Sensor-enabled surgical retractor devices, systems, and methods are disclosed herein that can be coupled to a surgical robot during a robotic or robot-assisted surgical procedure to maintain health of retracted anatomy and prolong the amount of time until a surgical procedure must be interrupted to adjust a retractor. In some embodiments, interruption of a surgical procedure can be avoided by providing for minor and, in some cases, automatically administered, adjustment of retractor devices to alleviate pressure on retracted tissue without requiring surgeon attention or intervention. Fine (e.g., minor) adjustments to the retractor can be made automatically over the course of a surgical procedure to prevent damage to retracted anatomy and increase the time until a major adjustment of the retractor is needed.

A retractor includes a first arm, a second arm, and a translating member. The first arm comprises a proximal portion configured to retain a first retractor member and a distal portion configured to rotate relative to the proximal portion about a first axis. The second arm is configured to retain a second retractor member, such that rotation of the distal portion about the first axis causes the first retractor member to pivot toward or away from the second retractor member when the first retractor member and the second retractor member are coupled to the first arm and the second arm, respectively. The translating member is coupled between the proximal portion and the distal portion, and is configured to receive a drive force that causes the translating member to bias the distal portion to pivot relative to the proximal portion about the first axis.

A modular retractor may include a first body portion that houses a distraction mechanism for opening and closing a first arm and a second arm. A first pivoting member may be coupled to a distal end of the first arm and a second pivoting member may be coupled to a distal end of the second arm, for example. A first blade attachment mechanism may be coupled to the first pivoting member and a second blade attachment mechanism may be coupled to the second pivoting member. The first and second blade attachment mechanisms may be configured to couple to first and second blades and be independently inclinable. A first actuator may be operably coupled to the distraction mechanism for opening and closing the first arm and second arm. Various embodiments may include at least one connection point for connecting to at least one retractor module.

A retraction system and method are provided for retracting tissues surrounding a surgical site. In one aspect, a method including engaging slide connections between a guide dilator and a plurality of tissue engaging members and sequentially enlarging an incision using the guide dilator and the plurality of tissue engaging members. In another aspect, a method of inserting a plurality of tissue engaging members into an incision including fixing tip portions of the plurality of tissue engaging members in an insertion configuration, advancing the tip portions into an incision, and restricting movement of the tip portions away from the insertion configuration. A guide dilator system comprising an elongate body, a plurality of tissue engaging members, and slide connections between the elongate body and the tissue engaging members is also provided.

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

A tissue protector has a body structure having a longitudinal extending thin web. The body structure has an unconstrained first shape configured to form a nerve shield and is configured to shrink about a longitudinal axis to a smaller constrained second shape sized to fit into a lumen of a cannula. Preferably, the second constrained shape is oval or round having a maximum diameter equal or less than an inside diameter of the lumen. The body structure is configured to return to the first shape when the cannula is withdrawn or returned to this shape as the implant advances.

Cooling systems are described herein that may be used in connection with one or more attached devices to cool patient tissue. The disclosed cooling systems include a refrigeration unit containing a thermoelectric element in thermal communication with a heat exchanger, a fluid pump in fluid communication with a fluid inlet and a fluid outlet, tubing connecting the fluid inlet to the fluid outlet, a fluid cooling element in thermal contact with the thermoelectric element, and a temperature sensor positioned to detect a temperature of fluid within the tubing. The temperature of fluid within the tubing can be controlled by a control unit having a user interface and a power controller to adjust cooling power to the thermoelectric element. Various types of devices can be configured to receive and circulate cooled fluid from the cooling systems, such as retractor blades, retractor shims, cooling pads, and scope sheaths.

The present invention relates to systems and methods for accessing the spine to place implants. In one embodiment, a system includes an adjustable rod structure having four rods radially surrounding a probe, a ring and a retractor. The adjustable rod structure is configured to have a closed and open profile controlled by the retractor such that the open profile creates a space between rods of the structure. The ring is configured to be placed within retracted rods to maintain the open profile after retraction. In a method embodiment, the adjustable rod structure is inserted through a percutaneous incision in the closed position until it reaches a target site. The retractor is then attached to the rods and used to retract the rods. The probe is then removed from within an opening created and a ring is advanced into the opening to hold the rods in place.

The present invention is directed at minimally invasive systems in which the proximal end portion of the working channel has either zero or a limited range of movement in the lateral direction. A first embodiment has a slidable collar attached to a pair of flanges, wherein movement of the collar is bounded by an annular frame. A second embodiment has a substantially spherical element attached to the tube. A third embodiment has a plurality of caps. A fourth embodiment is adapted for a larger working channel.

The present invention relates to systems and methods for accessing the spine to place implants. In one embodiment, a system includes an adjustable rod structure having four rods radially surrounding a probe, a ring and a retractor. The adjustable rod structure is configured to have a closed and open profile controlled by the retractor such that the open profile creates a space between rods of the structure. The ring is configured to be placed within retracted rods to maintain the open profile after retraction. In a method embodiment, the adjustable rod structure is inserted through a percutaneous incision in the closed position until it reaches a target site. The retractor is then attached to the rods and used to retract the rods. The probe is then removed from within an opening created and a ring is advanced into the opening to hold the rods in place.