Abstract: An assembly for exchanging retractor support arms within a retractor support clamp. The assembly includes a main body having a surface defining a cavity extending into the main body from a first end. A support arm having an end portion with a substantially complimentary configuration to the surface defining the cavity is positionable within the cavity. A retaining mechanism is disposed about the main body and in communication with the end portion where the retaining mechanism retains the end portion within the main body.

Abstract: Apparatus and methods for stabilizing and/or positioning tissues or organs during surgical procedures. One feature of the positioners of the invention includes the use of one or more suction elements used to grip the organ or tissue. The main body of the suction element comprises body defining a polyhedral shaped chamber, an elliptical ring structure and a vacuum port. The invention further includes structures to support the suction element and hold the suction element and attached tissue in a fixed position including catheters, lockable flexible arms, and retractors.

Abstract: A surgical assisting instrument and device having an elongated rectangular u-shaped body with fasteners extending outward therefrom. These fasteners can be of any number and mounted on the top or sides of the body. The body is affixed vertically on the long handle of a tenaculum or other similar elongated handles of surgical clasping instruments. This permits such surgical clasping devices to be anchored or braced onto a fixed surgical device to provide the surgeon with auxiliary clasping and holding assistance.

Abstract: A retractor retaining device retains an otherwise handheld retractor in the retraction position. The device includes a flexible loop that is detachably attached to a retractor support proximate the surgical wound with the loop engaging a proximal end or handle of the retractor to retain the retractor in the retraction position.

Abstract: An organ manipulator including at least one suction member or adhesive disc mounted to a compliant joint, a flexible locking arm for mounting such suction member or compliant joint, and a method for retracting and suspending an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) in at least the vertical direction during both steps. In preferred embodiments, a suction member exerts suction to retract a beating heart and suspend it in a retracted position during surgery. As the retracted heart beats, the compliant joint allows it to expand and contract freely (and otherwise move naturally) at least in the vertical direction so that hemodynamic function is not compromised. The suction member conforms or can be conformed to the organ anatomy, and its inner surface is preferably smooth and lined with absorbent material to improve traction without causing trauma to the organ.

Abstract: A coronary artery bypass graft procedure is performed through one or more openings made in the patient to create a point of entry to the thoracic cavity. A vein measurement device measures the distance between the proximal and distal anastomotic sites for each graft. A proximal anastomosis tool splits to release a graft vessel after deploying an anastomosis device at the proximal anastomosis site. The tool may be articulated. An integrated stabilizer stabilizes one or more tools relative to the surface of the beating heart at a distal anastomotic site. A distal anastomotic tool may be provided as part of the integrated stabilizer, and connects one end of the graft vessel to a target vessel. An epicardial dissector may be provided as part of the integrated stabilizer, and dissects the epicardium from the target vessel at a distal anastomotic site, as needed.

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: A first set of orange LEDs with a peak wavelength emission of about 612 nanometers, a second set of red light emitting LEDs with a peak wavelength of about 660 nanometers, and blue light LEDs. Two beam spreads, 15° and 30°, were provided for both the 660 nm LEDs and 612 nm LEDs. When directed perpendicularly upon tops of the plant leaves, 10% light transmission occurred through the leaves for the 30° LEDs, and 80% light transmission for the 15° LEDs. Thus, fully 50% of the orange/red spectrum primarily used for photosynthesis was transmitted through the upper leaf canopy, making it available to support photosynthesis in leaves below. LED lamps are positioned at varying distances from the growing plants for controlling plant growth rates that vary with these distances, thereby to control plant inventory, because growth of plants can be greatly slowed to preserve them during periods of slow sales.

Abstract: A surgical retractor for retracting a pair of opposed tissue edges to define a surgical opening extending in a surgical opening plane. The retractor consists of a pair of tissue blades configured to contact the tissue edges, an actuator releasably attached to the tissue blades for selective adjustment of the spacing between the blades, and a bracing member attachable to the tissue blades for maintaining the the blades in a desired retracted configuration when the actuator is separated from the blades.

