Abstract: Disclosed are devices and methods for delivering several sutures accurately and simultaneously around the perimeter of an annular prosthetic device (prosthetic heart valve, annuloplasty ring, etc.) to secure the prosthetic device within a native heart valve region. Devices can comprise a proximal handle portion including an actuator and a distal suturing portion including several curved and straight needles arrayed around the shaft axis. The straight needles and the curved needles are configured to simultaneously guide a plurality of sutures through the native tissue and through the annular prosthetic device. The actuator can cause the straight needles to move axially relative to the curved needles and can also cause the curved needles to rotate, such that the motions are coordinated to simultaneously place all the sutures.

Abstract: A surgical instrument can manipulate and pass suture through tissue. The device can easily pass suture through tissue with the suture fixed to the mechanism or where the suture is captured by the mechanism and allowed to slide. Along with this ability to control suture in one of two ways is a feature to provide a large amount of suture on the other side of the tissue that will be relatively easy for the surgeon to grab and pull out of the arthroscopic portal. The device includes a handle with a hollow shaft extending therefrom and a set of fingers movable into and out of the shaft. The fingers can be designed to capture suture, permit the suture to slide while captured, and optionally hold the suture in the device.

Abstract: A surgical instrument is provided. The surgical instrument has a drill bit employable in drilling procedures wherein the drill bit is made of a plurality of radially positioned drill bits which also may be utilized as a grasping device. As a result, the drill bit may not only drill into bone, but may also be used to grasp an object, such as a portion of the body. The present surgical instrument reduces contamination which may otherwise result from switching surgical instruments from a drill to a grasping mechanism or from the need to drill multiple holes into the patient's body.

Abstract: A surgical device includes a housing, an elongated shaft, an end effector, and an actuation mechanism. The housing pivotally supports a movable handle between unactuated, first actuated, and a second actuated positions. The elongated shaft extends distally from the housing and defines a longitudinal axis. The end effector has a pair of opposed jaw members that are movable between an open configuration in which the jaw members are spaced apart from one another and a closed configuration in which the jaw members are closer together. The actuation mechanism is configured to transition the end effector between the open and closed configurations as the movable handle is pivoted between the unactuated and first actuated positions and to maintain the end effector in the closed configuration when the moveable handle is between the first and second actuated positions.

Abstract: Various embodiments of a cartridge for loading a suture onto a suturing instrument are disclosed. In some embodiments, the cartridge is operable for loading a pre-tied knot formed from the suture onto the suturing instrument. The suturing instrument is typically of the type having a suture passing member defining a suture receiving passage therein. In some embodiments, the cartridge comprises a housing defining a chamber, and a partially pre-tied knot mounted about the housing or the chamber. The cartridge additionally provides a base coupled to the housing, the base defining a seat for releasably holding a portion of a suture to be aligned with, and transferred to, the suturing instrument. The portion of the suture may be held independently, or it may be coupled to a component such as a ferrule or shuttle.

Abstract: A port site closure instrument includes a pair of wings and a body having proximal, central, and distal portions. The proximal portion defines a proximal suture aperture and first and second needle apertures. The central portion defines third and fourth needle apertures. A first needle channel is defined through the body communicating the first and third needle apertures. A second needle channel is defined through the body communicating the second and fourth needle apertures. The distal portion defines distal suture apertures. A first suture channel is defined by the body communicating the proximal and distal suture apertures. The pair of wings is pivotally supported by the distal portion of the body. Each of the wings define a suture slot such that a suture exiting one of the distal suture apertures and positioned in the suture slots is aligned with one of the first or second needle channels.

Abstract: Apparatus for securing an object to bone, the apparatus comprising an anchor comprising a body comprising a passageway; and a movable element comprising a deformable portion; wherein the deformable portion is configured so that, (i) at a first level of force, the deformable portion restricts proximal movement of the movable element, and (ii) at a second, greater level of force, the deformable portion deforms and permits proximal movement of the movable element.

