Each part has a distal section merging into a proximal section standing outwardly from said longitudinal axis. In a first position, the distal end section of the parts are joined along said edges to form a distal body with the proximal section standing away. In a second position, the proximal sections of said parts are joined along said edges to form a hollow proximal body with said distal end section spreaded outwardly. The edges are provided with interacting features which are designed to block a lateral sliding of said joined parts transversely to said edges.

Abstract: An articulation mechanism for a vaginal speculum enables selective relative movement between an upper blade member and a lower blade member to affect vertical and angular spacing. The mechanism selectively enables quiet or clicking articulation according to at least one version.

Abstract: A speculum for internal examination of a body cavity such as a vagina, comprising at least two spoons, each comprising a spoon blade that can be inserted in the body cavity, which spoons are attached to one another via a hinge pin and are hingeable between a closed position in which the spoon blades are essentially in contact with one another and a spread position in which the spoon blades are some distance apart, and at least one operating handle which is located outside the body cavity during use, a body rest being provided which, in conjunction with the operating handle, effects spreading of the spoon blades.

Abstract: A vaginal dilator having side blades or having upper and lower blades comprising accessorial blades includes an upper blade (1), a press handle (3), a lower blade (2) and a handle (4). The upper blade (1) is connected with the lower blade (2) by a pin (5). The press handle (3) is engaged with the handle (4) by a first dilating fixation device. The vaginal dilator having side blades also includes a circular-arc movable locating sleeve (8) rotationally connected with the upper blade (1). Each end of the sleeve (8) is provided with a mounting base (11). The mounting base (11) is provided with a joint cavity for receiving a side blade (12) which can be retracted between the upper and lower blades (1, 2). The back portion of the side blade (12) is provided with a second dilating fixation device engaged with the back end of the upper blade (1) or a locating buckle (15) of the mounting base (11). A channel (18), a channel cover and a slot for inserting the channel cover are provided in the side blade (12).

Abstract: A guide is provided for insertion into a surgical incision to create interior access along a preferred plane to an interior surgical site. After inserting the guide into an incision, a retractor or other tool may be inserted though the guide to the interior surgical site. The guide serves as a pathway for the retractor to the interior surgical site of the patient.

Abstract: A speculum includes upper and lower members and a linear support member. The upper member includes an upper blade. The lower member includes a lower blade and a handle portion. The lower blade includes a support structure at a proximal end thereof which extends vertically on the right or left side of the lower blade, and a handle portion extending downwardly from the lower blade and defining a vertical track. The linear support member has a proximal end pivotally connected to the upper blade, a distal end, and an elongated body between the proximal and distal ends. The elongated body slidably engages the vertical track of the handle portion. The linear support member is formed with a hidden slot which slidably receives the support structure of the lower blade.

Abstract: The embodiments disclosed herein relate to disposable speculums, and more particularly to disposable vaginal speculums having single-sided support and operating mechanisms. In an embodiment, a speculum includes an upper member having an upper blade and a hinge assembly; a lower member having a handle and a lower blade, wherein a combined smoke channel light guide directs light from a light source in the handle to a distal end of the lower blade for smoke removal; and a linear support member having a proximal end, a distal end, and an elongated body therebetween, the linear support member vertically moveable within a track positioned in the lower member.

Abstract: An apparatus and method for an examination apparatus that includes a manually movable structure having a first movement from a free state to a compressed state and a second reversing movement from the compressed state to the free state. Also included is a plurality of fingers that are disposed adjacent to the structure. The fingers having a stowed state and an open state, the stowed state having a nested relationship between the fingers to reduce a silhouette profile size. In moving from the stowed state to the open state of the plurality of fingers requires a selected sequential movement of each the fingers to proceed from the nested relationship to the open state that is accommodated by an assemblage for moving the fingers sequentially utilizing the manually operated structure, wherein the fingers are moved from the stowed state to the open state and reversed manually.

