Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a connector system for connecting a source of energy and a source of fluid to an electrosurgical device. The connector system includes a hub which includes an electrically conductive lengthwise member having a lengthwise member distal region and a lengthwise member proximal region. The lengthwise member defines a hub lumen therebetween and is configured to be operatively coupled to an electrosurgical device.

Abstract: Disclosed is a multifunctional medical device, apparatus or system that is capable of performing a surgical procedure or operation and also capable of removing or reducing smoke particles generated by the surgical procedure or operation on a subject, the apparatus comprising a plurality of electrodes, two of which are configured to be in electrical communication with or being electrically connectable to opposite poles of a source of high voltage dc electricity to ionize, and remove or reduce smoke particles, and at least one of which is also configured to be part of a RF circuit to perform a surgical procedure or operation such as tissue cutting, cauterization, tissue sealing or coagulating at a surgical site on the subject. Also disclosed is a method of employing the above disclosed device, apparatus or system or variations thereof to perform a surgical procedure or operation at a surgical site and to remove or reduce smoke particles generated during the surgical procedure or operation.

Abstract: A multifunctional medical device, apparatus or system that is capable of perforating a surgical procedure or operation and also capable of attracting, collecting, removing or reducing debris generated by the surgical procedure or operation, on a subject. The apparatus comprising a plurality of electrodes, two of which are configured to be in electrical communication with or being electrically connectable to opposite poles of a source of high voltage dc electricity to ionize, attract, collect, and remove or reduce debris. At least one of the electrodes is also configured to be part of a RF circuit to perform a surgical procedure or operation such as tissue cutting, cauterization tissue sealing or coagulating at a surgical site on the subject.

Abstract: A surgical stapling instrument includes an end effector that has a first jaw; a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue between the first jaw and the second jaw; an anvil; and a staple cartridge with staples deployable into the tissue and deformable by the anvil. The surgical stapling instrument further includes a control circuit configured to: determine tissue impedances at predetermined zones; detect an irregularity in tissue distribution within the end effector based on the tissue impedances; and adjust a closure parameter of the end effector in accordance with the irregularity.

Abstract: A method, includes receiving an anatomical map of a patient organ, the anatomical map including properties obtained at respective locations on a first surface of the organ. A design line produced on a second surface of the anatomical map, is received. One or more of the properties that, when falling along the design line, will be visualized thereon, are selected, and the one or more properties falling along the design line, are visualized.

Abstract: A comprehensive and integrated solution, including a dedicated system structure and grounding mechanism, a main radio frequency (RF) coil to transmit and receive signal, secondary RF coils to saturate unwanted signals from non-region-of-interest (ROI) in the excited region, an RF shielding structure configured to shield the main RF coil from generating signals on the non-ROI, and an environmental noise active cancellation mechanism is proposed to construct an NMR system for non-invasive quantitative detection of organs, and further improves the target region selectivity and detection accuracy.

Abstract: A wearable electrosurgical return electrode includes an outer pad, an inner pad, and a conductive element disposed between the outer pad and the inner pad. The return electrode is formed as a flexible sheath and configured to be worn over at least a portion of a body during use.

Abstract: An electrosurgical system comprises a return electrode that includes a conductive element disposed between two pads. The conductive element comprises a flexible, conductive fabric material and an electrical bus bar disposed along an edge of the fabric. The return electrode, including the conductive element, is transparent to RF waves and other wavelengths used in medical imaging systems.

Abstract: A lung tumor ablation planning system includes a processor operable to compute a target ablation zone and a set of optimum ablation parameters to create the target lesion with the ablation catheter. A predictive algorithm is employed to model the ablation zone based on training data. Various ablation plans are displayed to the physician corresponding to various metrics including without limitation maximizing tumor ablation coverage, shortest travel, obstacle avoidance, and shortest ablation time. Related methods are described.

