Abstract: A surgical instrument includes a body, at least one user input feature, an elongate shaft, a needle applier, and a motor. The needle applier includes a needle and a drive assembly coupled to the needle. The drive assembly is configured to drive the needle along an orbital path about a rotation axis that is transverse to the longitudinal axis of the shaft, in response to an actuation of the user input feature. The motor is configured provide motion to the needle applier to thereby actuate the drive assembly.

Abstract: A surgical instrument and method for indicating a tissue penetration site includes an inner needle and a head. The inner needle has a driver configured to translate the inner needle form a first position to a second position. The head is securely attached to the inner needle at an end opposite the driver and is configured to expand from a contracted state to an expanded state and thereby indicate the tissue penetration site.

Abstract: An endoscopic stitching device includes a handle assembly having a main rod and first and second blade control members, and an elongate shaft assembly having first and second blade drive members, an axial rod, and an end effector. The first and second blade drive members are received in respective first and second grooves of the first and second blade control members and rotated about the first and second blade control members to be secured with a circumferential groove of the first and second blade control members, such that the first and second blade control members are movable with the respective first and second blade drive members. The axial rod is detachably coupled with the main rod for concomitant movement therewith. The end effector includes jaws operatively coupled with the axial rod, and needle receiving blades operatively coupled with the respective first and second blade drive members.

Abstract: Provided herein are devices and methods for securing surgical guide wires. In particular, provided herein are devices for securing radiologically located guide wires prior to surgery (e.g., lumpectomy).

Abstract: A suturing device includes an elongate body, a needle, an actuator, and a needle holder. The actuator interacts with the elongate body and is operable between a first operating position and a second operating position. The actuator is configured such that movement of the actuator from the first operating position toward the second operating position moves the needle in an advance direction. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder defines a needle passage and a distal opening. The needle is positioned in the needle passage when the actuator is in the first operating position. The needle holder is configured to move with respect to the elongate body to change the location of the distal opening with respect to the elongate body.

Abstract: A medical suturing instrument in which the movement of an operation part is transmitted with a time lag to a loop forming part and a suture thread by means of a loop feed/return mechanism and a suture thread feed mechanism, and once a loop has been fed out from the tip end of a loop introduction needle, the suture thread is fed out from the tip end of a suture thread introduction needle.

Abstract: The present invention provides a method for setting elastic threads in a ligation device and an automatic elastic thread ligation device using the method.

Abstract: Apparatus for facilitating anchoring of an anchor to a papillary muscle of a heart of a subject, the apparatus can include: (1) a housing, percutaneously deliverable to the heart, slidable along a guidewire, and shaped to define at least one opening; (2) a guide member, percutaneously deliverable to the heart, percutaneously removable from the subject, couplable to the housing, and having (a) a distal portion, including a chord-engaging element, configured to be percutaneously slidably coupled to at least one chorda tendinea of the heart, and decouplable from the at least one chorda, and (b) a proximal portion, including a longitudinal element; and (3) a deployment tool, configured (a) to be reversibly coupled to the anchor, (b) to be slidably coupled to the longitudinal element, and (c) to anchor the anchor to the papillary muscle. Other embodiments are also described.

Abstract: A suturing device includes an elongate body, a needle holder, and an actuator. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder defines a needle passage configured to hold an associated needle. The actuator is operable between a first operating position and a second operating position, and is configured such that movement from the first operating position toward the second operating position moves the associated needle in an advance direction. The actuator includes a manually operated member and a biasing mechanism biasing the actuator toward the second operating position. The manually operated member is operatively connected with the biasing mechanism so as to preclude the biasing mechanism from moving the actuator toward the second operating position until after the manually operated member has been moved from a non-actuated position toward an actuated position.

