Abstract: This invention provides a system and method for positioning, manipulating, holding, grasping, immobilizing and/or stabilizing a heart including one or more tissue-engaging devices, one or more suction sources, one or more fluid sources, one or more energy sources, one or more sensors and one or more processors. The system and method may include an indifferent electrode, a drug delivery device and an illumination device. The system's tissue-engaging device may comprise a tissue-engaging head, a support apparatus and a clamping mechanism for attaching the tissue-engaging device to a stable object. The system may be used during various medical procedures including the deployment of an anastomotic device, intermittently stopping and starting of the heart, ablation of cardiac tissues and the placement of cardiac leads.

Abstract: A method and apparatus for sensing a pressure difference between a first and second region is disclosed. The apparatus includes a motor assembly having a backplate and a diaphragm, the motor assembly being operably attached between the first and second regions. The motor assembly also having a capacitance responsive to a difference in atmospheric pressure between the first and second regions. A measurement device utilizes the capacitance for detecting the pressure difference between the two regions. The apparatus is adaptable for cooperation with a chemical dispenser for dispensing a prescribed dosage to an individual.

Abstract: This invention provides a system and method for positioning, manipulating, holding, grasping, immobilizing and/or stabilizing a heart including one or more tissue-engaging devices, one or more suction sources, one or more fluid sources, one or more energy sources, one or more sensors and one or more processors. The system and method may include an indifferent electrode, a drug delivery device and an illumination device. The system's tissue-engaging device may comprise a tissue-engaging head, a support apparatus and a clamping mechanism for attaching the tissue-engaging device to a stable object. The system may be used during various medical procedures including the deployment of an anastomotic device, intermittently stopping and starting of the heart, ablation of cardiac tissues and the placement of cardiac leads.

Abstract: A superelastic or shape-memory iris retractor for use in operating on the eye of a living creature, by means of which the iris is drawn outwards for widening the pupil. The iris retractor essentially comprises a superelastic or shape-memory grasping element and a preferably retainer which suitably is displaceable relative to the grasping element. In use, the grasping element is inserted suitably through a scleral, limbal or other incision and engages the iris for mechanically dilating the pupil. When removed, the grasping element can straighten so as not to catch on the scleral incision. In the shape-memory embodiment, the grasping element will revert to the element's original shape condition upon heat treatment. Both embodiments can withstand autoclaving for multiple reuses.

Abstract: A medical instrument for endoscopic removal of the saphenous vein has an elongated shaft which has 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 bone leveler or apparatus including a first blade member having a forward end suitable for contacting the bone and a rearward end, a second blade member having a forward end suitable for contacting the bone and a rearward end, and an elastic member having one end received by the first blade member and an opposite end received by a second blade member. Each of the blade members has an identical configuration. Each of the blade members has a hole formed between the forward end and rearward end. The elastic member has one end received by the hole of the first blade member and an opposite end received by the hole of the second blade member. Each of the blade members has a slot formed at the rearward end so as to extend inwardly therefrom. The respective ends of the elastic members are fixed into the slots of the respective blade members. The elastic member is a length of surgical tubing.

Abstract: The present invention provides apparatus, systems, and methods for manipulating a tissue structure within a body cavity. Preferably, the invention provides for retracting and supporting the heart wall to provide access into the heart during a cardiac surgical procedure. In one embodiment of the present invention, a surgical tool support apparatus comprises a base having an atraumatic tissue-engaging surface and an aperture for receiving an elongate tool. The apparatus also has a clamp assembly aligned with the aperture and spaced-apart from a surface of the base opposite to the tissue-engaging surface. The apparatus is particularly useful in maintaining a retracting force on a surgical tool used to manipulate tissue within a body cavity such as the thoracic cavity.

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: The invention is methods and devices which a surgeon may use to stabilize the beating heart during a surgical procedure on the heart. Pursuant to the invention, a stabilizing device is introduced through an opening in the chest and brought into contact with the beating heart. By contacting the heart with the device and by exerting a stabilizing force on the device, the motion of the heart caused by the contraction of the heart muscles is effectively eliminated such that the heart is stabilized and the site of the surgery moves only minimally if at all. Typically, in separate steps, the surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force on the stabilizing device such that the contraction of the beating heart causes only minimal excess motion at the surgery site.

