Abstract: A suturing assembly includes a handle and a head located distal to the handle. The handle includes an actuator coupled to a distal half of the handle. The head defines a head perimeter and includes a needle port and a capsule cavity located within the head perimeter. The needle port stores a needle that is connected with the actuator by a rod and the capsule cavity is sized to retain a suture capsule attached to a length of suture. A release mechanism is attached to the rod and located on the distal half of the handle. The needle is movable within the head perimeter to engage with the suture capsule and place the suture capsule into the needle port, and the release mechanism is operable to move the rod a distance in a proximal direction to separate the suture capsule from the needle.

Abstract: A suture passer device includes a shaft, a handle, an end effector, and a suture capturing member. The shaft has a shaft proximal end and a shaft distal end. The handle assembly is coupled to the shaft proximal end. The end effector is coupled to the shaft distal end. The suture capturing member is coaxial with and slideably coupled to the end effector, is coupled to the handle assembly, and is configured to capture a suture within the end effector. A suture needle includes a suture needle body and a suture needle tip, the suture needle body having a first portion and a second portion. The first portion is thicker than the second portion, and the first portion is configured to mate with a needle spacer that enables actuation of a suture needle passer device.

Abstract: A surgical device for closure Atrial Septal Defect (ASD) with minimally invasive approach includes a head portion which is movable and includes a distal jaw that is distal relative to a person holding the surgical device, a guide rod which drives the distal jaw, and a plurality of first suture-guide channels attached to the distal jaw, and a body portion which is stationary and includes a cylindrical base, a proximal jaw attached to the cylindrical base, and a plurality of second suture-guide channels attached to the proximal jaw, in which the guide rod drives the distal jaw to pass a pericardium patch through a patient's ASD while the proximal end remains extracorporeal, and the first suture-guide channels and the second suture-guide channels guide a suture thread to suture the pericardium patch onto an ASD rim.

Abstract: A suture passer comprising: a shaft having an axis; a first jaw mounted to the shaft in alignment with the axis, the first jaw being configured to releasably support a length of suture thereon; a second jaw movably mounted to the shaft; and a needle movably mounted to the shaft, the needle having a hook and being configured to reciprocate in alignment with the axis so that the hook can selectively pass by the second jaw and engage suture releasably supported on the first jaw; wherein the first jaw comprises a spring for selectively binding the suture to the first jaw, and further wherein the spring comprises a recess for receiving the suture therein.

Abstract: A suturing device of the present invention is in the form a compact, light-weight handheld device that includes a needle and suture assembly, a mechanism for gripping and releasing the needle/suture (a “needle transfer mechanism” or “needle shuttle mechanism”), safely capturing the needle/suture upon exit from the patient's tissue, and returning the needle to a position such that the process of delivering additional sutures to the patient can be repeated. A safety shield mechanism ensures the user is protected from the needle at all times. The device of the present invention accommodates the right or left-handed user, rests comfortably in the user's hand, allows sufficient visualization of the procedure site, and permits the user to either control penetration depth of the needle or default to a device-determined depth. The present device permits the user to utilize a wrist-rotation (pivoting) suture delivery technique.

Abstract: An endoscopic stitching device includes a tool assembly having a pair of juxtaposed jaws pivotally associated with one another, each jaw defining a needle receiving recess formed in a tissue contacting surface thereof; a drive assembly including a pair of concentric, individually rotatably and translatably supported barrels, each barrel defining a central lumen therethrough; and a pair of axially translatable needle engaging blades slidably supported, one each, in a respective jaw. The stitching device further includes a center rod slidably and rotatably disposed through the lumen of the barrels, a distal end of the center rod being operatively engaged with the pair of jaws.

Abstract: Methods and apparatuses are disclosed for closing a patent foramen ovale. Some of the disclosed apparatuses include an elongate body having a proximal end and a distal end, with first and second suture clasp arms adapted to hold end portions of a suture when in an extended position. A first suture catch mechanism is slidably housed in the elongate body and moves in a proximal-to-distal direction to engage the suture end held by the first suture clasp arm, and a second suture catch mechanism is slidably housed in the elongate body and moves in a distal-to-proximal direction to suture end held by the second suture clasp arm. The first suture clasp arm can be positioned around the septum primum to deliver a suture thereto, and the second suture clasp arm can be positioned around the septum secundum to deliver a suture thereto.

