Abstract: A surgical apparatus is described for performing cardiac surgery on the coronary organs of a patient. It has a contacting means capable of providing a mechanical load on at least a portion of said coronary organ, a positioning means which allows the setting of either or both the contacting means and coronary organ in a large number of positions or orientations within a surgical workspace. The apparatus also has a manipulation means serving as a single point control to position and orient the contacting means onto the coronary organ tissue. An adjustment means serves to bias the range of at least one motion degree of freedom of the surgical apparatus within a the limits of a restricted range that is less than the full range of motion of that degree of freedom of motion that would be otherwise achievable when the bias is not present or overridden.

Abstract: A stabilized cephalic medical apparatus includes an annular band for placement around a patient's head, and a pivotally adjustable bridge member for holding and supporting a medical instrument. The bridge member according to the invention is attachable to the annular band, and is preferably removable therefrom for cleaning and sterilization thereof. The bridge member is preferred to include a mounting member for supporting a medical instrument thereon, and a connector for connecting the mounting member to the annular band. The apparatus may further include a medical instrument attachable to the bridge member. The design of the apparatus according to the invention allows a medical instrument, such as a nasal speculum or retractor, to be operatively attached to, and to move concurrently with the patient.

Abstract: A retractor system of the present invention includes an adjustable arm, a carriage, and an activating device disposed in the carriage. The activating device causes movement of at least the adjustable arm to selectively stiffen or release the adjustable arm. The activating device further includes an engagement mechanism that causes movement of at least the carriage to selectively move the carriage. The present invention further includes a tubular retractor distally attached to the adjustable arm having a fiber optic cable embedded in the case of the tubular retractor that is capable of lighting the distal end of the tubular retractor when connected to a light source.

Abstract: In accordance with the present invention there is provided a device for stabilizing and/or manipulating moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissues. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube is operatively connected to a suction source so as to draw air through the tube from the distal end to the proximal end. The device further includes at least one foot operatively connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue. The distal surface of each foot has an outer perimeter having a substantially spherical profile. This spherical profile helps the device make better contact with the tissue, so the tissue can be more effectively manipulated.

Abstract: A mounting assembly for mounting a surgical instrument to a base, which facilitates positioning a surgical instrument relative to the surgical site so that only the minimum portion of the instrument is positioned in the free space available around the surgical site. A surgical instrument is also provided which includes a handle, a tool member, and a segmented flexible articulating arm which operatively connects the handle and the tool member. Also provided is an instrumentation kit having a surgical instrument which includes an end effector connecting assembly disposed at the distal end portion of an articulating arm to facilitate the removal or attachment of and end effector from the distal end of the articulating arm. The surgical instrumentation kit also includes a number of interchangeable surgical tool end effectors each having a uniform connector portion for interchangeable engagement with the end effector connecting assembly of the surgical instrument.

Abstract: This invention is methods and devices for stabilizing the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing device such that the contraction of the beating heart causes only minimal excess motion at the surgery site.

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 method is described for stabilizing moving tissue within the body. The method comprises creating a first opening for primary surgical access into the body, and a second opening spaced apart from the first opening in the body. An elongated stem having a proximal end and a distal end is inserted into the second opening. A foot having an upper and a lower surface is inserted into the first opening. The lower surface of the foot is engaged with the moving tissue within the body. The distal end of the stem is releaseably attached to the foot. The proximal end of the stem may be held so as to stabilize the moving tissue within the body.

Abstract: In accordance with the present invention there is provided a device for stabilizing moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissue. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube has a flexible hose extending through the lumen of the tube between its distal and proximal ends. The hose having a proximal end connected to a suction source so as to draw air through the tube from its distal end to its proximal end. The tube is made up of a plurality of segments which are detachable from one another. The device further includes at least one foot connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue.

Abstract: A surgical instrument includes a frame structure defining proximal and distal portions. The proximal portion has an articulating arm for repositionably mounting to a base and the distal portion supporting a stabilizing member. An attachment mounts on the stabilizing member, the attachment being configured and dimensioned such that upon contact with the heart the engaged heart tissue bulges outward. A method of surgery using the attachment includes providing a frame structure defining proximal and distal portions, the proximal portion being repositionably mountable to a base, supporting an attachment on the stabilizing member and engaging heart tissue with the attachment such that the tissue bulges outward to better present the tissue for surgery.

