Abstract: A steerable instrument (100) controllable by a robotic arm (200), having a proximal end (20) and a distal (40) end comprising: a cylindrical shaft (130), a cylindrical bendable proximal part (120) and a cylindrical bendable distal part (140), a connector (110) configured for dismountable attachment to the robotic arm (200), attached in fixed rotational relation to the bendable proximal part (120), an end effector (150) attached in fixed rotational relation to the bendable distal part (140), the steerable instrument (100) configured such that: the bendable distal part (140) bends responsive to bending of the bendable proximal part (120), and the end effector (150) is rotatable when the bendable distal part (140) is in a bent position by a complementary rotation of the connector (110), the shaft (130) is pivotable around a fulcrum zone (134) on the shaft (130) and changes direction responsive to a complementary movement of the connector (110), thereby providing control of the shaft (130) direction, bending of t

Abstract: An articulating rotary cutting tool configured to articulate a distal cutting tip upon a trigger being operated. The trigger can be locked into various articulating positions. The velocity of rotation of a cutting bit is substantially constant in both articulating and non-articulating positions. An articulation joint is one of a hex ball joint or a flexible spring joint. A button is included to release a locking pressure holding the trigger in a locked position. The trigger may employ articulating sliding surfaces that provide constraint to a flexed head in both directions of articulation.

Abstract: Articulated instruments that include tools for disrupting and/or distracting tissue, and methods of using the same.

Abstract: A device for a patient-specific acetabular and/or femoral guide. The guides can be used in a selected resection of at least one of a femur and an acetabulum to increase a range of motion of the femur relative to the acetabulum. Generally, a natural acetabulum and femoral head are maintained.

Abstract: A minimally invasive catheter and methods are provided for adjusting the chordae associated with an atrio-ventricular valve and for modifying the geometry of selected cardiac chambers. Clamps carried by the catheter are part of a prosthetic clamp assembly that includes the clamps and a cord attached to each of the clamps. The cord length can be adjusted after the clamps are attached to tissue. The clamps can be operated simultaneously or independently.

Abstract: The present invention relates to surgical instruments and methods for enhancing properties of tissue repaired or joined by surgical staples and, more particularly to surgical instruments and methods designed to enhance the properties of repaired or adjoined tissue at a target surgical site, especially when sealing an anastomosis between adjacent intestinal sections so as to improve tissue viability, prevent tissue infection, and to prevent leakage. The present invention further relates to circular stapling instruments and elongated tubular hollow sleeves deployed from such stapling instruments and establishing an isolated enclosure around the stapled and resected tissues at the anastomotic joint.

Abstract: Various surgical kits are provided including a sealing cuff configured to be positioned around a body lumen and a sealant. In one embodiment, the sealing cuff can form an enclosed loop around an anastomosis and can define an interior chamber for receiving sealant therein. The sealing cuff can ensure that sealant remains in contact with the body lumen as the sealant cures and reinforces the anastomosis. Methods for sealing an anastomosis are also provided and include delivering sealant to the sealing cuff, inserting inflatable members so that they are positioned adjacent to the anastomosis, and delivering fluid to at least one of the inflatable members to expand an inner wall of the tubular organ. In certain aspects, gas and/or liquid can be delivered to an anastomosis, such as after the sealant has solidified, in order to test the effectiveness of the seal.

Abstract: A tissue approximation device comprising two elongate arms, an attachment means to secure the elongate arms to each other, adhesive pads on at least a portion of the elongate arms to anchor the tissue approximation device to the skin, and a locking means to lock the elongate arms in place relative to each other.

Abstract: In a background-art medical gripping device, when a wall surface of an in vivo tissue has a large tear, a side portion of the tear can be gripped by the gripping device, but the other side portion opposed to the side portion cannot be gripped simultaneously. Therefore, to close the tear, complicated operation is required to be performed using plural gripping devices. A medical gripping device according to the present invention includes a fixed clip, a pair of movable clips made from an elastic material and provided to face the fixed clip, the movable clips having lower ends fixed to the fixed clip and the other ends opened, and a control mechanism which shifts from each other a timing at which a gripping target is gripped between one of the movable clips and the fixed clip and a timing at which the target is gripped between the other movable clip and the fixed clip.

