Abstract: Less invasive surgical techniques for performing brain surgery are disclosed in which a dilating obturator and cannula assembly is inserted into brain tissue until the obturator tip and cannula are adjacent to the target tissue. The obturator is removed and surgery is performed through the cannula. In preferred embodiments the obturator and cannula are placed using image guidance techniques and systems to coordinate placement with pre-operative surgical planning. A stylet with associated image guidance may be inserted prior to insertion of the obturator and cannula assembly to guide insertion of the obturator and cannula assembly. Surgery preferably is performed using an endoscope partially inserted into the cannula with an image of the target tissue projected onto a monitor. Dilating obturator structures having a rounded or semi-spherical tip and/or an optical window for visualizing brain tissue during expansion are contemplated.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A device for surgical operations on a prolapse, comprising a hollow stretcher body (2) having a prevalent development direction along a longitudinal axis (A) and being insertable in an orifice, the stretcher body (2) exhibiting a through-window (7), defining an area of intervention and realising a communication between an internal cavity (3) of the stretcher body (2) and a portion of a prolapse, a mobile wall (8) defining the through-window (7) in combination with the stretcher body (2) and being slidably associated to the stretcher body (2) in order to open and/or close the through window (7) between a configuration of minimum extension and a configuration of maximum extension of the through-window (7); characterized in that it comprises means for blocking (10) which act between the mobile wall (8) and the stretcher body (2) in order to maintain the through-window (7) stably in the configuration of minimum extension during insertion of the stretcher body (2).

Abstract: A cervical retractor includes a bi-folded body; a pair of primary pegs extending outward from the bi-folded body and in a first direction substantially perpendicular to a longitudinal axis of the bi-folded body; and a secondary peg extending outward from the bi-folded body in a second direction substantially opposite to the first direction and substantially linear with the pair of primary pegs. The bi-folded body includes a middle panel and a pair of side flanking panels, and each flanking panel includes a tab extending from a bottom portion of the flanking panel; and a pair of slots flanking the tab. The pair of slots aligns with the pair of primary pegs when the side flanking panels fold onto the middle panel, and the slots permit the primary pegs to outwardly extend there through.

Abstract: A patient-matched cutting block including a surface or point contact features adapted to at least partially conform to or reference a patient specific anatomy. The cutting block having guide slots configured for guiding the movement of cutting tools relative to the patient specific anatomy or features configured to mate to and guide standard cutting guides relative to patient specific anatomy in order to form plateau and eminence resections of the patient specific anatomy.

Abstract: A surgical kit for operations on the spinal column includes a surgical instrument having a handle body, the handle body having a substantially flat portion blended with the body, wherein the substantially flat portion is shaped to urge the gauze for draining a wound.

Abstract: A vaginal cuff closure system includes a speculum having a closed rear aspect, a secure suture ring and a fastener for removably attaching the secure suture ring with a blade of the speculum. A related method of using the closure system in knot-free laparoscopic hysterectomy is also disclosed.

Abstract: A device for removing a cerclage suture has a shaft sized and shaped to extend from a proximal end outside a vagina to a distal end near a cervix. The shaft also has a blunt end located at the distal end of the shaft and having a taper for allowing the blunt end to pass between a cerclage suture and cervical mucosa without cutting the mucosa and to move the suture away from the mucosa. The device includes a cutter having at least one blade at the distal end of the shaft. The cutter may be movable between an open non-cutting position and a closed cutting position for cutting the suture. Alternatively, the cutter may include one or more stationary blades. The device also may include a handle at the proximal end of the shaft that may comprise an actuator or may comprise a cylindrical or another suitable shape.

Abstract: A speculum having first and second arms beginning at a proximal point and ending at a distal end and having a cup positioned at the distal end, an attachment portion positioned on the first arm and proximal to the cup, and a user manipulation element positioned within the attachment portion. In another embodiment the speculum has a generally U-shaped frame having a proximal point and pair of distal ends, a pair of cups attached to the distal ends, a pair of user manipulation elements attached to the frame and positioned between the cups and the proximal point so that the user manipulation elements can rotate relative to the frame.