Abstract: Sutures can be placed in difficult to access areas of the human body with devices, and related methods, utilizing a suture carrier with a sharpened tip and a notch for holding a formed suture tip.

Abstract: A suture instrument includes a gripping portion that grips a plurality of tissue pieces by sandwiching them, and a suture needle that punctures and sutures the plurality of tissue pieces, the suture needle is supported so as to be able to move forwards or backwards relative to the gripping portion, and a direction of the forward or backward movement of the suture needle is set in a direction that intersects the tissue pieces gripped by the gripping portion.

Abstract: A surgical device for creating a secure closure of a laparoscopic port opening or similar wound. The device may employ a tissue grasping notch that grasps the fascia layer as a suture-bearing needle is deployed from the distal end of the device through the fascia layer and into a needle-capture mechanism. The fascia layer may then be released, the device turned and the fascia layer grasped and a second suture-bearing needle deployed. The two needles may be connected by a suture, and as the device is removed from the wound, the suture extends through the fascia on one side, across the wound on the deep side, and through the fascia on the other side, thus creating a secure closure of the port wound through the fascia layer.

Abstract: A device for suturing an opening in a tissue, having an elongated shaft, at least two arms movable to a deployed positioning which the arms are non-perpendicular to the shaft, the arms having needle receiving portions; and needles advanceable longitudinally along the shaft toward the needle receiving portions, the needles exiting through side walls of the shaft at a location proximal to the arms.

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: A suture passing instrument including an operation handle, a needle member, and a suture holder assembly. The operation handle has at least one actuator movable between a first position and a second position. The needle member extends from the operation handle. The needle member has a curved end portion and defines an eyelet extending therethrough. The suture holder assembly extends from the operation handle and has a movable suture carrier at a distal end configured to hold a suture. The movable suture carrier has a suture pusher telescopically and movably received in the movable suture carrier. The suture carrier is movable between a retracted position and an extended position. The suture pusher is movable beyond the suture carrier to carry the suture through the eyelet.

Abstract: Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably dispose through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract: A suture applying device includes a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to draw the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured by a needle receiver and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied or otherwise secured to close the puncture site.

Abstract: A suturing system for receiving and retaining a suture is disclosed and includes a suture, at least one retainer, and at least one needle. Each needle is able to receive and removably retain the suture within a groove located in a tapered end. The retainer has a body that defines an aperture therethrough. The shape of the aperture is formed by a central passageway, and a pair of diametrically opposed slots extending radially outward from the central passageway. The central passageway is sized to allow passage of the needle therethrough. Each slot defines a tortured path section that permits passage of the suture in a first direction and inhibits passage of the suture in a second direction.

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 are 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. Methods of suturing tissue using a dual deployment suture passer are also described.

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 movable 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: Suturing instruments in accordance with the invention are dimensioned and configured to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, transvaginal, laparoscopic, or endoscopic surgical procedures. In some embodiments, the suturing instruments include a distal portion that is deflectably and/or pivotally coupled to the remainder of the instrument for improved maneuverability and functionality during surgery. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies and/or reloading the needle and suture assembly without removing the instrument from the surgical site.

Abstract: An endoscopic stitching device is provided including an end effector configured and adapted to perform at least a pair of functions; and a single actuation cable operatively connected to the end effector, wherein the actuation cable is capable of effecting operation of at least the pair of functions. The actuation cable is capable of effecting a first operation of the pair of functions upon an axial translation thereof, and a second operation of the pair of functions upon a rotation thereof.

Abstract: A suture passer device includes a shaft, a handle, an end effector, and a suture capturing member. The shaft has a shaft proximal end and a shaft distal end. The handle assembly is coupled to the shaft proximal end. The end effector is coupled to the shaft distal end. The suture capturing member is within the end effector, is coupled to the handle assembly independently of the shaft, and is configured to capture a suture within the end effector.

Abstract: A suturing assembly configured to place suture in tissue includes a handle having an actuator, a shaft coupled to the handle, and a head coupled to the shaft. The head includes a proximal portion housing a needle movable through a needle exit port and a distal end spaced apart from the proximal portion by a throat, the distal end defining a cavity. The actuator is configured to move the needle out of the needle exit port formed in the proximal portion of the head and across the throat to engage a capsule disposed in the cavity formed in the distal end of the head, the capsule attached to the suture.