Abstract: An apparatus including a suture instrument including a handle and a post extending from the handle, the handle including a cavity; a cover slidably attached to the handle to cover the cavity; a post extending upward from a bottom surface of the cavity; and a suture spool removably positioned over the post; wherein the post includes a force member configured to provide upward force on the spool when the cover is slid off of the spool.

Abstract: An insertion instrument is configured to eject at least one anchor body into respective target locations, and subsequently apply a predetermined tensile force at least one actuation member of the at least one anchor member so as to actuate the at least one anchor body from a first configuration to a second expanded configuration. The insertion instrument can include a tension assembly that applies the predetermined tensile force to the at least one actuation member. The predetermined tensile force can be defined by a distance of travel, a predetermined failure force of a fuse, or a combination of distance of travel and a predetermined failure force of a fuse.

Abstract: A surgical suturing instrument includes a handle assembly, a shaft extending distally from the handle assembly, and an end effector. The end effector includes a body portion coupled to the shaft, a first jaw member pivotably coupled to the body portion, and a second jaw member pivotably coupled to the body portion. The first jaw member is rotatable about a longitudinal axis defined by the body portion and defines a hole configured for detachable receipt of a curved needle. The second jaw member defines a hole configured for detachable receipt of a curved needle such that the first and second jaw members transfer a curved needle therebetween upon rotation of the first jaw member about the longitudinal axis of the body portion toward the second jaw member.

Abstract: An end effector assembly for a surgical stitching device is provided. The end effector assembly includes an end effector, a housing, and a needle. The end effector includes a first jaw member and a second jaw member. The housing is movable relative to the end effector. The needle is releasably coupled to the housing and movable relative to the housing between a first, insertion position and a second deployed position. The needle is adapted, when in the second, deployed position, to releasably couple to one or both of the first jaw member and the second jaw member of the end effector.

Abstract: An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable.

Abstract: A surgical instrument includes a body, a shaft, a cartridge receiving assembly, and a suture cartridge. The body has an actuator. The cartridge receiving assembly includes a pair of jaws. The suture cartridge includes a cartridge body, a needle, and a needle cover. The needle cover is releasably connected to the cartridge body such that the needle cover surrounds at least a portion of the needle. The needle cover is releasably connected to the body by at least one of a securement or a distal extension. The securement is located between the needle cover and the cartridge body to releasably connect the needle cover to the cartridge body. The distal extension projects from at least one of the first jaw or the second jaw and is configured to engage the needle cover thereby holding the needle cover to the cartridge body in the closed position.

Abstract: Described herein suture passer apparatus (devices and systems) that may be used to suture tissue within a narrow, confined space. In particular, described herein are suture passers having an elongate body and a lower jaw member that houses a tissue penetrator that is adapted to extend laterally from the lower jaw member and be deflected by a second jaw member? The second jaw member typically deflects the tissue penetrator either distally or proximally.

Abstract: A surgical instrument includes a body, a shaft, a cartridge receiving assembly, a suture cartridge, and a cage securement. The suture cartridge is configured to be received within the cartridge receiving assembly and has a cartridge body, a needle, a drive assembly, and a cage. The cage is movably secured to the cartridge body to selectively move relative to the cartridge body from a closed position to an opened position. In the closed position, the cage is configured to contain the needle within the cartridge body. In the opened position, the cage is configured such that the needle is removable from the cartridge body. The cage securement is configured to move from a first position to a second position to inhibit movement of the cage from the closed position toward the opened position, yet release movement of the cage for selectively moving the cage to the opened position.

Abstract: An apparatus for closing an opening in a body tissue. The apparatus includes a shaft, a plurality of arms, and an expander. The arms each extend between a proximal end and a distal end. The distal end of each arm is hingedly attached to or integrally formed with the shaft. The arms are laterally spaced apart from each other. The arms are movable between a retracted configuration, in which the arms are each aligned along the shaft, and a deployed configuration, in which the proximal end of each arm pivots respectively about the distal end of the arm so as to extend laterally away from the shaft. The expander is positioned within the shaft, and movement of the expander causes the arms to move between the retracted and deployed configurations. Methods of using the apparatus are also included.

