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.

Abstract: Compliant inserts for jaw-type surgical instruments having improved traction are provided. The clamping surface of the inserts includes a plurality of short and densely arranged traction elements. The tractive force supplied by the traction elements approaches that of steel jawed clamps.

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 needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.

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

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic or open surgeries, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft. Portions of the devices may be disposable, replaceable, and/or reusable, with different needle-grasping jaws and/or different elongate extension bodies having different configurations optionally being selectably coupleably to an articulatable handle and housing so as to allow the user to configure the device for a particular procedure.

Abstract: Provided is a manipulator including a first forceps piece and a second forceps piece, which are connected by a pivotal axle and have a gripping part opened or closed on a leading end side thereof. The manipulator includes a manipulation member that is connected to a base end side of the pair of forceps pieces, and moves forward or backward in an axial direction to open or close the gripping part, a first buffer part that has a first spring constant, and undergoes elastic deformation to change a grasping force generated at the gripping part on the basis of the first spring constant and a pulling amount of the manipulation member, and a stopper that regulates the elastic deformation of the first buffer part.

Abstract: A method of suturing tissue includes driving a needle from a tool through tissue to form a channel in the tissue; inserting the needle into a capsule that is connected to a first length of suture attached to the capsule; engaging the needle with a second length of suture that is inserted through the capsule; and pulling both the first length of suture and the second length of suture through the channel formed in the tissue.

Abstract: A suture passer includes a handle, an elongated sleeve defining a distal end, an inner shaft slidably disposed within the elongated sleeve, and an end effector assembly disposed at a distal end of the inner shaft. The end effector assembly includes first and second arms, at least one which is movable relative to the other between a spaced-apart position and an approximated position for retaining a portion of a suture therebetween. The inner shaft and elongated sleeve are relatively movable between a first condition, wherein the first and second arms are disposed in the approximated position and the distal end of the elongated sleeve is exposed, a second condition, wherein the first and second arms are disposed in the approximated position and the distal end of the elongated sleeve is shielded, and a third condition, wherein the first and second arms are disposed in the spaced-apart position.

Abstract: A surgical incision suturing device particularly suited for minimally invasive surgical procedures comprising a suturing mechanism built into a trocar stern that enables a surgeon to stitch a patient by utilizing controls on the exposed top portion of the trocar.

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 needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A surgical instrument for holding a suturing needle comprises an operating section, an insert section having an insert-section distal end extension at a distal end of an insert section body, a clamping portion, a rotatable holder portion, a receiving member having a first contact surface, and a transmitting member having a second contact surface. The insert section body has an inner bore along a first axis in a longitudinal direction. The insert-section distal end extension has a rotation-allowing groove on an inner peripheral surface of an inner bore provided along a second axis at a predetermined angle with respect to the first axis. The rotatable holder portion is allowed to be passively rotatable about the second axis under an external force applied to the suturing needle when a gap is formed between the transmitting member and the receiving member.

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

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic or open surgeries, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft. Portions of the devices may be disposable, replaceable, and/or reusable, with different needle-grasping jaws and/or different elongate extension bodies having different configurations optionally being selectably coupleably to an articulatable handle and housing so as to allow the user to configure the device for a particular procedure.

Abstract: A device according to one exemplary embodiment is a compact, light-weight handheld device that includes a needle and suture assembly, a mechanism for gripping and releasing the needle and suture assembly (a “needle transfer mechanism” or “needle shuttle mechanism”), safely capturing the needle assembly upon exit from the patient's tissue, and returning the needle to position such that the process of delivering additional sutures to the patient can be repeated. 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 that is familiar to a user based on experience with other surgical techniques.

Abstract: Improved medical suturing devices, systems, and methods may hold a suture needle at a fixed location relative to a handle of the device, allowing the surgeon to grasp and manipulate the handle of the suturing device to insert the needle through tissues in a manner analogous to use of a standard needle gripper. Cycling the handle from a closed position to an open position and back to the closed position may alternate the device between gripping the needle with a first clamp (for example, along a proximal portion of the needle) to gripping the needle with a second clamp (for example, along a distal portion of the needle) and optionally back to gripping with the first clamp, with the needle often staying at a substantially fixed location relative to the suturing device body. Related single-clamp needle grasping devices can be bent plastically by a surgeon, and/or have bodies that are grasped by a hand while a portion of the hand actuates a handle.

