Abstract: A retractor blade includes a shaft having a head portion at a first end and a foot portion at a second end of the shaft. A connector is coupled to the head portion for coupling to a frame. A toe portion extends from the foot portion and has a width and longitudinal curvature configured to at least partially conform to a curvature of a spinal vertebral body.

Abstract: A rack and an apparatus for suture management are disclosed. The apparatus for suture management includes one or more racks, each rack including a plurality of cassette locations, each cassette location having an inside suture holder, an outside suture holder, and a cassette receiver. The apparatus for suture management also includes a plurality of suture grooves. The apparatus for suture management further includes a plurality of rack connection points. The apparatus for suture management also includes an attachment feature which may accept another surgical tool or mounting adapter.

Abstract: A surgical instrument includes at least one blade defining a longitudinal axis and includes a distal member. An actuator is engageable with the member to rotate the member relative to the longitudinal axis to space tissue adjacent a surgical site. Surgical systems, constructs, implants, and methods are disclosed.

Abstract: A device is described that can effectively increase the range of motion of a jaw of a patient to address physiological conditions that involve restricted range of motion of the jaw of the patient. The device can be used to apply opposing forces to the maxillary and mandibular teeth, which can stretch the temporomandibular joint and mandibular muscles, which in turn can aid in opening of the jaw. Furthermore, the device includes a spring, which is configured to be stretched when the patient performs mastication motions. Such stretching of the spring dynamically applies varying amounts of force on the jaw depending on the position of the jaw during the entire range of motion of the jaw, and severity of the physiological condition such as trismus. Such dynamic force requires the jaw to perform different amounts of work at various positions, which aids in the opening of the jaw.

Abstract: A retractor blade includes a shaft having a head portion at a first end and a foot portion at a second end of the shaft. A connector is coupled to the head portion for coupling to a frame. A toe portion extends from the foot portion and has a width and longitudinal curvature configured to at least partially conform to a curvature of a spinal vertebral body.

Abstract: A retractor for use in surgical operations comprises a pair of blade assemblies. In operation, the blade assemblies are initially in a closed position to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The retractor is adapted to rotate a first blade about a first axis and a second blade about a second axis. The retractor is adapted to move the pair of blade assemblies apart along a third axis. The retractor is adapted to pivot the first blade about a fourth axis and the second blade about a fifth axis. In some embodiments, a method of performing an operation, e.g. a spinal operation, on a patient using the disclosed retractor is provided.

Abstract: Various embodiments of a non-metal retractor device having a ratchet arm for retracting an incision and retaining a shunt are described herein.

Abstract: A system and method for an articulated arm based tool guide includes an elongated body having a guide hole, a first joint attached to a first end of the body, a second joint attached to a second end of the body opposite the first end, a first mounting arm coupled to the body using the first joint, and a second mounting arm coupled to the body using the second joint. The first mounting arm is configured to be attached to a first articulated arm of a computer-assisted medical device. The second mounting arm is configured to be attached to a second articulated arm of the computer-assisted medical device. The guide hole is adapted to receive a medical tool and maintain a working end of the medical tool in alignment with the guide. In some embodiments, the first mounting arm includes identifying information identifying the tool guide as a tool guide.

Abstract: Apparatus is disclosed for providing access to a functioning vascular system of a patient, the apparatus comprising: a main body having sidewalls defining an interior region and an exterior region, a bottom end and a top end; a base being formed at the bottom end of the main body, securing means being configured on the base so as to allow attachment and formation of a seal between the base and the functioning vascular system of the patient, and the base being configurable to provide a passageway from the interior region of the main body to the functioning vascular system of the patient; and a cover being formed at the top end of the main body, wherein the cover provides a barrier between the interior region and the exterior region at the top end of the main body.