Abstract: The invention relates to a system for performing an anastomosis between an organic wall having an opening and an organic hollow tube, comprising: a body inserted inside the tube and through the opening; external clamping elements defining with said body a tubular portion on the wall and forming an anchoring clamp; a device for connecting said tube and said tubular portion, comprising: suture elements connecting the external clamping elements to the body and each having a first end connected to a tightening device and a second end adapted for being retained on an external clamping element; and a suturing device adapted for moving the second end of the suture elements between a retracted configuration where it is located inside the tube, and an anchored configuration where it is retained on an external clamping element after passing through the tube.

Abstract: A method of repairing soft tissue of a joint of a human extremity, such as a hand or foot. The method includes maintaining a metapodial bone intact; inserting a suture passing instrument into a space adjacent the metapodial and phalangeal bones; passing the suture through a volar ligament near a distal end of the metapodial bone and reattaching the volar ligament to the proximal phalanx. The method also includes making an incision on the dorsal aspect of the extremity to expose the dorsal aspect; inserting the distal portion of the suture passer instrument through the incision on the dorsal aspect of the extremity; inserting the distal portion of the suture passing instrument into a tendon sheath connected to a volar plate; and passing a portion of a suture through the volar plate.

Abstract: Methods and devices for treating female stress urinary incontinence are disclosed. The methods include transvaginally accessing the pelvic cavity and introducing a suburethral sling into the retropubic space. In some embodiments the ends of the sling are attached to an anatomical support structure. In other embodiments, the ends of the suburethral sling are not attached to an anatomical support structure. The devices include a surgical instrument for blunt dissection of the pelvic cavity which includes a curved shaft and a blunt distal end. A hook deployment device may optionally be attached to the surgical instrument.

Abstract: Provided is an anastomosis device including a first head holding a first anastomosis ring, a second head holding a second anastomosis ring, a first guide bar connected to the first head and switching a release position and a standby position to each other, wherein the first guide bar includes a first rotation groove, a second guide bar connected to the second head and switching the release position and the standby position to each other, wherein the second guide bar includes a second rotation groove, and a rotation driver moving approximately in a parallel direction to the first and second guide bars and including a first guide protrusion and a second guide protrusion, which move along the first and second rotation grooves, respectively.

Abstract: A suture guide may include a base, a tissue guard extending from the base, and two flanking posts affixed to the base on opposite sides of the tissue guard. The posts may extend from the base in parallel planes, and each of the posts may define a plurality of channels passing through its width. The channels may be so oriented that, for each post (a) the channels define suture needle guide paths in one or more planes, and (b) at least one channel is not perpendicular to a long axis of the first flanking post, so that it defines an oblique suture needle guide path. The tissue guard may be connected to the base by a connector so adjustable as to control spacing between the posts and the tissue guard.

Abstract: An apparatus for approximating planes of a body tissue during a medical procedure may include an internal portion and an external portion. The internal portion may be implantable within a body of a patient and may include a first flexible sheet member, a first magnetic member, and a first working window through the first flexible sheet member. The external portion may include a second flexible sheet member, a second magnetic member, and a second working window through the second flexible sheet member. The first magnetic member and the second magnetic member may be attracted to one another to magnetically couple the internal and external portions and capture the body tissue between the internal and external portions. The first working window may be substantially aligned with the second working window to enable access to the internal and external surfaces of the body tissue through the respective first and second working windows.

Abstract: Provided is an anastomotic device including a first holder and a second holder for holding a first anastomotic ring and a second anastomotic ring, respectively, a first slave body which is connected to the first holder, and which has a first slave surface, a second slave body which is connected to the second holder, and which has a second slave surface, a first driving body which has a first driving surface sliding along the first slave surface, and which moves along a predetermined direction, and a second driving body which has a second driving surface sliding along the second slave surface, and which moves along the predetermined direction. The first slave body moves toward the second slave body and the second slave body moves toward the first slave body by the movements of the first driving body and the second driving body.

