Abstract: A tool configured to assemble a drain to a household appliance wall, the drain formed by an interior tube and an exterior tube, the tool including a jaw, a housing, a spring and a guide member. The jaw is formed by a pair of arms and configured to move between a closed position, in which the jaw is configured to be inserted through an aperture formed by the household appliance wall, and an open position in which the jaw is configured to engage the interior tube. The housing houses the jaw and the spring is fixed to the housing and configured to bias the jaw towards the closed position. And the pair of arms are configured to move from the closed position to the open position as the jaw is inserted through the aperture.

Abstract: Devices used to deploy transvascular medical device systems and methods for using such devices are described in this document. For example, this document describes dilating introducer devices used for the percutaneous vascular deployment of catheter-based medical devices such as structural heart medical devices. Such dilating introducer devices can facilitate the percutaneous vascular deployment of catheter-based medical devices without an additional introducer sheath.

Abstract: A control system configured to control manipulation of a surgical instrument in response to manipulation of a remote surgeon input device. The surgical instrument comprises an end effector having opposable first and second end effector elements connected to a shaft by an articulated coupling. The control system receives a command from the surgeon input device to both (i) change the orientation of the end effector, and (ii) open the first and second end effector elements relative to each other. In response to the command to change the orientation of the end effector, the control system determines an angle ? between the longitudinal axis of the articulated coupling and the end effector. In response to the command to open the first and second end effector elements, the control system determines an opening angle ? between the first and second end effector elements.

Abstract: Systems, devices, and methods for controlling cooperative surgical instruments are provided. Various aspects of the present disclosure provide for coordinated operation of surgical instruments accessing a common body cavity of a patient from different approaches to achieve a common surgical purpose. For example, various methods, devices, and systems disclosed herein can enable the coordinated treatment of surgical tissue by disparate minimally invasive surgical systems that approach the tissue from varying anatomical spaces and operate in concert with one another to effect a desired surgical treatment.

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: A suture device for use in combination with a delivery system including a lumen extending through the delivery system includes a needle usable to carry a suture, a distal shuttle configured to releasably secure the needle, a sleeve disposable over the distal shuttle, the distal shuttle movable relative to the sleeve between a locked position in which the needle is locked to the distal shuttle and an unlocked position in which the needle is releasable from the distal shuttle. A shaft is operably coupled to the sleeve and a control wire is operably coupled to the distal shuttle. A needle may include a needle cap.

Abstract: An endoscopic grasping device for use during an endoscopic procedure. The device includes at least a fork operably connected to a pair of jaws pivotally mounted about a pivot point to the fork. A pusher is disposed within the fork and operably connected to a drive wire and a pair of arms. Each arm is attached to a respective jaw and configured to move that jaw upon a movement of the pusher in a distal direction or proximal direction resulting in the pair of jaws being in a closed position and a open position. Each jaw includes a plurality of teeth extending therefrom and towards the opposite jaw. One or more of the teeth are backwards curved and angled in a proximal direction from the jaw to improve a grasping, cutting, and handling feature of the teeth.

Abstract: A method comprises receiving a surgical instrument into engagement with a grip actuator of a teleoperational activation system. The surgical instrument includes movable jaws, and the surgical instrument is received in a prearranged gripping configuration with the jaws gripping a surgical accessory. The method includes generating a first control signal for manipulating the surgical instrument while maintaining the surgical instrument in the prearranged gripping configuration. The method further includes generating a second control signal for manipulating the surgical instrument to move from the prearranged gripping configuration to a second configuration.

Abstract: A medical device including an elongate member extending from a proximal end toward a distal end, the elongate member having a lumen with a longitudinal axis, a hub portion towards the proximal end of the elongate member and configured for a user to hold and manipulate a position of the elongate member, a base portion including a first groove and a second groove separated by an opening, and two wings disposed towards a distal end of the medical device, the two wings being opposite each other across the longitudinal axis and on opposite sides of the base portion, wherein, the two wings are configured to move in relation to the longitudinal axis and wherein each wing has an elongate slot having a closed first end at a location between the base portion and a peripheral end of the wing.