Abstract: A spinal retractor system is provided to protect important structures of a patient while the surgeon performs surgery on spinal elements of the patient. The system includes a retractor blade including a retractor tab, a side body, and an upper platform having a tool connector tab for mating with a matching blade holder tool for securely holding the retractor blade. The retractor blade also has a screw holder attached to the side body of the retractor blade for receiving a bone screw provided in a channel of the screw holder A screwdriver is used to drive the bone screw into a vertebra of a patient, such as during an anterior spinal surgical procedure.

Abstract: Rib refraction devices and methods of its use and manufacture are disclosed. A retraction device may include a first frame portion and a second frame portion. The second frame portion may be attached to the first frame portion. The second frame portion may mechanically move between a first position and a second position with respect to the first frame portion. The retraction device may also include a first blade being pivotally attached to the first frame portion and comprising a flexible material. The retraction device may also include a second blade being pivotally attached to the second frame portion and comprising a flexible material.

Abstract: A medial lateral retractor system includes a first medial lateral retractor arm, a second medial lateral retractor arm movably coupled thereto, and a base member coupler coupled to one of the first medial lateral retractor arm and the second medial lateral retractor arm. The base member coupler is configured to couple to a base member to which a rostral refractor blade and caudal retractor blade are coupled. The first medial lateral retractor arm is configured to move relative to the second medial lateral retractor arm in a direction substantially perpendicular to a direction of movement of the rostral retractor blade relative to the caudal retractor blade when the base member coupler is coupled to the base member. In implementations the medial lateral retractor system further includes the base member, the rostral retractor blade and the caudal retractor blade, and the base member is coupled to the base member coupler.

Abstract: A retractor for use in surgical operations comprises a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis. The retractor further comprises a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In operation, the blade assemblies are closed to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The blade assemblies are then opened by rotating the blades about the set of axes, thereby stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision.) The retractor thus forms an aperture for passage of surgical instruments and viewing of the surgical field by surgical personnel.

Abstract: Devices and methods for sternal retraction that reduces bleeding from the cut edges of a sternum and reduces fracturing of the sternum during retraction. The devices and methods involve the use of sternal retractor blades having a certain geometry and inserts placed inside the sternal retractor blades during retraction of the sternotomy incision. The blades and inserts act to tamponade the blood flow from the cut sternal edge and reduce fracturing of the sternum during retraction.

Abstract: A retractor system for percutaneous surgery in a patient includes first and second retractor portions positionable opposite one another in an incision of the patient. The system also includes at least one actuating member operable to provide an oscillating motion to at least one of the first and second retractor portions. The actuating member is in communication with a controller and is responsive to the controller to move and adjust at least one of the first and second retractor portions between a first position and a second position. The system also includes at least one pressure sensor and display and at least one timing circuit with display. In another form, a method is directed to retracting tissue for percutaneous access to a surgical site in a patient using the pressure sensors and display as will as the timing circuit and display to assure that the amount of pressure applied and the duration does not exceed pre-determined values.

Abstract: A retractor system includes a frame and first and second retractor blades. The frame includes first and second securement features. At least one of the first and second securement features is movable with respect to the frame when the at least one of the first and second securement features is mounted to the frame. The first and second retractor blades each have a distal portion and a proximal portion. The proximal portions of the first and second retractor blades are configured to be secured proximate to the first and second securement features respectively, such that the first and second retractor blades may be positioned in a first position wherein the first and second retractor blades are laterally opposed.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, 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 before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A surgical access device including a frame, first and second supports, and first and second retractor blades releasably coupled with the first and second supports, respectively. The frame has first and second arms. The first support is releasably coupled with the first and second arms. The second support is slidably mounted on the first and second arms. The second support is movable between a first position with the retractor blades in close cooperative position and a spaced apart position with respect to the first support. The first and second retractor blades each have a distal end portion configured and adapted to engage a vertebral body. In one method of use, the retractor is inserted through an incision in first orientation with the blades in close approximation and rotated approximately 90°, before spreading the retractor blades to retract tissue.