Abstract: The present invention provides apparatus, systems, and methods for manipulating a tissue structure within a body cavity. Preferably, the invention provides for retracting and supporting the heart wall to provide access into the heart during a cardiac surgical procedure. In one embodiment of the present invention, a surgical tool support apparatus comprises a base having an a traumatic tissue-engaging surface and an aperture for receiving an elongate tool. The apparatus also has a clamp assembly aligned with the aperture and spaced-apart from a surface of the base opposite to the tissue-engaging surface. The apparatus is particularly useful in maintaining a retracting force on a surgical tool used to manipulate tissue within a body cavity such as the thoracic cavity.

Abstract: The present invention provides apparatus, systems, and methods for manipulating a tissue structure within a body cavity. Preferably, the invention provides for retracting and supporting the heart wall to provide access into the heart during a cardiac surgical procedure. In one embodiment of the present invention, a surgical tool support apparatus comprises a base having an atraumatic tissue-engaging surface and an aperture for receiving an elongate tool. The apparatus also has a clamp assembly aligned with the aperture and spaced-apart from a surface of the base opposite to the tissue-engaging surface. The apparatus is particularly useful in maintaining a retracting force on a surgical tool used to manipulate tissue within a body cavity such as the thoracic cavity.

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

Abstract: A surgical stabilizer especially adapted for use in cardiac surgery includes first and second hollow legs that are disposed generally parallel to each other, each leg having a closed end and an open end. Each leg has an upper surface and a lower surface, the lower surface including a plurality of openings that are disposed adjacent each other. A yoke extends between and connects the first and second legs. A manifold is connected to the open end of each leg. When a suction tube is connected to the manifold, a vacuum can be applied to the openings in the legs so as to attract the surface of the heart to the legs. An adjustable embodiment of the invention includes first and second support arms that are connected to first and second legs. The support arms are connected pivotally to each other to permit the legs to be moved toward or away from each other. The legs can be provided with small pins, sharpened edges, and/or suction in order to engage or grasp the heart.

Abstract: An apparatus for stabilizing a predetermined area on a heart or other organ of a patient to enable a surgical procedures the apparatus comprising a bifurcated member having two elongated prongs and an elongated handle segment pivotally and rotatably 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 preferred embodiment of the apparatus of the present invention further comprises a device to lock or fictionally hold the bifurcated member in a desired position both on the organ and relative to the handle segment during the surgical procedure.

Abstract: An organ-stabilizing element is covered with a layer of textile material such as cloth enhance slip-free engagement with an organ such as a beating heart during surgery thereon. The organ-stabilizing element is supported on a stacked structure of successive ball elements and rings that can be selectively flexible or rigid in response to tensioning of a flexible cable within a central bore of the structure.

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: A vaginal lateral walls retractor for use with a vaginal speculum to retract the vaginal lateral walls during vaginal/cervical examinations includes a generally tubular sleeve having cross-sectional dimensions that allow the sleeve to fit in between blades of the speculum while the blades are inserted and opened within a vagina. The sleeve retracts the vaginal lateral walls that have pushed in under the inserted and opened speculum blades. The cross-sectional dimension also provides an inside working area for examination and sampling of the vagina and cervix area.

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 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: The present invention provides a set of rakes for retraction of the patient's ribs and thoracic region in, e.g., a reoperative midsternotomy surgical procedure, for providing additional support as the surgical cavity is enlarged during the course of dissection of, e.g., the internal mammary artery during its harvest for use in a coronary bypass procedure. The present invention provides as a retraction device a xiphoid rake for providing support to a body portion in a surgical procedure which includes forming a surgical cavity by a xiphoid entry, wherein the xiphoid rake is substantially stronger than conventional retractor rakes and provides a large body-supporting portion for providing greater sternal support as required in the surgical procedure.

Abstract: A port device includes tubular body with a distal swivel, a platform movable along the length of the port body, and preferably three legs movable relative to the platform. The tubular body is inserted through the chest wall, and the platform is then positioned over the proximal end of the tubular body and adjusted such that feet on the legs contact the chest wall and clamp the chest wall between the feet and the swivel. The legs may be individually adjusted to provide the tubular body at a desired angle relative to the chest wall. According to preferred aspects of the port device, the platform may be ratcheted relative to the port body and the feet may be ratcheted relative to the platform to permit rapid adjustment of the port relative to the patient.