Abstract: Provided is a surgical instrument including a first holding member, a sleeve member, a linkage member, a second holding member, a hook member and an opening/closing member. The second holding member is pivotally connected to the first holding member and when the second holding member moves relative to the first holding member, the linkage member is moved inside the sleeve member so as to drive the opening/closing member to move relative to the hook member. Through the movement of the opening/closing member of the surgical instrument, surrounding soft tissues, blood vessels or nerves that have strayed into the hook member can be pushed out so as not to be damaged by the hook member during surgery.

Abstract: A surgical stitching device includes a suture needle configured to reliably pass through a typically thick scarred tissue present along, e.g., an edge of midline hernias. The surgical stitching device includes first and second jaws. The suture needle is selectively supported on the first or second jaws at, e.g., an acute, angle with respect to a longitudinal axis defined by the corresponding first or second jaw. The suture needle may be selectively secured with the first or second jaw by first and second needle receiving blades configured for reciprocating axial displacement. A suture is connected to the suture needle to perform suturing of tissue.

Abstract: An implant insertion system and methods of use of the implant insertion system are disclosed. The implant insertion system includes an implant and an instrument configured to deliver the implant to a biological structure and assist in deploying the implant to the biological structure. The instrument includes a retention member the secures the implant to the instrument and retains the implant in a first configuration. The retention member is movable to decouple the implant from the instrument. The implant is configured to transition from the first configuration to a second configuration, such that in the second configuration the implant is secured to the biological structure.

Abstract: One variation of a method for monitoring needle consumption in a surgical space during a surgery includes: accessing a sequence of images captured by a camera facing an inventory field within the surgical space; scanning the sequence of images for needle packages and needles; in response to detecting entry of a needle package into the surgical space in a first image, logging entry of the needle package, labeled as sterile, into the inventory field at a first time and incrementing a sterile packaged needle counter for the needle package according to a first quantity of sterile needles associated with a type of the needle package; and, in response to detecting removal of a first needle from the inventory field in a second image, incrementing a deployed needle counter at a second time succeeding the first time and decrementing the sterile packaged needle counter.

Abstract: The present disclosure relates to automated systems, devices, and methods of sewing a target device such as a prosthetic implant device. The systems and methods include forming a stitch on the target device, adjusting a thread coupled to a needle used to form the stitch so that the thread is clear of (e.g., does not interfere with) a path of the needle, and applying a targeted tension to the thread to tension the stitch on the target device. The suturing process can also include providing different targeted tensions during formation of the stitch. The suturing process can also include providing different targeted tensions at different stages of the formation of the stitch to aid in forming the stitch, to clear the needle path of the thread, and/or to hold the stitch in place in preparation for the next stitch.

Abstract: Side bite surgical suturing instruments or portions thereof for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing facilitate the use of larger needles to get a bigger bite while suturing.

Abstract: A movement transfer mechanism for a surgical scoping device, wherein a rotational proximal input force is transformed into a longitudinal force that is conveyed down the length of an instrument channel of the scoping device, where it is transformed again into an operational movement of a distal instrument. The operational movement can be rotational movement, but may be any movement that changes the orientation or configuration of the distal instrument. By conveying a linear force along the instrument channel rather than a twisting force, the problems of slipping and discontinuous operation of the distal instrument due to friction between the instrument and the instrument channel can be reduced or eliminated.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to single-use endoscopic medical devices with integrated and purpose-built functionality.

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 method for closing a wound in a tubular organ using a suture thread attached to a suture needle. The method includes grasping a first part of the suture thread by a grasper inserted in the tubular organ after the suture thread has been passed through tissue surrounding the wound at a first position; moving the first part away from the first position by moving the grasper grasping the first part along a longitudinal axis of the grasper; grasping a second part of the suture thread located between the first part and the first position by the grasper; and moving the second part away from the first position by moving the grasper grasping the second part along the longitudinal axis of the grasper.

Abstract: A system for performing minimally invasive procedures in a body lumen of a patient including a flexible catheter having a first lumen configured and dimensioned to receive an endoscope therethrough and a second lumen configured and dimensioned to receive a first flexible tube therethrough. The first flexible tube is movable through the second lumen and has a distal portion including a first curve extending in a first direction with respect to the longitudinal axis and a second curve extending in a second different direction with respect to the longitudinal axis. A retractor system is positioned at a distal portion of the catheter and is movable from a non-expanded insertion position to an expanded position forming an expanded cage to form a larger working space. The distal portion of the first flexible tube is movable within the expanded cage.

