Abstract: Suture passers and methods of use. Described herein are suture passers preloaded with suture, including cartridges that couple to a suture passer to form a loaded suture passer that are configured to prevent a length of suture (e.g., already-passed suture) from re-entering the channel of the suture passer jaw and getting recaptured and/or entangled by the tissue penetrator. In particular, described herein are preloaded and automatically re-loading suture passers that are adapted to include a gate, guide, or shield on one of the jaws of the suture passer, and methods of operating such suture passers for surgical use including repairing tissue.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an inner shaft having a distal end region. A valve implant may be releasably coupled to the distal end region. The valve implant may be capable of shifting between an elongated configuration and an expanded configuration. A post assembly may be disposed along the valve implant. The post assembly may include a release member that is axially slidable along the post assembly. The medical device may also include a rod designed to engage the release member. The rod may be designed to shift the valve implant between the elongated configuration and the expanded configuration. Axially shifting the release member along the post assembly may release the rod from the post assembly and deploy the valve implant.

Abstract: A delivery device for a prosthetic heart valve includes a shaft, a sheath, and a pull wire. The shaft has a proximal end, a distal end, and a longitudinal axis. The sheath is attached to the shaft and is rotatable about an axis transverse to the longitudinal axis of the shaft. The pull wire is mechanically coupled to the sheath such that movement of the pull wire rotates the sheath relative to the shaft. The sheath may be in a first position relative to the shaft when a distal end of the pull wire is in a first position and may be in a second position when the distal end of the pull wire is in a second position. Deflection of the sheath relative to the shaft enables a prosthetic valve to be axially aligned with the native valve annulus for deployment.

Abstract: A guide member configured for guiding a suture passer through a cannula and tissue surrounding the cannula to facilitate closure of an opening in tissue. The guide member includes a guide housing and an elongated guide shaft. The guide housing is configured for releasably engaging the guide member with the cannula and defines an entry aperture. The elongated guide shaft extends distally from the guide housing and defines an annular exterior surface. An exit aperture is defined through the annular exterior surface. The guide member defines a lumen extending from the entry aperture, through the guide housing and the elongated guide shaft, to the exit aperture. The entry aperture, lumen, and exit aperture cooperating to define a passageway extending through the guide member.

Abstract: An endovascular delivery system includes a bifurcated and inflatable prosthesis including a main tubular body having an open end and opposed ipsilateral and contralateral legs defining a graft wall therein between. A tether is disposed securably disposed to the contralateral leg, and the contralateral leg is releasably restrained towards the ipsilateral leg tether to prevent undesirable movement of the contralateral leg. A release wire within the endovascular delivery system releasably retains the tether near the ipsilateral leg.

Abstract: An endovascular prosthesis delivery system is disclosed. The system comprises: an inner cannula; a prosthesis releasably secured to the inner cannula, the prosthesis having a radially-inwardly contracted delivery configuration and a radially-expanded deployed configuration, wherein the prosthesis comprises at least two suture loops secured to an outer surface of the prosthesis and circumferentially spaced from each other; a releasable trigger wire extending along at least a portion of the length of the prosthesis, wherein the releasable trigger wire is wound around at least a portion of the inner cannula and wherein the releasable trigger wire engages at least one of the at least two suture loops to retain the prosthesis in the radially-inwardly contracted delivery configuration.

Abstract: A stent delivery system includes a guide catheter, a tubular stent into which the guide catheter can be inserted, and a tubular pusher catheter into which the guide catheter can be inserted and disposed nearer to a proximal end side than the stent. The pusher catheter includes a diameter expansion-suppressing part provided at a distal end part and having the same inner diameter as the stent and an intermediate part provided at a proximal end side of the diameter expansion-suppressing part and having a bending stiffness less than that of the diameter expansion-suppressing part. When the stent is pushed toward a distal end side by pushing the intermediate part of the pusher catheter toward the distal end side and bringing a distal end part of the diameter expansion-suppressing part into contact with a proximal end part of the stent, an inner diameter of the pusher catheter is prevented from expanding.

Abstract: Forceps include a tubular shaft, an inserted member, a gripping portion, a handle, and a fixing portion. The inserted member is a rod-like member that is inserted inside the tubular shaft and is movable in an axial direction inside the tubular shaft. The gripping portion is provided at a distal end of the inserted member and is coupled to a distal end of the tubular shaft. The handle is coupled to a terminal end of the inserted member. The fixing portion detachably fixes the handle to the tubular shaft in a state where the handle is coupled to the inserted member. The distal end of the tubular shaft has a larger diameter than the diameter of a main body of the tubular shaft. A joint portion, having a smaller diameter than the diameter of the main body of the tubular shaft, is formed at the terminal end of the inserted member. The handle is provided with a joint receptacle that houses the joint portion and is advanced and retracted by manipulation of the handle.

Abstract: An apparatus includes a handle, a cartridge configured to removably couple to the handle, an actuator movably coupled to the handle, and a lock operably coupled to the actuator. A first needle assembly and a second needle assembly of the cartridge are operably coupled to a first coupling portion and a second coupling portion, respectively, of the actuator when the cartridge is coupled to the handle. The first coupling portion is configured to transition the first needle assembly from a first configuration to a second configuration such that a first capture portion engages a first needle. The second coupling portion is configured to transition the second needle assembly from a first configuration to a second configuration such that a second capture portion engages the second needle. The lock is configured to selectively limit movement of the first coupling portion and the second coupling portion.