Abstract: A method for closing a puncture in a vessel wall of a blood vessel that includes advancing a guide member into proximity with a puncture in a vessel wall, positioning a distal end of an angle adjustment member distal to openings of the guide member, deploying the needle guides from the guide member through the openings, advancing the deflected needle guides and the suture securing devices through the vessel wall, retracting the needle guides to release the suture securing devices distally of the vessel wall, and establishing tension in the sutures to move the suture securing devices toward each other to thereby close the puncture.

Abstract: A delivery system for delivering a prosthesis, the delivery system including a housing, a sheath extending from within the housing, a clutching mechanism housed within the housing, and a cable. The clutching mechanism includes a one-way clutch that transmits a torque from an actuator to an inner shaft assembly when the actuator is rotated in a first direction and does not transmit a torque from the actuator to the inner shaft assembly when the actuator is rotated in a second opposing direction. The actuator is accessible from an exterior of the housing. The cable has a first end coupled to a proximal portion of the sheath and a second end coupled to the inner shaft assembly, and actuation of the actuator causes the actuator to rotate in the first direction, thereby causing the inner shaft assembly to wind up a portion of cable and retract the sheath.

Abstract: A trocar wound closure system includes a suture passing needle and a guide for directing the needle through the wound site. A distal portion of the needle includes a capture rod with a slot. An obturator tube with a cutout section can be axially actuated to align the cutout section with the slot, and then moved out of alignment so as to capture the suture. The guide includes at least two tracks for directing the needle through the tissue track. A snare loop is located adjacent to the exit of each track, and configured to be actuated from a radially extended configuration to a retracted configuration so as to capture the suture section inserted through each loop. Radially expandable arms at distal section are movable between an expanded configuration and a slender configuration.

Abstract: The present invention discloses a medical assembly and method to deliver and place a bodily implant inside a patient's body. The medical assembly includes an insertion tool such that a portion of the insertion tool defines a lumen. The medical assembly further includes a carrier configured to be coupled to the insertion tool and including a passageway. The medical assembly also includes a flexible elongate member configured to pass through the passageway of the carrier and the lumen. The elongate member is also configured to be coupled to the bodily implant such that a portion of the elongate member between the bodily implant and the carrier defines a length.

Abstract: A delivery system for endoluminal delivery of an expandable device comprising a catheter having a proximal end and an opposite distal end configured to support an expandable device, a primary sheath having a delivery position in which the primary sheath constrains the expandable device toward a collapsed configuration suitable for endoluminal delivery, and a handle having an actuator for axially displacing the primary sheath from the delivery position, wherein the handle includes a knob for operating one or more functions of the handle which is initially hidden to prevent use by a user and then revealed as a result of displacement of the primary sheath from delivery position so as to allow subsequent actuation of the knob by the user.

Abstract: A loader for a surgical suturing instrument is disclosed. The loader has a head having a protrusion configured to be releasably held by a tissue bite area of a surgical suturing instrument. The loader also has a tube interface. The loader further has one or more ferrule holders. The loader also has one or more ferrules, each corresponding to and held by one of the one or more ferrule holders and coupled to a suture end that leads from a tube releasably held by the tube interface.

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 surgical tensioner and methods for surgical repairs. A tensioner can tension a flexible strand (suture or wire) attached to tissue (for example, graft or bone segments). A tensioner can include an angled tip with a split hole to past-point on a knot and lock the construct during tensioning. A tensioner can include a securing mechanism that can capture a flexible strand and lock it into place.

Abstract: An end effector for use by a surgeon to staple an anatomical structure of a patient during a surgical procedure includes an anvil and a cartridge. Each of the anvil and the cartridge has a face that is positionable on the anatomical structure. The anvil is coupled to the cartridge at first and second ends. The anvil is movable relative to the cartridge to define a first gap between the faces at the first ends that is different from a second gap between the faces at the second ends.

