Abstract: An illuminated surgical retractor for defining and illuminating a subcutaneous surgical field in the space near a vessel (such as the radial artery or the basilic vein) during a procedure for harvesting the vessel, wherein the illuminated surgical retractor includes a handle member pivotally connected at an acute angle to a first elongate section that has a non-liner shape, and includes a second elongate section releasably connected to the first elongate section, wherein a portion of the second elongate section defines an illumination input end portion, which is optically coupled to a light source to substantially illuminate the second elongate section, and further including an insertion area positioned on the proximal end portion of the first elongate section to allow the second elongate section to be inserted into the first elongate section.

Abstract: A method for performing surgery on a shoulder joint utilizes one positionable support arm attached to a retractor support apparatus. The method includes incising a patient to expose the shoulder joint. After exposing the shoulder joint, the humeral ball is dislocated from the glenoid cavity. A retractor is mounted to one of the support arms at a proximal end. A humerus retractor blade at a distal end of the humerus retractor engages the humerus. The humerus retractor blade is positioned about the humerus and a mechanical system within the humerus retractor is manipulated to laterally displace the humeral ball from the glenoid cavity.

Abstract: Devices, systems and methods related to endoscopic surgery, particularly related to robotic surgical operations, provide a tissue stabilizer for endoscopically stabilizing a target tissue within a patient's body. For stabilizing a beating heart during a closed-chest coronary artery bypass grafting procedure, a stabilizer is inserted through an endoscopic cannula and provides sufficient surface area to contact the heart and effectively stabilize the target tissue area. The stabilizer can straddle a blood vessel, such as a coronary artery, which is targeted for an anastomosis. Vessel occlusion fasteners may occlude the target blood vessel prior to the anastomosis procedure.

Abstract: The present invention relates to a surgical retractor that immobilizes tissue at a surgical site. A preferred embodiment of the retractor is used during minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. Tape or thread can be used to connect the artery to the retractor with a holder.

Abstract: A ligament retractor assembly including a first retractor paddle, a second retractor paddle, a first elastic member having one end received in an opening of the first retractor paddle and an opposite end received by an opening of the second retractor paddle, and a second elastic member received in another opening of the first retractor paddle and an opposite end received in another opening of the second retractor paddle. Each of the first and second retractor paddles includes a first retaining section, a second retaining section and a lever section. The first and second retractor paddles are integrally formed of a polymeric material. The openings formed on the retaining sections of the paddles and each have a generally dog leg configuration.

Abstract: The present invention enables a physician to distract a previously created opening, determine the size of the opening, and alternatively, subsequently assist in inserting an implant between adjacent spinous processes. The distracting device has two prongs which separate as the handle of the device is closed. When the spinous processes are distracted to a desired diameter, the physician can lock the prongs in place, allowing him to determine and select an appropriately sized implant.

Abstract: A ligament retractor assembly including a first retractor paddle, a second retractor paddle and an elastic member having one end received in an opening of the first retractor paddle and an opposite end received by an opening of the second retractor paddle. Each of the first and second retractor paddles includes a retaining section and a lever section. The lever section extends at a generally acute angle with respect to the retaining section. The first and second retractor paddles are integrally formed of a polymeric material. Each of the first and second retractor paddles includes a gripping portion formed at an end of the retaining section adjacent the lever section. The opening is formed on the retaining section of the paddles and has a generally dog leg configuration opening at a side of the retaining section and extending at an angle toward a median of the retaining section. A hole is formed through the retaining section adjacent the opening.

Abstract: A heart stabilizer that may include a wrist which couples an end effector to a first linkage. The end effector and wrist may be inserted through an incision in the chest of a patient to assist in performing a minimally invasive coronary procedure. The wrist provides dexterity so that the end effector can be placed on the heart to stabilize the same.

Abstract: A support arm for a heart stabilizer that can be used to stabilize a heart during a beating heart coronary artery bypass graft procedure. The support arm may have an arm that is coupled to a table mount and an end effector. The table mount is adapted to be mounted to the rail of a surgical table. The end effector is adapted to hold the heart stabilizer. The arm may be adjustable to allow an end user to adjust the position of the end effector.

Abstract: A retractor and a surgical tool are positioned at the distal end of the cannula. A dissection cradle is located at the distal end of a distal portion of the retractor that is resiliently skewed relative to the cannula axis, and includes two substantially parallel, spaced legs with the retractor shaped in a loop therebetween. The procedure includes locating a vessel and side branch of interest and extending the retractor to retain the vessel in the dissection cradle to urge the vessel away from the axis of the cannula in order to isolate a side branch for exposure to the surgical tool.

