Abstract: A method of suturing patient tissue together is provided. The method comprises positioning a suture placement device adjacent patient tissue, the suture placement device having a body and a suture holder releasably attached on the body the method further comprises actuating the suture placement device, causing the suture placement device to pass an end portion of at least one suture element through patient tissue in response to actuating the suture placement device and causing the end portion of the at least one suture element to be held on the suture holder of the device after the end portion has been passed through the patient tissue. The method further comprises detaching the suture holder from the body of the device while the end portion of the at least one suture element is held thereon. A suture placement device and a suture placement system which can be used in the method of the invention are also provided.

Abstract: Devices, methods, and kits are provided for use with a body duct. More specifically, a device is provided for positioning sutures through a body duct. The device comprises a shaft structure for holding the end of the body duct and a suture organizer mounted about the structure. A plurality of needles are arranged on the shaft structure where each of the needles are advanced along a path in radially outward direction from the shaft structure through the end of the body duct and into a suture organizer. The suture organizer is movable relative to the shaft structure. Preferably, but not necessarily, moving the suture organizer extends the sutures from the body duct. Preferably, after the sutures have been positioned through the body duct, they may be tied off with sutures from a target body duct or tissue, where the tying off of the sutures will join the body duct to the targeted area. The suture organizer can hold the needle and sutures to facilitate the tying off of individual sutures.

Abstract: A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.

Abstract: A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.

Abstract: Devices, methods, and kits are provided for use with a body duct. More specifically, a device is provided for positioning sutures through a body duct. The device comprises a shaft structure for holding the end of the body duct and a suture organizer mounted about the structure. A plurality of needles are arranged on the shaft structure where each of the needles are advanced along a path in radially outward direction from the shaft structure through the end of the body duct and into a suture organizer. The suture organizer is movable relative to the shaft structure. Preferably, but not necessarily, moving the suture organizer extends the sutures from the body duct. Preferably, after the sutures have been positioned through the body duct, they may be tied off with sutures from a target body duct or tissue, where the tying off of the sutures will join the body duct to the targeted area. The suture organizer can hold the needle and sutures to facilitate the tying off of individual sutures.

Abstract: A knot tying device comprises a knotting guide which carries a pair of snare cords. Each snare cord comprises a suture capture end and a pull end. The snare cords are carried within the knotting guide in a loose, knotted configuration. By capturing a pair of free suture ends in the suture capture ends of the snare cords, the knotted configuration originally embodied in the snare cords can be transferred to the free suture ends by pulling those ends through the knotting guide.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture.

Abstract: A device for providing or enhancing hemostasis at a vascular puncture site disposed at the distal end of a tissue tract comprises a shaft having a non-compliant surface at its distal end. The non-compliant surface is oriented at an angle which allows it to lie flat over tissue puncture when the tissue tract is oriented obliquely, e.g., as the result of the Seldinger catheter introduction technique. The device may be used by itself or in combination with suturing of the vascular puncture, where the device enhances hemostasis and prevents blood leakage through the primary suture closure.

Abstract: The present invention provides medical devices and methods for: suturing tissue by proximally drawing sutures through a tissue layer in the proximity of an aperture; suturing vascular tissue while maintaining adequate perfusion or hemostasis, or both; anastomosing a graft to an aperture in a vessel wall while maintaining hemostasis at the anastomosis with physiological flow and/or pressure in the vessel lumen; punching and removing tissue to form an aperture in a vessel wall while maintaining hemostasis at the aperture with physiological flow and/or pressure in the vessel lumen; automatically and repeatably placing suture thread through vessel wall tissue surrounding an aperture in the vessel wall in a suture pattern that is useful for anastomosing a tubular graft to the aperture; and, deploying a suture with one end extending through the tissue that surrounds a punched aperture in a vessel wall and the opposite suture end extending radially through a tubular graft wall adjacent an open end of the graft, such

Abstract: An improved suturing device and method is provided. The suturing device is of the type including a guide body and means on the guide body for translating at least one needle relative to the guide body. The suturing device is improved by providing a rotatable sleeve disposed over at least a distal portion of the guide body to facilitate introduction of the device to a puncture site.

Abstract: An improved suturing device and method is provided. The suturing device is of the type including a guide body and means on the guide body for translating at least one needle relative to the guide body. The suturing device is improved by providing a rotatable sleeve disposed over at least a distal portion of the guide body to facilitate introduction of the device to a puncture site.

Abstract: A suture applying device comprises a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to push the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured on the shaft and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied and the knot pushed back through the tract to complete the closure. Alternatively, a locking fastener formed of a resorbable material can be placed into the penetration over the sutures and the sutures tied over the fastener.

Abstract: A knot pusher comprises a shaft having a fitting at its distal end. The fitting includes a radial slot for receiving a suture length therein. A mechanism is provided for closing the slot so that the suture can be contained within the slot as a knot is advanced over the contained suture length.

Abstract: A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.

Abstract: A suture applying device comprises a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to push the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured on the shaft and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied and the knot pushed back through the tract to complete the closure. Alternatively, a locking fastener formed of a resorbable material can be placed into the penetration over the sutures and the sutures tied over the fastener.

Abstract: A device for providing or enhancing hemostasis at a vascular puncture site disposed at the distal end of a tissue tract comprises a shaft having a non-compliant surface at its distal end. The non-compliant surface is oriented at an angle which allows it to lie flat over tissue puncture when the tissue tract is oriented obliquely, e.g., as the result of the Seldinger catheter introduction technique. The device may be used by itself or in combination with suturing of the vascular puncture, where the device enhances hemostasis and prevents blood leakage through the primary suture closure.

Abstract: A suture-applying device comprises a guide body having a needle guide at its distal end. Needles are reciprocatably carried on a shaft so that they may be advanced through the needle guide and tissue into the guide body. The suturing device is used by placing the needle guide within a vascular puncture. A contact surface is provided on the guide body, and the needle guide is configured so that the vascular wall surrounding the puncture is fully exposed to the needles passing therethrough. The suturing device may be combined with a predilator to form a system for suturing vascular punctures.

Abstract: A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.