Abstract: A single-handed meniscal biter instrument for probing and resecting meniscal tissue. The instrument includes a main body configured to be held by one hand and a cutting mechanism coupled to the main body and configured to be operable by the same hand while held. The instrument also includes an extendable probe coupled to the main body, wherein the probe is configured to the independently operable by the same hand while being held.

Abstract: In a generic aspect, an apparatus for delivering attachment devices includes a needle defining a lumen and a distal opening, and a plurality of attachment devices disposed within the lumen of the needle. Each attachment device includes a first attachment part, a second attachment part, and a connecting member coupled to the first attachment part and the second attachment part. The apparatus further includes an actuator configured to drive each attachment device out of the distal opening of the needle during a surgical procedure.

Abstract: Systems and methods for preparing a ligament graft for a ligament reconstruction procedure are provided. In general, the described techniques utilize a graft holder construct having a graft preparation holder and a suture assembly removably coupled thereto. The graft preparation holder includes an elongate support rail having a longitudinal axis, and a plurality of leaf segments positioned along the longitudinal axis in a spaced relationship and extending laterally from the support rail. The leaf segments can bend to a graft holding configuration so as to define a graft receiving channel configured to receive a graft therethrough. The holder also has at least one support structure configured to mate with the leaf segments to provide stability and rigidity to the segments. The suture assembly has at least one suture tail that can be pulled to affix the suture assembly to a graft without penetrating the graft.

Abstract: A suturing device for grasping soft tissue and placing stitches in soft tissue during endoscopic procedures is described. An elongate housing with a stationary jaw and a movable jaw disposed at the distal end are configured for grasping and releasing soft tissue. A movable needle disposed within the housing is actuated to engage a length of suture and drive the suture into and through the grasped soft tissue. A suture capture member is disposed on the movable jaw and is configured to allow passage of the needle therethrough while securing a portion of the stitched length of suture.

Abstract: A tunneling device for creating a pathway in subcutaneous tissue of a person's body. The tunneling device includes a member having two ends, where each of the ends defines an insertion surface that facilitates the insertion of the ends into the subcutaneous tissue of the person's body. The tunneling device includes an interchangeable handle connectable to each of the ends. The handle defines a grasping surface and an opening. The opening is configured to receive either of the ends. The grasping surface enables a user to securely hold the handle with one hand to forcibly move the member through the subcutaneous tissue of the person's body to create the pathway in the subcutaneous tissue, and pull a cable of an implant device through the created pathway.

Abstract: A device for repairing a tear in a portion of tissue comprises a proximal actuator portion, a transfer needle extending distally from the proximal actuator portion and a catch needle extending distally from the proximal actuator portion. A suture needle is disposed in the transfer needle, and is extendable from the transfer needle toward the catch needle and retractable from the catch needle toward the transfer needle. An extendable catch plunger is disposed in the catch needle for capturing suture therein when it is transferred from the transfer needle. A retractable insertion sheath is provided for covering the transfer needle and the catch needle when the device is inserted into a procedural site. A depth limiting apparatus limits the depth of insertion of the needle into the procedural site.

Abstract: A tissue closure device includes a needle and a suture extending therefrom, a proximal head including a proximal slot and a proximal locking mechanism for releasably engaging a first end of the needle in the proximal slot in a first configuration, and a distal head movably coupled to the proximal head so that the proximal and distal heads are movable relative to one another between an open configuration, in which a target tissue is received therebetween, and a closed configuration, in which the target tissue gripped therebetween. The distal head includes a distal slot and a distal locking mechanism for releasably engaging a second end of the needle in the distal slot in a second configuration, the needle movable between the first and second configurations by rotating the needle, the needle alternatingly passed between the proximal and distal heads to thread the suture through the target tissue.

