Tissue retractor for applications in transoral endocrine surgery

Abstract

The present disclosure concerns systems and methods related to an adjustable surgical dilation device for the mechanical dilation of an anatomical opening, including, but not limited to, an endoscopic or robotic port. In certain embodiments, this device may create and expand an anatomical opening with novel petal-like mechanism. In certain embodiments, this device may be utilized in laparoscopic procedures including, but not limited to, thyroid or parathyroid removal.

Description

TISSUE RETRACTOR FOR APPLICATIONS IN TRANSORAL ENDOCRINE SURGERY

[0001] This application claims priority to U.S. Provisional Patent Application Serial No. 63 / 651,494, filed May 24, 2024, which is incorporated by reference herein in its entirety.TECHNICAL FIELD

[0002] The present disclosure is directed at least to the fields of surgery, medicine, and medical devices.BACKGROUND

[0003] Traditionally patients with a wide range of conditions that are related to the parathyroid or the thyroid gland will undergo a parathyroidectomy or thyroidectomy. Approximately 150,000 thyroidectomies and 100,000 parathyroidectomies are performed in the United States every year to treat various conditions, such as substemal thyroid, benign nodules, an enlarged thyroid, or primary / secondary / tertiary hyperparathyroidism, etc.

[0004] Unfortunately, parathyroidectomies and thyroidectomies leave patients with highly visible and undesirable scars on their necks. These scars are a result of the current thyroidectomies and parathyroidectomies techniques which make use of a transverse incision on the neck to gain surgical access to the thyroid or parathyroid. The resultant unsightly scars from such operations have been shown to lower the self-esteem of patients and may become physically painful if the scar develops into a keloid.

[0005] A new surgical procedure has gained wide use in an effort to eliminate scarring of the neck. Transoral Endocrine Surgery (TES) is a procedure gaining popularity amongst surgeons in the United States. Roughly 140,000 patients in the United States are eligible to receive this surgery every year. An eligible patient’s surgeon may use TES to laparoscopically remove diseased thyroid or parathyroid glands without leaving a visible scar. Specifically during TES, surgical ports are inserted into the oral vestibule, located between the lower lip and gums, to advance laparoscopic surgical instruments into the space above the windpipe. Once the laparoscopic instruments are in place, the diseased gland is excised, collected in a bag and removed through the surgical port.

[0006] Surgeons performing TES are in need of a device that is quick, easy to use, and provides adequate traction to create a sizable work space for the procedure. In order to createadequate working space for the surgeon to access the diseased gland, the skin and muscle in the neck must be lifted. Typical methods of expanding a surgical space in parts of the body other than in the neck, such as using carbon dioxide gas, cannot be used as the tissue in the neck is too delicate. The current method of retraction involves looping sutures around the tissue to physically pull the skin and muscle up. However, placing these sutures is tedious and difficult work, driving up the time of the procedure by as much as 30 minutes. This is a significant increase in surgical time and can lead to surgical complications as well as increased costs for the procedure. In addition, patients with excess neck tissue make suture retraction even more complicated. As such, current TES techniques to create space in the surgical area, though adequate, may be improved upon.

[0007] To bolster better surgical outcomes and patient safety, surgical instruments should be specifically designed for use in transoral endocrine surgery. Therefore, there is significant need to design a novel device to improve TES surgical outcomes. To this end, the current disclosure is the first step in that effort.

[0008] The surgical procedures mentioned here are only representative and are included simply to highlight that a need exists for improved methods of expanding the surgical space. Embodiments described herein address certain surgical procedures but not necessarily each and every one described here or known in the art. Furthermore, embodiments described herein may present other benefits than, and be used in other ways than, those of the surgical procedures described above.BRIEF SUMMARYI. General Disclosures

[0009] The present disclosure is directed to a solution to the problems associated with surgical access during surgical procedures including, but not limited to, parathyroidectomy and / or thyroidectomy. Certain embodiments of the present disclosure may be used in endoscopic procedures, including TES thyroid or parathyroid removal. In certain aspects, the present disclosure is directed to systems and methods for the creation and dilation of a surgical path, including, but not limited to, endoscopic or TES procedures. In certain aspects, the retractor may create and / or expand the surgical path using a novel tissue-piercing retraction mechanism.II. Systems of the Disclosure

[0010] The present disclosure is directed to systems for providing and expanding a remote surgical path using a novel tissue-piercing retraction mechanism. In certain embodiments, the surgical tissue-piercing retraction comprises a surgical tissue-piercing retraction system. The retraction system may comprise one or more of the following elements: a line element; an anchor, which may be operatively coupled to the line element; and a penetrating element having a hollow lumen and an open tip configured for placement and removal of the anchor. In some embodiments, the anchor provides a surface for contact with a surgical tissue. In some embodiments, the penetrating element is configured to penetrate the surgical tissue. In some embodiments, the line element is configured to be coupled to an anchor at a distal end and secured to a line element retraction point at a proximal end during use. In some embodiments, the line element and anchor are configured to traverse the hollow lumen.

[0011] In certain embodiments, the penetrating element comprises a hypodermic needle, catheter, trocar, etc. In certain embodiments, the penetrating element comprises a needle and / or catheter having a size of 6G, 7G, 8G, 9G, 10G, 11G, 12G, 13G, 14G, 15G, 16G, 17G, 18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 28G, 29G, 30G, 31G, 32G, 33G, 34G, and any range therebetween. In certain embodiments, the penetrating element comprises a needle and / or catheter having a length of O. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having a size of 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having length of O. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween.

[0012] In certain embodiments, when the retraction elements are closed, the anchor may have a maximum radius of 1mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween.

[0013] In certain embodiments, the anchor may be capable of deployment of retraction elements equal to or greater than 0.5cm, 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm, 10cm, and any range therebetween, in length.

[0014] In certain embodiments, the line element comprises a nonflexible and / or flexible string. In certain embodiments, the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof. In certain embodiments, the natural string may be comprised of linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof. In certain embodiments, the synthetic string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co- caprolactone, polydioxanone, or a combination thereof. In certain embodiments, the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

[0015] In certain embodiments, the anchor comprises one or more medical grade plastics and / or medical grade metals. In certain embodiments, the medical grade plastic anchor comprises polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof. In certain embodiments, the medical grade metal anchor comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

[0016] In certain embodiments, the anchor’s shape comprises a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shape, or a combination thereof. In certain embodiments, the anchor comprises a gripping surface. In certain embodiments, the gripping surface comprises spikes, bumps, gripping material, or a combination thereof.

[0017] In certain embodiments, the anchor further comprises a retraction element coupled to the anchor by a hinge. In certain embodiments, the retraction element comprises a flexible material. In certain embodiments, the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor. In certain embodiments, the retraction element comprises a gripping surface. In certain embodiments, the retraction element gripping surface comprises spikes, bumps, gripping material, or a combination thereof.

[0018] In certain embodiments, the line element retraction fixture comprises one or more metals and / or one or more plastics. In certain embodiments, the metal line element retraction fixture may be comprised of stainless steel, copper, titanium, cobalt chrome,aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof. In specific embodiment, the plastic line element retraction fixture may be comprised of polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

[0019] In certain embodiments, there is a surgical tissue-piercing retraction system, including: a line element; an anchor comprising a site capable of being operatively connected to the line element; a retraction element coupled to the line element; and a penetrating element having a hollow lumen and an open tip configured for placement of the anchor, wherein the anchor is configured to provide a surface for contact with a surgical tissue, wherein the anchor and line element are configured to traverse the hollow lumen.

