Abstract: A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.

Abstract: Vascular closure devices and methods for closing a blood vessel puncture site disposed at a distal end of a tissue tract are described. A combination of the body's own natural mechanism with chemical and/or biological agents is relied upon to accelerate the hemostatic process. Included are steps of introducing a closure device through the tissue tract and deploying an expansible member at a distal end of the device within the blood vessel to occlude the puncture site. A sealing member disposed proximal the expansible member is then displaced by retracting and tensioning a coil spring so as to expose a chemical and/or biological region or release region of the device. The retraction and tensioning of the coil spring is limited by a coupling member. Exposure of blood and tissue to the chemical and/or biological sealing member promotes the clotting processing to accelerate the occlusion process in the tract.

Abstract: The invention relates to a device for the introduction of an implant (1) into blood vessels of the human body, said device comprising an implant (1), a pusher or insertion wire (14), and a tube-like sheathing (13), wherein the implant (1) is capable of being deformed inside a microcatheter in a manner that allows it to assume a shape of reduced diameter and, after omission of such external constraint exerted by the microcatheter, expand at the placement site and adapt to the blood vessel diameter, and wherein the implant (1) being provided at the proximal end with connection elements (6) attaching it to a retaining element (15) by means of which the implant (1) is coupled to the pusher wire (14), and wherein the retaining element (15) is provided with peripheral cutouts (16) into which the connecting elements (6) are fitted, with the tube-like sheathing (13) being drawn in a form-closed manner over the retaining element (15) with fitted connection elements (6) such that the connection elements (6) are secured

Abstract: A surgical instrument includes an elongate body defining a longitudinal axis, an actuation rod extending through the elongate body and a tool assembly coupled to the elongate body. The tool assembly includes a coupling member coupling the tool assembly to the elongate body and a tool portion pivotally associated with the coupling member. The tool portion includes a projection member including a blunt end portion and a cutting member extending distally outward from the projection member. The tool portion is operatively coupled to the actuation rod. Translation of the actuation rod causes pivotal movement of the tool assembly.

Abstract: A loading tool for loading a collapsible prosthetic heart valve into a delivery device may include a body extending in a longitudinal direction between a proximal end and a distal end, an extension on the distal end of the body, and a slot extending through the extension from a free end of the extension toward the distal end of the body. The body may include a lumen extending between the proximal end and the distal end, the body lumen having a first diameter. The extension may have a lumen coaxial with the body lumen, the extension lumen having a second diameter less than the first diameter so as to define a shelf surface between the proximal end of the body and the free end of the extension.

Abstract: Devices, systems and methods for passing a suture. In general, described herein are suturing devices, such as suture passers, as well as methods of suturing tissue. These suture passing devices may include dual deployment suture passers in which a first distal jaw member is moveable at an angle with respect to the longitudinal axis of the elongate body of the device and the second distal jaw member is retractable proximally to the distal end region of the elongate body and/or the first jaw member. Also described herein are suture passers in which the tissue penetrator passing the suture travels in an approximately sigmoidal pathway, with the distal end of the tissue penetrator extending distally from one jaw of the device.

Abstract: Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. In one exemplary embodiment, one or more constructs are disposed on a suture threader, which can be used to associate the construct(s) with a repair suture(s) being used to repair the soft tissue. Tissue augmentation constructs can include various blocks and patches, among other formations. Exemplary methods for manufacturing the tissue augmentation constructs are also provided.

Abstract: A surgical instrument includes a shaft, a force transmission mechanism disposed at a first end of the shaft, an end effector disposed at a second end of the shaft, an actuation element that extends along the shaft from the force transmission mechanism to the end effector, and an actuation element guide extending along the shaft. The actuation element guide defines a lumen in which the actuation element guide is received. The actuation element guide is compressed into a pre-compressed state along at least a portion of an axial length of the shaft. The actuation element guide can be compressed between first and second blocks of the instrument. The instrument can include a flush tube configured to receive a cleaning fluid, with the actuation element guide being in flow communication with the flush tube to receive the cleaning fluid in the lumen of the actuation element guide.

Abstract: Described are embodiments of a multilaminate or multiple layer implantable surgical graft with an illustrative graft comprising a remodelable collagenous sheet material, the graft including one or more interweaving members to stitch together the graft to help prevent the layers from delaminating or separating during handling and the initial stages of remodeling. The interweaving members may comprise lines of suture, thread, individual stitches, strips of material, etc. that are woven through the layers of biomaterial in a desired pattern. In one embodiment, the interweaving members comprise a pharmacologically active substance, such as a drug, growth factors, etc. to elicit a desired biological response in the host tissue. In another embodiment, the graft further comprises a reinforcing material, such as a synthetic mesh, within the layers of remodelable biomaterial and stitched together by one or more interweaving members.