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 retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool.

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 lid retractor for use, for example, in transconjuntival blepharoplasty electrosurgery on eyelids which avoids having to move the retractor during the procedure. The lid retractor comprises an elongated handle which at one end, the gripper end, divides into several projections each terminating in a hook that can be placed over the lower lid to enable the lower lid to be retracted to access lid or eye regions under the lid retractor. The gripper is dimensioned so that the whole eyelid can be pulled down such that several fat compartments under the eyelid can be accessed, visualized, and surgically treated without having to move the lid retractor position.

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. The system locates a suspension head near the apical region of the heart and a gross support near the base of the heart near the AV groove. A frame is positioned within the patient's thoracic region and moves with the patient, and a surgical target immobilizer can be used to assist in the movement of the heart if desired. A special suction cup is used which accommodates multiplanar movement of the heart and the myocardium while also preventing heart tissue from interrupting the suction being applied to the heart. One form of the system can be used in minimally invasive surgery.

Abstract: The present invention is directed to a new and useful device and method for stabilizing cardiac tissue at a surgical site during heart surgery, and specifically useful during beating heart surgery. The device includes a foot for contacting a heart tissue and two arms movably connected together for selective movement to vary and adjust the position of the foot on the heart. The foot and the arm assembly are designed to optimize stability of the foot in contact with heart tissue, and therefore, to optimize stability of the heart during surgical procedure. The device is capable of being mounted on a chest spreader. The foot has a bottom surface which is angled for better stabilization and engagement with the heart.

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

Abstract: An 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 member pivotally connected at an acute 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 shroud member is positioned on the proximal end portion of the first elongate section to aid in the dissection of the intervening tissue.

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 method for performing hip surgery using at least one support arm attached to a retractor support apparatus. The surgery includes incising the patient so as to expose the hip joint including the femoral head, the acetabulum and a portion of the femur. A femur retractor is positioned on the support arm and engages the femur, thereby dislocating the femoral head from the acetabulum. After disengaging the femur retractor from the femur, a femur elevating retractor is positioned on the support arm. The femur elevating retractor elevates the femoral head, thereby creating access to the acetabulum.

Abstract: Methods and devices used to stabilize a beating heart during a surgical procedure on the heart 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. Accordingly, the heart is stabilized and movement of the site of the surgery is minimized. Typically, in separate steps, a surgeon contacts the heart with the stabilizing device, assesses the degree of movement of the anastomosis site, and exerts a force with a stabilizing device such that the contractions of the beating heart causes only minimal excess motion at the surgery site. The stabilizing device may be attached to a rigid support or may be attached to a semi-rigid support which is rendered motionless mechanically, chemically or by human intervention.

Abstract: A wound protector retractor comprises an inner O-ring for insertion through a wound opening and a connecting sleeve extending between the O-ring and outer mounting assembly. The outer assembly is 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 adjustable surgical retractor and its use for improving a surgeon's ability to perform closed-chest video-assisted exploratory, diagnostic or surgical procedures on a patient. The surgical retractor is designed to have opposable blades which can be inserted into a surgical incision in a patient undergoing a surgical procedure then spread apart to form an elongated access opening through which a instrument may be inserted to perform exploratory, diagnostic or surgical procedures. The blades used in the surgical retractor may be flexible or rigid and are attachable to the retractor. The blades are of a width, depth and thickness to provide an access to an internal cavity or subcutaneous region to allow greater degrees of freedom to the surgeon in inserting instruments into the access opening. The use of the surgical retractor forms a substantially ovoid channel, through which a medical instrument can be inserted to aid a doctor in performing surgical or other operations.

Abstract: The present invention provides a group or kit of surgical instruments for use in minimally invasive surgical procedures.

Abstract: In an episiotomy retractor, distal portions of the blades are shaped to diverge away from one another for enhanced retraction and gripping of respective adjacent vaginal walls, proximal portions of the blades are shaped to diverge away from one another to retract the labia as the blades retract respective adjacent vaginal walls, and the proximal inferior longitudinal edges of the blades cooperatively define, when the retractor is in use, an open work area for a surgeon about the perineum and the posterior vaginal wall of a patient.