Abstract: An adjustable ratchet retractor support apparatus includes in one aspect a rotatable locking mount having first and second surfaces and an axis of rotation perpendicular to the surfaces. First and second rotatable pivot members are disposed respectively on the first and second surfaces for rotation around the axis of rotation. Each of the pivot members include ratchet teeth. First and second curved arm members are mounted respectively on and associated respectively with the first and second pivot members. Each of the arm members is rotatable about a respective axis of rotation perpendicular to the axis of rotation of the locking mount. Each arm member has mounted thereon a ratchet pawl for engagement with the ratchet teeth of the associated pivot member. First and second rotatable clamps are disposed respectively on the first and second pivot members for restraining rotation of the pivot members.

Abstract: Systems and methods for manipulation and stabilization of tissue and other structures during surgical and other specialized procedures. Components of the systems of this invention are widely applicable in both veterinary and human medicine, including procedures involving small or delicate structures or tissues requiring precise manipulation or stabilization, procedures requiring substantial retractive forces without causing tissue damage and procedures that benefit from exoskeletal retraction. Fixation components, which couple dynamic components and retraction or positioning components to base components, are easily adjustable, allowing manipulation of the system with one hand. Length and orientation of retraction or positioning components is also easily adjustable in several ways.

Abstract: An organ manipulator including at least one suction member or adhesive disc mounted to a compliant joint, a flexible locking arm for mounting such suction member or compliant joint, and a method for retracting and suspending an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) in at least the vertical direction during both steps. In preferred embodiments, a suction member exerts suction to retract a beating heart and suspend it in a retracted position during surgery. As the retracted heart beats, the compliant joint allows it to expand and contract freely (and otherwise move naturally) at least in the vertical direction so that hemodynamic function is not compromised. The suction member conforms or can be conformed to the organ anatomy, and its inner surface is preferably smooth and lined with absorbent material to improve traction without causing trauma to the organ.

Abstract: An epicardial cooled stabilizer system is useful for surgical or laparoscopic applications, especially beating heart surgery. The system comprises a stabilizer connected to a cooler/pump where coolant flows into tubing at the distal end of the stabilizer. The tubing is positioned at a surgical site to enhance traction and minimize trauma.

Abstract: A surgical access device includes two opposed side members each of which carries a downwardly depending flange. One lateral member adjustably connects a first end of the first side member to a first end of the second side member, with at least one of these first ends being moveable along a length of the first lateral member, thereby permitting adjustment of the space between the first ends. A second lateral member adjustably connects the second end of the first side member to the second end of the second side member, with at least one of these second ends being moveable along a length of the second lateral member, thereby permitting adjustment of the space between the second ends.

Abstract: Surgical procedures on the beating heart are enabled by an incision made in the xyphoid area and specially designed retractors and related devices to facilitate cardiac surgical procedures. Specifically, coronary artery bypass graft procedures (CABG) are achieved using a vertically offsetting retractor or access platform in combination with a beating heart stabilizer. The surgical methodology permits procedures such as the CABG procedure without penetrating the rib cage or performing a sternotomy or thorocotomy.

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: 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 system that is easily and quickly attached to the operating room table utilizing low profile retractor blades which minimize obstruction of the surgeons view and access to the surgical field. Retraction is accomplished quickly and simply with virtually infinite variability using a single or dual generally linear ratcheting system that gently and controllably elevates one side of an incision and moves it away from the other side of the incision.

Abstract: Surgical devices for stabilizing the heart which facilitate anastomosis under beating heart conditions. Various instruments or devices may be maneuvered and secured on a retractor device to provide stabilization of the heart. An instrument mount is provided which is preferably configured to accept a surgical instrument, such as a tissue stabilizer, and to allow the instrument to be easily maneuvered to a desired position and subsequently locked into position. Stabilizer devices each having at least one surface for contacting the heart and each being adapted to be mounted to the retractor while having the ability to be positioned in the desired location against the heart are provided.

Abstract: Methods and devices used to stabilize a beating heart during a surgical procedure on the heart and to expose a surgical site are disclosed. The stabilizing device is introduced through an opening through the chest and brought into contact with the beating heart, and by exerting a stabilizing force on the device, the motion of the heart caused by the contractions of the heart muscles is effectively eliminated. Exposure members are actuable to reposition a portion of the surface of the heart to better expose a target artery or other surgical site. Accordingly, the heart is stabilized and movement of the site of the surgery is minimized.

