Abstract: An articulation member for use in a surgical apparatus is provided. The articulation member includes a fitting for mounting to a support structure, a socket for receiving an arm of a surgical tool and a clamp moveable between a loosened position and a tightened position. In the loosened position the clamp permits movement between the fitting and the support structure, and permits rotation of the socket. In the tightened position, the clamp secures the fitting and the arm relative to the support structure.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. The apparatus may involve a tissue stabilizer, and in particular a tissue stabilizer for use in immobilizing or stabilizing a portion of the beating heart using a compressive force delivered to the heart via the tissue stabilizer. The stabilizer may include a stabilizer base and a shaft. The shaft may be secured within an appropriate instrument mount preferably fixed to a retractor or other stable platform as disclosed herein. The stabilizers of the present invention provide improved access to a surgical site at a target vessel on the surface of the heart and may include features which facilitate optimal presentation of the target vessel.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. The apparatus may involve a tissue stabilizer, and in particular a tissue stabilizer for use in immobilizing or stabilizing a portion of the beating heart using a compressive force delivered to the heart via the tissue stabilizer. The stabilizer may include a stabilizer base and a shaft. The shaft may be secured within an appropriate instrument mount preferably fixed to a retractor or other stable platform as disclosed herein. The stabilizers of the present invention provide improved access to a surgical site at a target vessel on the surface of the heart and may include features which facilitate optimal presentation of the target vessel.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor apparatus having one or more opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount preferably is configured to hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor apparatus having one or more opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount preferably is configured to hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

Abstract: A retractor for performing surgery, for instance cardiac surgery on the coronary organs of a patient, which has a driving member to which the surgeon input is applied in the form of a mechanical force or torque, a thoracic structure engaging member which interfaces and retracts the patient's thoracic structure when surgeon input is applied to the movable driving member, and a surgeon input load-reducing and load-normalizing mechanism provided in at least one mechanical interface between retractor components where relative motion therebetween occurs. The load-reducing and load-normalizing mechanisms are preferably non-lubricated, thereby tending to ensure an inert and sterile environment during surgery. The retractor is comprised of a locking arrangement allowing a retractor spreader arm to be secured at any longitudinal position along the rack bar, independently of the pinion's position.

Abstract: Surgical apparatus for coronary surgery of a patient comprising contacting means being capable of providing a mechanical force against at least a portion of the patient's coronary organs according to its positioning with regard to said organs, positioning means to set said contacting means in a given substantially stable spatial position and orientation within a given volume, said contacting means being pivotally connected to a sternum retractor via said positioning means. The surgical apparatus according to the invention allows to perform coronary artery revascularization without the need for extra-corporeal circulation.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor assembly having a pair of opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount may hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

Abstract: In accordance with the present invention, there is disclosed surgical methods and apparatus for accessing and stabilizing the heart. The methods and apparatus facilitate access to an anastomosis site, allows various instruments or devices to be maneuvered and secured in place, and provide stabilization of the heart. In particular, the apparatus involves a retractor assembly having a pair of opposing blades having a channel adapted to engage an incision in a patient. The retractor blades may have features to cooperatively engage an instrument mount. The instrument mount may hold an instrument, such as a tissue stabilizer, and allows the instrument to be easily maneuvered. The retractor blades may have a number of suture locks for securing sutures used during surgery. The retractor system is particularly useful in accessing, positioning and stabilizing the beating heart for coronary artery bypass graft surgery.

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 means, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing means such that the contraction of the beating heart causes only minimal excess motion at the surgery site.

Abstract: A surgical retractor with a special latch mechanism and arrangement for changing retractor blades without tools during surgery is disclosed.

Abstract: A retractor comprising a rack having a first section and a second section, a first blade fixedly attached to the rack, and a second blade movably attached to the rack. The first and second blades engage two adjacent ribs in a patient. The first section and the second section of the rack form a nonlinear angle therebetween so that when the first section is horizontally disposed, the second section is disposed at an angle relative to a horizontal plane. The present invention also uses an external lifting device disposed above the retractor and that creates an upwardly-directed force on the second blade. The retractor increases the field of vision for the surgeon based on the design of the rack and the use of the external lifting device.