Abstract: A minimally invasive suturing device is disclosed. The minimally invasive suturing device has a shaft and a distal tip. The minimally invasive suturing device also has a flexible span coupling the distal tip to the shaft. The flexible span has an angling link, a plurality of bending links, and an end link.

Abstract: A medical device includes a clevis, a first jaw, and a second jaw. The first jaw includes a first proximal gripping portion and a first distal gripping portion, and the first proximal gripping portion includes a first needle alignment portion. The second jaw is coupled to the clevis and includes a second proximal gripping portion and a second distal gripping portion, and the second proximal gripping portion includes a second needle alignment portion. The first and second needle alignment portions are located opposite each other when in the closed orientation. The first and second needle alignment portions define a clamp path when in the closed orientation within which the curved portion of the needle is received when the second jaw is in the open orientation. The first and second needle alignment portions are configured to rotate the needle when moving to the closed orientation.

Abstract: A laparoscopic device (10) comprising a handle assembly (30) by which the user may hold the laparoscopic device (30); and a tool gripping assembly (60) which holds a tool member (20) is disclosed. The tool gripping assembly (60) comprises a longitudinally extending rod (70) having a longitudinal axis A, a distal end (71) and a proximal end (72) The proximal end (72) is configured to be attached to the handle assembly (30), said distal end (71) is provided with a holding member (73) capable of holding a tool member (20). The tool gripping assembly (60) further comprises a first sleeve (80) partially surrounding and being longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said longitudinally extending rod (70), and a second sleeve (90) partially surrounding and being longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said first sleeve (80).

Abstract: A needle holder includes: a flexible sheath portion which is capable of being inserted into an instrument channel of a flexible endoscope; a first grasping member which is rotatably coupled with a distal end portion of the flexible sheath portion; and a second grasping member which is provided in the distal end portion of the flexible sheath portion. In a state where a curved needle is grasped by a first grasping surface of the first grasping member and a second grasping surface of the second grasping member, the second grasping surface inclines such that a grasped region of the curved needle that is grasped by the first grasping surface and the second grasping surface is positioned between a distal end of the second grasping member and a needle tip of the curved needle in a direction of a center axis of the second grasping member.

Abstract: A vapor delivery needle is provided that may include any of a number of features. One feature of the energy delivery probe is that it can apply condensable vapor energy to tissue, such as a prostrate, to shrink, damage, denaturate the prostate. In some embodiments, the vapor delivery needle can be advanced a predetermined distance into the prostate by an actuation mechanism. The actuation mechanism can comprise, for example, a spring, or at least one magnet. Methods associated with use of the energy delivery probe are also covered.

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: Devices and methods for inserting an implant into skin or other tissue of a patient can include a hyaluronic thread that is coupled at along distal portion with an insertion device. The insertion device can include a cover member and a piston that can collectively facilitate engagement with or disengagement of the distal portion of the thread with the device. For example, the piston can be positioned within an inner cavity of the cover member, and the distal portion of the thread can be engaged by and/or between the piston and the cover member. The thread can be released by movement of the piston relative to the cover member. Thus, some insertion devices can grasp or engage the distal portion of the thread and “push” the distal portion thread into and through into skin or other tissue of a patient.

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: A cutting tool, comprising a motor; two rods, a first rod and a second rod; a synchronization gearing; and a cutter. The motor, synchronization gearing, and the two rods are operatively coupled such that when the motor turns the first rod, the synchronization gearing turns the second rod at the same speed in an opposite direction. The cutter is connected to both of the two rods, such that when the two rods spin in opposite directions the cutter rotates.

Abstract: Disclosed herein are gear shifters to reverse an output shaft rotation and a method for using the same. A gear shifter in accordance with the present invention may include a housing, an input shaft, an output shaft and an idler shaft. The input shaft may have input gears, the output shaft may have output gears and the idler shaft may have idler gears. The output shaft may be slidably coupled with the input shaft and the idler shaft to rotate in a first direction in a first position and in a second opposite direction in a second position. A method of reversing an output shaft direction using a gear shifter may include the steps of pushing the gear shifter in a first direction to rotate the output shaft in a first direction and pushing the gear shifter in a second direction to rotate the output shaft in a second direction.