Abstract: Devices and methods are disclosed for accessing and stabilizing an unstable or moving tissue structure within a patient's body, and in particular, for temporarily stabilizing a target site on the beating heart. The devices generally involve tissue stabilizers having at least one multiple link support member operably connecting a stabilizer foot to a retractor. To minimize motion at the stabilizer foot and improve overall stabilization of the target site, the tissue stabilizer may involve the a stabilizer foot having multiple support members connected to the stabilizer foot at discreet locations. To improve the ability of an instrument support member to be easily articulated through an access incision to position the stabilizer foot as desired, the instrument support member may be operable associated with an attachment or mount which provides additional degrees of freedom at the connection to the retractor.

Abstract: A three-dimensional tilt ratchet mechanism that is able to rotate, pivot, and bend forwards or backwards with ease is provided. The mechanism includes a device for multi-dimensional movement and placement of a retractor blade which comprises a first member adapted to receive a stem of a retractor blade. The first member has a locking mechanism effective to enable selective lateral adjustment of the retractor blade relative to the first member. Also provided is a second member to which the first member is mated. The first member is vertically pivotable with respect to the second member to enable selective vertical pivoting adjustment of the retractor blade relative to the second member. A rotator indexing body is mated to the second member and is adapted to mount onto a rim of a surgical support.

Abstract: A device for securing a retractor to a support arm, the retractor including a handle and a blade, the device includes a spheroidal member having a through bore adapted to engage the handle of the retractor where the spheroidal member is rotatably captivated within a spheroidal member retaining portion of a main member of a housing of the device. The housing also includes a retaining member operably attached to the main member where the main member and the retaining member cooperate to engage the support arm. A tightening mechanism is operably attached to the main member and is in communication with the retaining member.

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 cardiac stabilizer for use during cardiac surgery. The stabilizer has a cardiac engagement member having at least two vacuum ports, wherein each vacuum port is connected to a separate pressure tube. The pressure in each vacuum port is individually controlled by a multiplexing unit.

Abstract: Methods and systems for stability of a human breast during biopsy and surgical procedures are disclosed. An outward lesion is applied to external surface regions of the breast to facilitate and increase the accuracy of access to lesions and other target sites.

Abstract: Retractor system to be used in surgery comprising an assistance nipple with a base plate and an adhesive patch underneath for attachment to the patient's skin or a surgical sheet, and a retractor for retracting outwardly and fastening the edges of an incision and capable of releasably fastening to the nipple, and a surgical sheet having a large opening corresponding to the surgical site with a plurality of holes surrounding the large opening through which assistance nipples may protrude. In an alternative embodiment, a ring having a plurality of nipples and adhesive to secure the ring to the patient's skin surrounding a surgical site is provided to hold a plurality of retractors.

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: Methods and apparatus are described to manipulate the position of the heart to provide surgical access to lateral and posterior portions of the heart. A jack apparatus connected to a surgical retractor can be positioned in the surgical cavity to produce a sideways force on the heart. A tripod apparatus can be used to hold up the heart into a desired position. A band can be attached to the heart to rotate its position. Fingers attached to the bottom of a blade on a surgical retractor can be used to manipulate the hearts position.

Abstract: A retractor systems includes a retractor blade with a blade portion and a handle portion that fit together in a modular way to allow different blades to be removably and interchangeably affixed to the handle assembly. A dovetail mounts the blade in a plane substantially transverse or perpendicular to the shaft. Preferably, the handle assembly translates within a multi-position locking mechanism to allow adjustment of the handle extension along one or more axes, while the in-plane swing of the blade about the shaft conveniently positions the tip of the blade under tissue to be retracted when bone or hard tissue may impede access along a retraction direction parallel to the axis of the shaft. The interchangeable blades may have different sizes between approximately 5 and 15 centimeters length, and are manually affixed to the handle to set the reach and scope of the retractor for a particular operation.

Abstract: A surgical retractor system comprises a retractor frame secured to an operating structure. The retractor frame includes a cross bar that comprises a plurality of pivotally connected cross bar sections.

Abstract: An organ manipulator including at least one suction member or adhesive disc mounted to a compliant joint, a flexible locking arm for mounting such suction member or compliant joint, and a method for retracting and suspending an organ in a retracted position using suction (or adhesive force) so that the organ is free to move normally (e.g., to beat or undergo other limited-amplitude motion) in at least the vertical direction during both steps. In preferred embodiments, a suction member exerts suction to retract a beating heart and suspend it in a retracted position during surgery. As the retracted heart beats, the compliant joint allows it to expand and contract freely (and otherwise move naturally) at least in the vertical direction so that hemodynamic function is not compromised. The suction member conforms or can be conformed to the organ anatomy, and its inner surface is preferably smooth and lined with absorbent material to improve traction without causing trauma to the organ.

Abstract: The present invention relates to surgical retractors having improved blades for use, on the retractor and devices for stabilizing a predetermined area of the body during a surgical procedure, more particularly to surgical retractors and stabilizing devices used in connection with minimally invasive coronary artery bypass grafting surgical procedures, and more specifically to surgical retractors and stabilizing devices especially configured for use with each other for such surgical procedures wherein the retractor includes a plurality of grooves on the bottom surface thereof and a plurality of blades having a member that is releasably received in the grooves and which also allows for the pivotal movement of the blades relative to the arms of the retractor and further including nesting blades having a third section which is generally linear and second sections which are preferably curved about 180 degrees to allow for the simplified insertion of the blades into the chest incision and the providing for the secur

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: 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: The present invention relates to a stabilizer that immobilizes tissue at a surgical site wherein the device includes a stabilizer having a base portion with elongate extending members that surround the sides of an aperture area and an end portion which is removable from the base portion and which surrounds the remaining side of the aperture area and wherein the stabilizer is preferably used in combination with a pair of flexible connectors that are threaded through the tissue adjacent to the aperture area to draw the tissue into contact with the aperture area of stabilizer and into contact with a pair of tab members extending from the bottom surface of the stabilizer such that the flow of blood through a blood vessel is occluded by tab members when the flexible connectors are releasably attached to the stabilizer.

Abstract: A retractor system having a blade assembly with notches for receiving a portion of a surgical retractor stay. A retractor system having a cam lock mechanism and/or a ratchet mechanism to restrict movement of the paddle arms. A retractor system having pinions to engage an elastic band to aid the frame and paddle arms to automatically self-position during a surgical procedure.

Abstract: To reliably expose the treated organ during surgical procedures, retraction devices are used with a holding arm (2) to which clamps (1) or the like are fastened, so that the clamps (1) canquickly be replaced and brought into a new position at the holding arm (2), the holding arm (2) designed as a rod with a hollow space, in which a blade-shaped locking bar (13) is guided. The holding arm (2) has openings (3), and the locking bar (13) has notches (12) aligned with the openings (3), so that, in the unlocked position, the openings (3) are exposed, while, in the locked position they are partly covered by the locking bar (13). Clamps (1) with shafts (10) can be inserted into the openings (3). The shaft (10) of a clamp (1) has a groove (11), into which the locking bar (13) can be slid, so as to fasten the clamp (1) in the opening (1) of the holding arm (2).

Abstract: A surgical retractor system comprises a retractor frame secured to an operating structure. The retractor frame includes a cross bar that comprises a plurality of pivotally connected cross bar sections.

Abstract: A surgical retractor has a frame and first and second retractor blades coupled to the frame. The retractor blades engage opposite sides of an incision in a patient's body and are relatively movable toward or away from each other along a first axis. When using the retractor in lift mode, a foot is coupled to the frame or one of the blades and engages the patient's body adjacent the incision. An actuator imparts relative movement to the retractor blades along the first axis and the foot acts as a support base with one of the blades moving relative to the frame to lift the ribs at one side of the incision above the other. To use the retractor in spread mode the foot is removed and the retractor blades spread of the ribs without lifting.

Abstract: The invention is methods and devices which a surgeon may use to stabilize 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 system for manipulating and supporting a beating heart during cardiac surgery, including a gross support element for engaging and supporting the heart (the gross support element preferably including a head which is sized and shaped to cradle the myocardium of the left ventricle), a suspension head configured to exert lifting force on the heart when positioned near the apical region of the heart at a position at least partially overlying the right ventricle, and a releasable attachment element for releasably attaching at least one of the gross support element and the suspension head to the heart. The releasable attachment element can be a mechanical element (such as one or more staples or sutures) or an adhesive such as glue. Alternatively, the system includes a suspension head and a releasable attachment element for releasably attaching it to the heart, but does not include a gross support element.

Abstract: In one embodiment, the present invention relates to a low profile support member for a surgical retraction apparatus which includes a support member in which a lower portion of the support member has a rectilinear portion for insertion into an anchoring receptacle; an upper portion of the support member has a first horizontal extension; a splined coupling adaptor connects together the lower and upper portions, in which the splined coupling adaptor includes a splined segment having a key-like splined portion and a lock-like splined portion; and an extender portion having both a vertical extension and a second horizontal extension. The extender portion is mountable on the first horizontal extension.

Abstract: In a hands-free, spreader retractor for thoracic or abdominal surgery comprising a frame with parallel, blade-supporting arms movable toward and away from each other by a rack and pinion mechanism, plural blades are supported on the arms by depending pylons which are substantially narrower than the widths of the blades measured in the direction of elongation of the arms, to permit accumulation of fat of an obese patient between adjacent pylons. The lower portions of the pylons are connected to the undersides of the arms by narrow stems which are spaced from the edges of the arms to allow auxiliary instrument supports to slide lengthwise along the arms.

Abstract: The present invention relates to an irrigation system for use with surgical retractors and devices for stabilizing a predetermined area of the body during a surgical procedure and more particularly to an irrigation system for use with medical devices that are used in connection with minimally invasive coronary artery bypass grafting surgical procedures, and more specifically to an irrigation system for use with surgical retractors and stabilizing devices configured for use with each other for such surgical procedures wherein the irrigation system provides a controlled flow of fluid to a desired surface of the medical device to maintain a clear surgical 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 retractor systems includes a retractor blade with a blade portion and a handle portion that fit together in a modular way to allow different blades to be removably and interchangeably affixed to the handle assembly. A dovetail mounts the blade in a plane substantially transverse or perpendicular to the shaft. Preferably, the handle assembly translates within a multi-position locking mechanism to allow adjustment of the handle extension along one or more axes, while the in-plane swing of the blade about the shaft conveniently positions the tip of the blade under tissue to be retracted when bone or hard tissue may impede access along a retraction direction parallel to the axis of the shaft. The interchangeable blades may have different sizes between approximately 5 and 15 centimeters length, and are manually affixed to the handle to set the reach and scope of the retractor for a particular operation.

Abstract: The present invention encompasses tools and a tool-holding retractor assembly. The retractor assembly spreads an incision and holds the incision open. At least one extension device, having a tool holder on one end, attaches to the assembly. The holder includes a selectively locking multi-axis adjustable mounting element adapted to grip a tool shaft. The mounting element acts as a universal mounting providing rotational and sliding movement of the tool shaft. The extension device adjusts to position the tool holder peripherally of the surgical field. Once the retractor is placed, the extension device provides full access to regions below the incision. The extension device allows the surgeon to chose the insertion point and insertion angle of the tool shaft.

Abstract: A tissue compression shield can help minimize trauma to tissue during surgical retraction. One such shield has a shell having a rigid outer surface adapted to abut a surgical retractor and a concave inner surface defining an elongate tissue-receiving channel. The concave inner surface is adapted to deform under localized pressure to increase surface area in contact with tissue within the channel, thereby more widely distributing pressure across the tissue. If so desired, the shield can include a compressible inner pad that contacts the tissue. In an alternative design, a shield employs a shell including a central body and a pair of opposed legs defining therebetween an elongate tissue-receiving channel. An upper one of the legs has a notch along an outer edge thereof which defines a bone-seating recess which is smaller than the tissue-receiving channel.

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 stabilizng member and engaging heart tissue with the attachment such that the tissue bulges outward to better present the tissue for surgery.