Abstract: The present invention relates to a composition for skin whitening or wound treatment including liquid-type plasma, and more particularly, to a cosmetic composition for skin whitening and a pharmaceutical composition for treating and preventing skin pigmentation diseases which contain liquid-type plasma as an active ingredient. In addition, the present invention relates to a pharmaceutical composition for wound treatment, a quasi-drug composition, and a health functional food composition, which include liquid-type plasma and a growth factor as active ingredients, and a wound treatment method including a step of administering the composition to a subject or a step of applying the composition on the skin. The composition including liquid-type plasma and a growth factor of the present invention is capable of inducing the proliferation of fibroblasts, thereby exhibiting excellent wound treatment efficacy.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a connector system for connecting a source of energy and a source of fluid to an electrosurgical device. The connector system includes a hub which includes an electrically conductive lengthwise member having a lengthwise member distal region and a lengthwise member proximal region. The lengthwise member defines a hub lumen therebetween and is configured to be operatively coupled to an electrosurgical device.

Abstract: An irrigation system for a surgical instrument includes an irrigation tube arranged to convey an irrigation fluid and an irrigation clip structurally arranged to receive a portion of the irrigation tube. The irrigation clip includes a proximal portion, a distal portion, a body portion, and an arm portion. The arm portion is structurally configured to selectively attach the irrigation clip to the surgical instrument and to bias the irrigation clip toward the surgical instrument with a biasing force. The irrigation clip includes a tube locking portion structurally arranged to cooperate with the surgical instrument to engage the outer surface portion of the irrigation tube to inhibit rotation and axial displacement of the irrigation tube relative to the irrigation clip in response to the biasing force.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a handle or hub which includes an electrical connector configured to receive, in a releasable manner, an electrically conductive component operable to be electrically coupled to an energy source.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a handle or hub which includes an electrical connector configured to receive, in a releasable manner, an electrically conductive component operable to be electrically coupled to an energy source.

Abstract: The invention relates to a flat flexible coating arrangement comprising a coating surface (9) for placing on a body region of a living being and at least one electrode (3, 3?) arranged above the coating surface (9), and a dielectric (1) containing the at least one electrode (3, 3?), the at least one electrode (3, 3?) comprising a supply line for an AC high voltage in order to form a dielectrically impeded plasma. Said arrangement enables fusion processes over the course of the plasma treatment and optionally wound healing without removing the coating arrangement from the body region by means of at least one built-in sensor (14) for determining at least one parameter of the body region.

Abstract: The disclosure notably relates to a system for phrenic nerve stimulation. The stimulation system comprises a catheter including one or more intravascular electrodes each arranged on a distal portion of the catheter. The catheter is configured to be introduced in the superior vena cava of a human patient. The stimulation system also comprises an extracorporeal electrode patch configured to be affixed to the patient opposite to the distal portion relative to the phrenic nerve. The extracorporeal electrode patch is operable in a bipolar mode with the one or more intravascular electrodes. Such a system forms an improved solution for phrenic nerve stimulation, in particular during a cryoablation procedure.

Abstract: The subject of this disclosure is devices, systems, and uses thereof to treat a plurality of patients for paroxysmal atrial fibrillation. The solution can include delivering a multi-electrode radiofrequency balloon catheter and a multi-electrode diagnostic catheter to one or more targeted pulmonary veins; ablating tissue of the one or more targeted pulmonary veins using the multi-electrode radiofrequency balloon catheter; diagnosing the one or more targeted pulmonary veins using the multi-electrode diagnostic catheter; and achieving at least one of a predetermined clinical effectiveness and acute effectiveness of the method or use based on use of the multi-electrode radiofrequency balloon catheter and the multi-electrode diagnostic catheter in the isolation of the one or more targeted pulmonary veins.

Abstract: Embolic coils with detachable segments that are separated by detachment capsules that are thermolytically degradable such that varying lengths of coil may be implanted into a vascular malformation to occlude same. The capsules are radiotransparent when compared to the adjoining coil segments to the location of the segments is easily seen. The capsules further include protruding electrical contacts that make positive contact with terminals on a delivery catheter. The terminals on the delivery catheter serve as markers so the relationship between the detachment capsules and the terminals is easily visible under x-ray.