Abstract: Provided is a medical treatment endoscope including: an endoscope main body which includes an elongated insertion portion having a lumen and an image capturing mechanism disposed in a distal end of the insertion portion; an arm which is able to be inserted into or extracted from the lumen and has a treatment tool lumen for allowing an endoscope treatment tool to be inserted therethrough; and a positioning mechanism which positions a part of the arm inserted through the lumen with respect to the endoscope main body.

Abstract: A medical needle driver including an elongated member having a proximal end, a distal end, and a lumen extending therebetween. The medical needle driver may also include an end-effector disposed at the distal end of the elongated member, the end-effector may include at least two arms connected at their proximal ends to form a jaw-like structure, wherein at least one of the at least two arms may be configured to rotate relative to the other arm. In addition, each arm may include an inner face, the inner face of at least one of the arms including at least one groove configured to receive a portion of a needle, wherein the groove may include a first geometric structure configured to mate with a corresponding second geometric structure on the needle.

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. 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. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. 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: The present invention relates generally to a continuous driver device with changeable parameters, more specifically, a continuous driver with changeable parameters used in surgical procedures such as suturing, wherein said continuous driver device is employed as a continuous suture rotational needle driver which enhances the tissue suturing procedure, particularly the one performed on restricted, deep and less accessible locations. The device incorporates a plurality of interactive portions comprising several extended members wherein said extended members are provided with rotational needle driving points at a distal end into a single device and is operated by the twist of a single knob. The use of the mechanism prevents problems associated with loss of needle control during the suturing procedure as well as the ones associated with the handedness of existing needle drivers.

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic (with or without access ports) or other surgeries in which access is limited, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft that has axial stiffness (such as being stiff in compression) and lateral flexibility or an axial movement of a cable. An extension body (within which the shaft or cable moves) between the handle and jaws can be pre-bent or custom bent by the user. Portions of the devices may be disposable, replaceable, and/or reusable. A spring adjacent the clamp may open the clamp or impose a gripping force.

Abstract: A needle capture device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, a housing at the distal ends of the shaft and tubular member, and a capture mechanism situated within housing. The housing has an alternating arrangement of flights and spaces radially arrayed about its exterior dimensioned to be closely received within an endoscopic instrument channel so as to coaxially orient said housing with the instrument channel. The capture mechanism has a first configuration in which it is adapted to receive and retain a needle presented into the distal end of the instrument channel, and a second configuration in which it is adapted to release the needle from the instrument channel.

Abstract: A surgical stitching device intended for suturing deep and difficult-to-reach wounds. It is a distinctive type of needle-holder designed to carry a straight needle alongside its main body. This instrument is distinguished from the currently available devices because it may not need laparoscopic visualization and sutures wounds from an inside out direction rather than from side-to-side.

Abstract: An apparatus and method for passing suture in tissue repair and other surgical procedures. The apparatus includes a pair of jaws mounted on a distal end of a shaft, a handle assembly mounted on a proximal end of the shaft, and two needles mounted on the handle assembly and through a cannulation of the shaft. A dual-needle actuator communicates with the two needles. A suture is placed at the tip of the lower jaw. By advancing the dual-needle actuator relative to the body of the instrument, the two needles are pushed forward to capture the suture and advance it through the tissue to be sutured.

Abstract: A new, quick, simple, efficient, safe, and reproducible surgical technique for the treatment of female urinary incontinence, in which the posterior urethra is suspended using a tape passed through the obturator orifices from inside (underneath the urethra) to outside (thigh folds). A variety of specifically designed surgical instruments are utilized to perform this operative procedure.

Abstract: A system for providing wireless remote control over one or more devices. Included in the system is at least one wireless button that can be placed at various locations and which communicates with at least one sensor when the wireless button and sensor are brought within close proximity to one another. According to one embodiment, a wireless button can only be activated when the button is located within an authorized activation area. In another embodiment, a wireless button can only be activated by an authorized user. In yet a further embodiment, a wireless button can only be activated by an authorized user when the button is located within an authorized activation area.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing including a cartridge having a suturing needle having a pointed end, 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 including 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: Medical suturing devices, systems, and methods will be useful for endoscopic or open surgeries, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft. Portions of the devices may be disposable, replaceable, and/or reusable, with different needle-grasping jaws and/or different elongate extension bodies having different configurations optionally being selectably coupleably to an articulatable handle and housing so as to allow the user to configure the device for a particular procedure.