Abstract: An illuminated surgical retractor for defining and illuminating a subcutaneous surgical field in the space near a vessel (such as the radial artery or the basilic vein) during a procedure for harvesting the vessel, wherein the illuminated surgical retractor includes a handle member pivotally connected at an acute angle to a first elongate section that has a non-liner shape, and includes a second elongate section releasably connected to the first elongate section, wherein a portion of the second elongate section defines an illumination input end portion, which is optically coupled to a light source to substantially illuminate the second elongate section, and further including an insertion area positioned on the proximal end portion of the first elongate section to allow the second elongate section to be inserted into the first elongate section.

Abstract: A spinal implant insertion instrument for intervertebral implant surgery formed from a hollow first element of various external diameters, including a channel to accommodate and incorporate a vertebral pedicle, and a second element joined by a hinge to the first element, allowing reduction of the external diameter of the leading edge of the spinal implant insertion element sufficient to allow the passage of the spinal implant insertion instrument into the intervertebral disc space in a safe fashion, as the first maneuver, to be followed by activation of the second element upon the first, restoring the internal diameter of the spinal implant insertion instrument to a sufficient radius to allow successive passage of cutting, reaming, tapping instruments, and subsequent implantation of a spinal interbody implant device.

Abstract: An illuminated surgical retractor for defining and illuminating a subcutaneous surgical field in the space near a vessel (such as the saphenous vein or radial artery) during a procedure for harvesting the vessel, wherein the illuminated surgical retractor includes a handle member pivotally connected at an acute angle to a first elongate section that has an at least partially tapered width, and includes a second elongate section releasably connected to the first elongate section, wherein a portion of the second elongate section defines an illumination input end portion, which is optically coupled to a light source to substantially illuminate the second elongate section, and further including an insertion area positioned on the proximal end portion of the first elongate section to allow the second elongate section to be inserted into the first elongate section.

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

Abstract: Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

Abstract: A surgical retractor system including: a surgical retractor for retracting tissue surrounding an opening; and an attachment member having a linear or non-linear edge along a length; and an accessory device for use with the surgical retractor, the accessory device having a channel in sliding engagement with the edge along the length, the channel being the other of linear and non-linear along a width thereof such that the accessory device is movable along the length of the edge into a desired position upon the application of a moving force and locked in the desired position in the absence of the moving force. Also provided are various mounts for disposing the edge in the channel and a pseudoelastic arm for supporting the accessory device from the attachment member, the arm being capable of articulation into a desired position yet also maintaining the desired position during a surgical procedure.

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 orgy minimal excess motion at the surgery site.

Abstract: A method and device for endoscopic harvesting of blood vessels from a patient for use in subsequent procedures. The device having a two piece headpiece. A vessel to be removed is inserted into the headpiece and the top and bottom portions of the headpiece are alternatively extended in reciprocating fashion to dissect above and below the vessel. The headpiece having electrodes for ligation of any side branch vessels which are uncovered in the dissection process.

Abstract: The present invention relates to a retraction plate for displacing soft tissue. The plate includes a window located in between first and second end parts. Each of the end parts has connecting elements for removably securing an elongate element. Coupling of elongate elements to the connecting elements allows lifting of the plate to retract soft tissue, thereby creating a cavity between the soft-tissue mantle and bone to perform a surgical procedure. The retraction plate provides access to a fracture and allows fracture fixation using a minimally invasive surgical technique.

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 distractor for separating adjacent elements, such as vertebrae. The distractor preferably has a scissors-type distracting mechanism, either in a simple scissors or double-acting scissors configuration. The distractor includes blades that are removable from the jaws of the distractor such that different blades may be used depending on the patient and situation with which the distractor is to be used. The jaws include a mating fixture and the blades include a mating portion for removable association with the mating fixture.

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

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

Abstract: 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: A medical instrument for endoscopic removal of the saphenous vein has an elongated shaft which hat at the distal end a spatula tip and in whose proximal region is arranged a laterally projecting handle. The instrument further has an endoscopic optical system which has an eyepiece cup that is arranged at the proximal end of the instrument. The handle is joined to the shaft in such a way that an outer side of the instrument facing away from the handle continuously has a surface that, from the distal to the proximal end, is free of projections. The eyepiece cup is arranged in oblique orientation with respect to a longitudinal center axis of the shaft and encloses with the handle, with respect to the longitudinal center axis, an angle of less than 90°.

Abstract: A surgical instrument 10 to aid a medical practitioner to manipulate a patients uterus and vaginal vault, the instrument 10 includes a shaft 12 that is inserted through the patient's vagina and cervix so as to protrude into the uterus. A hollow member 19 is sealingly engaged with the shaft 12 and extends therefrom so as to engage the vaginal wall to sealingly connect the shaft 12 with the vaginal wall. This enables a surgeon to cut the vaginal wall surrounding the cervix while delivering a gas under pressure to the body cavity surrounding the uterus.