Abstract: A retractor for use in various types of surgical procedures such as harvesting mammary arteries, coronary bypass surgery, heart valve repairs, mitral valve replacement, partial sternotomies, and other types of surgery includes a toothed crossbar to which a pair of small grips are attached. The first grip is attached to an arm which is removably connected to a first block. The first block is movable along the crossbar, thereby permitting the first grip to be moved toward or away from the second grip. The second grip is attached to an arm which is removably connected to a second block. The second block can be fixed or movably connected to the crossbar. The crossbar includes a hinge that enables the grips to be pivoted relative to each other. Pivoting is accomplished by a pair of vertically extending brackets that are connected to the blocks and which are connected to each other by an adjustable connector.

Abstract: Apparatus and method for surgery is disclosed which includes a retractor having a substantially planar base defining an opening for overlying an operative site on a patient, and at least one retractor blade slidably mounted to the base. The base is positioned on the patient such that the opening therein overlies the operative site. The operative site is percutaneously accessed, and obstructing tissue is retracted by engaging the tissue with the retractor blade. A surgical instrument is provided which is engageable with the base and operable at the operative site through the opening in the base. A surgical procedure is carried out through the opening in the base with the surgical instrument.

Abstract: An articulating supporting bracket for a surgical tissue stabilizer comprises a series of elements joined to one another by articulating ball-and-socket joints. A flexible cable extends through passages in the elements, and, when tightened, causes the balls and sockets to lock together frictionally. The ball of each joint fits into its socket by an interference fit, whereby the ball and socket of each joint engage one another over an area of contact when the cable is tightened, thereby providing a strong, rigid support for the tissue stabilizer.

Abstract: In accordance with the present invention there is provided a device for stabilizing and/or manipulating moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissues. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube is operatively connected to a suction source so as to draw air through the tube from the distal end to the proximal end. The device further includes at least one foot operatively connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue. Each foot is attached to the tube by a ball and socket connector. The ball and socket connector is operatively connected to an actuator which can release and re-engage the ball from the socket.

Abstract: A surgical instrument positioning system includes a belt assembly positionable adjacent and across the body of the patient and a surgical instrument, such as a retractor, provided with an attachment portion for attachment to one or more of a plurality of adjustment positions provided on the belt assembly.

Abstract: The present invention is a method and apparatus for performing peritoneal distension. The method includes providing a support structure on a surgical table, wherein the support structure includes a substantially vertical post and an arm assembly. A distal end of the arm assembly is positioned over a patient on the surgical table while the vertical post remains stationary. A peritoneal distension instrument extending from the arm assembly is coupled to a peritoneal structure of the patient. The peritoneum of the patient is distended by vertically raising the arm assembly while the post remains stationary relative to the surgical table. The apparatus is a surgical instrument support structure including a substantially vertical post having a gear rack disposed generally along the post's axis and an arm assembly movably coupled along the gear rack extending from the gear rack for holding a surgical instrument.

Abstract: Each pivotal shaft normally urged in one direction by the urging means drives the movable barrel to push the pressure spring, so that the clutch disposed either to the inner ball or to the outer ball in each joint is brought into press contact with the other ball to lock the joint. Accordingly, once the holding arm holds a tool, the holding force of the arm does not decline with time. Since the pressure applied to the pressure spring by the movable barrel is released by turning the pivotal shaft in the opposite direction by the driving means, each joint assumes an unlocked state. Thus, the tool held at the free end portion of the holding arm can be moved to a desired position, and also the holding position can be changed very easily.

Abstract: A cannula and associated endoscope are secured to an operating table by a mechanical linkage assembly having linear and angular connections. These connections are adjustable for supporting an endoscope extending through an incision. Two angular connections are friction joints that allow manual repositioning of the scope by pivoting about respective orthogonal axes that intersect at a point along the scope that is coincident with the location of the incision.

Abstract: A halo style surgical retractor having fixed and movable curvilinear members each of which has an outwardly directed retractor channel extending over the full length of the member. A support arm is attached to the fixed member to hold the fixed member in a desired fixed, but adjustable position. The ends of fixed and movable members are coupled together so that, first, when the members are brought into a generally coplanar relationship, there is an uninterrupted and continuous retractor holder path around the combined length of the fixed and movable members. Second, the couplings permit the movable member to pivot to a position directly above and overlaying with the fixed retractor member, that is, a position in which the movable retractor member is in a plane directly above and generally parallel to the plane of the fixed retractor member.

Abstract: An adjustable position fixing apparatus for fixing instruments such as an endoscope and an illuminator in a desired spatial position is provided. The adjustable position fixing apparatus for an instrument and the like comprises a cylinder communicating with a pressure fluid supplying machine, such as a compressor, through a switching device, a mount member for mounting an instrument and the like thereon, and an adjustable bending arm portion through which a linear element such as a wire extends. The arm portion is disposed between the cylinder and the mount member over an entire area or a part thereof. One end of the linear element is attached to a reciprocating rod of the cylinder and the other end is attached to the mount member.