Abstract: An anchor placement jig for partial thickness rotator cuff repair. The anchor placement jig includes a frame, a target extending from a distal end of the frame, and a guide disposed on the frame and aligned with the target. The guide has a guide axis that intersects an aperture that extends through the target. The aperture is sized to receive a suture anchor. The target includes a perimeter structure. The perimeter structure extends at least partially around the aperture. The perimeter structure includes a perimeter clearance between the perimeter structure of the target and the aperture of less than one sixteenth of an inch.

Abstract: Devices, systems, methods and kits are provided for endoscopically accessing a body cavity and providing a directed pathway toward a target tissue within the cavity. The directed pathway is provided by a multi-catheter guiding system which is positioned in a desired configuration, generally directed toward the target tissue. Interventional devices may then be passed through the guiding system to the target tissue. Depending on the location of the target tissue and the desired angle of approach, the guiding system may be required to maintain one or more curves in one or more planes to properly direct the interventional devices. The multi-catheter guiding system of the present invention comprises an outer guiding catheter and a coaxially positioned inner guiding catheter, each of which independently form curvatures so that together the curves properly direct the interventional device.

Abstract: Apparatus and methods for endoscopic colectomy are described herein. A colectomy device having a first and a second tissue approximation device is mounted on a colonoscope separated from one another. During deployment of the colectomy device, a diseased portion of the colon is positioned inbetween the tissue approximation devices. The tissue approximation devices are radially expanded such that they contact and grasp the colon wall at two sites adjacent to the diseased portion of the colon. The diseased portion is separated from the omentum and is transected using a laparoscope or is drawn into the colonoscope for later removal. The tissue approximation devices are then urged towards one another over the colonoscope to approximate the two free edges of the colon into contact together where they are fastened to one another using the tissue approximation device as a surgical stapler to create an end-to-end anastomosis.

Abstract: A vascular clip for use in end-to-side anastomoses having a handle connected to a lower ring and an upper ring. The handle includes a resilient element biasing the two rings together so that the rings are closely juxtaposed when the clip is closed. The respective facing surfaces of each of the rings may be provided with a rough surface. A graft vessel or an artificial aneurysm may be sutured to the lower ring. The graft vessel or artificial aneurysm may be autologous or heterologous material or may be made of synthetic material. The handle may fit into a clip applier that facilitates the application of the clip. The handle and the clip applier may be of different shapes depending on the various applications of the clip.

Abstract: A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to flex relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. Tissue suturing and suture securing instruments are provided each having a sufficiently flexible shaft locatable through the accessory tube.

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: The invention provides devices and methods for performing closed-chest surgical intervention within an internal cavity of a patient's heart or great vessel. A scope extending through a percutaneous intercostal penetration in the patient's chest is used to view an internal portion of the patient's chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient's chest. An interventional tool is inserted through the internal penetration to perform a surgical procedure under visualization using the scope. A cutting tool is introduced into the patient's left atrium from a right portion of the patient's chest to remove the patient's mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.

Abstract: A suture organizer to maintain a plurality of sutures attached to a patient during a surgical procedure or operation in position relative to each other during the surgical procedure or operation comprising a hemostat retainer including a hemostat retainer member to receive and retain the finger hole or thumb hole of a corresponding hemostat connected to a corresponding suture and a clasp including a pair of clasp members to cooperatively clamp a surgical drape or the like therebetween to hold the suture organizer in position during the surgical procedure or operation.

Abstract: According to an aspect of the present disclosure, a surgical suture needle assembly is provided including an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. The present disclosure further provides for methods of using the surgical suture needle assembly in anastomotic procedures and the like.