Abstract: A member of a rigid flexible elastic material, the member including a body portion and an aperture portion with the member adapted for delivery through an axial longitudinal channel of a percutaneous delivery subsystem, the aperture portion including an expanded mode having a lateral dimension greater than an inner diameter of the channel when the aperture portion extends outside the channel and a collapsed mode wherein the lateral dimension is not greater than the inner diameter of the channel when the aperture portion is within the channel, the channel including a first axial opening and a second axial opening with the aperture portion transitioning from the expanded mode to the collapsed mode when inserted into the openings and the aperture transitioning from the collapsed mode to the expanded mode when exiting from the openings.

Abstract: A method for passing suture through tissue and a suture passing instrument having a first jaw coupled to an end of an elongated shaft, a second jaw coupled to the first jaw, and formed with a holder for supporting a suture, and a needle slidably disposed within the first jaw, having a hook on a side for releasably capturing a portion of a suture, is provided. The first jaw defines a channel for receiving the needle and a ramp for deflecting the needle transversely of the shaft when advanced to an extended position.

Abstract: An implantable port with an integral attachment mechanism. The implantable port includes one or more suture needles enclosed within a port body, the suture needle(s) coupled to a movable member such that movement of the movable member results in movement of the suture needle(s) out of the port body and into the tissue of a body into which it is implanted. The movable member can be a cam or tensioning member that rotates about a central port axis. The movable member can be coupled to a gear to permit movement of the movable member following implantation of the port within a subcutaneous pocket.

Abstract: An endoscopic tissue apposition device that includes a vacuum chamber configured to securely hold a portion of tissue therein, the vacuum chamber being defined by a proximal wall and a distal wall opposite to the proximal wall. Working and vacuum channels are provided in communication with the vacuum chamber. A portion of tissue may be held in the vacuum chamber when vacuum is applied in the vacuum chamber through the vacuum channel. A carrier needle is disposed on a proximal side of the vacuum chamber and is longitudinally advanceable into and across the vacuum chamber, while a punch needle is disposed on a distal side of the vacuum chamber and is configured to receive the carrier needle therein. A hold and release mechanism holds and releases the punch needle to facilitate joining portions of tissue together.

Abstract: A needle delivery device that has particular application for providing needles for minimally invasive spinal surgical procedures. The device includes an elongated pincher having opposing rails that is slidable within a channel defined in an extended base portion. Widened end portions of the rails hold the needle and push it out of an end of the device where it is released. The pincher is then retracted to a location where the end portions can pick up a next needle to be delivered.

Abstract: Methods and apparatuses are disclosed for closing a patent foramen ovale. Some of the disclosed apparatuses include an elongate body having a proximal end and a distal end, with first and second suture clasp arms adapted to hold end portions of a suture when in an extended position. A first suture catch mechanism is slidably housed in the elongate body and moves in a proximal-to-distal direction to engage the suture end held by the first suture clasp arm, and a second suture catch mechanism is slidably housed in the elongate body and moves in a distal-to-proximal direction to suture end held by the second suture clasp arm. The first suture clasp arm can be positioned around the septum primum to deliver a suture thereto, and the second suture clasp arm can be positioned around the septum secundum to deliver a suture thereto.

Abstract: A gastropexy kit includes a plurality of safety needle assemblies. Each safety needle assembly includes a needle and a stylus. A fastener is positioned in a distal end of the needle. The fastener is coupled to one end of the suture and a suture retention hub is coupled to an opposite end of the suture. The fastener is deployed in a patient's stomach via the needle and stylus which has a blunt distal end which extends through the needle to push the fastener out of the needle and to blunt the needle. The suture retention hub is positioned on a patient's skin and adjustably tensions the suture, which, desirably, is a resorbable suture.

Abstract: An apparatus includes a carrier configured to be movably disposed within a channel defined by an elongate member. The carrier includes a proximal end portion and a distal end portion. The proximal end portion is configured to be coupled to an actuator. The distal end portion includes a protrusion and an engagement surface. The protrusion has a tip configured to bodily pierce tissue. The protrusion is configured to be received within a lumen defined by a connecting portion of an implant, such as, for example, a pelvic floor implant, such that the tip extends through the lumen defined by the connecting portion of the implant. The engagement surface is configured to engage a portion of the connecting portion of the implant to limit movement of the connecting portion of the implant relative to the protrusion.

Abstract: A device for automatically providing needles to a sealing apparatus for sealing a puncture in an anatomical structure, the sealing apparatus including a needle insertion lumen and a needle pusher channel having a needle pusher disposed therein. The device may include a housing coupled to the sealing apparatus and a cartridge disposed in the housing. The cartridge has a first and a second needle slot extending from a distal end of the cartridge to a proximal end of the cartridge. The first and second needle slots have first and second needles disposed, e.g., pre-loaded, therein, respectively. The cartridge is moveable relative to the housing between a first position in which the first needle slot is aligned with the needle insertion lumen and the needle pushing channel, and a second position in which the second needle slot is aligned with the needle insertion lumen and the needle pushing channel.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element has can have shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: A suture system configured to place suture in tissue includes a tool and a suture assembly. The tool includes a proximal portion, a distal end spaced apart from the proximal portion by a throat, and a needle that is movable through a needle exit port formed in the proximal portion of the tool to a cavity formed in the distal end of the tool. The suture assembly includes a leader that is insertable into the cavity. The leader has a distal end attached to a length of suture and a band having at least two prongs extending from a proximal edge of the band. The prongs are configured to engage with the needle to allow the needle to extract the leader from the cavity and deliver it to the needle exit port.

Abstract: An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: A device and method for treatment of hemorrhoids, in which the devices includes: a housing insertable into the rectum; a tissue port configured to receive a tissue segment containing at least a portion of a hemorrhoidal blood vessel; opposing needle chambers including at least one pair of corresponding needles coupled by a suture in which the pair of corresponding needles are substantially opposite to one another and in an active position substantially aligned with the tissue segment; a needle driver that advances the pair of corresponding needles through the tissue segment to encircle a portion of the hemorrhoidal blood vessel with the suture, thereby ligating the hemorrhoidal blood vessel; and an actuator coupled to at least one of the needle chambers that actuates the needle chambers such that another pair of corresponding needles is in the active position.

Abstract: Methods and devices for driving a suture assembly employing elastically pre-shaped needles for piercing a tissue. The pre-shaped needles are held in a constrained state and can revert to a natural pre-shaped state prior to or during ejection from the device before entry into tissue allowing for the suture to follow a defined path similar to the pre-shaped needle such that removal of the needle allows for subsequent securing of the suture in or around tissue.

Abstract: A perforation suturing method has the steps of: inserting a needle into a wall of a hollow organ at a periphery of the perforation formed in the hollow organ, and piercing the wall; withdrawing the needle from the wall after delivery of an anchor attaching suture thread from the needle, and having the suture thread transit the wall; and tightening the suture thread so that the mated insertion points at the time of insertion of the needle into the wall approximately coincide after having the needle pierce the wall at the periphery of the perforation a plurality of times, and making surfaces of the wall where the insertion points are formed coincide with each other.

Abstract: A surgical device for suturing body lumen is described, as well as methods for suturing tissue employing the surgical device. The device can include a body having a shaft and a foot for insertion into an opening in a body lumen. The body can include tissue ports between the shaft and the foot configured to receive tissue of the body lumen surrounding the opening. The foot can include a suture secured to needle capture devices. Needle can be advanced within the shaft, through tissue within the tissue ports, and into the needle capture devices. The needle capture devices cuffs can then be withdrawn, thereby harvesting the suture, which can then be used to close the opening in the body lumen.

Abstract: The present invention relates to a surgical suture apparatus having a sewing function. In accordance with one aspect of the present invention, there is provided a surgical suture apparatus comprising: a coupling part, a shaft part connected to the coupling part, an operating part, and a suture part connected to the shaft part by way of the operating part, the suture part including a support, a surgical needle and a needle driving part, wherein the surgical needle operates in a direction substantially orthogonal to the support by the needle driving part, and a suture thread from the surgical needle and a suture thread from the support are entangled with each other by the operations.

Abstract: An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A method for inserting an instrument through a natural orifice. The instrument has a low profile orientation and a deployed orientation which is larger than the size of the natural orifice through which it is to be inserted. The method is achieved by coupling the instrument to an endoscope and placing the instrument in its low profile orientation, inserting the endoscope and the instrument through a natural orifice to a target position within a body while the instrument is in its low profile orientation, actuating the instrument to it is deployed orientation, and returning the instrument to its low profile orientation and withdrawing the instrument from the body through the natural orifice.

Abstract: A suturing instrument is configured for to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, or endoscopic surgical procedures. The suturing instrument includes an elongate body member, a needle exit port, a needle receiving port, and a needle deployment mechanism. The suturing instrument eliminates the need for a preassembled needle and suture and reduces or eliminates the possibility of needle loss during suturing.

Abstract: An endoscopic suturing device that can be employed to suture tissue using endoscopic techniques to place one or more stitches in tissue during a single intubation of an endoscope. The suturing device may include a suturing capsule with a suction chamber that is configured to capture tissue that is to be sutured. A needle is movable along a pathway across the suction chamber to penetrate and place stitches in the captured tissue. A catch is located distal to the suction chamber to receive and retain the suture during a stitching sequence. The catch may be movable along the needle pathway and configured to release the suture when the catch moves a predetermined distance along the pathway. The catch may be configured so that a predetermined amount of force is required to move the catch the predetermined distance required to release the suture.

Abstract: A filament-guiding device directs a filament to spool over a rotating device within tissue. The filament-guiding device has both closed and open positions. In the closed position, the filament-guiding device is resiliently straightened for delivering into tissue. Within tissue, the filament-guiding device resumes a curved configuration in the open position to orient the filament perpendicular to the rotating device for spooling. The spooled filament is deployed by withdrawing the rotating device and filament-guiding device to bulk and repair the tissue.

Abstract: An endoscopic tissue suturing device may include a suturing head configured to capture tissue at a tissue capture region. A needle can move through the region to place stitches in the tissue. A control handle includes an actuator coupled to the needle. The control handle supports a suture spool about an axis of rotation. The axis of the spool may be parallel to the direction of movement of the actuator. The spool surface may be tapered at an angle relative to the axis of rotation. A spool end wall may be configured to urge the spool in an axial direction. The handle may provide external access to a portion of the suture. A cover may be provided to cover the spool. The cover may be rotatably supported on the handle independent of the spool. Suture material may be wound onto the spool by rotating the cover.

Abstract: A suture insertion device (120) includes a shaft (124), which is adapted to be inserted into a body cavity (154). First and second needles (160) hold respective first and second ends of a suture thread (122). First and second needle guides (130) are attached to the shaft and respectively hold the first and second needles. The needle guides have a first operative configuration in which the needle guides are held parallel to the axis of the shaft for insertion of the shaft into the body cavity and a second operative configuration in which the needle guides are deployed outward from the shaft within the body cavity so as to point the needles in a proximal direction. An ejector (164) is operative to eject the needles from the needle guides in the second operative configuration so as to cause the needles to penetrate tissue (156) adjoining the body cavity.

Abstract: An apparatus comprises a shaft, a needle throwing arm, and a needle receiving arm. The arms are movable asynchronously along planes that are substantially parallel to a longitudinal axis defined by the shaft. The arms selectively engage a surgical needle, such that the throwing arm may pass the surgical needle through tissue for receipt by the receiving arm, and the receiving arm may then pass the surgical needle back to the throwing arm for additional stitching. The arms may pivot about a common pivot. Such versions may include a single actuator for both arms or separate actuators for the arms. The arms may also pivot about their own respective axles, which may facilitate a forward reset motion for a needle, allowing the needle to continue travelling along a circular path in a single direction to create several stitches. The apparatus may also convert reciprocating movement of actuators into rotational motion.

Abstract: An instrument for delivering a suture transfascially may include a handle, a shaft extending from the handle, and a pair of needles that are moveable to an extended position beyond the end of the shaft. One or more sutures are carried by the instrument and may be delivered transfascially. A transfascial suture assembly includes a suture having a first segment, a second segment, and an intermediate segment therebetween. A force distributing member is locatable at the intermediate segment. Suture retainers may be provided at the end of each suture segment, and may have a connection that is moveable relative to the portion of the suture segment connected therewith. A method of delivering transfascial sutures includes inserting a twin-needle instrument loaded with one or more sutures into an abdominal cavity and deploying, from within the abdominal cavity, the suture carrying needles through a soft tissue repair patch and then through at least part of the abdominal wall.

Abstract: Provided is an endoscopic suturing system for joining internal body tissues in a variety of procedures. The system comprises a suturing capsule releasably mountable to the distal end of an endoscope and capable of forming multiple stitches in tissue at a plurality of locations without requiring withdrawal of the capsule from the patient between stitches. Also enclosed is a suture lock to secure the placed stitch that is delivered by a device introduced through the working channel of the indwelling endoscope. Suitable control handles for the suturing capsule and for the suture lock delivery device positioned at the proximal end of the endoscope are provided to facilitate operation by the user.