Abstract: An instrument for therapeutically cytotoxically ablating parathyroidal tissue is disclosed. A substance is capable of transforming the parathyroid gland from overproduction of parathyroid hormone when the substance's quantity exceeds a set amount, and is capable of transforming the parathyroid gland from overproduction only when activated by application of sufficient units of an electromagnetic energy having a frequency ranging from 400 THz to 30 PHz when the substance's quantity is below the set amount. A delivery device is operable to introduce the substance into the parathyroidal tissue and to quantitatively limit the quantity to below the set amount. An energy device is operable to apply units of the electromagnetic energy after the substance has been introduced. A sensor is operable to monitor the activation of the substance as the electromagnetic energy is applied. The energy device is further operable to modulate applying the electromagnetic energy when the substance has been activated.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed, with the system including a signal generator for generating pre-ablation signals and pulse waveforms for medical ablation therapy that may be coupled to an ablation device including at least one electrode for ablation pulse delivery to tissue. The signal generator may generate and delivery pre-ablation signals to subsets of electrodes of the ablation device and measure currents associated with the delivery to determine whether the currents meet one or more predetermined criteria. The signal generator may also generate and deliver voltage pulses to the ablation device in the form of a pulse waveform after determining that the currents meet the one or more predetermined criteria.

Abstract: An embodiment includes a system comprising: an outer conduit; a shape memory polymer (SMP) foam; a metal backbone including: (a)(i) a first portion that extends from the SMP foam proximal end to the SMP foam distal end and which is generally covered by the SMP foam, and (a)(ii) a distal portion that extends distally from the SMP foam distal end and which is not covered by the SMP foam; wherein: (b)(i) SMP foam and the metal backbone are both included within the outer conduit adjacent to the outer conduit distal end; (b)(ii) the metal backbone distal portion transitions from a secondary shape that is uncoiled to a primary shape that is coiled; and (b)(iii) the metal backbone distal portion is in the metal backbone distal portion secondary shape and is located between the SMP foam distal end and the distal end of the outer conduit.

Abstract: A surgical forceps comprising: a first working arm and a second working arm configured to move towards and away from each other; and an electromagnetic latching system; wherein the electromagnetic latching system is configured to create a force that is in a direction aligned with closing of the forceps or opposite to the closing of the forceps when an electromagnetic activation button is depressed.

Abstract: A surgical stapling instrument includes an end effector that has a first jaw; a second jaw movable relative to the first jaw between an open configuration and a closed configuration to grasp tissue between the first jaw and the second jaw; an anvil; and a staple cartridge with staples deployable into the tissue and deformable by the anvil. The surgical stapling instrument further includes a control circuit configured to: determine tissue impedances at predetermined zones; detect an irregularity in tissue distribution within the end effector based on the tissue impedances; and adjust a closure parameter of the end effector in accordance with the irregularity.

Abstract: Described embodiments include an apparatus for removal of a thrombus from a body of a subject. The apparatus includes a first electrode, made of a first conductive metal, a second electrode, made of a second conductive metal that is different from the first conductive metal, and a voltage source, configured to apply a positive unipolar voltage between the first electrode and the second electrode while the first electrode is in contact with the thrombus, and while the second electrode is inside the body of the subject. Other embodiments are also described.

Abstract: The exemplified systems and methods facilitate a nerve conduction block at a target nerve using electrical stimulation applied from one or more electrodes located on a percutaneous lead that are placed in parallel, or substantially in parallel, and without direct contact, to a long axis of the peripheral nerve over an overlapping nerve region of greater than about 3 millimeters. The exemplified system and method can be further configured to block nerve condition without eliciting onset activity and co-excitation of non-targeted structures. The exemplified method and system can be performed using conventional percutaneous leads, though an improved percutaneous lead design is disclosed herein. In an aspect, an introducer is disclosed that facilitates accurate and consistent insertion of the percutaneous lead to the specified or intended position relative to the target nerve. In another aspect, a treatment kit comprising the various system components to treat pain is disclosed.

Abstract: A method is disclosed for delivering energy to a region of tissue within a patient's body using a medical treatment system. The medical treatment system comprises an energy delivery device coupled to an energy source and the method includes steps of delivering energy, measuring an energy delivery parameter, determining distance of the energy delivery device from a conductive object and optionally adjusting a position of the energy delivery device based on the determined distance.