[0020] In certain embodiments, the penetrating element comprises a hypodermic needle catheter, trocar, etc. In certain embodiments, the penetrating element comprises a needle and / or catheter having a size of 6G, 7G, 8G, 9G, 10G, 11G, 12G, 13G, 14G, 15G, 16G, 17G, 18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 28G, 29G, 30G, 31G, 32G, 33G, 34G, and any range therebetween. In certain embodiments, the penetrating element comprises a needle and / or catheter having a length of O. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having a size of 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having a length O. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween.

[0021] In certain embodiments, when the retraction elements are closed, the anchor may have a maximum radius of 1mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween.

[0022] In certain embodiments, the anchor may be capable of deployment of retraction elements equal to or greater than 0.5cm, 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm, 10cm, and any range therebetween, in length.

[0023] In certain embodiments, the string comprises a nonflexible and / or flexible string. In certain embodiments, the string may be comprised of one or more natural fibers, oneor more synthetic fibers, one or more metals, or a combination thereof. In certain embodiments, the natural fiber string may be comprised of linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof. In certain embodiments, the synthetic fiber string may be comprised of polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof. In certain embodiments, the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

[0024] In certain embodiments, the string guide comprises a needle coupled to the line element. In certain embodiments, the needle is a suture needle.

[0025] In certain embodiments, the anchor comprises one or more medial grade plastics and / or one or more medical grade metals. In certain embodiments, the medical grade plastic may be comprised of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof. In certain embodiments, the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

[0026] In certain embodiments, the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof. In certain embodiments, the anchor comprises a gripping surface. In certain embodiments, the gripping surface comprises of spikes, bumps, gripping material, or a combination thereof.

[0027] In certain embodiments, the anchor further comprises a retraction element coupled to the anchor by a hinge. In certain embodiments, the retraction element may be comprised of a flexible material. In certain embodiments, the retraction element comprises a configuration for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor. In certain embodiments, the retraction element comprises a gripping surface. In certain embodiments, the retraction element extension gripping surface comprises spikes, bumps, gripping material, or a combination thereof.

[0028] In certain embodiments, the anchor comprises a string guide placement mechanism. In certain embodiments, the string guide placement mechanism comprises of a tube that extends through the length of the anchor. In certain embodiments, the tube comprisesslitted length along the dorsal portion of the anchor. In certain embodiments, the size of the slitted length comprises a gap wide enough to pass string, but not the string guide. In certain embodiments, the entrance to the string guide placement mechanism comprises a funneled entrance. In certain embodiments, the string guide placement mechanism comprises an attractive element. In certain embodiments, the tube’s attractive element comprises a magnet.

[0029] In certain embodiments, the anchor comprises a string guide placement locking mechanism. In certain embodiments, the string guide placement locking mechanism comprises a needle plunger. In certain embodiments, the needle plunger is positioned on a lifting element. In certain embodiments, the lifting element comprises a spring placed on a base element.

[0030] In certain embodiments, the line element retraction fixture comprises one or more metals and / or one or more plastics. In certain embodiments, the metal line element retraction fixture comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof. In certain embodiments, the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.III. Methods of the Disclosure

[0031] The present disclosure is directed to methods for providing surgical access using a novel tissue-piercing retraction mechanism. In certain embodiments, the method comprises one or more steps of: inserting a penetrating element comprising a hollow lumen and an open tip into a surgical site; positioning an anchor coupled to a line element inside the hollow lumen; advancing the anchor and the line element into the surgical site; deploying the anchor; removing the piercing element of the tissue-piercing retraction device from the patient; applying traction to the surgical site via a force on the anchor through the line element.

[0032] In certain embodiments, the method comprises one or more steps of: preparing a patient for surgery; preparing a device; inserting the device; applying traction to the device. In certain embodiments, the method comprises one or more steps of: preparing a patient for surgery; preparing a device for insertion by at least fixing a string to the device and loading the device into an insertion mechanism; preparing the tissue to receive the device; inserting the device through the tissue into the surgical area at the desired point of traction via the insertion mechanism; applying traction to the string attached to the device to enable the device to gainpurchase on the underside of the tissue; apply traction to the device via the string to retract the tissue; secure the string to a fixed point to ensure constant consistent traction to the tissue thereby increasing the surgical space.

[0033] In certain embodiments, the method comprises one or more steps of: preparing a patient for surgery; preparing the device for patient insertion; insert the device; insert a line element; insert the line element into the device; apply traction to the device; secure the line element. In certain embodiments, the method comprises one or more steps of: preparing a patient for surgery; preparing the device for insertion by at least loading the device into an insertion mechanism; preparing the tissue to receive the device; inserting the device via the insertion mechanism into the surgical area through a surgical port; inserting a suture needle with attached suture through the tissue at the point of desired traction; after the needle has passed through the tissue, insert the suture needle into the device positioned within the surgical area via laparoscopic techniques; apply traction to the suture to enable the device to gain purchase on the underside of the tissue; apply traction to the device to retract the tissue; secure the suture to a fixed point to ensure constant consistent traction to the tissue thereby increasing the surgical space.

[0034] In certain embodiments, the penetrating element comprises a hypodermic needle, catheter, trocar, etc. In certain embodiments, the penetrating element comprises a needle and / or catheter having a size of 6G, 7G, 8G, 9G, 10G, 11G, 12G, 13G, 14G, 15G, 16G, 17G, 18G, 19G, 20G, 21G, 22G, 23G, 24G, 25G, 26G, 27G, 28G, 29G, 30G, 31G, 32G, 33G, 34G, and any range therebetween. In certain embodiments, the penetrating element comprises a needle and / or catheter having a length of O. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having a size of 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, , 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween. In certain embodiments, the penetrating element comprises a trocar having a length of 0. lin, lin, 2in, 3in, 4in, 5in, 6in and any range therebetween.

[0035] In certain embodiments, when the retraction elements are closed, the anchor may have a maximum radius of 1mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm and any range therebetween.

[0036] In certain embodiments, the anchor may be capable of deployment of retraction elements equal to or greater than 0.5cm, 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm, 10cm, and any range therebetween, in length.

[0037] In certain embodiments, the line element is made of a nonflexible and / or flexible string. In certain embodiments, the string further comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof. In certain embodiments, the natural string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof. In certain embodiments, the synthetic string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof. In certain embodiments, the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

[0038] In certain embodiments, the anchor comprises one or more medical grade plastics and / or medical grade metals. In certain embodiments, the medical grade plastic anchor is made of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof. In certain embodiments, the medical grade metal anchor comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

[0039] In certain embodiments, the anchor’s shape comprises round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof. In certain embodiments, the anchor comprises a griping surface. In certain embodiments, the griping surface comprises spikes, bumps, gripping material, or a combination thereof.

[0040] In certain embodiments, the anchor further comprises a retraction element coupled to the anchor by a hinge. In certain embodiments, the retraction element comprises a flexible material. In certain embodiments, the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor. In certain embodiments, the retraction element comprises a gripping surface. In certain embodiments, the retraction element gripping surface comprises spikes, bumps, gripping material, or a combination thereof.