Abstract: Methods and devices for treating female stress urinary incontinence are disclosed. The methods include transvaginally accessing the pelvic cavity and introducing a suburethral sling into the retropubic space. In some embodiments the ends of the sling are attached to an anatomical support structure. In other embodiments, the ends of the suburethral sling are not attached to an anatomical support structure. The devices include a surgical instrument for blunt dissection of the pelvic cavity which includes a curved shaft and a blunt distal end. A hook deployment device may optionally be attached to the surgical instrument.

Abstract: Medical devices and methods are provided for forming an intestinal bypass anastomosis, such as for treatment of obesity. The medical devices and methods are minimally invasive and reduce complications. Two magnet assemblies are deployed in a spaced apart relationship, and are transluminally brought together to approximate the tissue and form an anastomosis therebetween.

Abstract: Methods and devices are provided to allow the same component used to access a surgical site to assist in closing the surgical opening in which it was disposed. In one exemplary embodiment a flexible retractor is provided that includes proximal and distal ends and a lumen extending therethrough. A wound closure component is associated with the flexible retractor and is configured to engage tissue adjacent to a surgical incision in which the retractor is disposed and move tissue from one side of the surgical incision toward a second side of the surgical incision to assist in closing the surgical incision. In one embodiment the wound closure component includes strands of suture having hooks disposed on a distal end. In another embodiment the wound closure component includes a ring having hooks disposed around a circumference of the ring. Exemplary methods for closing a surgical opening are also provided.

Abstract: The present invention provides a medical suturing device structured with a retrieval puncturing needle formed with through-hole; a retrieval member able to be inserted through through-hole; an insertion puncture needle formed with through-hole; a hollow tube that can be inserted through insertion through-hole, and the distal tip of which is formed into a deformable bent portion; and a suture that can be inserted through the inside of hollow tube. The retrieval member is structured with an annular engagement member that can be deformed into a straight shape, a rod member that is connected to annular engagement member, and a grip that is provided with a mark. The mark is furnished on hollow tube, such that when retrieval puncturing needle and insertion puncture needle are in a condition where mark and mark are facing each other, the upper supporter and lower supporter can be detachably attached.

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

Abstract: Continuous wound-closure techniques use one-way suture. The one-way suture has tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is passed alternately through tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Abstract: A surgical instrument and method for manipulating surgical suture during minimally invasive surgical procedures. Surgical instrument includes an elongate body with a handle at the elongate body's proximal end. Elongate body also includes a distal portion, a longitudinal axis and an outer surface, and the distal portion includes at least one moveable wire. This wire moves so as to selectively capture and release a suture and suture purchase may be substantially obtained between the wire and the elongate body outer surface. The instrument also includes an actuation mechanism connecting the handle to the wire. The wire is moved via the actuation mechanism and a substantial component of the motion of the wire is eccentric rotation.

Abstract: A cannula has a flange and a body with slots extending through the entire flange and into the body. The cannula may also have a longitudinal slot extending its entire length. An obturator used with the cannula may also have a longitudinal slot extending along its length. A surgical method using these instruments includes separating lengths of suture and managing the suture by placing lengths of suture in the slots in the cannula. The cannula and obturator may be used after suture is already in place by placing the suture in the longitudinal slots and then introducing the cannula and obturator to the tissue defect site. The cannula may also be used to deliver a therapeutic implant to the tissue defect site. The instruments and method may be used in mensical surgery.

Abstract: There are disclosed various embodiments of auxiliary and detachable caps for managing the passage of suture materials through a surgical cannula. The disclosed suture management caps generally include one or more frame members defining a central opening for the passage of suture material and surgical instruments. The frame members include one or more grasping members for temporarily securing a length of suture material. A plurality of cutouts is also provided in the rim of the frame defining the central opening for maintaining the lengths of suture material in a spaced apart relationship.

Abstract: An apparatus useful for performing various surgical procedures, including but not limited to plastic surgery such as mid face lifts, neck lifts, brow lifts, under eye lifts, breast lifts, and organ repositioning, includes a body 2, 3, 31, 52 having at least one elongate member 6, 7, 36, 51 and a guide 13, 43, 54 which cooperate to position a suture 60, 65, 120, 130 inside a layer of subcutaneous tissue, from a remote access point. A suture 60, 65 having modified portions 63 is additionally provided for use with the apparatus to implement a desired surgical procedure.