Abstract: A device for suturing an anatomic valve can comprise an elongate body, a suture catch mechanism and a suture clasp arm. The suture catch mechanism can be operatively coupled to the elongate body for movement between a retracted position and an advanced position. The suture clasp arm can be attached to the elongate body for movement between a retracted position and an extended position. The suture clasp arm can comprise a suture clasp configured to releasably retain a suture portion. In some embodiments, the suture clasp is positioned on the suture clasp arm such that the suture catch mechanism retrieves the suture portion from the suture clasp arm while the arm is at least partially retracted. In some embodiments, the suture clasp arm can be closed about a tissue portion without damaging the tissue portion.

Abstract: Instruments for placing complex sutures into animal tissues, including instruments useful in arthroscopic surgical techniques which minimize incision size. Manipulate the flat tissue by, for example, rolling, wrinkling, folding, bending or tucking the tissue so that a needle can be placed through the tissue more than once. Sutures are placed, for example from top-to-bottom and bottom-to-top with a single pass of a straight needle. Roll, wrinkle, fold, bend or tuck the flat tissue so that a needle can be placed through the tissue more than once. Suturing a loop through the tissue that another suture will pass through result in sewing both sides of the tissue. This will allow surgeons to place complex locking and grasping suture configurations that will significantly improve the repair.

Abstract: A suturing device for minimally invasive surgery is disclosed. The suturing device has a head defining one or more ferrule holders and a tissue bite area. The device also has a first needle comprising a flywheel portion and one or more curved arms extending from the flywheel portion, each of the one or more curved arms comprising a ferrule engaging tip, wherein the first needle is pivotably coupled to the head. The suturing device further has a first actuator coupled to the first needle and configured to rotate it from a retracted position, where the ferrule engaging tip of each of the one or more curved arms starts away from the one or more ferrule holders, through the tissue bite area, and to an engaged position where the ferrule engaging tip of each of the one or more curved arms is operationally aligned with the one or more ferrule holders.

Abstract: Articulating surgical instruments are disclosed. In one embodiment, a surgical instrument may include an elongated shaft assembly including an articulable portion moveable between a non-articulated configuration and an articulated configuration. First and second articulating shafts of the elongated shaft assembly may be coaxially arranged and axially fixed at an attachment point located distally from the articulable portion. Proximal portions of the first and second articulating shafts may be displaceable in opposing directions to articulate the articulable portion from the non-articulated configuration to the articulated configuration. In another embodiment, an articulation control may be movable from a first position to a second position to move an articulation lock from a locked configuration to an unlocked configuration to selectively permit articulation of a surgical instrument. The articulation lock also may be movable from the second position to a third position to articulate the surgical instrument.

Abstract: Exemplary embodiments provide methods and systems for delivering a prosthesis to a target location in a lumenal system of a patient. At least one tether is secured proximate the target location to serve as a rail, and a prosthesis is advanced along the rail to the target location and secured in place. Exemplary methods and systems provide for repair of the mitral and tricuspid valves, as well as abdominal aortic aneurysms, stomach valves, fallopian tubes and the pulmonary system, among others. Also disclosed are various prostheses suitable for use with the disclosed methods and systems.

Abstract: An elongated deployment shaft carrying a needle deployment assembly with needles carrying sutures and a stabilizer. A catcher tube over the shaft having a catcher assembly at a distal end may retain a portion of the needles when passed through the tissue into engagement with catcher assembly. The catcher and needle deployment assemblies are configured to asynchronously engage the plurality of needles when moved distally beyond the catcher assembly. A sheath over the catcher tube may sandwich the tissue against the stabilizer when expanded. A first actuator may move catcher tube distally to decrease distance between proximal and distal ends of the stabilizer expand it and may move the sheath distally to sandwich the tissue. A second actuator may deflect the needles outward to move proximally through the tissue and engage the catcher and return a portion of each not retained by the catcher to a distal position.

Abstract: An exemplary surgical device includes a handle including a bore, and a trigger configured to advance or retract a needle through the bore of the handle. The trigger is configured to rotate about a pivot axis and is further configured to slide in distal and proximal directions. The device may be operated using one hand, and permits a user, such as a surgeon, to advance a needle through the device using intuitive, relatively easy thumb movements. While the device may be used in other techniques, it is particularly useful in meniscal repairs, including inside-out meniscal repairs.