Abstract: An instrument for passing sutures in tissue repair and/or other mini-open procedures. The instrument includes a pair of jaws mounted on a distal end of a shaft, a hand assembly mounted on a proximal end of the shaft, and a needle mounted on the hand assembly and through a cannulation of the shaft. The pair of jaws includes a lower jaw and an upper jaw, the lower jaw being provided with a slot configured to engage a plurality of sutures. The hand assembly has a finger lever with a ratchet and a releaser with a hook, the hand assembly being designed to move the needle from a first position to a second position, and to sequentially engage the needle with each of the plurality of sutures.

Abstract: Sutures can be placed in difficult to access areas of the human body with devices, and related methods, utilizing a needle carrier. The devices and methods can be used in conjunction with both endosurgical and traditional open surgery procedures.

Abstract: This treatment system includes: a supporting portion; a first grasping member and a second grasping member supported by the supporting portion so as to approach and separate from each other; a needle member including a distal end portion which has a sharp distal end and punctures a tissue, and a proximal end portion continuous with the distal end portion; a holding portion mounted on the first grasping member and releasably holding the proximal end portion of the needle member; and a locking portion mounted on the second grasping member and locking the distal end portion of the needle member such that the proximal end portion of the needle member is removed from the holding portion when the first grasping member and the second grasping member are separated from each other from a position at which the first grasping member and the second grasping member approach each other.

Abstract: An apparatus comprises a body, a shaft assembly, an end effector assembly, and a drive assembly. The body may include a handpiece with an integral motor. The shaft assembly may include two pairs of concentric shafts. The end effector assembly may include arms that selectively grasp and release a suturing needle. The drive assembly is operable to drive the end effector assembly via the shaft assembly. The drive assembly is operable to convert a single rotary input into at least two rotary outputs. In some versions, the drive assembly comprises a plurality of shaft assemblies that include an input shaft, a first output shaft, a second output shaft, and a third output shaft. The drive assembly is operable to selectively rotate and hold the shaft assemblies in accordance with a predetermined sequence, such as to perform tissue suturing through a trocar in a minimally invasive surgical procedure.

Abstract: A suturing assembly is provided that is configured to pull a capsule attached to a suture through tissue. The suturing assembly includes a shaft aligned on a longitudinal axis of the suturing assembly, and a head coupled to the shaft. The head includes a proximal portion and a distal end spaced apart from the proximal portion by a throat. The proximal portion houses a needle that is movable through a needle exit port. The proximal portion of the head and the needle exit port are both aligned on the longitudinal axis. A proximal side of the distal end of the head defines a cavity adapted to receive the capsule and a distal side of the distal end of the head defines a slot adapted to allow the suture to pass through the distal end of the head and into the cavity.

Abstract: An apparatus comprises an end effector, a shaft assembly, and a drive assembly. The end effector comprises needle receiving arms operable to grasp a needle. The drive assembly comprises drive members that are rotatable about respective drive axes that are perpendicular to the axis of the shaft assembly. The drive assembly is operable to drive the needle receiving arms to selectively engage and disengage the needle; and to selectively pass the needle from one needle receiving arm to the other needle receiving arm. The drive assembly provides an interface to a controller that is operable via a remote user interface. The drive assembly may include helical gears, clutch assemblies, a rack and pinion, or other components to convert motion of the drive members into motion at the end effector.

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 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 having a respective pair of jaws driven by a respective drive shaft. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The handle assembly includes a control assembly that is operable to rotate the drive shafts to transfer the suture needle between the grasping arms. In some versions, the control assembly may include an actuatable rack. The rack may include one or more control features that selectively rotate the drive shafts as the rack is actuated. The rack may further include cam surfaces to selectively restrict the motion of the drive shafts as the rack is actuated. In some versions the rack may actuate vertically.

Abstract: The surgical needle holder includes two elongated arms having scissor finger loops on one end and a pair of needle gripping jaws on the opposite end. The elongated arms are pivotally attached to each other. ? first jaw is pivotally mounted via an actuator rod interconnecting the first jaw to one of the arms, opening and closing with respect to the second jaw as the elongated arms pivot with respect to each other. The jaws are designed to grip a surgical needle when in the closed position. Ratchet lock members attached to the elongated arms lock the jaws in the closed position in a manner similar to the locking of a hemostat. Mechanical configuration of the needle holder allows motion of the needles to be along any plane parallel to the longitudinal axle of the device while the surgeon's hand is in a neutral position.