[0041] In certain embodiments, the line element retraction fixture is a long rod shaped post that may anchored to the surgical bed. The string may then be coupled to the post in order to provide constant traction to the surgical site. In certain embodiments, the line element retraction fixture is made of one or more metals and / or one or more plastics. In certain embodiments, the metal line element retraction fixture comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof. In specific embodiment, the plastic line element retraction fixture comprises polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.BRIEF DESCRIPTION OF THE DRAWINGS

[0042] For a more complete understanding of the present disclosure, reference is now made to the following descriptions taken in conjunction with the accompanying drawing, in which.

[0043] FIG. 1 illustrates a front view of one embodiment of an anchor showing a needle entrance including the cylindrical hole, funneled opening, and slitted length along the dorsal portion of the anchor.

[0044] FIG. 2 illustrates a side interior view of one embodiment of an anchor showing an internal perspective view of a cavity in which the locking mechanism for a string guide is housed.

[0045] FIG. 3 illustrates a rear view of one embodiment of an anchor showing an external perspective view of the anchor in which an attractive element is place (such as, but not limited to, a magnet).

[0046] FIG. 4A illustrates an orthogonal view of one embodiment of the needle plunger.

[0047] FIG. 4B illustrates a side interior view of one embodiment of the needle plunger.

[0048] FIG. 5 illustrates an orthogonal view of one embodiment of a base plate.

[0049] FIG. 6 illustrates a side interior view of one embodiment of the string guide placement locking mechanism and base plate.

[0050] FIG. 7A illustrates an external perspective view of one embodiment of the string guide placement mechanism.

[0051] FIG. 7B illustrates a side interior view of one embodiment of a string guide placement mechanism.

[0052] FIG. 8A illustrates one embodiment of a string guide placement mechanism and needle plunger.

[0053] FIG. 8B illustrates one embodiment of the complete anchor delivery system with an internal perspective view of one embodiment of the needle plunger and the string guide placement mechanism.

[0054] FIG. 9 illustrates step by step use of one embodiment of the complete anchor delivery system.

[0055] It is to be understood that the figures are not necessarily drawn to scale, nor are the objects in the figures necessarily drawn to scale in relationship to one another. The figures are depictions that are intended to bring clarity and understanding to various embodiments of apparatuses, systems, and methods disclosed herein. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. Moreover, it should be appreciated that the drawings are not intended to limit the scope of the present teachings in any way.DETAILED DESCRIPTIONI. Example Description of Terms

[0056] As used herein, the terms “proximal” and “distal” are used with reference to an operator (e.g., doctor, nurse, technician) such that a proximal side refers to the side closer to the operator and a distal side refers to the side away from the operator. For example, a blade end of a knife used by a surgeon to create an incision in a patient's body is the distal end, while a handle end held by the doctor would be the proximal end.

[0057] As used herein, the term “hollow cylindrical configuration” refers to an cylinder with a hollow cylindrical channel, also known as an open cylinder, coaxial cylinder, or hollow tube.

[0058] As used herein, the term “diameter of dilation” refers to the diameter of a circle defined by the tips of the dilator petal assembly in the open position.

[0059] While the present teachings are described in conjunction with various embodiments, it is not intended that the present teachings be limited to such various embodiments. On the contrary, the present teachings encompass various alternatives, modifications, and equivalents, as will be appreciated by those of skill in the art.

[0060] As used herein the specification, “a” or “an” may mean one or more. As used herein in the claim(s), when used in conjunction with the word “comprising,” the words “a” or “an” may mean one or more than one. Some embodiments of the disclosure may consist of or consist essentially of one or more elements, method steps, and / or methods of the disclosure. It is contemplated that any method or composition described herein may be implemented with respect to any other method or composition described herein and that different embodiments may be combined.

[0061] In describing the various embodiments, the specification may have presented a method and / or process as a particular sequence of steps. However, to the extent that the method or process does not rely on the particular order of steps set forth herein, the method or process should not be limited to the particular sequence of steps described, and one skilled in the art can readily appreciate that the sequences may be varied and still remain within the spirit and scope of the various embodiments.

[0062] As used herein, the phrase “at least one of,” when used with a list of items, means different combinations of one or more of the listed items may be used and only one of the items in the list may be needed. The item may be a particular object, thing, step, operation, process, or category. In other words, “at least one of’ means any combination of items or number of items may be used from the list, but not all of the items in the list may be required. For example, without limitation, “at least one of item A, item B, or item C” means item A; item A and item B; item B; item A, item B, and item C; item B and item C; or item A and C. In some cases, “at least one of item A, item B, or item C” means, but is not limited to, two of itemA, one of item B, and ten of item C; four of item B and seven of item C; or some other suitable combination.

[0063] The use of the term “or” in the claims is used to mean “and / or” unless explicitly indicated to refer to alternatives only or the alternatives are mutually exclusive, although the disclosure supports a definition that refers to only alternatives and “and / or.” For example, “x, y, and / or z” can refer to “x” alone, “y” alone, “z” alone, “x, y, and z,” “(x and y) or z,” “x or (y and z),” or “x or y or z.” It is specifically contemplated that x, y, or z may be specifically excluded from an embodiment. As used herein “another” may mean at least a second or more.

[0064] Throughout this specification, unless the context requires otherwise, the words “comprise”, “comprises” and “comprising” will be understood to imply the inclusion of a stated step or element or group of steps or elements but not the exclusion of any other step or element or group of steps or elements. Further, the words “comprising” (and any form of comprising, such as “comprise” and “comprises”), “having” (and any form of having, such as “have” and “has”), “including” (and any form of including, such as “includes” and “include”), “characterized by” (and any form of including, such as “characterized as”), or “containing” (and any form of containing, such as “contains” and “contain”) are inclusive or open-ended and do not exclude additional, unrecited elements or method steps. By “consisting of’ is meant including, and limited to, whatever follows the phrase “consisting of.” Thus, the phrase “consisting of’ indicates that the listed elements are required or mandatory, and that no other elements may be present. By “consisting essentially of’ is meant including any elements listed after the phrase, and limited to other elements that do not interfere with or contribute to the activity or action specified in the disclosure for the listed elements. Thus, the phrase “consisting essentially of’ indicates that the listed elements are required or mandatory, but that no other elements are optional and may or may not be present depending upon whether or not they affect the activity or action of the listed elements.

[0065] Reference throughout this specification to “one embodiment,” “an embodiment,” “a particular embodiment,” “a related embodiment,” “a certain embodiment,” “an additional embodiment,” or “a further embodiment” or combinations thereof means that a particular feature, structure or characteristic described in connection with the embodiment is included in at least one embodiment of the present embodiment. Thus, the appearances of the foregoing phrases in various places throughout this specification are not necessarily allreferring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in various embodiments.II. General Embodiments

[0066] Embodiments of the disclosure include systems and methods useful for the mechanical dilation of a surgical path. In certain embodiments, the surgical path is a central laparoscopic surgical port created and utilized during thyroid or parathyroid removal. In certain embodiments, a device may create and / or be inserted into an initial surgical path while in the closed state and then the device may be opened to dilate the surrounding tissue into the desired diameter. In certain embodiments, the device may be retracted from the initial surgical path while in the expanded state to dilate the surgical path as the device passes back out of the tissue.