Abstract: A method for creating a sequence of access channels to provide access for performing surgery on a lumbar spine; through positioning a patient to facilitate surgical access to the lumbar spine; docking a retractor device against a proximal surface of the psoas muscle and maintaining the pre-psoas access channel with the retractor device docked at the proximal surface of the psoas muscle. Making a direct visual inspection of the psoas muscle before splitting the psoas muscle to create and maintain a psoas access channel that extends from the pre-psoas access channel to the spine. Holding open the psoas access channel with a pair of retractor blades. After completing a surgical process on the spine removing the pair of retractor blades from the psoas access channel.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: The present invention is directed to a device including an inner cannula having one or more wings or leaflets attached to one end thereof. The wings or leaflets can be cut to length or shaped to facilitate holding the operative field open for optimal visualization and the use of surgical instruments. A shorter, outer cannula is fitted over the inner cannula and a flange attached to the outer cannula is moved from a closed position in which the wings are covered by the inner surface of the cannula or to an open, deployed position in which the wings are opened. The outer cannula may be textured or shaped to aid in holding the desired position. The device also includes a dam or barrier at the end or other convenient location in the inner cannula to control the flow of air or fluids in the cannula as to make it useful in arthroscopic or endoscopic surgery of all types.

Abstract: Techniques for operating a subcutaneous implant device are disclosed. The implant device can be formed of a non-magnetic material that is compatible with diagnostics such as magnetic resonance imaging (MRI) and can include a rotor element that rotates under the influence of an external magnetic field. The implant device includes a tension relief mechanism for relieving excessive force applied between the implant device and a portion of a patient's tongue. A non-implanted device can include a stator and drive circuitry for generating the external magnetic field. The non-implanted device can receive a user command and can vary the external magnetic field based on the command. When activated by the magnetic field, the implant device can change its operating state to interact with the patient's body.

Abstract: A surgical tissue retractor for use in aortic or pulmonary valve surgery coupled to a sternal retractor or similar base comprising a retractor assembly including a retractor support to operatively support a plurality of radially adjustable retractor blades to engage and retain a heart valve open during a surgical procedure, a retractor coupling assembly including a retractor connecting member coupled to the retractor support frame by a support frame mount and adjustably coupled to the sternum by a sternal retractor mount to operatively position and maintain the radially adjustable retractor blades in place during the surgical procedure.

Abstract: Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described.

Abstract: A spreadable retractor for use in joint arthroplasty. The retractor includes a first arm having a first portion and a second portion that is movably coupled to the first portion. The second portion is also coupled to a first retaining member that is sized and shaped to retain a portion of a coracoid process. A second arm is also included in the retractor and is movably coupled to the first arm. The second arm has a first portion and a second portion that is movably coupled to the first portion. Also, the second portion is coupled to a second retaining member that is sized and shaped to couple to a resected humerus.

Abstract: A spreader for aortic valve reconstruction having a dimensionally stable ring and three retractor arms comprising, respectively, a stem and a blade, with the blade being distally disposed on the stem, and wherein the retractor arms are disposed, offset relative to each other by respectively 120° in the direction of circumference of the ring, on said ring, and wherein the stems of the retractor arms are substantially aligned as perpendicular relative to the plane of the ring, and wherein the retractor arms are supported on the ring in such a way by the proximal end of their stems that they can be radially moved relative to each other toward the inside and radially expanded by the spring force of the ring.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: Described are surgical procedure systems, devices, tools, and methods, useful for treating pelvic conditions in a male or female, involving an expansion member. The invention relates to an expansion member that includes a proximal end, a distal end, a length extending from the proximal end to the distal end, two longitudinal blades extending in the length direction, and a connector connecting the blades. The connector allows movement of the blades to increase or decrease a distance between the blades at the distal end.

Abstract: The present invention is directed to a device including an inner cannula having one or more wings or leaflets attached to one end thereof. The wings or leaflets can be cut to length or shaped to facilitate holding the operative field open for optimal visualization and the use of surgical instruments. A shorter, outer cannula is fitted over the inner cannula and a flange attached to the outer cannula is moved from a closed position in which the wings are covered by the inner surface of the cannula or to an open, deployed position in which the wings are opened. The outer cannula may be textured or shaped to aid in holding the desired position. The device also includes a dam or barrier at the end or other convenient location in the inner cannula to control the flow of air or fluids in the cannula as to make it useful in arthroscopic or endoscopic surgery of all types.