Abstract: Apparatus and methods for removing surgical fasteners. The apparatus includes a mechanism for opening the fastener so that it may be removed from, for example, tissue, prostheses or graft material.

Abstract: A system for transdermal repair of soft tissue includes an instrument comprising a proximal actuator portion, a fixed needle having a lumen and extending distally from the proximal actuator portion, and a movable needle having a lumen and extending distally from the proximal actuator portion. The movable needle is movable axially between an advanced position and a retracted position relative to the proximal actuator portion. A suture needle is disposed within the lumen of one of the fixed and movable needles, and has a length of suture connected thereto. Needle graspers are disposed in the lumen of each needle, for securing the suture needle and assisting in the transfer of the suture needle from one needle to the other to complete a suture passing step.

Abstract: A surgical suturing device has a grasper device that is translatable within an outer lumen where a first end of a needle is grasped with the grasper device. The needle may be resilient to a curved resting state. The grasper device translates proximally relative to the outer lumen such that the needle is translated into the outer lumen, wherein the outer lumen tends to straighten the needle from the curved resting state. The grasper device may be translated distally relative to the outer lumen such that a second end of the needle extends distally from the outer lumen and pierces the tissue. The needle may return to the curved resting state as it exits the outer lumen. When a second end of the needle emerges from the tissue, the second end of the needle may be grasped with the grasper device.

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

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

Abstract: A 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.

Abstract: A surgical treatment instrument according to the invention includes an insertion portion, an operation portion provided on one end of the insertion portion, a treatment portion provided so as to extend from the other end of the insertion portion, two gripping members provided on the treatment portion, each having a gripping face, an open/close operating member provided on the operation portion to perform opening/closing by at least one of the two griping members being moved, variable angle operating members respectively provided on the operation portion to change the treatment portion to a predetermined angle, a braked member provided within the operation portion and operating in conjunction with the operation of the variable angle operation portion, and a braking member provided within the operation portion to brake the braked member by operating in conjunction with the operation of the open/close operation member, wherein the treatment portion maintains a predetermined angle by the braked member being brake

Abstract: A device for closure of a patent foramen ovale. The device includes at least one elongated tissue anchor at the distal end of the device. A distal end portion of the tissue anchor is selectively deployable between a closed position in which the distal end portion of the tissue anchor is capable of penetrating the septum and the flap, and a radially extensible position in which the distal end portion of the tissue anchor is capable of engaging the septum or flap so that the septum and flap may be urged into registry. A deployment member is associated with the tissue anchor for selectively deploying the distal end portion of the tissue anchor between the closed position and the radially extensible position. A closure element is disposed at the distal end of the device. The closure element is engageable with the septum and the flap when the septum and flap are in registry, for maintaining such registry.

Abstract: An endoscopic stitching device including a tool assembly having a pair of juxtaposed jaws; a rotatably supported camming hub defining a groove formed in an inner surface of a central lumen thereof; and a center rod slidably and rotatably disposed within the lumen of the camming hub. The center rod is operatively engaged with the groove formed in the camming hub and engaged with the pair of jaws. The inner groove of the camming hub is configured such that, in at least one position, axial translation of the center rod relative to the camming hub results in rotation of the camming hub and at least one of opening and closing of the pair of jaws. The inner groove of the camming hub is configured such that, in at least one other position, rotation of the canter rod results in rotation of the tool assembly.

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 modification to a standard needle driver in the form of a deployable and retractable projection at the working end of the needle driver with which the operator can control the suture in order to facilitate tying a knot in the suture. This modification solves the difficult problem of controlling the suture during the rate-limiting step of knot tying allowing for faster, easier knot tying in laparoscopic and single port surgery.

Abstract: A suturing instrument includes a handle, an elongate shaft, and a suturing head. One or more pull wires extend from the handle into the elongate shaft for controllably deflecting a deflectable portion of the elongate shaft in one or more directions and/or planes for improved maneuverability within the body of a patient during an endoscopic or laparoscopic surgical procedure and for changing the positioning of the suturing head.

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic (with or without access ports) or other surgeries in which access is limited, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft that has axial stiffness (such as being stiff in compression) and lateral flexibility or an axial movement of a cable. An extension body (within which the shaft or cable moves) between the handle and jaws can be pre-bent or custom bent by the user. Portions of the devices may be disposable, replaceable, and/or reusable. A spring adjacent the clamp may open the clamp or impose a gripping force.