Access platform for internal mammary dissection

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• spreading a first side of the incision relative to a second side of the incision in a generally lateral direction;
• raising the first side of the incision relative to the second side of the incision in a generally vertical direction;
• lowering the second side of the incision relative to the first side of the incision in a generally vertical direction;
• and
• retracting soft tissue away form the opening of the incision.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• providing an access platform comprising a spreader member and first and second blades pivotally coupled to the spreader member;
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade;
• pivoting the spreader member away from the incision;
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction;
• offsetting the first side of the incision relative to the second side of the incision in a generally vertical direction;
• dissecting an internal mammary artery of the patient;
• and
• performing an anastomosis through the incision using the internal mammary artery.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• providing an access platform comprising a spreader member and first and second blades pivotally coupled to the spreader member;
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade;
• pivoting the spreader member away from the incision;
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction;
• offsetting the first side of the incision relative to the second side of the incision in a generally vertical direction;
• and
• retracting soft tissue away from the opening of the incision.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• providing an access platform comprising a spreader member and first and second blades pivotally coupled to the spreader member;
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade;
• pivoting the spreader member away from the incision;
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction;
• offsetting the first side of the incision relative to the second side of the incision in a generally vertical direction;
• providing a torsional member coupled to the first blade and the spreader member and a support pad coupled to the first blade;
• positioning the support pad on the patient's chest, and
• actuating the torsional member to lift the first blade relative to the second blade.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• providing an access platform comprising a spreader member and firsthand second blades pivotally coupled to the spreader member;
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade;
• pivoting the spreader member away from the incision;
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction;
• offsetting the first side of the incision relative to the second side of the incision in a generally vertical direction;
• providing a lead screw rotatably coupled to the second blade and adjustably coupled to the first blade, and
• actuating the lead screw to lift the first blade relative to the second blade.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient;
• providing an access platform comprising a spreader member and first and second blades pivotally coupled to the spreader member;
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade;
• pivoting the spreader member away from the incision;
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction;
• offsetting the first side of the incision relative to the second side of the incision in a generally vertical direction;
• providing a pry bar having a sternal pad and an offset blade coupled thereto,
• positioning the support pad on the patient's chest,
• capturing the first blade with the offset blade, and
• pulling the pry bar to pivot the offset blade about the sternal pad to lift the first blade relative to the second blade.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a chest region of a patient,
• providing an access platform comprising a spreader member and first and second blades detachably coupled to the spreader member,
• engaging a first side of the incision with the first blade and a second side of the incision with the second blade,
• spreading the first side of the incision relative to the second side of the incision in a generally lateral direction,
• positioning a retaining arm between the first and second blades, and
• detaching the spreader member from the first and second blades.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• spreading and lifting simultaneously a first side of the incision relative to a second side of the incision;
• providing an access platform having a spreader member and a support pad coupled to first and second blades, the spreader member comprising first and second drive members, wherein adjustment of the first drive member moves the first blade relative to the second blade in a generally lateral direction, and adjustment of the second drive member lifts the first blade relative to the second blade,
• engaging the first side of the incision with the first blade and the second side of the incision with the second blade, and
• simultaneously actuating the first and second drive members to simultaneously spread and lift the first blade relative to the second blade.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• spreading and lifting simultaneously a first side of the incision relative to a second side of the incision;
• providing an access platform having a spreader member, a support pad, support pad arm, and first and second blades, wherein the first blade is pivotally coupled to the spreader member, and
• engaging the first side of the incision with the first blade and the second side of the incision with the second blade.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• independently applying a lifting force in addition to a spreading force to simultaneously lift and spread a first side of the incision relative to a second side of the incision;
• dissecting an internal mammary artery of the patient through the incision;
• and
• performing an anastomosis through the incision using the internal mammary artery.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• independently applying a lifting force in addition to a spreading force to simultaneously lift and spread a first side of the incision relative to a second side of the incision;
• and
• retracting soft tissue away from the opening of the incision.

A minimally invasive method of thoracic surgery comprising the steps of

• providing a conically shaped blade-less retractor comprising first, second, and third sections,
• penetrating the thoracic cavity of a patient and creating an incision by screwing the first section through the tissue between adjacent ribs,
• positioning the second section of the retractor between opposing ribs,
• removing the first section from the retractor,
• positioning the third section of the retractor between opposing ribs to spread opposing ribs apart, and
• removing the second section from the retractor.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• applying a first force to a first side of the incision, and applying a second force to a second side of the incision to simultaneously spread and lift the first side of the incision relative to the second side of the incision;
• dissecting an internal mammary artery of the patient through the incision;
• and
• performing an anastomosis through the incision using the internal mammary artery.

A minimally invasive method of thoracic surgery comprising the steps of

• creating an incision in a thoracic region of a patient;
• applying separately a lateral force and a vertical force to a first and a second side of the incision to simultaneously spread and lift the first side of the incision relative to the second side of the incision;
• dissecting an internal mammary artery of the patient through the incision;
• and
• performing an anastomosis through the incision using the internal mammary artery.