Abstract: Medical devices, assemblies and methods for guarding sharp tips of medical needles are disclosed herein. Some embodiments include an expandable device configured to be at least partially disposed within the needle lumen. The device may include an expandable distal portion that is designed to shift between a first configuration in which the expandable distal portion has an outer diameter that is the same as or less than the inner diameter of the needle lumen and a second configuration in which the expandable distal portion has an outer diameter that is greater than the inner diameter of the needle lumen. An elongated inner member may be used to shift the expandable distal portion from the first configuration to the second configuration.

Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, includes an occlusive device comprising a mesh having a low-profile state for intravascular delivery to the aneurysm and a deployed state, the mesh comprising a first end portion, a second end portion, and a length extending between the first and second end portions, and a first lateral edge, a second lateral edge, and a width extending between the first and second lateral edges. The mesh may have a predetermined shape in the deployed state in which (a) the mesh is curved along its width, (b) the mesh is curved along its length, and (c) the mesh has an undulating contour across at least a portion of one or both of its length or its width. The mesh is configured to be positioned within the aneurysm in the deployed state such that the mesh extends over the neck of the aneurysm.

Abstract: Systems and methods are provided for modeling and for providing a graphical representation of tissue heating and electric field distributions for medical treatment devices that apply electrical treatment energy through one or a plurality of electrodes. In embodiments, methods comprise: providing one or more parameters of a treatment protocol for delivering one or more electrical pulses to tissue through a plurality of electrodes; modeling electric and heat distribution in the tissue based on the parameters; and displaying a graphical representation of the modeled electric and heat distribution. In another embodiment, a treatment planning module is adapted to generate an estimated target ablation zone based on a combination of one or more parameters for an irreversible electroporation protocol and one or more tissue-specific conductivity parameters.

Abstract: A control device for use with a treatment tool that includes a heating element to apply heat to a treatment target. The control device comprises a processor configured to set a target temperature for the heating element and to control the heating element so that temperature of the heating element follows the target temperature. The processor is configured to switch the control of the heating element from a first phase to a second phase. A first followability of the temperature of the heating element in the first phase is higher than a second followability of the temperature in the second phase. The processor is configured to terminate the controlling of following the temperature of the heating element to the target temperature when a parameter is beyond a predetermined range wherein the parameter being defined as a fluctuation between the temperature of the heating element and the target temperature.

Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, includes an occlusive device comprising a mesh having a low-profile state for intravascular delivery to the aneurysm and a deployed state, the mesh comprising a first end portion, a second end portion, and a length extending between the first and second end portions, and a first lateral edge, a second lateral edge, and a width extending between the first and second lateral edges. The mesh may have a predetermined shape in the deployed state in which (a) the mesh is curved along its width, (b) the mesh is curved along its length, and (c) the mesh has an undulating contour across at least a portion of one or both of its length or its width. The mesh is configured to be positioned within the aneurysm in the deployed state such that the mesh extends over the neck of the aneurysm.

Abstract: A method of altering skin tissue includes creating an electrochemical reaction in the tissue, wherein the electrochemical reaction occurs while avoiding electro-thermal damage to the tissue.

Abstract: A surgical instrument and method for implantation of follicular units into the scalp of a patient, includes a non-incising cylindrical tip attached to a distal end of a handle body, wherein the non-incising cylindrical tip defines a lumen and a slot for cradling a follicular unit in preparation for implantation. The lumen and the slot are configured to load a follicular unit through the slot into the lumen and to accommodate the loaded follicular unit in the lumen.

Abstract: The present invention provides an electroporation device and a method for controlling an electroporation device for facilitating delivering active substances into skin such as stratum corneum while minimizing discomfort of a user by modulating applied voltage pulses. The electroporation device according to the present invention comprises: a measurement unit being configured to provide multiple outputs of one or more resistance measurement voltage pulses for measuring a resistance of skin of a user at a predetermined interval; and an output unit being configured to provide an output of one or more electroporation voltage pulses to the skin of the user based on the resistance of the skin of the user per each output of the one or more resistance measurement voltage pulses.