Abstract: A spring suture for primary closure of surgical incisions includes a center spring hingedly connected at each end with surgical tape. In one embodiment, the tape is connected to the center spring through a tape clamp and pin hinge. In another embodiment, the tape is connected to the center spring through welding flanges attached to membrane hinges. In operation, when the spring suture is in place on a wound or incision line, the distal ends of the surgical tape relative to the center spring, in conjunction with the center spring, are adapted to produce closure forces along the incision line that are remote from the incision, enabling such forces to act through the thickness of the skin through shear force transfer and provide closure force at the dermal level of the skin that is initially applied at the epidermal level, thus overcoming the problem of skin inversion at incision line common to skin tapes of the prior art.

Abstract: A method of delivering a collapsible prosthetic heart valve may include providing a delivery device having a catheter assembly and an operating handle. The catheter assembly may include a compartment adapted to receive the valve and a slidable distal sheath. The operating handle may include a housing and first and second lead screws each movable in first and second opposite longitudinal directions. The method may include loading the valve into the compartment and covering the compartment and the valve with proximal and distal segments of the distal sheath. The method may include inserting the catheter assembly into the patient, and partially deploying the valve by moving the first lead screw in the first longitudinal direction. The method may include fully deploying the valve by simultaneously continuing movement of the first lead screw in the first longitudinal direction and moving the second lead screw in the second longitudinal direction.

Abstract: Improved medical suturing devices, systems, and methods for maintaining a position and orientation of a suture needle at a fixed location relative to a suturing device. An exemplary device include a clamp having opposing grasping surfaces for grasping the needle at a first location, and a needle contacting surface for contacting the needle at a second location, the second location a distance axially away from the first location so as to inhibit unintended movement of the needle relative to the device, which may include rotation of the needle about the first location and rotation of the needle about its axis. In many embodiments, the device includes a first and second clamp and a mechanism for alternating grasping of the needle between the first and second clamp. The device may also be incorporated into a single-clamp needle grasping device.

Abstract: Disclosed herein are gender-specific implantable mesh for inguinal hernia repair in a patient, comprising: a fabric layer comprising a side defining a surface area wherein the fabric layer is configured to enable tissue adhesion to said mesh; an anti-adhesive barrier comprising a shape configured to prevent direct contact between the fabric layer and both a spermatic cord and a genital nerve upon implantation, wherein the shape covers a part of the surface area on the side of the fabric layer, the part being less than 25%, and wherein the shape is oblique to a horizontally-oriented centerline and a vertically-oriented centerline; and a keyhole configured to fit the genital nerve and the spermatic cord of the patient therethrough without constriction, wherein the keyhole is oblique and inferior to a horizontally-oriented centerline and medial to a vertically-oriented centerline.

Abstract: Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

Abstract: Medical devices and methods for making and using the same. An example medical device may include an elongate tubular member, an endosurgery stent disposed on the outer surface of the tubular member, a push tube slidably disposed along the outer surface of the tubular member, and a push member slidably disposed in a lumen formed in the tubular member. The push member may be coupled to the push tube.

Abstract: Deployment systems and methods are provided herein for percutaneous transcatheter deployment of medical devices. A medical device deployment system includes a body member and a body locking member that is configured to cooperatively engage along a portion of the body member such that the body member is releasably coupleable to a medical device.

Abstract: Devices and methods for treating tricuspid regurgitation (TR) are provided. A clasp or clamp is used to anchor a TR-treatment device to an existing lead of a pacemaker or an implantable cardioverter defibrillator (ICD) that passes through the tricuspid valve. The TR-treatment device can be a balloon occluder that is adjustable by filling or withdrawing filler material from the occluder through a proximal port implanted in the skin of the patient.

Abstract: A device for applying a compressive force to the uterus, the device comprising a contact portion for contacting the uterus and providing a compressive force thereto, and at least two elongate handles each extending from the contact portion along a respective longitudinal axis. The at least two elongate handles are configured to facilitate insertion of the device into the body and handling of the device from outside the body when inserted. At least a part of the contact portion is configured to be radially moveable relative to the longitudinal axes between a first radial position and a second radial position where the second radial position is radially outward of the first radial position.

Abstract: Various embodiments of the present disclosure include an apparatus comprising a clip which includes a first side including a first ring configured to pass over an end of a first vessel, the first ring configured to engage the first side with the first vessel, and a second side coupled to the first side, the second side including a second ring configured to pass over an end of a second vessel, the second ring being configured to engage the second side with the second vessel. The first and second sides, when in a closed position, are configured to maintain the first and second vessels in substantially end-to-end contact.

Abstract: There is provided an endoscopic snare including: a flexible sheath 1; a cable 2 configured to slide in the sheath; a snare loop 3 connected to the cable 2, and projecting from or retracting into the sheath 1; a distal end tip 4 disposed in a distal end part of the sheath and retaining the snare loop 3; and a hand operating part for operating the snare loop 3 via the cable 2. One end of the snare loop 3 is attached to the distal end tip and the other end of the snare loop 3 is attached to a distal end of the cable. The snare loop 3 is expanded into a ring shape without a protruding portion when it is projected from the sheath 1, and is formed into an asymmetric shape where expansion is deviated to either side about an axis of the sheath.