Abstract: A surgical instrument is provided. The surgical instrument includes a housing. A movable handle is coupled to the housing and is configured to approximate a pair of jaw members toward and away from one another. A latch mechanism operably couples to the movable handle and includes one or more mechanical interfaces configured to selectively engage a corresponding mechanical interface disposed within the housing to lock and unlock the jaw members in an approximated configuration. When the movable handle is in a jammed position, the mechanical interface(s) of the latch mechanism is/are configured to deform and separate from the corresponding mechanical interface disposed within the housing when the movable handle is moved from the jammed position.

Abstract: The present invention relates to medical device management units and methods of their use. The medical device management units comprise two main pieces, a base piece, and a slide piece, as well as at least one medical device pathway defined by a surface means and a plurality of trenches. The invention may be used to keep two or more medical devices organized or it may be used to maintain control over the capture and release of a single medical device.

Abstract: A surgical suturing instrument has a chamber for receiving and aligning a ferrule with a reciprocating needle. The chamber includes a plurality of protuberant concave and convex surfaces for positioning and aligning the ferrule within the chamber and the plurality of suture receiving chambers disposed between the aligning ridges for receiving a suture and preventing the suture from jamming the ferrule in the chamber.

Abstract: A self-articulating joint is disclosed for a minimally invasive surgical apparatus. The self-articulating joint has a first elbow component pivotably coupled to a second elbow component, wherein the first and second elbow components are biased to form a non-linear angle relative to each other. The self-articulating joint also has an elbow latch configured to releasably hold the first and second elbow components at a substantially fixed non-linear operating angle.

Abstract: A cannula insertion device includes a rigid elongated body having a first end and a second end, an insertion tip located at a first end of the rigid elongated body, a cannula holder located along the rigid elongated body between the first and second ends, the cannula holder being configured to receive, hold, and release a cannula that is at least partially deformable; and a cannula insertion device control means located at a second end of the rigid elongated body. A system for facilitating access to a surgical site via minimally invasive means includes a cannula insertion device and a cannula having a deformable flange at one end.

Abstract: A suture needle driving instrument comprises a shaft and an end effector. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. Each jaw has a needle grasping member operable to align a suture needle along a predetermined arc path. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A surgical suturing device (10) having an axis extending between a proximal end and a distal end is operable to move a suture (32) through body tissue (34). A handle assembly (110) is coupled to an elongated shaft (14) having a hollow configuration. An actuating rod (16) is disposed to extend between the handle assembly (110) and the shaft (14). A thumb actuation assembly is coupled to a proximal end of the actuating rod (16) for moving the rod both axially and rotationally. A needle assembly (2) at the distal end of the actuating rod (16) is movable with the actuating rod (16) between an extended state and a retracted state and at various angular orientations.

Abstract: A rotational action needle driver that comprises an cumbersome ergonomically designed handle, rotational mechanism and an integrated locking/unlocking system that permits surgeons to perform the surgical suturing procedure in a less complicated and more secure way by allowing more control over the suturing needle and the area to be stitched, even when the suturing area is small, deep, and/or restricted.

Abstract: A wound closure system includes a device, a sleeve, and a needle assembly. The device includes a shaft and one or more arms movable relative to the shaft between a retracted position and a deployed position. The sleeve is removably positionable about the shaft and is slidable about the shaft to retain tissue between the distal end of the sleeve and the arms when the arms are in the deployed position. The needle assembly includes a base one or more needles insertable through respective needle lumens of the sleeve. The base defines a central aperture for removably positioning the base about the shaft. The base is slidable relative to the shaft and sleeve between a proximal position, wherein the needles are disposed within respective needle lumens, and a distal position, wherein the needles extend from respective needle lumens towards respective arms.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: A wound closure system includes a device, a sleeve, and a needle assembly. The device includes a shaft and one or more arms movable relative to the shaft between a retracted position and a deployed position. The sleeve is removably positionable about the shaft and is slidable about the shaft to retain tissue between the distal end of the sleeve and the arms when the arms are in the deployed position. The needle assembly includes a base one or more needles insertable through respective needle lumens of the sleeve. The base defines a central aperture for removably positioning the base about the shaft. The base is slidable relative to the shaft and sleeve between a proximal position, wherein the needles are disposed within respective needle lumens, and a distal position, wherein the needles extend from respective needle lumens towards respective arms.