Abstract: A retractor having interchangeable or replaceable blades facilitates the expansion of a surgical site below an incision in the skin, and establishes a work-through surgical space. The retractor includes a frame connected to two collar arms, a pair of blades connected to the collar arms, a sheath for encompassing the blades and providing a circumscribed working space, and a device for rotating the collar arms, thereby displacing the blades and any tissue surrounding them.

Abstract: A speculum cover that is adapted to sheath the blades of a speculum, and to support lateral vaginal walls to facilitate vaginal/cervical examination during gynecological exams and surgery. The speculum cover includes top and bottom pockets for the respective blades of the speculum, and side portions having openings therein for sampling of tissue at the vaginal locus. In a specific implementation, the speculum cover is of a four-ply construction, formed by impulse welding or other polymeric film joining technique, and the two inner plies of the cover include rearwardly extending flaps to which are adhesively secured donning guide members for facilitating installation of the cover on the speculum.

Abstract: The present invention relates to a vaginal speculum embodying an applicator for the uniform delivery of a standardized dose of a liquid diagnostic marker onto the woman's lower genital tract. The applicator can comprises of a marker container and a mechanism for transferring a desirable quantity of its content to an injection probe for dispensing the marker onto the tissue surface. The cross section of the injection probe is substantially smaller than the rear opening of the speculum, so that the monitoring of the optical effects provoked to the tissue by the marker and the insertion of treatment tools is not obstructed.

Abstract: The present invention provides a speculum comprising a body (100), an opening (20), a first blade (2) pivotably secured to the body and a second blade (3) that is integral with the body. The blades are located at opposed sides of the opening. The first blade is pivotally secured with respect to the body by means of pivot pins. The first blade is movable between a first retracted position in which it lies adjacent to the second blade and a second extended position in which it is spaced apart from the second blade. A mechanism (5, 41) is also provided that is configured to move the first blade (2) from the first position to the second position. When the first blade is in the extended position, there is an inspection channel (20) formed that extends through the opening and between the blades. The mechanism for moving the first blade is preferably located substantially outside the periphery of the opening when the first blade is in the extended position.

Abstract: A speculum (1) for internal examination of a body cavity such as a vagina (25), comprising at least two spoons (3,4), each comprising a spoon blade that can be inserted in the body cavity (25), which spoons (3,4) attached to one another via a hinge pin (7) and are hingeable between a closed position in which the spoon blades (3,4) are essentially in contact with one another and a spread position in which the spoon blades (3,4) are some distance apart, and at least one operating handle (5) which is located outside the body cavity (25) during use, a body rest being provided which, in conjunction with the operating handle (5), effects spreading of the spoon blades.

Abstract: A vaginal speculum having a handle portion and a set of blade pairs some of which can be removably attached to the distal end of the handle and others can be slidingly inserted through the proximal end of the handle. Both pairs of the blades have snapping engagement with one and the same locking mechanism of the handle. The handle may constitute a permanent part, and the blades may be replaceable.

Abstract: The embodiments disclosed herein relate to disposable speculums, and more particularly to disposable vaginal speculums having single-sided support and operating mechanisms. In an embodiment, a speculum includes an upper member having an upper blade and a hinge assembly; a lower member having a handle and a lower blade, wherein a combined smoke channel light guide directs light from a light source in the handle to a distal end of the lower blade for smoke removal; and a linear support member having a proximal end, a distal end, and an elongated body therebetween, the linear support member vertically moveable within a track positioned in the lower member.

Abstract: A vaginal speculum includes a pair of opposed blades. One of the opposed blades is movably mounted for controllable movement towards and away from the other of the pair of opposed blades. Each blade includes an elongate arcuate paddle defining an interior compartment between the paddles. A solid rounded lip defines the terminal end of each side and the distal end of the blades. The lips may comprise a unitary structure which may be integrally formed with the paddle or separately formed and attached to each paddle such as by welding or mechanical attachment. The solid rounded lips protrude laterally from the first and second sides and the distal end of the blade to provide a smooth brim configured to urge tissue away from the blade. The solid rounded lip is preferably flush with the interior compartment defined by each elongate arcuate paddle. The solid rounded lip has a major radius of at least 2 mm and preferably 2 mm to 5 mm and approximately ½ to 1/20 times the blade radius.