Abstract: The invention is a sternal retractor comprising a curved crossbar and a pair of arms perpendicularly attached to the crossbar, at least one of which may slide over the length of the crossbar. Sternum engaging blades extend from the arms in a general direction from the concave side to the convex side of the retractor. The present invention lifts the ribcage, allowing access to the internal mammary artery while decreasing tissue damage associated with current retractors.

Abstract: A surgical retractor has a connection region to connect to cannulas, tubing, blood pumps, and the like. By fixing these items against the surgical retractor, they are kept out of the surgical field of view and thus do not interfere with the surgery.

Abstract: Surgical apparatus for coronary surgery of a patient comprising contacting means being capable of providing a mechanical force against at least a portion of the patient's coronary organs according to its positioning with regard to said organs, positioning means to set said contacting means in a given substantially stable spatial position and orientation within a given volume, said contacting means being pivotally connected to a sternum retractor via said positioning means. The surgical apparatus according to the invention allows to perform coronary artery revascularization without the need for extra-corporeal circulation.

Abstract: A retractor for use in partial sternotomy includes a toothed crossbar to which a pair of small, parallel grips are attached. The first grip is attached to an arm which is fixed to one end of the crossbar. The second grip is attached to an arm which is movably attached to the crossbar by a pinion, thereby permitting the second grip to be moved along the crossbar toward or away from the first grip. A first rod is connected to the fixed arm by means of a bracket, while a second rod is connected to the movable arm by means of a similar bracket. Retractor blades of different configurations can be connected to the rods by universal clamps. Suture holders are disposed atop each of the arms. A holder for a carbon dioxide tube can be removably connected to the toothed portion of the crossbar.

Abstract: Apparatus and method for expanding a perivascular cavity at a surgical site includes an elongated retractor having a tip at the distal end for convenient insertion into a perivascular cavity, and having a slidable coupler near the proximal end for convenient coupling to an elevator element supported in a retractor frame. The elongated retractor supports an endoscope thereon to facilitate visualization of surrounding tissue during insertion into the perivascular cavity. With the retractor inserted in the cavity, the retractor frame is positioned on the skin in alignment with and straddling the cavity, and the elevator element is selectively coupled to the retractor to elevate the retractor relative to the base of the retractor frame, thereby to expand or distend the cavity to provide ample access to tissues and vessels for surgical manipulations within the cavity.

Abstract: A rotatable retractor clamp having a detachable blade clamp. A retractor blade is rotatably secured to a blade clamp by a boss fitting a socket in a clamp body that includes a blade release lever that locks the blade onto the clamp body. After attachment to the clamp, the blade may freely rotate on the blade clamp allowing adjustment after placement of a retractor in an incision. The blade is rotatably held in a socket in the clamp body when installed on a retractor arm but may be easily detached for replacement by a different length blade.

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

Abstract: 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 retractor comprising a rack having a first section and a second section, a first blade fixedly attached to the rack, and a second blade movably attached to the rack. The first and second blades engage two adjacent ribs in a patient. The first section and the second section of the rack form a nonlinear angle therebetween so that when the first section is horizontally disposed, the second section is disposed at an angle relative to a horizontal plane. The present invention also uses an external lifting device disposed above the retractor and that creates an upwardly-directed force on the second blade. The retractor increases the field of vision for the surgeon based on the design of the rack and the use of the external lifting device.

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

Abstract: 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: 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: A lumbar laminectomy retractor and distractor system comprised of a unique retractor system and unique distractor system. The retractor has one or more retractor frames including retractor blades for placement in an incision. The blades can be placed in an incision and then engaged by a retractor frame to spread the incision for viewing the surgical site. An optional, but preferred feature is a provision for tilting the retractor frame arms to spread the retractor blades, providing greater visualization of a surgical site. The distractor system has a distractor frame offset at right angles to the retractor frame, having fixed distractor blades, introduced into the incision and optionally held in place by screws, screwed into the vertebrae adjacent to the diseased or damaged disc. The screws are incorporated into the distractor blades on the distractor frame.