Abstract: A catheter adapted for use in the pericardial sac to sense temperature of an ablation site and surrounding heart tissue within one of the heart's ventricles or atria via proximity with the epicardium in the pericardial sac, includes a catheter body and a temperature sensing array adapted for placement on and contact with the epicardium. The temperature sensing array may comprise a 2-D body, with a surface adapted to contact an area on the epicardial tissue or in pericardial space. The array may also comprise at least one finger member, each having at least one temperature sensing location. The array may further comprise an elongated body having a generally circular configuration, a distal portion of which is movable to a spirally inward position.

Abstract: A multifunctional medical device, apparatus or system that is capable of perforating a surgical procedure or operation and also capable of attracting, collecting, removing or reducing debris generated by the surgical procedure or operation, on a subject The apparatus comprising a plurality of electrodes, two of which are configured to be in electrical communication with or being electrically connectable to opposite poles of a source of high voltage dc electricity to ionize, attract, collect, and remove or reduce debris. At least one of the electrodes is also configured to be part of a RF circuit to perform a surgical procedure or operation such as tissue cutting, cauterization tissue sealing or coagulating at a surgical site on the subject.

Abstract: A multi-electrode renal denervation method and system using an integrated circuit are provided. The multi-electrode renal denervation system presented in the present invention comprises: a power generator transmitting control data for controlling the temperature of a plurality of electrodes; and a catheter in which the plurality of electrodes, which has an integrated circuit embedded therein and is controlled by the control data received from the power generator, are arranged, and the information measured using the integrated circuit is transmitted to the power generator.

Abstract: A system for thermal ablation of tissue and temperature monitoring of said tissue is disclosed. They system includes an insertion device configured to be inserted into said tissue, a radio-frequency source configured to transmit radio-frequency energy into said tissue via the insertion device, a pulse generator configured to pulse the radio-frequency source at a pre-determined pulse rate and generate a thermoacoustic signal in said tissue, a thermoacoustic transducer configured to receive the thermoacoustic signal, and a processor configured to utilize the thermoacoustic signal to calculate a temperature of said tissue.

Abstract: A multifunctional medical device, apparatus or system that is capable of perforating a surgical procedure or operation and also capable of attracting, collecting, removing or reducing debris generated by the surgical procedure or operation, on a subject The apparatus comprising a plurality of electrodes, two of which are configured to be in electrical communication with or being electrically connectable to opposite poles of a source of high voltage dc electricity to ionize, attract, collect, and remove or reduce debris. At least one of the electrodes is also configured to be part of a RF circuit to perform a surgical procedure or operation such as tissue cutting, cauterization tissue sealing or coagulating at a surgical site on the subject.

Abstract: A new method for the ablation of undesirable tissue such as cells of a cancerous or non-cancerous tumor is disclosed. It involves the placement of electrodes into or near the vicinity of the undesirable tissue through the application of electrical pulses causing irreversible electroporation of the cells throughout the entire area of the undesirable tissue. The electric pulses irreversibly permeate the cell membranes, thereby invoking cell death. The irreversibly permeabilized cells are left in situ and are removed by the body immune system. The amount of tissue ablation achievable through the use of irreversible electroporation without inducing thermal damage is considerable.

Abstract: An method for installing a fusion implant into a sacroiliac joint (“SI Joint”) without the use of a rotary cutting instrument. The method incorporates a multimodal abrading device having abrading surfaces on opposing sides and an open tip comprising a cutting edge. The method includes the step of using the abrading head to cut bone tissue from the SI Joint at an insertion point while simultaneously using the abrading surfaces to decorticate the cortical bone at the insertion point.

Abstract: Disclosed is a multifunctional medical device, apparatus or system that is capable of performing a surgical procedure or operation and also capable of removing or reducing smoke particles generated by the surgical procedure or operation on a subject, the apparatus comprising a plurality of electrodes, two of which are configured to be in electrical communication with or being electrically connectable to opposite poles of a source of high voltage dc electricity to ionize, and remove or reduce smoke particles, and at least one of which is also configured to be part of a RF circuit to perform a surgical procedure or operation such as tissue cutting, cauterization, tissue sealing or coagulating at a surgical site on the subject. Also disclosed is a method of employing the above disclosed device, apparatus or system or variations thereof to perform a surgical procedure or operation at a surgical site and to remove or reduce smoke particles generated during the surgical procedure or operation.