Abstract: The present disclosure includes a soft material anchoring system including an elongate, tubular braided soft anchoring implant. The implant has a first elongate state where the implant may easily slide within a bone tunnel, and a second axially compressed state where the implant is wedged within the bone tunnel. The implant also includes at least one suture pathway that extends along and through an implant side wall; this pathway receives at least a portion of a length of suture that is also attached to soft tissue. This length of suture may slide along the suture pathway and transition the implant from the first elongate state to the second compressed state. The system also includes a binding element that at least partially extends within the implant, the binding element having both a first larger binding portion and a second smaller sliding portion.

Abstract: A urinary incontinence prevention clip for men includes: a clip body having an upper frame positioned so as to correspond to the upper part of male genitalia, a lower frame positioned so as to correspond to the lower part of the male genitalia, and a connection part connected to one side of the upper frame and the lower frame and providing elastic force in a direction, in which the upper frame and the lower frame are spread; cushion parts respectively provided on the inside of the upper frame and the inside of the lower frame; and locking parts formed at both ends of the clip body so as to be fastened to each other, wherein the upper frame is formed so as not to press the blood vessels of the male genitalia and the lower frame is formed so as to press the urethras of the male genitalia.

Abstract: Medical devices, systems, and methods reduce the distance between two locations in tissue in a minimally invasive manner, often for treatment of congestive heart failure. In one embodiment, an anchor of an implant system may, when the implant system is fully deployed, reside within the right ventricle in engagement with the ventricular septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along an epicardial surface of the heart. Deployment of the anchor within the right ventricle may be performed by inserting a guidewire through the septal wall into the right ventricle. The anchor may be inserted into the right ventricle over the guidewire and through a lumen of a delivery catheter. Delivering the anchor over the guidewire may provide improved control in the delivery and placement of the anchor within the right ventricle.

Abstract: Suturing devices and systems used to close openings into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more arms, and one or more needles. One or more sheaths may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

Abstract: A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a closure element having a foot portion and a needle guide portion. The foot portion and the needle guide portion are each movable between a delivery configuration and a deployed configuration. The foot portion includes cuffs removably mounted thereon and having sutures connected therebetween. The needle guide portion includes needle guide apertures that guide the needles to the cuffs. The needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.

Abstract: A suturing device for minimally invasive surgery is disclosed. The suturing device has a head defining one or more ferrule holders and a tissue bite area. The device also has a first needle comprising a flywheel portion and one or more curved arms extending from the flywheel portion, each of the one or more curved arms comprising a ferrule engaging tip, wherein the first needle is pivotably coupled to the head. The suturing device further has a first actuator coupled to the first needle and configured to rotate it from a retracted position, where the ferrule engaging tip of each of the one or more curved arms starts away from the one or more ferrule holders, through the tissue bite area, and to an engaged position where the ferrule engaging tip of each of the one or more curved arms is operationally aligned with the one or more ferrule holders.

Abstract: Embodiments of the invention are directed towards a medical device, method and system thereof for the placement or passage of patches, sutures, anchors, tags, tissue sensors and more particularly to a medical device for repairing female pelvic organ or tissue prolapsed region. The device may be used for the placement of stereotactic markers into tissue near joints or tumors for guidance during orthopedic or neurosurgical procedures.

Abstract: A suturing device includes a needle, and a shuttle. The needle has an elongated shape extending in a predetermined direction and is configured to hold a first thread-like member. The needle is reciprocally movable forward and backward in the predetermined direction and is rotatable about an axis extending in the predetermined direction. Rotation of the needle about the axis permitting the first thread-like member to cross the needle to form a loop in the first thread-like member. The shuttle includes a holding portion. The holding portion is configured to hold a second thread-like member. The shuttle is configured to permit the holding portion to pass through the loop.

Abstract: The present disclosure relates to electromechanical surgical systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument transmits a rotation of a rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. A distal neck assembly of the surgical instrument includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly is configured to enable off-axis articulation of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly.