Abstract: A multiple-firing crimp device comprises crimps, a shaft, a crimp movement assembly, and a snare. Each crimp has an internal hollow. The shaft has a distal crimping location, an exterior surface, and an interior with the clips stacked therein, the crimps moving therein along a longitudinal axis. The shaft defines a lateral opening proximal to the crimping location and communicates the interior to the environment outside the exterior surface. The crimp movement assembly within the shaft delivers the first crimp to the distal crimping location by moving the first crimp longitudinally from a first proximal position into the distal crimping location and returning to a second proximal position without the first crimp. The snare pulls at least one cord from distal of the first crimp through the first crimp and through a portion of the shaft and out the side of the shaft through the lateral opening.

Abstract: Systems are provided for delivering a suture to close a surgical opening. An elongated deployment member may have at its distal end a retracted counterforce member. The counterforce member may be inserted into the surgical opening and deployed to resist being withdrawn from the opening. A compression member may be slid down the elongated member to compress the tissue to be sutured against the counterforce member. Suture passers loaded with suture ends may be passed through needle tubes within the elongated member to emerge from the elongated member and pierce the tissue to be sutured, then deposit the suture ends with a suture catcher. The suture passers may be withdrawn, leaving the suture ends. The suture catcher may be retracted, retaining the suture ends and the device—elongated member, retracted suture catcher, and retained suture end—may be withdrawn from the surgical opening. The suture may then be completed.

Abstract: Suture clip deployment devices for applying suture clips to sutures are described. Some embodiments can include a generally tubular main body and a vacuum port located at the distal end, a hollow inner body longitudinally slidable within the main body and extending from the main body at its distal end, and a suture recess located in the generally tubular main body. At least one suture clip configured to frictionally fit on an outer surface of the inner body is deployed during use. Clip deployment can occur after a vacuum source is applied to the device so as to draw the suture into the device. The suture lines can be retrieved through the suture recess, and the device can be actuated so as to deliver the suture clip off the delivery device and onto the suture, locking the suture in place.

Abstract: In a general aspect, a medical device includes a receiving arm configured to be coupled to at least a portion of an implant, and a clamping arm having a proximal end coupled to the receiving arm and having a track at a distal end of the clamping arm. The medical device also includes a sliding component including a needle and configured to slidably move along the track of the clamping arm.

Abstract: Disclosed is a laparoscopic port site closure device. The device is configured such that a cartridge receiving a surgical suture therein is provided at a fore-end of a needle guide for port site closure; the surgical suture is caught in a needle tip that is pierced through a body tissue by being guided by the needle guide; and when the needle is withdrawn, the surgical suture is pulled out along a path through which the needle was pierced into the tissue, and the surgical suture is tied outside a patient's body, thereby being capable of closing a laparoscopic port site.

Abstract: Systems are provided for delivering a suture to close a surgical opening. An elongated deployment member may have at its distal end a retracted counterforce member. The counterforce member may be inserted into the surgical opening and deployed to resist being withdrawn from the opening. A compression member may be slid down the elongated member to compress the tissue to be sutured against the counterforce member. Suture passers loaded with suture ends may be passed through needle tubes within the elongated member to emerge from the elongated member and pierce the tissue to be sutured, then deposit the suture ends with a suture catcher. The suture passers may be withdrawn, leaving the suture ends. The suture catcher may be retracted, retaining the suture ends and the device—elongated member, retracted suture catcher, and retained suture end—may be withdrawn from the surgical opening. The suture may then be completed.

Abstract: An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

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: Devices and methods for locating sinus ostia and positioning a guide wire within the sinus ostia. The subject devices comprise a shaft having a distal end, a proximal end, a curved region located between the distal and proximal ends, and an interior channel, an extensible and retractable guide wire movably mounted within the interior channel and a probe tip joined to the guide wire. Certain devices further include expandable portions for engaging and treating body anatomy.