Abstract: A pupil dilation system including a generally circular deformable and discontinuous ring member is provided. The ring member expands circumferentially and applies an expansile force substantially uniformly around a pupillary margin of a pupil for dilating the pupil along an entirety of a circumference of the ring member. The ring member in an uncoiled configuration allows insertion of the ring member through a single incision in the eye and unfolds into a coiled configuration. A circumferential groove defined on an outer surface of the ring member allows continuous contact with the pupillary margin along the circumference of the ring member. One or more connector members are positioned on the circumference of the ring member for engaging with a surgical manipulating element that allows movement and manipulation of the ring member. The ring member is composed of a thermoplastic material or a bioabsorbable material that naturally dissolves within the eye.

Abstract: A bag with one or more openings is placed within a body cavity. Excised tissue is placed within the opening of a deflated bag. One or more openings of the bag are withdrawn outside the body cavity and the bag is inflated. Instruments including laparoscopic visualization are placed within the inflated bag that remains within the body cavity. The tissue retained within the bag is morcellated/crushed/reduced and removed. The bag is deflated and removed with residual tissue/blood/fluids inside. The tissue to be removed is retained in the bag which prevents potentially harmful material such as cancerous cells from being released in the body cavity.

Abstract: A portable diagnostic instrument for use by medical professionals. The portable diagnostic instrument can comprise a circuit control that can maintain the output of the light intensity constant, even when battery power is reduced. The circuit control system can also comprise a warning system to provide information about remaining battery life to the user. Furthermore, the portable diagnostic instrument can comprise an otoscope further comprising a separate, folding magnifying lens assembly and a separate, folding specula assembly.

Abstract: A retracting eye drape assembly is disclosed for use around a patient's eye to seclude and seal off the operative field during eye surgery. The drape assembly includes a retraction member connected to the drape and configured to engage the patient's eyelid, an extension member connected to the retraction member or to the drape and configured to substantially enclose the patient's eyelid, and a retraction flap configured to secure the patient's eyelid in a substantially retracted position. A method of applying an eye drape assembly is disclosed. After application of the drape to the patient's face, and while the patient's eyelid is closed, the patient's eyelid is engaged by a retraction member connected to the drape and retracted. While retracted, the patient's eyelid is substantially enclosed to seclude the eyelid and eyelashes from the operational area. The secluded eyelid and eyelashes are then secured in a retracted position.

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: Provided is a surgical retractor capable of preventing an organ of a human body from being damaged when the organ of the human body positioned over a surgical area in the human body is lifted up. The surgical retractor includes a support body including a plurality of support members that are inserted below an organ of a human body which is positioned over a surgical area in the body of a patient to lift the organ of the human body in an upward direction, the plurality of support members being fastened to a joint, and a protective film member joined to the support body to cover a region between the support members, and configured to enclose and protect a lower surface of the organ of the human body.

Abstract: An apparatus for use in connection with an endoscopic surgery comprises an elongated body adapted to be placed at least partially in the vagina of a female patient partially passing through the wall of the vagina such that an end portion of said elongated element is introduced into rectouterine pouch; the elongated body comprises at least an attachment means for accommodating at least a part of at least a surgical instrument comprising an end portion adapted to be received inside the vagina, the surgical instrument and the apparatus are movable to each other. An endobag having an elongated port is provided through the vagina into the pelvis.

Abstract: A minimally invasive surgical method includes inserting a first port that defines a first pathway to a first vertebra, advancing a first anchor through the first port to the first vertebra, inserting a second port that defines a second pathway to a second vertebra, advancing a second anchor through the second port to the second vertebra, positioning a first end of a fixation element in the first port, and advancing the first end of the fixation element subcutaneously through an opening in the first port and an opening in second port to the second anchor. A surgical access port includes a proximal end, a distal end, and a sidewall defining a lumen extending from the proximal end to the distal end. The port may include a first opening formed in the sidewall that defines a passageway for medical hardware from the lumen to external to the port.