Abstract: Instruments and techniques to pass a suture are presented. The instruments and techniques are particularly useful where access to confined spaces and the ability to pass a suture through difficult to penetrate materials are needed. The instruments and techniques are particularly useful in surgery of the hands and feet.

Abstract: A suture passer and a method with the suture passer can include a first needle extending along a first longitudinal axis. The first needle can have a sharp tip and a first hook member configured to grasp a portion of a suture. The suture passer can include a shaft extending along a second longitudinal axis. The shaft can have an eyelet that intersects with the first longitudinal axis of the first needle. The suture passer can also have an actuation mechanism coupled to the first needle, and the method can include actuating the actuation mechanism to move the first needle to a position in which the first needle's sharp tip extends through the eyelet, and releasing the actuation mechanism to move the first needle to a position in which the first needle's sharp tip is a spaced apart a distance proximal of the eyelet.

Abstract: A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a foot portion having one or more feet slidably mounted relative thereto. The feet are movable between a deployed position and a delivery position. The feet include cuffs removably mounted therein, with sutures connected between the cuffs. When the feet are in the deployed position and the needles are advanced, the needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.

Abstract: The present disclosure relates to devices, systems and methods for endoscopic suturing or stitching through an access tube or the like. An endoscopic stitching device is provided and includes a handle assembly; an elongate shaft supported by and extending from the handle assembly; and an end effector supported on a distal end of the elongate shaft. The end effector includes a neck assembly configured and adapted for articulation in one direction between a substantially linear configuration and an off-axis configuration, and a pair of juxtaposed jaws pivotally associated with one another. Each jaw defines a suture needle receiving recess formed in a tissue contacting surface thereof.

Abstract: The present invention includes a suture article and a suture placement device adapted to insert into opposing tissue surfaces the anchors of a suture article having anchors on its terminal ends, the device comprising in general terms: (a) an optional handle portion; (b) an insertion portion extending from the handle having a distal end comprising anchor-directing portions that diverge from one another so as to form a V-shape, adapted to releasably engage the anchors; and (c) a hollow cinching cannula/suture conduit slidingly engaged by the handle portion so as to be moveable between a position relatively nearer the handle and a position relatively nearer the insertion portion distal end.

Abstract: In one embodiment, the present invention is a system for repairing a meniscus including: a suture assembly including a first anchor, a second anchor, and a flexible suture connecting the first anchor and the second anchor, the flexible suture including a slide knot between the first anchor and the second anchor; and an inserter including a needle having a longitudinal extending bore and an open distal end, the bore being configured to receive the first anchor and the second anchor, a housing operatively connected to a proximal end of the needle, the housing having a lumen and a slot, the slot including a first portion, a second portion, a first shoulder and a second shoulder and a pusher configured to rotate and slide within the lumen of the housing and the longitudinal extending bore of the needle, the pusher having an extension extending through the slot and configured to be maneuverable through the first portion and second portion and engageable with the first shoulder and second shoulder.

Abstract: Apparatus and methods for Achilles tendon repair are described where an elongate tendon repair assembly may be introduced into a single incision to access the damaged tissue. The assembly may define a channel for receiving a portion of the tendon and which may provide support to the tissue during repair. One or more retractable needles each carrying a length of suture may be deployed within the channel for piercing through the tendon and a cinching member may secure each of the suture lengths for tensioning the suture against the damaged tendon. Once the suture lengths have been deployed, the needles may be retracted and the device removed from the incision.

Abstract: A device and method for delivering a synthetic mesh or graft for anatomical repair at a defect site. A plurality of flexible arms is connected to the synthetic mesh or graft. Grasping jaws are individually controlled at or near a proximal end of the device for connection of the graft and release of the graft at the surgical site. The flexible arms, with graft attached are positioned through a surgical incision to the defect site. An actuator positions the flexible arms to assume a radial array at the surgical site, unfolding and spreading the graft for attachment. The length of each flexible arm is individually adjustable to adapt to the size and shape of the graft selected for installation at the defect site to repair the defect.