Abstract: The present invention relates to a minimally invasive surgical instrument implementing a motor. According to one embodiment of the present invention, a minimally invasive surgical instrument comprises a shaft, an end effector connected to one end of the shaft, and a handle unit connected to the other end of the shaft. The handle unit includes a pair of linearly moving members, at least one rotating member for moving the pair of linear moving members away from each other in opposite directions, and a driving element for driving said at least one rotating member. The pair of linearly moving members operates the end effector in the pitch direction or in the yaw direction.

Abstract: A system for delivering an implant including a handle, a trigger, and an actuation assembly. The actuation assembly can include a planet carrier, at least one planet gear operatively coupled to the planet carrier, a sun gear shaft operatively engaged with the planet gear, a ring gear operatively engaged with the planet gear, a first clutch driver, and a second clutch driver. The actuation assembly can be configured to displace the outer tubular member in the proximal direction a distance (d) relative to the handle and to separately move the inner shaft member distally a distance (x) relative to the handle upon deployment of the trigger from a first position to a second position, and move the inner shaft member proximally a distance (y) relative to the handle with no displacement of the outer tubular member upon return of the trigger from the second position to the first position.

Abstract: A system for delivering an implant including a handle, a trigger, and an actuation assembly. The actuation assembly can include a planet carrier, at least one planet gear operatively coupled to the planet carrier, a sun gear shaft operatively engaged with the planet gear, a ring gear operatively engaged with the planet gear, a first clutch driver, and a second clutch driver. The actuation assembly can be configured to displace the outer tubular member in the proximal direction a distance (d) relative to the handle and to separately move the inner shaft member distally a distance (x) relative to the handle upon deployment of the trigger from a first position to a second position, and move the inner shaft member proximally a distance (y) relative to the handle with no displacement of the outer tubular member upon return of the trigger from the second position to the first position.

Abstract: This document provides vascular filtering devices and methods for their use. In some embodiments, the vascular filtering devices include an elongate member having a wall with one or more apertures and a lumen. The vascular filtering devices can also include a porous membrane bag portion with multiple elongate extensions that extend through the apertures of the elongate member and through the lumen of the elongate member, exiting the lumen at the proximal region of the elongate member.

Abstract: In a surgical tool, the treatment tool piece operating joint includes a first operating rotation member which is coupled to the moving member and is rotated around a predetermined rotation center; a second operating rotation member which is coupled to the first operating rotation member so as to relatively rotate around a rotation center coaxial with the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member or around a rotation center that is a position closer to the first bending rotary shaft than the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member; and a link which converts a rotational force of the second operating rotation member into the operation of the treatment tool piece.

Abstract: Suture anchors and associated methods are disclosed having suture locking features able to lock multiple suture ends extending from a body tissue, such as from a bone tunnel, with a single device.

Abstract: Techniques for mesh augmentation and prevention of incisional hernia, including systems and methods for affixing mesh to a fascial incision. A mesh strip can be integrated with one or more uni-directional fasteners. Each fastener can include an anchoring mechanism adapted for affixation to anterior abdominal wall fascia and a mating interface. An applicator can include tension arms adapted to interface with the mating interfaces of the fasteners to maintain a vertical tension of the mesh strip and a handle coupled with the tension arms adapted to spread the tension arms and thereby control a horizontal tension of the mesh strip. The mesh strip can be configured to be aligned over a fascial incision using the applicator and affixed under tension to anterior abdominal wall fascia by tissue penetration of the anchoring mechanisms of the one or more fasteners.

Abstract: A prewire channel stent has a structure that includes a balloon having a metallic mesh material outside the balloon, a central passage inside the balloon, and a second passage disposed between the metallic mesh material and the balloon. The second passage allows a second guidewire to be received therein, and the use of the second guidewire thereby avoids the problem of wire exchange and stent dislodgement in known devices.

Abstract: A tissue puncture closure device includes an anchor, a sealing plug, a compaction member, a suture, a handle portion, a sheath attachment member, and a sheath adapter. The compaction member is configured to compress the sealing plug towards the anchor. The suture is coupled to the sealing plug and anchored. The handle portion is arranged proximal of the sealing plug and anchor. The sheath attachment member extends from the handle portion. The sheath adapter has a first end portion configured to mount to the sheath attachment member, and a second end portion configured to mount to a procedural sheath that is inserted into a tissue puncture.

Abstract: A lancing device includes a lancet body (14) of elongate form and having a sharp tip (16) at the forward end thereof; a drive spring (26) for imparting generally longitudinal movement to the lancet body, and a housing (10) receiving the lancet body and having an aperture (22) in the forward end thereof through which the sharp tip (16) of the lancet body projects in use when the device is fired. The device includes elements (28, 30, 32) for controlling movement of the lancet body (14) to cause the tip of the lancet to execute a lateral movement when it projects from the aperture.

Abstract: The present embodiments provide an endoluminal prosthesis having modular branches, and systems and methods for facilitating deployment of the endoluminal prosthesis. In one example, the endoluminal prosthesis comprises a graft including a bifurcated body of a biocompatible material. The bifurcated body includes distally extending limbs. Limb extensions can be longitudinally and circumferentially adjusted prior to mating with the limbs to enable an “off-the-shelf” prosthesis that can conform to various complex anatomy. When adjusted and mated, fenestrations in the limb extensions can align with branch vessels.