Abstract: A retracting eye drape assembly is disclosed for use around a patient's eye to seclude and seal off the operative field during eye surgery. The drape assembly includes a retraction member connected to the drape and configured to engage the patient's eyelid, an extension member connected to the retraction member or to the drape and configured to substantially enclose the patient's eyelid, and a retraction flap configured to secure the patient's eyelid in a substantially retracted position. A method of applying an eye drape assembly is disclosed. After application of the drape to the patient's face, and while the patient's eyelid is closed, the patient's eyelid is engaged by a retraction member connected to the drape and retracted. While retracted, the patient's eyelid is substantially enclosed to seclude the eyelid and eyelashes from the operational area. The secluded eyelid and eyelashes are then secured in a retracted position.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A dilator includes a first portion and a second portion movable between a first position and a second position. The first portion includes a first wall that defines a first cross section and a first cavity. The second portion includes a second wall that defines a second cross section, which is less than the first cross section, and a second cavity. The second portion dilates and/or dissects tissue adjacent a surgical site. In the first position, the second cavity provides direct visualization of the surgical site and the first cavity supports an instrument. In the second position, the second cavity is expandable such that the instrument is movable along the longitudinal axis in the second cavity. Methods of use are disclosed.

Abstract: The device relates to methods and devices for the treatment of obstructive sleep apnea syndrome.

Abstract: A deployable jaws retraction device is provided for retracting a body organ away from an operative site without occupying an incision or surgical access port during the surgical procedure. The deployable jaws retraction device includes a jaw assembly having two or more jaws joined at one end and a retention device to maintain the jaws of the closed condition about a target body organ. The deployable jaws retraction device additionally includes an anchoring assembly for securing the jaw assembly and body organ away from the operative site during the surgical procedure. The anchoring assembly includes a needle having a tissue penetrating tip and a length of suture material connecting the needle to the jaw assembly. There is also provided an applicator instrument for applying the deployable jaws retraction device onto a target body organ.

Abstract: A device auxiliary to surgery, for anchoring and lifting cavity walls or internal organs of a patient. The device provides a virtual port; that is an instrument that can be non-invasively, or minimally invasively and removably attached to the undersurface of a patient's cavity, or to various tissues within a cavity, and to which various retracting means are attached. The device includes means allowing it to be moved from one position to another and reattached to the undersurface of the abdominal wall, or to various tissues within a cavity, without creating any additional openings in the cavity wall. The device includes means for attaching various retractors.

Abstract: An anoscope kit comprising an anoscope having a plurality of spaced apart fingers having free ends and a dilator removably positionable within the anoscope to aid insertion of the anoscope. The dilator has a proximal region, an intermediate region and a distal region, the distal region including an enlarged distal head. A ramped surface extends from the enlarged distal head toward the intermediate region, the intermediate region having an outer surface to contact the fingers of the dilator.

Abstract: Described are various embodiments of surgical procedure systems, devices, tools, and methods, useful for treating pelvic conditions such as vaginal prolapse and other conditions caused by muscle and ligament weakness, the devices and tools being useful for transvaginally accessing a posterior region of pelvic anatomy, and related methods.

Abstract: A method for accessing a spinal disc of a lumbar spine of a patient using a surgical access system including a tissue distraction assembly and a tissue retraction assembly. The method can include maintaining an operative corridor along a lateral, trans-psoas path using the retraction assembly.

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: A device for facilitating the examination of an orifice includes a mount for a light source for illuminating the orifice, a connector for detachably mounting a dilator for insertion into and dilation of an orifice, and an actuator for operating a mounted dilator. The mounted dilator includes operative parts able to move apart from one another.

Abstract: A surgical tool for visually assessing or measuring the aortic structures contained within a generally tubular aortic root. The surgical tool is appropriately configured and sized to be insertable within an aortic root during surgery. The surgical tool comprises a handle portion and a cylindrical portion connectable thereto. The cylindrical portion defines an external cylindrical surface and extends in height along a tool axis between a base portion and a top portion. The cylindrical portion being optically clear or having at least a section thereof that is sufficiently transparent whereby, in use, when the surgical tool is placed within the aortic root and the aortic structures are in contact with the external cylindrical surface, the aortic structures are visible through said optically clear or sufficiently transparent section.

Abstract: A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. A component of the system engages the heart with a heart positioning device, repositions the heart into a displaced position and maintains it in the displaced position while the heart continues to beat with substantially unabated and uninterrupted cardiac output. One form of the system can be used in minimally invasive surgery.