Abstract: An obturator configured for use with a trocar includes a head and a distally extending shaft configured to be received within a working channel of a trocar. The obturator further includes a distal tip configured to puncture tissue, first and second needle entrance ports each arranged on at least one of the head or the shaft, and first and second needle exit ports arranged on the shaft. The first and second needle entrance ports communicate with the first and second needle exit ports, respectively, to define respective first and second suture paths extending obliquely to the central axis. Each of the first and second suture paths includes at least one sealing element. In some examples, the obturator further includes at least one deployable member coupled to the shaft and configured to project radially outwardly in a deployed position.

Abstract: A tissue puncture closure device that includes an anchor (208, 508), a sealing pad (210, 510), a compaction member (212, 312, 412, 512), a suture (204, 504), and a suture cutting member (270, 472, 570). The compaction member is configured to compact the sealing pad toward the anchor. The suture is coupled to the sealing pad and anchor, and a portion of the suture extends through at least a portion of the compaction member. The suture cutting member is operable to cut the suture. The suture cutting member is operable within a portion of the compaction member to cut the suture.

Abstract: A suture passer comprising: a hollow tube, said hollow tube comprising a distal end, a proximal end, and a lumen extending from said distal end to said proximal end; and a suture manipulation rod slidably received in said lumen of said hollow tube and selectively projectable out said distal end of said hollow tube, said suture manipulation rod comprising a distal end and a proximal end, said distal end of said suture manipulation rod being bifurcated into a first arm and a second arm, wherein said first arm includes a hook comprising a proximally oriented hooking surface and a return extending proximally of said hooking surface; wherein said hollow tube and said suture manipulation rod are sized so that said suture manipulation rod may capture a suture disposed adjacent to said distal end of said hollow tube and draw the suture into said lumen of said hollow tube, and further wherein, after a suture has been drawn into said lumen of said hollow tube, distal movement of said suture manipulation rod causes t

Abstract: Suturing devices and systems used to apply sutures and/or to close openings at, within, or into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more distal arms, one or more proximal extensions, and one or more needles. A sheath may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

Abstract: The present disclosure includes, in one embodiment, a tensioner instrument having a body having a channel and a plurality of arms projecting outward from the body, each arm including a cleat having a slot adapted to receive a suture; a base member positioned within the channel of the body; an actuating mechanism having a first coupling member adapted to engage a second coupling member on the body to removeably couple the actuating mechanism to the body; and a universal joint adapted to allow for relative movement between the base member and the body such that, when each suture is positioned within each cleat and the actuating mechanism is actuated, the tensioner applies uniform tension to each suture positioned in each cleat.

Abstract: Provided herein is a mechanical device including a rotating spool assembly and a disposable valve assembly. The rotating spool assembly includes a hub, an arm, and a spool inserted through an opening in the arm. The rotating spool assembly can be sterilized after each use. The disposable valve assembly includes a mating stem member, a sealing member, and a flushing port member. The disposable valve assembly can be disposed of after every use. A loading member is also provided including a wire that can be formed from metal drawn out into a thin flexible thread. The loading member can be pre-formed in a helix to form coils in the wire. A release cord is provided including a braided cord with two single filaments and a plurality of beads formed along a length of the single filaments at a distal end of the braided cord.

Abstract: A suturing device is disclosed. The suturing device has a guide tip. The guide tip has first and second framing arms that define a viewing port from a first orientation. The guide tip also has proximal and distal ends of the guide tip which, with the first and second framing arms, define a tissue bite area from a second orientation. The suturing device also has a ferrule holder located in the distal end of the guide tip and centered relative to the first orientation. The suturing device further has a needle movable within the guide tip along a path through the tissue bite area and centrally viewable in the viewing port relative to the first orientation.

Abstract: A suturing device includes an elongated body having an outer wall defining an interior space of the body, a shaft located in the interior space, and a needle mounted on a distal end of the shaft. The needle has a distal section transverse to a longitudinal axis of the shaft. The distal section of the needle terminates in a first jaw and a second jaw forming a forceps defining a piercing tip. The first jaw and second jaw have a grasping position wherein the first jaw and second jaw grasp a suturing material, and a release position wherein the first jaw and second jaw release the suturing material. After grasping the suturing material with the needle, the shaft rotates the needle to advance the needle and suturing material through tissue and mesh placed on the tissue. Spaced apart portions of the suturing material are then fused to create a suture.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A combined tissue grasper and suture retriever instrument and methods for surgical repairs are disclosed. An instrument allows grasping of tissue with simultaneous passage of a flexible strand from a suture passer.