Abstract: An improved rib retractor that is adapted to contact adjacent ribs in a person through a thoracotomy incision. The apparatus of the invention comprises a longitudinally-extending rack with two support members, each having a longitudinal edge. The longitudinal edge of each of the support members is attached to the rack wherein at least one of the support members is movable along a portion of the length of the rack so that the support members are longitudinally movable relative to each other. A pair of blunt blades is provided, that are each adapted to contact a selected one of the ribs in the subject person. A hinge rotatingly connects a portion of each of the support members to a portion of each of the blades.

Abstract: Variable length blades for use with a retractor or distractor include a fixed upper portion and an adjustable extension that allows adjustment to accommodate a wide range of patients. A variable length retractor blade has a fixed upper portion that can vary in length from 10 to 15 cm. having a telescoping extension that can be adjusted to vary the length of the blade from 12 to as much as 24 cm. The variable blades include conventional flanges with a header for securing the variable blades on the end of retractor/distractor arms. An additional option is the inclusion of tubular guides in the variable length blade extension for placement of plurality of fixation screws and a light pipe to provide intensive illumination for the surgical site. Three tubular guides are provided in the upper and lower ends of the telescoping extension on the variable length blade for use with a distractor.

Abstract: Apparatus and method for expanding a perivascular cavity at a surgical site includes an elongated retractor having a tip at the distal end for convenient insertion into a perivascular cavity, and having a slidable coupler near the proximal end for convenient coupling to an elevator element supported in a retractor frame. The elongated retractor supports an endoscope thereon to facilitate visualization of surrounding tissue during insertion into the perivascular cavity. With the retractor inserted in the cavity, the retractor frame is positioned on the skin in alignment with and straddling the cavity, and the elevator element is selectively coupled to the retractor to elevate the retractor relative to the base of the retractor frame, thereby to expand or distend the cavity to provide ample access to tissues and vessels for surgical manipulations within the cavity.

Abstract: An intermammary harvesting retractor comprised of a retractor frame having a fixed or stationary arm on one end of a crossbar and a movable arm mounted on the crossbar by a crank mechanism. The crank mechanism allows the movable arm to be adjusted toward or away from the stationary arm. A support tower is mounted on the free end of the retractor crossbar to allow the angle of the retractor to be adjusted after placement in an incision. The angular adjustment allows the upper portion of a patient's ribcage to be lifted to provide improved access and visualization to the intermammary artery. Adjustable lifter blades are provided on the movable arm to also adjust the lift angle of the upper ribcage. One embodiment has an adjustable lifter blade that can be adjusted after placement in the incision and adjustment of the angle of the retractor crossarm.

Abstract: In accordance with the present invention, there is provided an apparatus for pivoting a surgical retractor having two arms. The apparatus has a bridge for engaging at least one arm of the surgical retractor. The bridge has a distal end, a proximal end and a longitudinal axis extending therebetween. The bridge further includes a distal coupling attached to the distal end of the bridge for attaching the bridge to the surgical retractor. An arm extender comprising a bridge coupling and a blade is attached to the bridge and engages with the tissue of the surgical patient. The apparatus also has a lifting assembly comprising an elevator. The lifting assembly is for applying an upward force to the proximal end of the bridge, so that when the apparatus is attached to the arm of the surgical retractor, the lifting assembly pivots the retractor with respect to the surgical patient.

Abstract: An improved retractor blade mounting system for use in surgical instrument retractors. In one embodiment the system includes a mounting clip attached to a retractor blade that engages a longitudinal groove in the retractor arm. To assure a positive tight grip on retractor arm the clip has a tongue that fits a longitudinal groove in a retractor arm and has tapered or angled surface that abuts a sharp edge of the longitudinal groove preventing the blade from moving once installed. In an optional embodiment the mounting clip is provided with a narrower tongue that is constructed with a beveled surface that fits over the corner or edge of the longitudinal groove securely holding the clip on the retractor arm.