Abstract: A retractor assembly for positioning tissue during a surgical procedure, having two opposing arms disposed adjacent to one another and sized and configured to be urged substantially laterally away from one another during actuation of the retractor assembly into an open position, and one or more posts, each post being connected to, or integral with, and extending radially outwardly from a respective one of the opposing arms, each of the one or more posts having a length sufficient so that each of the one or more posts will extend through a respective aperture defined by a modular component to be detachably attached to the respective one of the opposing arms. Related methods of positioning tissue during surgery are also described.

Abstract: A surgical access device includes a body having a first member and a second member relatively movable between open and closed configurations. Each member is positionable within an opening in tissue to provide access to an interior space of a patient. Each member includes a top surface, a bottom surface, a leading end, and a trailing end. The top surfaces are positioned in close cooperative alignment when the first and second members are in the closed configuration. The trailing ends are positioned in close cooperative alignment when the first and second members are in the open configuration. In the open position, the first and second members define a passage therethrough to permit access to the interior space for passage of a surgical instrument therethrough.

Abstract: This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column during a medialized posterior lumbar interbody fusion (PLIF) procedure.

Abstract: Implants, instruments, and methods for performing surgical procedures on the spine, including one or more of creating an operative corridor to the spine, delivering implants to the spine, fusing one or more segments of the spine, and fixing one or more segments of the spine. A method for attaching a fixation system to the spine of a patient, the fixation system including at least two bone anchors and a spinal rod linking the at least two bone anchors.

Abstract: Disclosed is a rib spreader including a stationary arm having a first bent portion; a first hook having a contact surface to contact with one incision plane of a sternum of human, and attached to the stationary arm ahead of the first bent portion so as to be pivotable over a predetermined angular range; a rack fixed to the base end of the stationary arm at a predetermined angle and curved archwise; a movable arm supported at the base end of the movable arm by the rack so as to be movable along the rack, to thereby vary the distance from the stationary arm; and a second hook having a contact surface to contact with the other incision plane, and is attached to the movable arm ahead of the second bent portion so as to be pivotable over a predetermined angular range.

Abstract: An anterior cervical retractor comprises a first medial-lateral retractor body having a base arm and a moving arm and a pair of retractor blades. The retractor blades may be side loading or top loading. The cervical retractor comprises a second cranial-caudal retractor body having a pair of moving arms and a pair of retractor blades. The retractor blades may have an adjustable angulation. The retractor blades may also be fixed to the spine and provide distraction upon operation of the second retractor body. The blades of the first retractor body and/or the second retractor body may be coupled to light elements that illuminate the operative corridor between the blades.

Abstract: A spine retractor and distractor device comprises spinal process clamps and a retractor assembly, which may be rotatably coupled with the spinal process clamps. The retractor assembly may include a retractor ring, or frame, and a plurality of retractor blades adjustably coupled to the frame, e.g., by clamps. The spinal process clamps can maintain a grip on the spinal processes of the patient, and distraction pliers may be used to impart a distraction force on the spinal process clamps to distract the spinal segments. Additionally, other components, features, or tools, e.g., a light source and/or a camera, can be mounted on the instrument.

Abstract: An anterior cervical retractor comprises a retractor body having a base arm and a moving arm and a pair of retractor blades having a side loading blade and a top loading blade. The base arm includes a first track and a side loading connector. The first track extends perpendicularly from a proximal end of the base arm and the first track includes an articulating arm post and a gear teeth. The moving arm is located opposite to the base arm and includes a first track receptacle and a top loading connector. The moving arm is advanced along the first track by means of a knob extending from the base arm. The side loading blade includes a first blade portion and a first connection post and the top loading blade includes a second blade portion and a second connection post.

Abstract: A retractor device for spearing the body tissue apart is provided. The retractor includes a housing configured to include a plurality of sections, wherein each section is configured to accommodate placement of at least one blade, a blade holding mechanism configured to secure the at least one blade within the housing, a translation mechanism configured to provide translation movement of at least one of the sections, and a rotation mechanism configured to provide rotation movement of at least one blade.