Abstract: A retractor blade comprising a blade body having first and second ends, the first end including means to allow connection of the blade body to a support member, the second end including a first part disposed in a first plane and a second part disposed in a second plane, wherein the first and second parts are orthogonal and at least one of said first and second parts terminates in an end at least part of which includes a contour which generally conforms to a contour of a spinal vertebrae.

Abstract: A process for surgical operations on a rectal/haemorrhoidal prolapse comprises stages of realising, in the anal canal, at least a first circular stitching at a first portion of a haemorrhoidal prolapse; realising at least a second circular stitching in a second portion of the haemorrhoidal prolapse, and nearing the first circular stitching and the second circular stitching in order to create a constriction of the haemorrhoidal prolapse. The invention also relates to a device, preferably for actuating the process, which comprises a hollow divaricator (17) having a prevalent development direction along a longitudinal axis (Z) and being insertable in a patient's anal orifice. The device further exhibits a window (29) defining an operational area and creating a communication between a cavity (17b) internal of the divaricator (17) and a portion of haemorrhoidal prolapse. The device further comprises means for opening and closing (31) the window (29).

Abstract: Various universal ports for installation into a colon are disclosed. Some embodiments include means for permitting an anvil of a surgical stapler to pass through a port in a first direction and means for permitting a portion of the patient's colon to pass through the port in a second direction. Some embodiments also employ a flexible sleeve that may extend from the port out through the anus to provide a passageway for passing surgical instruments and into and out of the rectum and also for removing severed specimens therefrom.

Abstract: A process for surgical operations on a rectal/haemorrhoidal prolapse comprises stages of realising, in the anal canal, at least a first circular stitching at a first portion of a haemorrhoidal prolapse; realising at least a second circular stitching in a second portion of the haemorrhoidal prolapse, and nearing the first circular stitching and the second circular stitching in order to create a constriction of the haemorrhoidal prolapse. The invention also relates to a device, preferably for actuating the process, which comprises a hollow divaricator (17) having a prevalent development direction along a longitudinal axis (Z) and being insertable in a patient's anal orifice. The device further exhibits a window (29) defining an operational area and creating a communication between a cavity (17b) internal of the divaricator (17) and a portion of haemorrhoidal prolapse. The device further comprises means for opening and closing (31) the window (29).

Abstract: A surgical retractor assembly is disclosed that includes a bone plate and a retractor. The bone plate has a tapered end portion. The retractor includes a base having (i) a body defining a bottom surface and a distal portion, the distal portion defining a distal surface, (iii) a first pair of tabs extending from the body that are spaced apart from each other, and (iv) a second pair of tabs extending from the body that are spaced apart from each other. The retractor further includes a handle attached to the base. The first pair of tabs and the bottom surface define a first plate space. The second pair of tabs and the distal surface define a second plate space.

Abstract: A surgery assisting instrument for retinal surgery includes a cylinder and a strip connected with each other. The cylinder and the strip are made of a soft and biocompatible material. The cylinder is preferably connected with the strip at a side surface and close to an edge of the strip. The surgery assisting instrument is placed in a fornix around an eye at a position according to a retinal tear. The cylinder is pressed against the eye and the strip is pressed against the eyelid. Thus the retina is forced toward the back wall of the eye.

Abstract: Devices and methods for moving tissue and/or moving the devices relative to the tissue during a surgical procedure are disclosed. The devices and methods disclosed herein can be used in conventional, open surgical procedures, or in minimally invasive surgical procedures, such as laparoscopic and endoscopic procedures. In one aspect, the method can be used to provide an enlarged opening in the stomach wall for transgastric access.

Abstract: A short (60-70 mm) endonasal speculum for performing operations within and around the sellar region of the human head includes two side members each of which is composed of a handle and an elongated blade. The handles are attached to each other by a hinge and one of the handles includes a variable dilation control that is used to open the speculum. The elongated blades are arcuate in cross section and have distal ends that are opposed to each other in a trapezoidal configuration, either up or down, which permits greater visualization and access into the regions above and below the sella and greater instrument maneuverability within the speculum.

Abstract: A surgical access system including a tissue distraction assembly and a tissue refraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.