Abstract: A manipulator adapted to grasp and draw tissue comprises first and second arms having proximal ends and distal ends separated by a distance. First and second grasping surfaces each connected to and extending from respective distal ends of the first and second arms are biased toward each other by a respective spring force. When the first and second arms are actuated to reduce the distance, the manipulator is configured such that tissue arranged between the first and second grasping surfaces resist actuation of the first and second arms. The first and second arms are further actuatable to overcome the spring force of the first and second grasping surfaces so that the first and second grasping surfaces pivot at respective pivot points such that the distance between the distal ends of the first and second arms is reduced.

Abstract: A medical device including an elongate member having a proximal end, a distal end, and a lumen extending therebetween. The medical device may further include an end-effector disposed at the distal end of the elongate member, the end-effector may include a first arm, the first arm may have a distal end, a proximal end, and an opening configured to receive a needle therein. The medical device may also include a second arm movably connected to the first arm and configured to alternate between a closed position and an open position relative to the first arm, wherein the second arm is movably connected to the first arm at a pivot point disposed at a location closer to the distal end of the second arm than the proximal end of the second arm.

Abstract: An apparatus and a method for surgical suturing with thread management is provided. An apparatus for tissue suturing includes a cartridge with a suturing needle that includes a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly including a cartridge holder with a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue with the apparatus is also provided.

Abstract: A needle holder includes a first shaft on which a first gripping body is provided at a front end, and a second shaft on which a second gripping body is provided at a front end and which slides in an axial direction relative to the first shaft. The first gripping body and the second gripping body have continuous curved convex shapes at at least sides opposed to each other and abut against each other as the second shaft slides relative to the first shaft. An abutment keeping mechanism by which abutment between the first gripping body and the second gripping body is kept while the first shaft and the second shaft are separated from each other as the second shaft further slides relative to the first shaft in the same direction from a state where the first gripping body and the second gripping body abut against each other is provided.

Abstract: A surgical instrument includes first and second members, with each member including a handle adjacent a first end of the member, a working portion having an inner surface and an outer surface and extending from a second, opposite end of the member, and a pivot portion located between the handle and the working portion. The first and second members are pivotally connected at the pivot portions about a pivot axis such that the handles are movable between an open position in which the handles are spaced apart and the working portions are adjacent one another and a closed position in which the handles have been brought together and the working portions are spaced apart.

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a handle assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms operable to grasp and release a needle. The handle assembly comprises a trigger-operated actuation assembly that is operable to rotate a second grasping arm relative to the shaft. The trigger-operated actuation assembly may include a trigger and a trigger gear assembly that is operable to rotate the second grasping arm. A clutch assembly may also be included to selectively couple a drive shaft associated with the second grasping arm to another shaft. The handle assembly may further include a toggle actuation assembly that is operable to grasp and release a needle with the grasping arms. A locking feature may be included to prevent use of the toggle actuation assembly until trigger-operated actuation assembly has been operated.

Abstract: A suture passer including 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 includes a spring for selectively binding the suture to the first jaw.

Abstract: An apparatus is operable to secure suture fasteners to sutures to eliminate the need to tie knots in the sutures. The apparatus comprises a shaft, an end effector disposed at the distal end of the shaft, and a suture fastener removably secured to the end effector. The end effector may include a pivoting jaw or a suture cutter. The suture fastener may be secured to one, two, or more strands of suture. The apparatus may include several suture fasteners and may secure those fasteners to one or more sutures in a serial fashion without having to remove the apparatus from the patient for reloading. A plurality of fasteners may be arranged within the apparatus in an end-to-end configuration. The suture fastener may include an inner fastener member and an outer fastener member, and may capture one or more strands of suture between the inner and outer fastener members.

Abstract: A needle holder includes a shaft and a needle driver located at the distal end of the shaft. The needle driver is operable to rotate a needle such that the needle forms a non-perpendicular angle with a longitudinal axis of the shaft. In some versions, the needle driver includes a first arm and a rotatable assembly that is configured to longitudinally clamp about a portion of a needle. The rotatable assembly may include self-righting features to right the needle perpendicular to the first arm. The needle driver may further include a second arm that is pivotable relative to the first arm. The rotatable assembly may include a top member associated with the second arm and a bottom member associated with the first arm. In some versions, spring-loaded collets may secure the needle to a rotatable assembly. Alternatively, a pair of actuating arms may pivot the needle about a curved surface.