[0067] There are multiple areas of the body that may benefit from dilation of a surgical path by such a device. The device is designed so that it is agnostic to tissue type, thus the device may be used to create, expand, and / or dilate any bodily organ or tissue that requires dilation. Non-limiting examples of specific tissues and organs include: any luminal organ and their junctions such as the esophagus, stomach, duodenum, small intestine, large intestine, rectum or anus; blood vessels such as peripheral veins and arteries, central veins and arteries, or coronary veins and arteries; genitourinary organs and tissues such as the ureters, bladder, and urethra; fascia and fascial planes such as the chin or neck fascia and fascial planes, abdominal wall fascia and fascial planes, fascia and fascial planes of the extremities; and skin, soft tissue, muscle, and subcutaneous tissue such as the tissues of the neck, abdominal wall, chest wall or limbs.

[0068] The anchor may be long and narrow in order to be capable of exerting large, consistently applied forces while being capable of laparoscopic delivery to the surgical site. In certain embodiments, the anchor shape comprises but is not limited to, a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof. Such shapes may allow for strong mechanical force to be exerted by the surgical user and experienced by the device.

[0069] In certain embodiments, the anchor is covered in a griping surface. The griping surface may be any suitable surface including bumps, gripping material, or small spikes the enable the anchor to grip the surrounding tissue and with stand traction being applied without passing out of the tissue at the surgical site. Such anchor outer coverings may ensure the anchorcouples well to the surgical tissue without slipping when a retractive force is applied to the anchor thereby maximizing the expansion of the surgical space to facilitate extraction of a thyroid.

[0070] In certain embodiments, the anchor, has retraction elements fixed to the outer sides of it. In certain embodiments, when the retraction elements are closed, the anchor may have a maximum radius of 20 millimeters (an adequate size for insertion). In certain embodiments, the anchor may be capable of deployment of retraction elements equal to or greater than 5 millimeters in length. In certain embodiments, the device, when the retraction elements are open and coupled to the surgical tissue, may increase the coupled surface area between the anchor and the surgical tissue to maximum expansion of the surgical space to facilitate extraction of a thyroid.

[0071] In certain embodiments, the anchor comprises one or more medial grade plastics and / or medical grade metals. Such non-limiting examples of medical grade plastic include polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof. Examples of medical grade metals, include but are not limited to stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

[0072] In certain embodiments, the surgical path is made through an epithelial layer, such as the oral mucosa in TES, of the patient via a penetrating element. In certain embodiments, the surgical track is made through connective tissue, such as the chin fascia in TES via a penetrating element. In certain embodiments, the insertion tip of the penetrating element penetrates and expand the tough, thick connective tissue found underneath the chin for use during thyroid or parathyroid removal. In certain embodiments, the penetrating element may be a catheter or hypodermic needle. In certain embodiments, the penetrating element may utilize a sharp insertion tip to create a port. In certain embodiments, the penetrating element may create a central port from 5 millimeters to 20 millimeters in diameter for anchor placement.

[0073] The penetrating element may have an insertion tip with a sharp rigid point at the distal end for precise and easy insertion into tissue. The insertion tip point allows for improved track formation with minimal user force required. In certain embodiments, the insertion tip may be at the distal end of a hypodermic needle. The insertion tip may be up to approximately 1.5mm in diameter and approximately up to six inches in length. In another embodiment, the insertion tip may be at the distal end of a catheter. The catheter may be sized from 5 millimeters to 20 millimeters in diameter and approximately up to six inches in length.

[0074] The proximal end of the insertion tip may taper to a flat edge to allow placement of the delivery plunger within the penetrating element to allow for smooth placement of the anchor. The delivery plunger size may be from 1.4 millimeters to 20 millimeters in diameter to fit snuggly in the penetrating element to enable consistent pressure to be applied to the anchor as the plunger moves through the penetrating element through the insertion tip to the surgical site.

[0075] In certain embodiments, the line element is coupled to the anchor. In certain embodiments, the distal end of the line element may be coupled to the anchor at a point between either end of the anchor. In certain embodiments, the distal end of the line element may be coupled to the proximal end of the anchor. In certain embodiments, the line element may be inserted into the anchor and secured via the needle plunger.

[0076] In certain embodiments, the line element may be made of a flexible string. In certain embodiments, flexible string would enable the user to apply constant traction but retain the flexibility to manipulate the string as needed during the surgery. In certain embodiments, the line element may be made of nonflexible string. In certain embodiments, nonflexible string would provide a rigged material for the surgical user to apply ridged traction along a nonflexible material.

[0077] In certain embodiments, the flexible and / or non-flexible string could be made of suture material. In certain embodiments, the suture could be made of natural fibers, synthetic fibers, or one or more metals. Such nonlimiting examples of natural fiber suture would include linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof. Synthetic fiber suture example may include, but are not limited to, polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof. Metal suture non-limiting examples may include stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

[0078] In certain embodiments, the suture will have a string guide. In certain embodiments, the string guide would be a suture needle. In certain embodiments, the stringwould be secured to the proximal end of the string guide. In certain embodiments, the string guide distal end would tapper to a point. In certain embodiments, the string guide could be a suture needle.

[0079] In certain embodiments, the suture needle could be made medical grade metal or plastic. Such examples of medical grade plastic suture needles may include, but are not limited to, polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof. Medical grade metal suture needle examples may include, but are not limited to, stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

[0080] In certain embodiments, the anchor has a string guide placement mechanism to facilitate placement of the string guide. In certain embodiments, the string guide placement mechanism is a tubular cavity that runs the length of the anchor. In certain embodiments, the string guide placement mechanism has a slit along dorsal side allowing a line element to pass through but not the string guide. In certain embodiments, the entrance to the string guide placement mechanism has a funneled opening on the proximate side to facilitate placement of the string guide within the anchor.

[0081] In certain embodiments, the anchor has a string guide placement locking mechanism. In certain embodiments, the string guide placement locking mechanism is made of a base plate, spring, and needle plunger. In certain embodiments, the base plate sits within the anchor abutting the ventral side of the anchor. In certain embodiments, one end of the spring is coupled to the base plate and the needle plunger on the other end of the spring, thereby applying constant outward force on the needle plunger. In certain embodiments, as the string guide is fed into the proximal funneled entrance hole to the needle plunger, the force from the application of the string guide depresses the needle plunger, depressing the spring, thereby allowing the string guide to pass through the needle plunger. In certain embodiments, once the string guide has passed all the way through the needle plunger, the spring returns to undepressed length, causing the needle plunger to return to its original position. In certain embodiments, in such a position, the string guide will be unable to return through the needle plunger, thereby being secured in place.

[0082] In certain embodiments, once the string guide is locked within the string guide placement locking mechanism, and the anchor is positioned at the surgical site, the surgical user may employ a retractive force creating space at the surgical site. The surgical user may apply traction with the line element by securing the proximal end of the line element around a fix point in the surgical room, or by directly applying traction by hand.

[0083] In certain embodiments, the line element retraction fixture comprises one or more metals and / or one or more plastics. Such non-limiting examples of line element retraction fixture metal materials include, stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof. Examples of plastic line element retraction fixture materials include, but are not limited to, polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

[0084] In certain embodiments, the anchor comprises an attractive element at the distal end. Such an attractive element may be, but is not limited to, a magnet. In certain embodiments, the recovery plunger will have an attractive element. Such an attractive element may be, but is not limited to, a magnet. In certain embodiments, at the conclusion of the surgical event, the recovery plunger may be inserted into the delivery catheter, the magnetic element on the distal end of the recovery plunger will couple with the magnetic element on the distal end of the anchor. The recovery plunger may be removed from the delivery catheter bringing the anchor with it. In certain embodiments, the retraction elements will be automatically retracted as it is pulled through the placement catheter.III. Systems of the Disclosure

[0085] Embodiments of the disclosure include systems and methods useful for the mechanical dilation of a surgical path. Turning to the figures, FIG. 1 illustrates an orthogonal view of one embodiment of the anchor 100. Along the dorsal side of the anchor 100, there is a slitted length 102 to allow the line element to pass through, but not the string guide. At the proximal side of the anchor 100, the anchor has a funneled opening 103 that allows for the entrance of the string guide into the into the central cavity 101 of anchor 100. The anchor 100 may have an outer surface that is smooth 104, bumpy, spiky, and / or be made of a gripping material. A retraction element 105 is positioned on the anchor 100. The retraction element may be smooth, or have bumps, spikes protruding from the retraction element, and / or be made of a gripping material.

[0086] FIG. 2 shows a side interior view of one embodiment of the anchor. The anchor has a string guide placement locking mechanism cavity 203 in which the string guide placement locking mechanism is housed. There is a lip 201 present in the string guide placement locking mechanism cavity 203 to limit the upward movement of the string guide placement locking mechanism. The base plate is positioned within the anchor base plate cavity 202 located within the anchor on the ventral side.

[0087] FIG. 3 displays the rear view of the anchor. In some embodiments, at the distal end of the anchor, there is attractive element cavity 301 in which an attractive element, such as, but not limited to a magnet, may be positioned.

[0088] FIG. 4A and FIG. 4B illustrates the needle plunger 400. FIG. 4A demonstrates an orthogonal view of the needle plunger 400 which will be positioned within the string guide placement locking mechanism interior cavity 203 noted in FIG. 2. The groove 401 on the top portion of the needle plunger 400 will receive the line element. The needle plunger lip 402 will catch the lip within the string guide placement locking mechanism interior cavity 203. FIG. 4B denotes a side interior view of the needle plunger 400 showing the spring cavity 403.

[0089] FIG. 5 presents an orthogonal view of the base plate 500. The base plate 500 is positioned at the base of the string guide placement locking mechanism interior cavity 203 noted in FIG. 2. Base plate spring location 501 is located in the central portion of the base plate 500.

[0090] FIG. 6 displays an assemble view of the elements within string guide placement locking mechanism interior cavity 203 show in FIG. 2. FIG. 6 illustrates the positioning of the needle plunger 400, base plate 500, and spring 603 within the locking mechanism interior cavity 203. The base plate 500, is at the base of the locking mechanism interior cavity 203. The spring 603 is located at the base plate spring location 501, and received by the spring cavity 403 of the needle plunger 400 shown in FIG. 4A.

[0091] FIG. 7 A and FIG. 7B illustrates a catheter 701 used to deliver the anchor. The anchor may be placed in the distal end 702 of the catheter. The anchor is positioned within the anchor catheter cavity 704. A plunger may be inserted into the plunger catheter cavity 705 and may pass into the anchor catheter cavity 704. The catheter attractive element cavity 703 may hold an attractive element, such as but not limited to a magnet.

[0092] FIG. 8A and FIG. 8B show the plunger 801. The surgical user may apply force to the plunger at plunger cylindrical face 803. The plunger shaft 801 fits snuggly within the plunger catheter cavity 705.

[0093] FIG. 9 demonstrates one embodiment where the skin is punctured with a hallow 18G needle 901. The Puncture is advanced through the tissue layers including the strap muscle 902. The “T” shaped anchor is deployed through the needle 903. The needle is retracted 904. Skin is retracted by applying traction outside the body 905.

[0094] One non-limiting example includes a situation where a medical practitioner is preparing a surgical space in anticipation of a partial thyroidectomy. In some embodiments, surgical ports are inserted into an oral vestibule, located between a lower lip and gums, to advance laparoscopic surgical instruments into the space above the windpipe. The surgeon may prepare an anchoring system by (1) placing an anchor 100 within an anchor catheter cavity 704 on the distal end of a catheter 701 and (2) placing a plunger 801 into the plunger catheter cavity 705 on the proximal end of the catheter 701. The surgeon may insert the loaded catheter 701 into the surgical site via the access gained by the surgical ports. Upon the distal end of the catheter 701 gaining access to the surgical site, the surgeon may apply pressure on the plunger 801 thereby expelling the anchor 100 from the anchor catheter cavity 704 into the surgical site. The surgeon may then remove the catheter 701 from the surgical site. The surgeon may next select a location of which she wants to apply traction in order to create more surgical space. The surgeon may advance the suture needle and attached suture through the tissue. The surgeon may apply laparoscopic techniques to direct the suture needle into a funneled opening 103 through a central cavity 101 past a string guide placement locking mechanism cavity 203 of the anchor 100. Once the suture needle is secure within the anchor 100, the surgeon may then apply steady traction to a distal end of the suture which is now affixed to the anchor 100. Such traction will enable retraction elements 105 of the anchor 100 to deploy thereby increasing the contact area of the anchor to underside of the tissue creating a more secure traction point. The distal end of the suture may then be affixed to a post fastened to a surgical bed thereby creating constant traction to the tissue. When traction is no longer needed, the sutures can be cut, and the anchor 100 holding the suture can be removed through a laparoscopic surgical port, using a magnetic tip on the retrieval catheter to attract the anchor 100. In some embodiments, one or more of the enumerated steps may be omitted or performed in a different order.

[0095] One non-limiting example includes a situation where a medical practitioner is preparing a surgical space in anticipation of a parathyroidectomy. In some embodiments, once the patient is prepared for the surgery, a surgeon may insert a suture needle fixed to the proximal end of a suture through a funneled opening 103 into a central cavity 101 of an anchor 100. Once the suture needle passes through a string guide placement locking mechanism cavity 203 and is secured within the anchor 100, the anchor 100 may be placed within an anchor catheter cavity 704 at the distal end of a catheter 701. A plunger 801 may be inserted into a plunger catheter cavity 705 at the proximal end of the catheter 701. The surgeon may apply surigical techniques to insert the catheter 701 through the tissue. Upon gaining access to the surgical site, the surgeon may apply pressure on the plunger 801 causing the plunger 801 to pass into the anchor catheter cavity 704 thereby expelling the anchor 100 into the surgical site. The surgeon may then apply steady traction to the distal end of the suture affixed to the anchor 100 allowing retraction elements 105 of the anchor 100 to deploy. The distal end of the suture may then be affixed to a post fastened to the surgical bed providing constant traction to the tissue. When traction is no longer needed, the sutures can be cut, and the anchor 100 holding the suture can be removed through a surgical port, using a magnetic tip on the retrieval catheter to attract the anchor 100. In some embodiments, one or more of the enumerated steps may be omitted or performed in a different order.

[0096] One non-limiting example includes a situation where a medical practitioner is preparing a surgical space in anticipation of a thyroidectomy. In some embodiments, the surgeon may ensure an anchor 100 is affixed to the distal end of a string and load the anchor into a hollow lumen of a hypodermic needle. After the surgeon has properly prepared the patient for the thyroidectomy, the surgeon may apply two hemostat clamps some short distance apart from each other and retract the tissue from the surgical area creating an anchor 100 insertion site. The surgeon may gain access to the surgical site by penetrating the retracted tissue between the hemostats with the anchor 100 fed hypodermic needle. The surgeon may use the anchor 100 fed hypodermic needle to inject the anchor 100 into the surgical site. The surgeon may then remove the hypodermic needle from the surgical site by passing the needle towards the proximal end of the string. Upon application of traction to the string by the surgeon, the retraction elements 105 of the anchor 100 may deploy. The surgeon may next apply traction to the string retracting the tissue. When traction is no longer needed, the string may be cut, and the anchor 100 may be removed through a surgical port, using a magnetic tip on the retrievalcatheter to attract the anchor 100. In some embodiments, one or more of the enumerated steps may be omitted or performed in a different order.

[0097] Although the present disclosure and its advantages have been described in detail, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the design as defined by the appended claims. Moreover, the scope of the present application is not intended to be limited to the particular embodiments of the process, machine, manufacture, composition of matter, means, methods and steps described in the specification. As one of ordinary skill in the art will readily appreciate from the present disclosure, processes, machines, manufacture, compositions of matter, means, methods, or steps, presently existing or later to be developed that perform substantially the same function or achieve substantially the same result as the corresponding embodiments described herein may be utilized according to the present disclosure. Accordingly, the appended claims are intended to include within their scope such processes, machines, manufacture, compositions of matter, means, methods, or steps.

[0098] Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the appended claims. Moreover, although the foregoing descriptions and the associated drawings describe exemplary embodiments in the context of certain exemplary combinations of elements and / or functions, it should be appreciated that different combinations of elements and / or functions may be provided by alternative embodiments without departing from the scope of the appended claims. In this regard, for example, different combinations of elements and / or functions than those explicitly described above are also contemplated as may be set forth in some of the appended claims. In cases where advantages, benefits or solutions to problems are described herein, it should be appreciated that such advantages, benefits and / or solutions may be applicable to some example embodiments, but not necessarily all example embodiments. Thus, any advantages, benefits or solutions described herein should not be thought of as being critical, required or essential to all embodiments or to that which is claimed herein. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.ASPECTS OF THE DISCLOSUREAspect 1 : What is embodied is: A surgical tissue-piercing retraction system, comprising: a line element; an anchor operatively coupled to the line element, wherein the anchor is providing a surface for contact with a surgical tissue; and a penetrating element having a hollow lumen and an open tip configured for placement and removal of the anchor, wherein the penetrating element is configured to penetrate the surgical tissue, wherein the line element is configured to be coupled to an anchor at a distal end and secured to a line element retraction point at a proximal end during use, and wherein the line element and anchor are configured to traverse the hollow lumen.Aspect 2: The surgical tissue-piercing retraction system of aspect 1, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.Aspect 3: The surgical tissue-piercing retraction system of aspect 1 or 2, wherein the penetrating element comprises a needle having a size between 6G to 34G.Aspect 4: The surgical tissue-piercing retraction system of aspect 1 or 2, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.Aspect 5: The surgical tissue-piercing retraction system of any one of aspects 1 to 4, wherein the line element comprises a nonflexible string.Aspect 6: The surgical tissue-piercing retraction system of any one of aspects 1 to 5, wherein the line element comprises a flexible string.Aspect 7: The surgical tissue-piercing retraction system of aspect 5 or 6, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.Aspect 8: The surgical tissue-piercing retraction system of aspect 7, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.Aspect 9: The surgical tissue-piercing retraction system of aspect 7, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel,polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.Aspect 10: The surgical tissue-piercing retraction system of aspect 7, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.Aspect 11 : The surgical tissue-piercing retraction system of any one of aspects 1 to 10, wherein the anchor comprises one or more medial grade plastics and / or medical grade metals.Aspect 12: The surgical tissue-piercing retraction system of aspect 11, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.Aspect 13: The surgical tissue-piercing retraction system of aspect 11, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.Aspect 14: The surgical tissue-piercing retraction system of any one of aspects 1 to 13, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.Aspect 15: The surgical tissue-piercing retraction system of any one of aspects 1 to 14, wherein the anchor comprises a griping surface.Aspect 16: The surgical tissue-piercing retraction system of aspect 15, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.Aspect 17: The surgical tissue-piercing retraction system of any one of aspects 1 to 16, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.Aspect 18: The surgical tissue-piercing retraction system of aspect 17, wherein the retraction element comprises a flexible material.Aspect 19: The surgical tissue-piercing retraction system of aspect 17 or 18, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.Aspect 20: The surgical tissue-piercing retraction system of aspect 18 or 19, wherein the retraction element comprises a gripping surface.Aspect 21: The surgical tissue-piercing retraction system of aspect 20, wherein the retraction element gripping surface comprises spikes, bumps, gripping material, or a combination thereof.Aspect 22: The method of claim 1, wherein the line element retraction point is established at a stable point.Aspect 23: The method of claim 22, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.Aspect 24. The surgical tissue-piercing retraction system of claim 23, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.Aspect 25: The surgical tissue-piercing retraction system of any one of aspects 1 to 24, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.Aspect 26: The surgical tissue-piercing retraction system of aspect 25, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.Aspect 27: The surgical tissue-piercing retraction system of aspect 25, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.Aspect 28: A method for placing a tissue-piercing retraction device in an individual, comprising: inserting a piercing element comprising a hollow lumen and an open tip into a surgical site; positioning an anchor coupled to a line element inside the hollow lumen; advancing the anchor and the line element into the surgical site; deploying the anchor; removing the piercing element of the tissue-piercing retraction device from the patient; applying traction to the surgical site via a force on the anchor through the line element.Aspect 29: The method of aspect 28, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.Aspect 30: The method of aspect 28 or 29, wherein the penetrating element comprises a needle having a size between 6G to 34G.Aspect 31 : The method of aspect 28 or 29, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.Aspect 32: The method of any one of aspects 28 to 31, wherein the line element comprises a nonflexible string.Aspect 33: The method of any one of aspects 28 to 31, wherein the line element comprises a flexible string.Aspect 34: The method of aspect 32 or 33, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.Aspect 35: The method of aspect 34, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.Aspect 36: The method of aspect 34, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.Aspect 37: The method of aspect 34, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.Aspect 38: The method of any one of aspects 28 to 37, wherein the anchor comprises one or more medial grade plastics and / or one or more medical grade metals.Aspect 39: The method of aspect 38, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.Aspect 40: The method of aspect 38, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.Aspect 41 : The method of any one of aspects 28 to 38, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.Aspect 42: The method of any one of aspects 28 to 41, wherein the anchor comprises a griping surface.Aspect 43: The method of aspect 42, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.Aspect 44: The method of any one of aspects 28 to 43, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.Aspect 45: The method of aspect 44, wherein the retraction element compromises of a flexible material.Aspect 46: The method of aspect 44 or 45, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.Aspect 47: The method of aspect 45 or 46, wherein the retraction element comprises a gripping surface.Aspect 48: The method of aspect 47, wherein the retraction element gripping surface comprise spikes, bumps, gripping material, or a combination thereof.Aspect 49: The method of any one of aspects 28 to 48, wherein a line element retraction point is established at a stable point.Aspect 50: The method of aspect 49, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.Aspect 51 : The method of aspect 50, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.Aspect 52: The method of any one of aspects 28 to 51, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.Aspect 53: The method of aspect 52, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.Aspect 54: The method of aspect 52, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.Aspect 55: A surgical tissue-piercing retraction system, comprising: a line element; an anchor comprising a site capable of being operatively connected to the line element; a retraction element coupled to the line element; and a penetrating element having a hollow lumen and an open tip configured for placement of the anchor, wherein the anchor is configured to provide a surface for contact with a surgical tissue, wherein the anchor and line element are configured to traverse the hollow lumen.Aspect 56: The surgical tissue-piercing retraction system of aspect 55, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.Aspect 57: The surgical tissue-piercing retraction system of aspect 55 or 56, wherein the penetrating element comprises a needle having a size between 6G to 34G.Aspect 58: The surgical tissue-piercing retraction system of aspect 55 or 56, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.Aspect 59: The surgical tissue-piercing retraction system of any one of aspects 55 to 58, wherein the line element comprises of a string and a string guide.Aspect 60: The surgical tissue-piercing retraction system of aspect 59, wherein the string comprises a nonflexible string.Aspect 61 : The surgical tissue-piercing retraction system of aspect 59, wherein the string comprises a flexible string.Aspect 62: The surgical tissue-piercing retraction system of aspect 60 or 61, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.Aspect 63 : The surgical tissue-piercing retraction system of aspect 62, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.Aspect 64: The surgical tissue-piercing retraction system of aspect 62, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.Aspect 65: The surgical tissue-piercing retraction system of aspect 62, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.Aspect 66: The surgical tissue-piercing retraction system of aspect 59, wherein the string guide comprises of a needle coupled to the line element.Aspect 67: The surgical tissue-piercing retraction system of aspect 66, wherein the needle is a suture needle.Aspect 68: The surgical tissue-piercing retraction system of any one of aspects 55 to 67, wherein the anchor comprises one or more medial grade plastics and / or one or more medical grade metals.Aspect 69: The surgical tissue-piercing retraction system of aspect 68, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.Aspect 70: The surgical tissue-piercing retraction system of aspect 68, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.Aspect 71 : The surgical tissue-piercing retraction system of any one of aspects 55 to 70, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.Aspect 72: The surgical tissue-piercing retraction system of any one of aspects 55 to 71, wherein the anchor comprises a griping surface.Aspect 73: The surgical tissue-piercing retraction system of aspect 72, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.Aspect 74: The surgical tissue-piercing retraction system of any one of aspects 55 to 73, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.Aspect 75: The surgical tissue-piercing retraction system of aspect 74, wherein the retraction element comprises of a flexible material.Aspect 76: The surgical tissue-piercing retraction system of aspect 74 or 75, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.Aspect 77: The surgical tissue-piercing retraction system of aspect 75 or 76, wherein the retraction element comprises a gripping surface.Aspect 78: The surgical tissue-piercing retraction system of aspect 77, wherein the retraction element extension gripping surface comprise spikes, bumps, gripping material, or a combination thereof.Aspect 79: The surgical tissue-piercing retraction system of any one of aspects 55 to 78, wherein the anchor has a string guide placement mechanism.Aspect 80: The surgical tissue-piercing retraction system of aspect 79, wherein the string guide placement mechanism comprises of a tube that extends through the length of the anchor.Aspect 81 : The surgical tissue-piercing retraction system of aspect 80, wherein the tube has a slitted length along the top portion.Aspect 82: The surgical tissue-piercing retraction system of aspect 81, wherein the size of the slitted length comprises a gap wide enough to pass string, but not the string guide.Aspect 83: The surgical tissue-piercing retraction system of any one of aspects 79 to 82, wherein the entrance to the string guide placement mechanism comprises a funneled entrance.Aspect 84: The surgical tissue-piercing retraction system of aspect 79, wherein the string guide placement mechanism has an attractive element.Aspect 85: The surgical tissue-piercing retraction system of aspect 84, wherein the tube’s attractive element contains a magnet.Aspect 86: The surgical tissue-piercing retraction system of any one of aspects 55 to 85, wherein the anchor comprises a string guide placement locking mechanism.Aspect 87: The surgical tissue-piercing retraction system of aspect 86, wherein the string guide placement locking mechanism comprises a needle plunger.Aspect 88: The surgical tissue-piercing retraction system of aspect 87, wherein the needle plunger is positioned on a lifting element.Aspect 89: The surgical tissue-piercing retraction system of aspect 88, wherein the lifting element comprises a spring placed on a base element.Aspect 90: The surgical tissue-piercing retraction system of aspect 55, wherein the line element retraction point is established at a stable point.Aspect 91 : The method of claim 90, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.Aspect 92. The surgical tissue-piercing retraction system of claim 91, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.Aspect 93: The surgical tissue-piercing retraction system of any one of aspects 55 to 89, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.Aspect 94: The surgical tissue-piercing retraction system of aspect 93, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.Aspect 95: The surgical tissue-piercing retraction system of aspect 94, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene,polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