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: 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. Additionally, one or more of the blades, distracting mechanism, and handles are offset with respect to the other to facilitate visualization and to increase the space available for an implant holder. The blades are configured to enhance versatility of the distractor. In a first embodiment, the blades 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. In a second embodiment, curved portions are provided between the blades and jaws such that the blades are offset from the jaws in a smooth transition which does not expose sharp edges to internal organs or vasculature of the patient.

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 pivotally and rotatably 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 preferred embodiment of the apparatus of the present invention further comprises a device to lock or frictionally hold the bifurcated member in a desired position both on the organ and relative to the handle segment during the surgical procedure.

Abstract: A surgical apparatus is described for performing cardiac surgery on the coronary organs of a patient. It has a contacting means capable of providing a mechanical load on at least a portion of said coronary organ, a positioning means which allows the setting of either or both the contacting means and coronary organ in a large number of positions or orientations within a surgical workspace. The apparatus also has a manipulation means serving as a single point control to position and orient the contacting means onto the coronary organ tissue. An adjustment means serves to bias the range of at least one motion degree of freedom of the surgical apparatus within a the limits of a restricted range that is less than the full range of motion of that degree of freedom of motion that would be otherwise achievable when the bias is not present or overridden.

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 heart's position.

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 self-supporting retractor for holding open an anatomic space for performing endoscopic surgical procedures. The retractor includes a substantially rigid elongate member, having proximal and distal ends, and having an arch shape or “C” cross-section, defining a passage and longitudinal working window along the retractor. The distal end is preferably rounded or streamlined to facilitate insertion along a dissected space with minimized tissue trauma, and may include a hooded portion enclosing the passage at the distal end. The elongate member may include radially cooperating segments or self-retaining edges to maximize the area of the space held open by the retractor. The retractor may include a handle or a pivotable finger grip on the proximal end to manipulate the retractor during use, and/or a curved handle to tent the incision providing access to the dissected space. The retractor may also include a channel member for an endoscope, integrally formed or pivotally attached to the retractor.

Abstract: A stabilized cephalic medical apparatus includes an annular band for placement around a patient's head, and a pivotally adjustable bridge member for holding and supporting a medical instrument. The bridge member according to the invention is attachable to the annular band, and is preferably removable therefrom for cleaning and sterilization thereof. The bridge member is preferred to include a mounting member for supporting a medical instrument thereon, and a connector for connecting the mounting member to the annular band. The apparatus may further include a medical instrument attachable to the bridge member. The design of the apparatus according to the invention allows a medical instrument, such as a nasal speculum or retractor, to be operatively attached to, and to move concurrently with the patient.

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 system for locally stabilizing an anastomotic site of a vessel of a beating heart during a surgical procedure is disclosed. The system includes bonding a pad to the myocardium and attaching a control arm to the pad, all by use of a bioabsorbable adhesive. The control arm is grasped and manipulated by a retractor thereby stabilizing the anastomotic area during the surgical procedure. The pad is optional and can be ommitted in one embodiment where the control arm has feet that are directly bonded to tissue. The pad may also have barbs or can include suction cups. The pad can include a helix-shaped fastener or a mechanical fastener that can be easily linked or hooked to a surgical instrument for manipulation.

Abstract: A retractor includes an elongate member having an arcuate cross-section defining an elongate passage therein, and a handle molded to its proximal end. A transparent illumination member has a proximal portion connectable to a light source, and a distal portion that extends within the elongate passage along an inner surface of the elongate member, and includes a plurality of grooves for diffusing light transmitted from the proximal portion uniformly into and along the elongate passage. The device may also include a support member attachable to the proximal end of the elongate member to further facilitate visualization of and/or access into the elongate passage.

Abstract: In accordance with the present invention there is provided a device for stabilizing and/or manipulating moving tissue, such as a beating heart, so as to facilitate surgical procedures on such tissues. The device includes a tube having a proximal end, a distal end and a lumen extending therebetween. The tube is operatively connected to a suction source so as to draw air through the tube from the distal end to the proximal end. The device further includes at least one foot operatively connected to the distal end of the tube. The foot extends laterally from the tube. In a preferred embodiment the device includes a pair of feet which are spaced apart laterally from each other. Each foot has a proximal surface, and a distal surface for making contact with the tissue. The distal surface of each foot has an outer perimeter having a substantially spherical profile. This spherical profile helps the device make better contact with the tissue, so the tissue can be more effectively manipulated.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool.