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An air gap retractor illumination system includes any suitable retractor with a channel in the blade to accommodate an air gap illuminator. The illuminator is preferably made from a suitable light conducting plastic material. The illuminator has active portions in which light passes and inactive or

An air gap retractor illumination system includes any suitable retractor with a channel in the blade to accommodate an air gap illuminator. The illuminator is preferably made from a suitable light conducting plastic material. The illuminator has active portions in which light passes and inactive or dead zones in which light does not pass. The illuminator is formed to have an air gap surrounding any active portion of the illuminator extending from the light input to the light output portion. The dead zones may include elements to allow the illuminator to securely engage the retractor. The light output portion of the illuminator contains from two to eight output zones, each zone having specially designed output optical structures that control and direct light to escape the illuminator to shine onto a predetermined area of interest or to form one or more predetermined shapes or footprints.

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1. An illuminated surgical system comprising: a surgical instrument having a front side, a back side, and one or more engagement elements disposed on the surgical instrument,wherein the back side is adapted to engage tissue at a surgical site; andan illuminator having a front surface, a rear surface

1. An illuminated surgical system comprising: a surgical instrument having a front side, a back side, and one or more engagement elements disposed on the surgical instrument,wherein the back side is adapted to engage tissue at a surgical site; andan illuminator having a front surface, a rear surface, a light input portion, a light output portion, and a collar,wherein the illuminator transmits light therethrough by reflection,wherein the illuminator is disposed adjacent the surgical instrument such that the rear surface of the illuminator is disposed adjacent the front side of the surgical instrument, andwherein the one or more engagement elements on the surgical instrument engage the illuminator or the collar so as to maintain a first air gap between the surgical instrument and illuminator, andwherein light is extracted from the light output portion of the illuminator and projected onto a surgical site, andwherein the collar at least partially surrounds the light input portion, and a second air gap is at least partially disposed therebetween, the second air gap disposed at least partially circumferentially around the light input portion. 2. The system of claim 1, wherein the illuminator comprises a plurality of active zones where light is transmitted therethrough by total internal reflection and a plurality of dead zones where total internal reflection does not occur, and wherein the one or more engagement elements on the surgical instrument engage the illuminator in one or more of the plurality of dead zones. 3. The system of claim 1, wherein the one or more engagement elements on the surgical instrument engage the collar. 4. The system of claim 1, wherein the illuminator comprises a plurality of engagement elements for coupling with the one or more engagement elements on the surgical instrument. 5. The system of claim 4, wherein the plurality of engagement elements on the illuminator comprise a retention clip that releasably engages the engagement elements on the surgical instrument. 6. The system of claim 1, wherein the illuminator releasably engages the surgical instrument. 7. The system claim 1, wherein the one or more engagement elements on the surgical instrument comprise a receptacle for receiving a portion of the illuminator. 8. The system of claim 1, wherein the light output portion comprises a plurality of output zones, each zone formed from a plurality of parallel primary facets alternating with a plurality of parallel secondary facets. 9. The system of claim 8, wherein the plurality of primary facets and the plurality of secondary facets are disposed on the front surface of the illuminator. 10. The system of claim 8, wherein the primary facets and the secondary facets of each output zone have different dimensions and are oriented at different angles relative to the rear surface of the illuminator. 11. The system of claim 10, wherein the primary facets and the secondary facets are oriented relative to the rear surface of the illuminator such that the primary facet forms a primary angle relative to the rear surface and the secondary facet forms a secondary angle relative to the rear surface, and wherein at least some of the primary angles are acute. 12. The system of claim 11, wherein at least some of the secondary angles are obtuse. 13. The system of claim 8, wherein each output zone has depth relative to the rear surface of the illuminator, and wherein each depth is the same. 14. The system of claim 1, wherein the illuminator comprises a distal end zone having a rear reflector and a terminal facet. 15. The system of claim 1, wherein the illuminator is uncoated. 16. The system of claim 1, wherein the light input portion comprises a generally cylindrical portion transitioning to a generally rectangular neck portion. 17. The system of claim 1, wherein the front surface of the illuminator is planar. 18. The system of claim 1, further comprising a film or coating disposed on the illuminator. 19. The system of claim 18, wherein the film or coating supports total internal reflection within the illuminator. 20. The system of claim 18, wherein the film or coating extracts light from the illuminator. 21. An illuminated surgical instrument for illuminating a surgical field, the surgical instrument comprising: a surgical instrument adapted to engage tissue, the surgical instrument having one or more engagement receptacles, a proximal portion having a longitudinal axis, a distal portion transverse to the longitudinal axis of the proximal portion and an arcuate connector coupling the proximal and distal portions; andan illuminator shaped to substantially conform to the shape of the surgical instrument and coupled with the surgical instrument with an air gap disposed therebetween, the illuminator comprising a light input portion adapted to receive light from a light source, a light conducting portion, a light output portion having a longitudinal axis and adapted to illuminate the surgical field, and one or more tabbed fingers separated by a gap from the light output portion and adapted to releasably engage the one or more engagement receptacles on the distal portion of the surgical instrument,wherein the light input portion, light conducting portion, and light output portion act as a waveguide, andwherein the light conducting portion conducts light from the light input portion to the light output section by reflection, andwherein reflection does not occur in the one or more tabbed fingers, andwherein the light conducting portion further comprises a curved neck zone and the arcuate connector of the surgical instrument further comprises a curved neck slot for accommodating the curved neck zone so as to maintain an air gap between the light conducting portion and the arcuate connector of the surgical instrument. 22. The surgical instrument of claim 21, wherein the light input portion is transverse to the longitudinal axis of the light output portion. 23. The surgical instrument of claim 21, wherein the thickness of the illuminator tapers from the light input portion to the light output portion. 24. The surgical instrument of claim 21, wherein the light output portion comprises a rectangular cross-section. 25. The surgical instrument of claim 21, wherein the light conducting portion comprises a rectangular cross-section. 26. The surgical instrument of claim 21, wherein the light input portion comprises a generally cylindrical proximal portion transitioning to a generally rectangular neck portion. 27. The surgical instrument of claim 21, wherein the one or more tabbed fingers on the illuminator comprise one or more retention clips. 28. The surgical instrument of claim 27, wherein the one or more tabbed fingers are integrally molded into the illuminator. 29. The surgical instrument of claim 21, wherein the light input portion has an input dead zone where reflection does not occur and an input collar connected to the illuminator in the input dead zone, the collar surrounding the light input portion and forming an input air gap at least partially circumferentially therearound. 30. The surgical instrument of claim 21, wherein the illuminator is uncoated. 31. The surgical instrument of claim 21, wherein the light output portion comprises optical structures that extract light therefrom and control and direct the extracted light to shine onto an area of predetermined shape. 32. The surgical instrument of claim 31, wherein optical structures are molded into the light output portion so as to be integral therewith. 33. The surgical instrument of claim 31, wherein the light output portion comprises a plurality of parallel prism shapes each having a primary facet and a secondary facet. 34. The surgical instrument of claim 33, wherein the primary facets and the secondary facets are oriented relative to a plane substantially parallel to a rear surface of the light output portion such that the primary facet forms a primary angle relative to the plane and the secondary facet forms a secondary angle relative to the plane. 35. The surgical instrument of claim 34, wherein at least some of the primary angles are acute. 36. The surgical instrument of claim 34, wherein at least some of the secondary angles are obtuse. 37. The system of claim 1, wherein the surgical instrument comprises a surgical retractor blade. 38. The illuminated surgical instrument of claim 21, wherein the surgical instrument comprises a surgical retractor blade.