Claims

CLAIMSWhat is claimed is:

1. A surgical tissue-piercing retraction system, comprising: a line element; an anchor operatively coupled to the line element, wherein the anchor is providing a surface for contact with a surgical tissue; and a penetrating element having a hollow lumen and an open tip configured for placement and removal of the anchor, wherein the penetrating element is configured to penetrate the surgical tissue, wherein the line element is configured to be coupled to an anchor at a distal end and secured to a line element retraction point at a proximal end during use, and wherein the line element and anchor are configured to traverse the hollow lumen.

2. The surgical tissue-piercing retraction system of claim 1, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.

3. The surgical tissue-piercing retraction system of claim 1, wherein the penetrating element comprises a needle having a size between 6G to 34G.

4. The surgical tissue-piercing retraction system of claim 1, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.

5. The surgical tissue-piercing retraction system of claim 1, wherein the line element comprises a nonflexible string.

6. The surgical tissue-piercing retraction system of claim 1, wherein the line element comprises a flexible string.

7. The surgical tissue-piercing retraction system of claim 5, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.

8. The surgical tissue-piercing retraction system of claim 7, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.

9. The surgical tissue-piercing retraction system of claim 7, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.

10. The surgical tissue-piercing retraction system of claim 7, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

11. The surgical tissue-piercing retraction system of claim 1, wherein the anchor comprises one or more medial grade plastics and / or medical grade metals.

12. The surgical tissue-piercing retraction system of claim 11, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

13. The surgical tissue-piercing retraction system of claim 11, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

14. The surgical tissue-piercing retraction system of claim 1, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.

15. The surgical tissue-piercing retraction system of claim 1, wherein the anchor comprises a griping surface.

16. The surgical tissue-piercing retraction system of claim 15, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.

17. The surgical tissue-piercing retraction system of claim 1, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.

18. The surgical tissue-piercing retraction system of claim 17, wherein the retraction element comprises a flexible material.

19. The surgical tissue-piercing retraction system of claim 17, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.

20. The surgical tissue-piercing retraction system of claim 18, wherein the retraction element comprises a gripping surface.

21. The surgical tissue-piercing retraction system of claim 20, wherein the retraction element gripping surface comprises spikes, bumps, gripping material, or a combination thereof.

22. The method of claim 1, wherein the line element retraction point is established at a stable point.

23. The method of claim 22, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.

24. The surgical tissue-piercing retraction system of claim 23, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.

25. The surgical tissue-piercing retraction system of claim 1, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.

26. The surgical tissue-piercing retraction system of claim 25, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.

27. The surgical tissue-piercing retraction system of claim 25, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene,polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

28. A method for placing a tissue-piercing retraction device in an individual, comprising: inserting a piercing element comprising a hollow lumen and an open tip into a surgical site; positioning an anchor coupled to a line element inside the hollow lumen; advancing the anchor and the line element into the surgical site; deploying the anchor; removing the piercing element of the tissue-piercing retraction device from the patient; applying traction to the surgical site via a force on the anchor through the line element.