Abstract: An surgical instrument for use during procedures to harvest saphenous veins simultaneously retracts tissue and exposes sections of the vein. Removable spacer limbs are selectively attached to the instrument to aid in retracting tissue and to make the instrument self-retaining.

Abstract: The present invention relates to surgical retractors and devices for stabilizing a predetermined area of the body during a surgical procedure, more particularly to surgical retractors and stabilizing devices used in connection with minimally invasive coronary artery bypass grafting surgical procedures, and more specifically to surgical retractors and stabilizing devices especially configured for use with each other for such surgical procedures wherein the retractor includes an external rail system which enables the surgeon to position a stabilization arm having first and second shaft segments on either of the arms or the rack segment of the retractor and also includes a connector which is spaced apart from the sled member and stabilization device to releasably control the movement and rotation of the stabilization device with respect to the stabilization arm and the rotation of the stabilization arm with respect to the retractor actuation of a single knob or actuator.

Abstract: Apparatus is provided that distracts and maintains the distracted position of adjacent vertebral bodies during a surgical procedure within a vertebral disc space. The distraction device includes a first and second plate, each of which includes at least one extension member for removably attaching to a vertebral body. The distraction device further includes a locking member for locking the first plate with respect to the second plate across a vertebral disc space and a cam mechanism for effecting relative movement of the first and second plates. Each extension member includes at least one bore for receiving a bone screw. The first and second plates are preferably crescent shaped and coupled together by a pin member. The first and second plates are rigidly locked together in a distracted position by a threaded locking screw. A method of distracting a space between vertebral body portions and a method of using a distraction device during implantation of a fusion implant is also disclosed.

Abstract: A surgical retraction and positioning device comprises a stable platform and a flexible tape attached thereto for easier retraction and manipulation of a heart during cardiac surgery. The stable platform has an elongate body having a curved handle extending into an organ contacting base. The base is formed at the distal end of the handle and is at least partially concave to conform to the contours of the outer surface of the heart. A portion of a flexible element, such as umbilical tape, is secured to the base, leaving at least one free end to enable the surgeon to wrap, or secure, the heart against the organ contacting base.

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

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

Abstract: A method for manipulating a tissue structure within a thoracic cavity of a patient includes the step of providing a tissue positioning tool having a shaft, a tool support apparatus and a tissue supporting member releasably connectable to the shaft. The tool support apparatus includes a clamp assembly configured to secure the shaft to the tool support apparatus. The tool support apparatus is positioned on an outer surface of a patient's chest and at least a portion of the shaft and the tissue supporting member are introduced into the patient's thoracic cavity. The tissue supporting member is attached to the portion of the shaft that is disposed within the patient so as to contact a tissue structure. A force is applied to the shaft to displace the tissue structure and the shaft is locked to the tool support apparatus with the clamp assembly.

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

Abstract: An illuminated deep pelvic surgical retractor for illuminating a surgical site and retracting tissue adjacent thereto, the illuminated surgical retractor having a handle member interconnected at an obtuse angle to a first elongate section and a second elongate section that is releasably connected to the first elongate section and a portion of the second elongate section defining an illumination input end portion which is optically coupled to a light source so that the second elongate section is substantially illuminated, and, a shield member is positioned adjacent to the distal end portion of the first elongate section to aid in directing light selectively from the second elongate section to the desired tissue or organ.

Abstract: A system for performing through port off-pump coronary artery bypass surgery includes a port insertable between ribs into a chest wall of a patient, a heart stabilizer extendable through and stably couplable to the port, and an instrument stabilizer adapted to dampen extraneous movement to which a surgical instrument extending through the stabilizer is subject.

Abstract: A wound protector comprises an inner O-ring for insertion through a wound opening and a connecting sleeve extending between the O-ring and outer mounting means. The outer means are provided by rings between which the sleeve is led. The rings are rotated relative to each other and the inner ring to form a centralized lumen of reduced cross section and to shorten the axial extent of the sleeve. A wound is both retracted and protected.

Abstract: An apparatus for stabilizing a predetermined area on a heart or other organ of a patient to enable a surgical procedure, the apparatus comprising a bifurcated member having two elongated prongs and an elongated handle segment pivotably attached to the bifurcated member. The handle segment can be movably attached to a rib retractor or other surgical device so that a person is not required to hold the handle segment. The apparatus may further comprise an attachment or inlay to prevent lateral movement thereof when being used in the surgical procedure.

Abstract: A tissue or foreign body extractor. A coil member is provided, and in one embodiment of the invention, is disposed within the lumen of a needle. The needle includes one or more cutting edges for cutting into tissue located in the body, a core of the tissue being received in the lumen. The coil member is connected to an elongate shaft that extends through the lumen of the needle for remotely operating the coil member Turning the shaft threads the coil member into the core. Thereafter, retracting the shaft tears the core at its juncture with the remaining mass of tissue or foreign body, and withdraws the core from its locus in the body.