Abstract: This invention relates to a cervix examination device capable of containing and separating a light module. The cervix examination device comprises a first blade having a first open part and a first holding part; a second blade, which is pivoted to the first blade, comprising a second open part and a second holding part; an adjuster installed between the first and the second blades for adjusting the relative angle between the first and the second open parts; and a container installed inside the first open part, the container comprising an open portion and a closed portion, the light module can be contained in the closed portion via the open portion.

Abstract: A disposable plastic vaginal speculum constructed for heavy duty use and/or for long duration gynecological procedures including intrauterine device insertion and vaginal surgical procedures. The hinge region of the speculum, as well as other regions, are reinforced so that the speculum can bear forces of a magnitude normally bearable only by metal vaginal specula.

Abstract: A childbirth instrument and method of use. The instrument may have guide and/or guard portions with concave posterior sides, and may have one or more grips. The guide may have first, second, and third elongated reference slots for performing episiotomy cuts therethrough, with the reference slots locating the angle and position of the episiotomy cuts, and the guard provides protection for the unborn infant. Another embodiment has one or more apertures through which a hypodermic needle may deliver a local anesthetic prior to making episiotomy cuts. The instrument may have one or more grips, which may be removable, and may have a movable stop and/or guide aperture. The angle of the episiotomy cut may be adjusted with one embodiment. The guide and guard portions may separate. Finger-receiving portions may be provided on the guard.

Abstract: A vaginal speculum assembly (100) including first and second speculum jaws (101, 103) to engage a vaginal aperture (402) and to provide a desired opening of the vaginal aperture (402), wherein at least one of the first and second jaws (101, 103) is associated with a mounting configuration (110) to support an inspection device (112) at a desired position relative to a vaginal cavity (404) associated with the vaginal aperture (402).

Abstract: The invention describes a disposable device for operations on the arteria haemorroidalis, which comprises a retractor tube (1), closed and rounded on the end (101) which is inserted in the anal cavity, and open and diverging on the external end (201) to which is connected a griping handle (M) which removable houses a luminous source (F). In the connection zone of the handle to the external mouth of the retractor there is provided a channel (C) which contains a parabola (5) which reflects the light supplied from said luminous source (F) and which sends the reflected light inside of the same retractor, to illuminate a lateral window (8) through which appears the rectal mucosa upon which the operation must be made for the ligature of the arteria haemorroidalis.

Abstract: The opening area of the vagina contains most of its nerve endings; this area is generally much more sensitive to pressure than the inner two-thirds of the vagina. This portion of the vagina is also more constricted than the inner two-third of the vaginal area. When dilated, such as during a vaginal examination, pressure on and near the vaginal opening may increase pressure upon the adjacent urethral opening and the pubic bone, causing increased discomfort without providing additional expansion of the area. The middle area of the vagina is more dilatable, has fewer nerve endings, and more readily deforms when pressure is applied. The disclosed speculum is intended to place little pressure on the somewhat constricted vaginal opening and allow for increased expansion through the middle area, resulting in less discomfort to the patient during examination and maximized viewing area. A speculum and method of use are disclosed. Embodiments of speculum include upper and lower speculum blades.

Abstract: A vaginal speculum having a universal connection between the handle and each of a plurality of blades, for selectively detaching and attaching one or more of the blades at any one of a plurality of angles between the handle axis and the blade axis. Preferably, the vaginal speculum is part of a kit having a plurality of elongated blades adapted to penetrate and fully enter a vagina while providing surgical access, each being interchangeably connectable to the handle, thereby providing a variety of options for blade length, blade width, or blade contour to better fit the vaginal structure of a particular patient. Each blade is made of a rigid or semi-rigid plastic, that is disposable after each use. The handle is preferably made of heavy metal, with a permanent plastic sheath or coating.

Abstract: Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.