29. The method of claim 28, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.

30. The method of claim 28, wherein the penetrating element comprises a needle having a size between 6G to 34G.

31. The method of claim 28, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.

32. The method of claim 28, wherein the line element comprises a nonflexible string.

33. The method of claims 28, wherein the line element comprises a flexible string.

34. The method of claim 28, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.

35. The method of claim 34, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.

36. The method of claim 34, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.

37. The method of claim 34, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

38. The method of claims 28, wherein the anchor comprises one or more medial grade plastics and / or one or more medical grade metals.

39. The method of claim 38, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

40. The method of claim 38, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

41. The method of claim 28, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.

42. The method of claim 28, wherein the anchor comprises a griping surface.

43. The method of claim 42, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.

44. The method of claim 28, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.

45. The method of claim 44, wherein the retraction element compromises of a flexible material.

46. The method of claim 44, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.

47. The method of claim 45, wherein the retraction element comprises a gripping surface.

48. The method of claim 47, wherein the retraction element gripping surface comprise spikes, bumps, gripping material, or a combination thereof.

49. The method of claim 28, wherein a line element retraction point is established at a stable point.

50. The method of claim 49, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.

51. The method of claim 50, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.

52. The method of claim 50, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.

53. The method of claim 52, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.

54. The method of claim 52, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

55. A surgical tissue-piercing retraction system, comprising: a line element; an anchor comprising a site capable of being operatively connected to the line element; a retraction element coupled to the line element; and a penetrating element having a hollow lumen and an open tip configured for placement of the anchor, wherein the anchor is configured to provide a surface for contact with a surgical tissue, wherein the anchor and line element are configured to traverse the hollow lumen.

56. The surgical tissue-piercing retraction system of claim 55, wherein the penetrating element comprises a hypodermic needle, catheter, or trocar.

57. The surgical tissue-piercing retraction system of claim 55, wherein the penetrating element comprises a needle having a size between 6G to 34G.

58. The surgical tissue-piercing retraction system of claim 55, wherein the penetrating element comprises a trocar having a size between 5mm to 20mm.

59. The surgical tissue-piercing retraction system of claim 55, wherein the line element comprises a string and a string guide.

60. The surgical tissue-piercing retraction system of claim 59, wherein the string comprises a nonflexible string.

61. The surgical tissue-piercing retraction system of claim 59, wherein the string comprises a flexible string.

62. The surgical tissue-piercing retraction system of claim 59, wherein the string comprises one or more natural fibers, one or more synthetic fibers, one or more metals, or a combination thereof.

63. The surgical tissue-piercing retraction system of claim 62, wherein the natural fiber string comprises linen flax, hemp, cotton, hair, tendons, arteries, muscle strips and nerves, silk, catgut, plain gut, chromic gut, or a combination thereof.

64. The surgical tissue-piercing retraction system of claim 62, wherein the synthetic fiber string comprises polytetrafluoroethylene, polypropylene, polyester, stainless steel, polyglycolic acid, rapid polyglycolic acid, polyglycolide-co-caprolactone, polydioxanone, or a combination thereof.

65. The surgical tissue-piercing retraction system of claim 62, wherein the metal string comprises stainless steel, tantalum, silver wire, coper wire, aluminum wire, vitallium, piano wire, or a combination thereof.

66. The surgical tissue-piercing retraction system of claim 59, wherein the string guide comprises of a needle coupled to the line element.

67. The surgical tissue-piercing retraction system of claim 66, wherein the needle is a suture needle.

68. The surgical tissue-piercing retraction system of claims 55, wherein the anchor comprises one or more medial grade plastics and / or one or more medical grade metals.

69. The surgical tissue-piercing retraction system of claim 68, wherein the medical grade plastic comprises of polycarbonates, polypropylene, polyethylene, polyvinylchloride,acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

70. The surgical tissue-piercing retraction system of claim 68, wherein the medical grade metal comprises stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, iridium, tantalum, or a combination thereof.

71. The surgical tissue-piercing retraction system of claim 55, wherein the anchor comprises of a round bar, a flat bar, a circle, a cross shape, “T” shape, a mesh shaped, or a combination thereof.

72. The surgical tissue-piercing retraction system of claims 55, wherein the anchor comprises a griping surface.

73. The surgical tissue-piercing retraction system of claim 72, wherein the griping surface comprises of spikes, bumps, gripping material, or a combination thereof.

74. The surgical tissue-piercing retraction system of claim 72, wherein the anchor further comprises a retraction element coupled to the anchor by a hinge.

75. The surgical tissue-piercing retraction system of claim 74, wherein the retraction element comprises of a flexible material.

76. The surgical tissue-piercing retraction system of claim 74, wherein the retraction element is configured for deployment from the anchor such that the retraction element is substantially perpendicular to the anchor.

77. The surgical tissue-piercing retraction system of claim 75, wherein the retraction element comprises a gripping surface.

78. The surgical tissue-piercing retraction system of claim 77, wherein the retraction element extension gripping surface comprise spikes, bumps, gripping material, or a combination thereof.

79. The surgical tissue-piercing retraction system of claims 55, wherein the anchor has a string guide placement mechanism.

80. The surgical tissue-piercing retraction system of claim 79, wherein the string guide placement mechanism comprises of a tube that extends through the length of the anchor.

81. The surgical tissue-piercing retraction system of claim 80, wherein the tube has a slitted length along the top portion.

82. The surgical tissue-piercing retraction system of claim 81, wherein the size of the slitted length comprises a gap wide enough to pass string, but not the string guide.

83. The surgical tissue-piercing retraction system of claim 79, wherein the entrance to the string guide placement mechanism comprises a funneled entrance.

84. The surgical tissue-piercing retraction system of claim 79, wherein the string guide placement mechanism has an attractive element.

85. The surgical tissue-piercing retraction system of claim 84, wherein the tube’s attractive element contains a magnet.

86. The surgical tissue-piercing retraction system of claim 55, wherein the anchor comprises a string guide placement locking mechanism.

87. The surgical tissue-piercing retraction system of claim 86, wherein the string guide placement locking mechanism comprises a needle plunger.

88. The surgical tissue-piercing retraction system of claim 87, wherein the needle plunger is positioned on a lifting element.

89. The surgical tissue-piercing retraction system of claim 88, wherein the lifting element comprises a spring placed on a base element.

90. The surgical tissue-piercing retraction system of claim 55, wherein the line element retraction point is established at a stable point.

91. The surgical tissue-piercing retraction system of claim 90, wherein the stable point is established by manual constant traction, or by securing the line element to a line element retraction fixture.

92. The surgical tissue-piercing retraction system of claim 91, wherein the line element retraction fixture is attached to the surgical bed, or other surgical tool fixed to the surgical bed.

93. The surgical tissue-piercing retraction system of claims 55, wherein the line element retraction fixture comprises one or more metals and / or one or more plastics.

94. The surgical tissue-piercing retraction system of claim 93, wherein the metal line element retraction fixture comprises of stainless steel, copper, titanium, cobalt chrome, aluminum, magnesium, gold, platinum, silver, Iridium, tantalum, or a combination thereof.

95. The surgical tissue-piercing retraction system of claim 94, wherein the plastic line element retraction fixture comprises a polycarbonate, polypropylene, polyethylene, polyvinylchloride, acrylonitrile butadiene styrene, polystyrene, polyethylene terephthalate glycol, polymethyl methacrylate, or a combination thereof.

Images