Abstract: The present invention is directed to a surgical instrument assembly that includes an operative element and an insertion instrument removably engageable to the operative element. The insertion instrument is positionable in a patient with the operative element engaged thereto to position the operative element at an operative site in the patient. A transfer instrument is removably engageable to the operative element when the operative instrument is located at the operative site. The insertion instrument can then be removed. Methods for using the surgical instrument assembly are also disclosed.

Abstract: A spinal implant insertion instrument for intervertebral implant surgery formed from a hollow first element of various external diameters, including a channel to accommodate and incorporate a vertebral pedicle, and a second element joined by a hinge to the first element, allowing reduction of the external diameter of the leading edge of the spinal implant insertion element sufficient to allow the passage of the spinal implant insertion instrument into the inteivertebral disc space in a safe fashion, as the first maneuver, to be followed by activation of the second element upon the first, restoring the internal diameter of the spinal implant insertion instrument to a sufficient radius to allow successive passage of cutting, reaming, tapping instruments, and subsequent implantation of a spinal interbody implant device.

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

Abstract: An illuminated retractor for creating a working space for dissecting instruments in support of a surgical procedure such as rectal examination or for the removal of polyps or hemorrhoids or other types of procedures which require the illumination and access to tissue in the rectal area of a patient, the illuminated retractor having a handle member pivotally connected at an obtuse angle to a first cylindrical and elongate section and a second elongate section that is releasably connected to the first elongate section and a portion of the second elongate section defining an illumination input end portion which is optically coupled to a light source so that the second elongate section is substantially illuminated, and, an operating channel extends along the lengthwise dimension of the first elongate section and the operating channel is illuminated by the second elongate section in use.

Abstract: A illuminated surgical retractor for illuminating a subcutaneous surgical field in the space between a vessel, such as the saphenous vein, and the subcutaneous tissue when the illuminated retractor is used to retract the subcutaneous tissue away from the superior surface of the vessel, the illuminated surgical retractor having a handle connected at an acute angle to a distal end of a first blade section, a second blade section that is connected, and substantially co-planer, to the first blade section, a distal end of the second blade section defining an illumination input end, a connector coupled to the illumination input end so that a source of illumination can be optically coupled, via the connector, to the illumination input end so that the second blade section is substantially illuminated, and, alternatively, a bent tip extending from the proximal end of the first blade section to aid in the required dissection of the intervening tissue.

Abstract: The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration.

Abstract: An endoscopic stabilization device is provided. The device includes first and second support elements positioned opposite each other, a plurality of linkages, each linkage including a first end portion attached to the first support element and a second end portion attached to the second support element; and a cable operatively attached to the linkages at a first end to allow a user to pull a second end of the cable to move the first support element in a direction away from the second support element. Methods of using the device to stabilize and immobilize components in the body are also provided.

Abstract: A illuminated surgical retractor for illuminating a subcutaneous surgical field in the space between a vessel, such as the saphenous vein, and the subcutaneous tissue when the illuminated retractor is used to retract the subcutaneous tissue away from the superior surface of the vessel, the illuminated surgical retractor having a handle connected at an acute angle to a distal end of a first blade section, a second blade section that is connected, and substantially co-planer, to the first blade section, a distal end of the second blade section defining an illumination input end, a connector coupled to the illumination input end so that a source of illumination can be optically coupled, via the connector, to the illumination input end so that the second blade section is substantially illuminated, and, alternatively, a bent tip extending from the proximal end of the first blade section to aid in the required dissection of the intervening tissue.

Abstract: A port device is insertable between the ribs of a patient and functions as an entryway for surgical instruments. The port device includes a tubular body having proximal and distal portions. The distal portion of the tubular body is coupled to a swivel adapted to be moved between a first orientation in which the swivel extends in substantially a same direction as the body, and a second orientation at an angle relative to, and preferably substantially perpendicular to, the first orientation. In the second orientation, the swivel engages the inside of the chest wall. The proximal portion of the tubular body has a clamping assembly which clamps the chest wall against the swivels to secure the port in its location. The port body can be anchored in a various angular positions.

Abstract: A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to provide a stabilized area sufficiently large to allow an accurate anastomosis to be performed. According to preferred aspects of the invention, the stabilizer is particularly adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also preferably adapted to be automatically deployed into its final configuration by release of a lock actuated at a proximal portion of stabilizer extending outside the port. In addition, the stabilizer is adapted to automatically fold when being pulled back through the port.

Abstract: The present invention relates to a surgical retractor that immobilizes tissue at a surgical site. A preferred embodiment of the retractor is used during minimally invasive direct coronary bypass procedures to arrest movement of the grafting site while the heart continues pumping. Tape or thread can be used to connect the artery to the retractor with a holder.