Abstract: A method of treating an occlusion in a body lumen of a patient is described. The method uses advancing a first end of a wire guide through the body lumen of the patient from an entry point towards a first side of an occlusion. The method also advances the first end of the wire guide through the occlusion to a second side of the occlusion. The method further advances the first end of the wire guide through a second entry point and out of the lumen. The method involves removing a portion of the first end of the wire guide extending outside the second percutaneous entry point to expose a modified terminal end of the wire guide.

Abstract: A method and apparatus for the concurrent treatment of multiple oral diseases and defects while promoting general oral hygiene utilizing direct current electricity and methods for manufacturing the same. Electrodes are used to deliver a direct current to the gingival tissues of a mouth in order to achieve a number of therapeutic, prophylactic, and regenerative benefits. These benefits include killing oral microbes, increasing oral vasodilation, reducing oral biofilm, improving oral blood circulation, reversing oral bone resorption, promoting oral osteogenesis, treating gum recession, and fostering gingival regeneration. Other benefits include the treatment of gingivitis, periodontitis, and oral malodor, and other systemic diseases correlated with oral pathogens.

Abstract: Systems and methods for non-thermal ablation of tissue are provided. A non-implantable minimally invasive system for treatment of tissue in a body via direct current ablation is provided including a catheter, a plurality of electrodes for deployment through the catheter, a power source for applying power to the electrodes, and a fixation element for maintaining the catheter in a treatment position during treatment of the tissue. A minimally invasive method for treating tissue in a body via direct current ablation is provided including inserting a catheter into the body such that a portion of the catheter remains outside of the body, deploying a fixation element to fix the catheter in a treatment position, deploying a plurality of electrodes through the catheter, applying power to the plurality of electrodes, using the electrodes to apply a current to the tissue, and removing the catheter from the body.

Abstract: A method of modifying a tissue includes providing an electrochemical reaction in the tissue by the use of an anodic electrode and a cathodic electrode wherein at least one of the anodic and cathodic electrodes is in contact with the tissue; and setting a concentration of electrochemically generated chemical agents that affect the tissue.

Abstract: Disclosed is a system and a method for aesthetic skin treatment. The system includes an array of RF electrodes assembled on a flexible or rigid substrate. A plurality of RF voltage generators configured to address individually each of the RF electrodes of the array and supply to each pair of RF electrodes RF voltage. The amplitude of the RF voltage applied to inner pair of RF electrodes is lower than the RF voltage applied to outer pair of RF electrodes.

Abstract: An apparatus and related methods are described. The apparatus is described that includes a structural metal element including a metallic foam layer. The apparatus also includes a second metal element and a nonmetallic spacer. The nonmetallic spacer arranged between the structural metal element and the second metal element, the metallic foam layer joined to the nonmetallic spacer.

Abstract: Systems and methods for endometrial ablation. The systems include a handle and elongated introducer sleeve extending to an expandable working end having a fluid-tight interior chamber. A thin dielectric wall surrounds at least a portion of the interior chamber and has an external surface for contacting endometrial tissue. The thin dielectric wall surrounds a collapsible-expandable frame and receives an electrically non-conductive gas. First and second polarity electrodes are exposed to the interior and exterior of the chamber, respectively. A radiofrequency power source operatively connects to the electrode arrangement to apply a radiofrequency voltage across the first and second electrodes, wherein the voltage is sufficient to initiate ionization of the neutral gas into a conductive plasma within the interior chamber, and to capacitively couple the current in the plasma across the thin dielectric wall to ablate endometrial tissue engaged by the external surface of the dielectric structure.

Abstract: A method of performing an operation, e.g. a spinal operation, on a patient using a retractor comprising a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis, and further comprising a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In the method, the blade assemblies are closed to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The blade assemblies are then opened by rotating the blades about the set of axes, stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision.).