Abstract: A retractor clamp is provided for a low profile retractor system including a spreader including first and second arms joined by a cross-bar. The first and second arms define an arm level. The refractor clamp includes a gripping assembly, a main body, an extension arm, a retractor blade arm, and a securement assembly. The refractor clamp is movably and securably joined along the at least one of the first arm, second arm, and cross-bar at substantially the arm level. The refractor blade arm is joined to the main body by the extension arm, and is positioned at a refractor blade arm level above the arm level. The refractor blade arm accepts a blade clamp. The securement assembly includes an adjustment member accessible by an operator substantially at the arm level. The securement assembly is operatively connected to the gripping assembly.

Abstract: A device, system and method for orthopedic spine surgery using a novel screw-based retractor, disclosed herein, that allows for access to the spine through a minimally or less invasive approach. The retractor device is designed to be coupled to a pedicle screw and then to have opposed arms of the retractor spread apart to open the wound proximally. The retractor is removed by pulling it out of the wound whereby the retractor is deformed to pass over the pedicle screw head. The retractor is intended to be made of a stiff plastic material, sterile packaged and disposable after one use. A system and method for using the retractor and performing a minimally invasive spine surgical procedure are also disclosed.

Abstract: A retractor system includes a frame and first and second retractor blades. The frame includes first and second securement features. At least one of the first and second securement features is movable with respect to the frame when the at least one of the first and second securement features is mounted to the frame. The first and second retractor blades each have a distal portion and a proximal portion. The proximal portions of the first and second retractor blades are configured to be secured proximate to the first and second securement features respectively, such that the first and second retractor blades may be positioned in a first position wherein the first and second retractor blades are laterally opposed.

Abstract: Devices and methods for sternal retraction that reduces bleeding from the cut edges of a sternum and reduces fracturing of the sternum during retraction. The devices and methods involve the use of sternal refractor blades having a certain geometry and inserts placed inside the sternal retractor blades during retraction of the sternotomy incision. The blades and inserts act to tamponade the blood flow from the cut sternal edge and reduce fracturing of the sternum during retraction.

Abstract: A patient-referenced surgical support frame and method of use are provided. In one embodiment, a surgical support frame can have at least three support members coupled by adjustable linkages. Each support member can have a lumen extending therethrough for receiving a cannula, and each support member can be configured such that the at least three support members (or the cannulas extending therethrough) are angularly adjustable relative to one another, and such that a distance between each of the at least three support members is adjustable. In use, the surgical support frame can be positioned on a skin surface of a patient and used to retain one or more instruments extending through the support members in a fixed orientation or position with respect to the patient, thereby allowing more than two instruments to be used simultaneously.

Abstract: A tissue retractor for displacing body tissue during surgery includes a tissue piercing member such as a surgical needle, a wire-like filament such as a suture line affixed to the surgical needle, a fixed element such as an anchoring port being associated with a stable surgical platform such as a sternum retractor and a movable element such as an anchoring plug cooperating with anchoring port to engage a portion of suture line after the suture line is threaded through the body tissue with the surgical needle and after the suture wire is tensioned to effect a predetermined displacement of the body tissue. The predetermined displacement of body tissue is maintained by retention of the engaged portion of suture line by the fixed anchoring port and the movable anchoring plug.

Abstract: A retractor system includes a frame and first and second retractor blades. The frame includes first and second securement features. At least one of the first and second securement features is movable with respect to the frame when the first and second securement features is mounted to the frame. Proximal portions of the first and second refractor blades are secured proximate the first and second securement features respectively. In a first position the first and second refractor blades are laterally opposed. Movement of the securement feature adjusts the angle of at least one of the retractor blades so that at least one of the retractor blades may be adjusted between an acute angle and an obtuse angle to horizontal.

Abstract: Systems, devices and methods related to retractor systems that retract tissue to allow access to a surgical site are described. The retractor systems can include a first rotatable arm attachable to a first blade, a second rotatable arm attachable to a second blade and a third linearly translatable arm attachable to a third blade. An attachment mechanism that is attachable to a fourth blade can be removably coupled to a mount on the frame. The retractors systems can also include two blade systems whereby when the retractor is in a closed configuration, the two blades form an oval opening.

Abstract: Embodiments of the invention include instruments and methods for providing surgical access to a surgical site. Some embodiments include a flexible arm that adjustably holds a retractor blade to enable access to the surgical site.

Abstract: A tissue retractor for displacing body tissue during surgery includes a tissue piercing member such as a surgical needle, a wire-like filament such as a suture line affixed to the surgical needle, a fixed element such as an anchoring port being associated with a stable surgical platform such as a sternum retractor and a movable element such as an anchoring plug cooperating with anchoring port to engage a portion of suture line after the suture line is threaded through the body tissue with the surgical needle and after the suture wire is tensioned to effect a predetermined displacement of the body tissue. The predetermined displacement of body tissue is maintained by retention of the engaged portion of suture line by the fixed anchoring port and the movable anchoring plug.

Abstract: A retractor system includes a frame and first and second retractor blades. The frame includes first and second securement features. At least one of the first and second securement features is movable with respect to the frame when the at least one of the first and second securement features is mounted to the frame. The first and second retractor blades each have a distal portion and a proximal portion. The proximal portions of the first and second retractor blades are configured to be secured proximate to the first and second securement features respectively, such that the first and second retractor blades may be positioned in a first position wherein the first and second retractor blades are laterally opposed.

Abstract: A minimal incision maximal access system allows for maximum desirable exposure along with maximum access to the operative field utilizing a minimum incision as small as the METRx and Endius systems. Instead of multiple insertions of dilating tubes the design is a streamlined single entry device to avoid repetitive skin surface entry. The system offers the capability to expand to optimum exposure size for the surgery utilizing hinged bi-hemispherical or oval working tubes applied over an introducer obturator which is controllably dilated to slowly separate muscle tissue. Deeper end working and visualization areas with maximum proximal access and work dimensions are provided to makes the operative procedure safer in application and shorten the surgeons's learning curve because it most closely approximates the ability to use open microdiskectomy techniques. a dual frame system enables full or partial spreading of a working tube set, while an open frame facilitates a four point retraction system.

Abstract: A surgical retractor system having a frame and a plurality of arms connected thereto is disclosed. At least one arm is moveable relative to the frame and the relative movement is constrained to a direction along the longitudinal axis of the arm. At least one retractor blade is removably connected to each of the plurality of arms. The blade is fixably rotatable about an axis normal to the longitudinal axis of the arm to which it is connected.

Abstract: A surgical retractor includes a pair of parallel arms that are mounted to a toothed crossbar. One of the arms is fixed to one end of the crossbar, while the other arm is movable along the crossbar by means of a pinion. One or both of the arms includes on its upper surface a bar having a longitudinally extending flat surface. A rod is connected to the bar by means of a bracket. The bracket can be locked in position relative to the bar by a first set screw that engages the flat surface. A rod extends through an opening in the bracket and is retained in place there by a second set screw. The rod includes a circumferentially extending shoulder that engages the bracket so as to locate the rod in a desired position. One or more flat surfaces are formed on the rod adjacent the shoulder for engagement by the second set screw.

Abstract: An access platform having a first and a second blade interconnected to a spreader member that laterally drives the blades apart or together and a sternal pad interconnected to a blade. The superior blade is preferably pivotally coupled to the spreader member such that it naturally rises as the blades are separated. Alternatively, a vertical displacement member is operably interconnected to a blade and the spreader member and is used to vertically displace the interconnected superior blade and, thus, increase a surgeon's working space and visual access for the dissection of an internal mammary artery. A tissue retractor is interconnected to the blades to draw the soft tissue around an incision away from the surgeon's working area.