Abstract: A device for repair meniscus tears utilizing transfer cannulas that are pulled or kedged through the meniscus tear by a pulling element. The transfer cannulas are positioned via sliding guide to prevent a shear force acting on the meniscus.

Abstract: Assembly for endoscopically securing gastrointestinal tissue folds, comprising a first tissue anchor and a second tissue anchor, a first suture thread part and a second suture thread part, each of the first and second thread parts having a connected end and a free end opposite the connected end. The first thread part and the second thread part are tied to each other through a sliding knot, such that the first thread part firms a post of the sliding knot along which the sliding knot is arranged to slide during tightening of the assembly and such that the second thread part wraps around the post to create the sliding knot. The first thread part extends from the first anchor to past the sliding knot where the first thread part's free end forms a post free end, and the second thread part extends from the second anchor to past the sliding knot where the second thread part's free end is free, such that the sliding knot is interposed between the first and second anchors.

Abstract: An insertion tool for deploying a flip anchor cable, including: a mechanism having a safety button and a slider, wherein the mechanism is configured to apply a clamping force on a portion of the flip anchor cable when the mechanism is in a first position; an inner tube having a proximal end connected to the mechanism configured to house a second portion of the flip anchor cable; a handle including a safety button opening and a slider opening, wherein the handle is configured to enclose a portion of the mechanism; and an outer tube having a proximal end connected to the handle configured to receive the inner tube; wherein the mechanism is configured to decrease the clamping force on the flip anchor cable when the mechanism is in a second position and to deploy a flip anchor of the flip anchor cable in the second position.

Abstract: An apparatus for delivering therapeutic agent to an eye includes a body, a cannula, a hollow needle, and an actuation assembly. The cannula extends distally from the body and is sized and configured to be insertable between a choroid and a sclera of a patient's eye. The actuation assembly is operable to actuate the needle relative to the cannula to thereby drive a distal portion of the needle along an exit axis that is obliquely oriented relative to the longitudinal axis of the cannula. The cannula may be inserted through a sclerotomy incision to position a distal end of the cannula at a posterior region of the eye, between the choroid and sclera. The needle may be advanced through the choroid to deliver the therapeutic agent adjacent to the potential space between the neurosensory retina and the retinal pigment epithelium layer, adjacent to the area of geographic atrophy.

Abstract: A hand-held, surgical suturing device that can be operated and manipulated with one hand. The device has a suture spool that can be locked The device can rotate in either direction. It is configured to accept at least two different types of needles, a single hook needle and a corkscrew needle useful in different suturing applications. These needles can be supplied in different sizes and shapes. The needle, suture spool and needle carrier are typically supplied in sterile packages and are disposable. A first embodiment has a triangular-shaped squeeze handle that, when squeezed, causes the needle to rotate. A second embodiment has a cylindrical handle for manual stitching where the needle can be released to freely rotate by pressing a control button. In either embodiment, the suture spool can be locked or allowed to rotate freely by activating a releasing rod.

Abstract: An apparatus for delivering a clip includes an introducer sheath including an outer surface extending between its proximal and distal ends. A clip is carried on the outer surface, e.g., on a carrier assembly that is slidable along the outer surface from the proximal end towards the distal end. A skin overlies the outer surface of the sheath and the carrier assembly that is separable from the outer surface as the carrier assembly is advanced from the proximal end towards the distal end of the sheath. During use, the distal end of the sheath is inserted into an opening through tissue, e.g., into a puncture communicating with a blood vessel. The carrier assembly is advanced towards the distal end of the sheath, causing the skin to separate from the outer surface of the elongate member, and the clip is deployed from the carrier to seal the opening.

Abstract: The present invention relates to micro-sewing devices, specifically a micro-sewing device for percutaneous, endoscopic, laparoscopic and minimally invasive surgical procedures for suturing in small areas. The device allows for sewing-off and stitching in either direction, in very tight spaces.