Abstract: A minimally invasive coronary anastomosis procedure includes providing an incision in an intercostal space between two ribs of a patient, the incision providing access to a selected anastomosis site on a blocked coronary artery. A spreader device is inserted between the two ribs, the spreader device spreading the two ribs apart to sufficiently widen the incision for the procedure to be performed through the incision. An internal mammary artery is dissected from the thoracic wall, and the heart is pharmaceutically treated to substantially reduce its heartbeat. The blocked coronary artery is clamped at two spaced-apart positions at the selected anastomosis site. The blocked coronary artery is incised, and the dissected internal mammary artery is sutured to the incision at the anastomosis site.

Abstract: In accordance with the present invention, there is provided a device for pivoting a surgical retractor with respect to a patient it is being used on. The device includes a bridge having distal and proximal ends wherein a distal coupling is attached to the distal end of the bridge and a proximal coupling is slidably attached to the bridge proximal to the distal coupling. The proximal and distal couplings include a means for releasably attaching itself to a surgical retractor. The device further includes a lifting assembly attached to the bridge proximal to the proximal coupling. The lifting assembly comprises a means for applying an upward force to the proximal coupling, whereby when the device is attached to a surgical retractor, the lifting assembly pivots the retractor upward about the distal coupling.

Abstract: A surgical retractor is disclosed that is able to form an oblique tunnel-like opening at an incision site wherein, in addition to spreading the sides of the site incision substantially parallel to the contour of the patient's body, the present surgical retractor additionally spreads the incision sides so that one side is depressed toward the patient and the other is directed outwardly from the patient. Accordingly, the present retractor is useful for forming a tunnel-like opening to, for example, the heart by obliquely spreading the patient's ribs. Further, the present retractor is particularly useful in keyhole or mini-surgery wherein the initial incision site is not immediately adjacent to the target surgery site.

Abstract: An improved surgical retractor of the type that comprises a rack and pinion for moving an arm mount which supports the pinion and is moved when the pinion is turned, a hinge connecting the mount to an arm and a blade mount and a fixed arm mounted on the other end of the rack, a hinge connecting the mount to an arm and a blade mount wherein the improvement comprises a pair of opposed blade assemblies mounted on the respective blade mounts, said blade assemblies being so configured and constructed as to permit the respective blades to pivot independently of the blade mount and to be locked at an angle relative to each other and to the rack, is disclosed.

Abstract: A combination of complementary surgical instruments including a pair of retractors positioned at right angles to and overlaying one another during surgery. Each retractor has a pair of hinged arms. A top retractor has a stepped tip at each end of one arm to avoid interference with the bottom retractor during surgery. Each retractor has a pair of vertical semicircular flared openings in an outer edge of a blade securement end of a respective arm for demountable attachment of a surgical blade. The combination is especially useful in cervical or neck surgery.

Abstract: An improved rib retractor adapted to contact adjacent ribs in a person through a thoracotomy incision comprising a longitudinally-extending rack with two support members, each having a longitudinal edge. The longitudinal edge of each of the support members is attached to the rack wherein at least one of the support members is movable along a portion of the length of the rack so that the support members are longitudinally movable relative to each other. A pair of blunt blades is provided, each adapted to contact a selected one of the ribs in the patient. A hinge rotatingly connects a portion of each of the support members to a portion of each of the blades.

Abstract: A sternal retractor for applying an opening force evenly along the respective edges of a patient's sternum during heart surgery comprises a curved rack having a length, a width, and a thickness, wherein the rack is curved in the thickness direction, hinged arms mounted to the rack, a cog mechanism for forcing one of the arms to move along the rack, and retractor blades pivotally mounted to the arms. An atrial retractor which are used to retract the left and right atrium connects to an arm of the sternal retractor by an H-shaped mounting rod assembly. The assembly comprises two elongated rods mounted in spaced parallel relationship by a clamp proximate the center of the rods. A ball clamp associated with the sternal retractor and atrial retractor comprises locking discoid blocks for releasably interconnecting a plurality of rods together.

Abstract: An apparatus and method of performing a cholecystectomy procedure through a 3-centimeter incision in the minimum stress triangle through the falciform ligament which provides for direct vertical view of the biliary ducts during dissection. Special tools are provided for this type and other types of surgical operations including obtuse-angled retractors having optionally fixed thereto lighting devices and/or suction devices.

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

Abstract: An improved speculum for increased exposure of the superior surgical limbus and stabilization of the eye during eye surgery.