Abstract: The present invention discloses a safe surgical mouth gag (MG) having a substantially planar frame larger than the maximal mouth aperture which is defined by at least two cross members, i.e., a longitudinal maxillary cross member and a mandibular cross member and by at least one rod connecting said maxillary and said mandibular cross members; and modules maneuverably interconnected to the same. The modules are selected from a tongue blade approximately perpendicular to the frames' plane, which is vertically displaceable with respect to said mandibular cross member; a retaining member within which said tongue blade shaft is slidably displaceable; retraction elements for urging the cheeks away from the oral cavity; abutment members for contacting the upper teeth or upper maxilla; and at least one light auxiliary located adjacent to oral cavity, adapted to illuminate the same effectively.

Abstract: A suture retainer for use with a surgical instrument comprises a slot defined in the surgical instrument, the slot having a bottom and lateral slot ends. A retainer block comprises a bottom and lateral block ends. The lateral block ends and the lateral slot ends are configured to matingly engage to define a v-shaped gap adjacent a lateral slot end near a mouth of the slot.

Abstract: The invention is a sternal retractor comprising a pair of arms each of which includes a downward extending blade, and one of which includes a proximal portion and a distal portion pivotally mounted on the proximal portion, a curved cross bar on which said arms are disposed so that in use the retractor can open the bottom of the sternum wider than the top of the sternum to minimize damage to the upper ribs and numbness, which sometimes occurs in the hands of open chest surgery patients. The retractor also has applications within other surgical procedures, as well, for the same general purpose of providing an opening of varying size along the length of an incision.

Abstract: A surgical tool holder that includes a base portion, an incremental retraction portion, and an attachment portion. The base portion is configured for releasably mounting to a first surgical tool support in a fixed association. The incremental retraction portion includes a drawing mechanism configured for operably engaging and incrementally drawing a surgical retractor under tension to a selected position and holding the surgical retractor in the selected position, and a crank member configured to operate the drawing mechanism. The attachment portion includes a post configured for rotatably mounting a yoke of a second surgical tool support, and a securing member operably associated with the post for releasably fixing the second surgical tool support thereto.

Abstract: A surgical retractor includes a retractor body and a retractor arm. The retractor arm includes a first portion and a second portion. The first portion is attached to the retractor body and the second portion is rotatably attached to the first portion. The second portion is configured to retain a retractor blade and to rotate about an axis parallel to a line drawn along a length of the retractor arm.

Abstract: A retractor has a rail, a first holding arm protruding from this rail at an angle at a second holding arm extending approximately parallel to the first holding arm. A distance between the two arms being modifiable. At least one functional element is mounted on one of these holding arms, which functional element has a section extending transversely to the holding arms and a swivel bracket protruding from this transverse section. The functional element being pivotable about a pin extending roughly parallel to the arms via the swivel bracket, a swiveled position can be set by grasping the function element with a hand. A locking mechanism serves for locking the functional element in a swiveled position.

Abstract: This invention includes surgical retractors that comprise an expandable frame that includes at least two base components, a connector, and at least two retractor blades attached to the expandable frame. Also included are surgical retractors that comprise a housing component that includes a cylindrical portion and a contiguous blade portion, assemblies comprising a surgical retractor assembled to at least one obtruator, illuminated surgical cannulas, and methods of using the same during a surgical procedure.

Abstract: A surgical retractor may be provided for a surgical procedure such as spinal surgery. The surgical retractor may include a separator, a first and second blade holder coupled to the separator, and blade assemblies coupled to the blade holders. The separator may move the blade holders to change the position of the first blade holder relative to the second blade holder. The blade assemblies may retract tissue of a patient. An activator of a blade holder may be used to rotate a first blade of the blade assembly. Rotating the first blade tilts the blade assembly to create a larger opening at a distal end of the retractor. In some embodiments, side blades may be placed in the retractor.