Abstract: A rotational driver that comprises a interactive portion, wherein each interactive portion comprises a first extended member and a second extended member, a rotational system and a linear motion system, wherein the rotational driver permits a left or right handed surgeons to perform the surgical suturing procedure in a less complicated and more secure way by allowing more control over the angled suturing needle and the area to be stitched, even when the suturing area is small, deep, and/or restricted. Also the rotational driver comprises several configurations at the interactive portion ends to provide selected angles for the needle during the suturing procedure.

Abstract: An implant for assisting contraction and/or extension of a muscle that includes a stem with an adhesion resistant segment and an anchoring segment wherein at least a portion of each of the adhesion resistant segment and the anchoring segment is configured to be implantable within a muscle and the anchoring segment is positioned on a distal portion of the stem and the adhesion resistant segment is positioned proximally on the stem relative to the anchoring segment.

Abstract: A pushing tool of the present invention includes a tissue pushing part having a shaft portion that is formed in a rod-shape, a linear portion including a pressing portion that is connected to the shaft portion and extends in a longitudinal direction, and a stopper maintaining an angle between the shaft portion and the linear portion at a desired angle when the pressing portion is closely pressed against an outer surface of a hollow organ.

Abstract: The present disclosure concerns a surgical instrument for manipulating suture. In particular, the present disclosure relates to an instrument for passing suture through tissue. There is described a surgical instrument having a shaft and a handle connected to the proximal end of the shaft. The shaft is formed from a tubular member having a proximal end and a distal end, with a lumen extending between the proximal and distal ends, and a tip distal to the tubular member. The shaft also includes a distal portion having an opening in a sidewall, proximal to the tip. The opening is in communication with the lumen through a side channel. The instrument further includes a suture snare, the snare being slidably receivable within the lumen and side channel, and movable between extended and retracted positions for capturing suture.

Abstract: A system for controlling a relationship between first and second bodies and made up of a suture assembly with at least a first suture configured to define a restrictable loop structure with the suture assembly in an operative state. At least first and second restrictable sub-loops cooperatively define a first loop that can be reduced in size to thereby produce a force on the first and second bodies that urges them towards each other. A first loop length has a first sliding portion with a second loop length having a second sliding portion. At least one knot extends around the first and second sliding portions. The first and second sliding portions, upon each being moved within the at least one knot in a tightening sliding direction, cause a size of a respective sub-loop to be reduced.

Abstract: A suturing system including at least one drive gear with a plurality of outward protrusions and a needle with a first end, a second end, and a plurality of indentations therebetween wherein the plurality of indentations engage with the plurality of outward protrusions of the drive gear to circularly rotate the needle. Additional suturing systems and a method of suturing biological material are also included.

Abstract: A surgical suturing device is disclosed. The surgical suturing device has a forked guide tip having a plurality of legs, wherein each of the plurality of legs comprises a proximal end, an anatomical variation, and a distal end. A method of chord replacement for a heart valve is also disclosed. A suture is placed in a papillary muscle using a surgical suturing device having a forked guide tip and a papillary suture. A leaflet suture is placed in a leaflet. The papillary suture and the leaflet suture are loaded in a suture fastener from opposite directions in a coaxial fashion. The length of the papillary suture and/or the leaflet suture are adjusted relative to the suture fastener to achieve a desired replacement chord length. The suture fastener is attached to the papillary suture and the leaflet suture to lock the desired replacement chord length.

Abstract: In accordance with invention an application device for nasal splints is created, comprising at least one hollow body for accommodating a nasal splint, and a plunger which can be moved within the hollow body, wherein one end face of the hollow body is open so that a nasal splint contained in the hollow body can be introduced through a movement of the plunger from the hollow body through the open end face into the nose of a patient.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.