Abstract: Devices, systems, methods and kits are provided for endoscopically accessing a body cavity and providing a directed pathway toward a target tissue within the cavity. The directed pathway is provided by a multi-catheter guiding system which is positioned in a desired configuration, generally directed toward the target tissue. Interventional devices may then be passed through the guiding system to the target tissue. Depending on the location of the target tissue and the desired angle of approach, the guiding system may be required to maintain one or more curves in one or more planes to properly direct the interventional devices. The multi-catheter guiding system of the present invention comprises an outer guiding catheter and a coaxially positioned inner guiding catheter, each of which independently form curvatures so that together the curves properly direct the interventional device.

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

Abstract: The present disclosure relates to a surgical aimer including a shaft having a proximal portion and a distal portion and a handle coupled to the proximal portion of the shaft. The handle includes a mechanism for coupling the shaft to the handle and releasing the shaft from the handle.

Abstract: Methods and devices for treating female stress urinary incontinence are disclosed. The methods include transvaginally accessing the pelvic cavity and introducing a suburethral sling into the retropubic space. In some embodiments the ends of the sling are attached to an anatomical support structure. In other embodiments, the ends of the suburethral sling are not attached to an anatomical support structure. The devices include a surgical instrument for blunt dissection of the pelvic cavity which includes a curved shaft and a blunt distal end. A hook deployment device may optionally be attached to the surgical instrument.

Abstract: A prosthesis, introducer device and a method for repair of an aortic aneurysm which is positioned at least partially in the ascending aorta (62). The prosthesis (3) has a proximal end (15) and a distal end (5) and is formed from a biocompatible material, the proximal end is adapted to be surgically fastened adjacent and around the aortic heart valve (60) of a patient and the distal end is adapted to extend into the descending aorta (66). The distal end has a distally extending exposed self-expanding stent (9). The introducer device can be deployed through an incision (75) in the thoracic arch (64) and extend down the descending aorta to place the distal end of the prosthesis first and then removed so that the proximal end of the prosthesis can be sutured in place around the aortic heart valve (60).

Abstract: A device for assisting in a vascular procedure is provided that includes a handle and one or more legs that are operable to move in response to a force being applied to the handle. The legs are operable to extend and to contract in order to manipulate a conduit. In a more particular embodiment, the device can be used in conjunction with a stand operable to receive the conduit such that the conduit can be removed from the stand by the device. The stand may include one or more graduations that indicate the size of the conduit once it is positioned on the stand.

Abstract: An auxiliary device for a puncture needle allowing an easier manipulation of puncture needles as well as being capable of improving the suture stability. The auxiliary device for a puncture needle comprises a plate-shaped auxiliary device main body on the surface of which parallel guide grooves were formed, and a plate-shaped rotating-sliding contact part rotatably attached to one of the edge parts of the auxiliary device main body. Moreover, a stabilization plate was provided at the lower end part of the auxiliary device main body. And, a window part for confirming an insertion-puncture needle-outer needle and a pullout-puncture needle were provided at the lower part side portion of the auxiliary device main body. Moreover, a projecting edge part was formed at the upper end part of the auxiliary device main body, and an opening side width of a portion located at the projecting edge part of the guide grooves was made wider than the width of the other portion of the guide grooves.

Abstract: Apparatus and methods for endoscopic colectomy are described herein. A colectomy device having a first and a second tissue approximation device is mounted on a colonoscope separated from one another. During deployment of the colectomy device, a diseased portion of the colon is positioned inbetween the tissue approximation devices. The tissue approximation devices are radially expanded such that they contact and grasp the colon wall at two sites adjacent to the diseased portion of the colon. The diseased portion is separated from the omentum and is transected using a laparoscope or is drawn into the colonoscope for later removal. The tissue approximation devices are then urged towards one another over the colonoscope to approximate the two free edges of the colon into contact together where they are fastened to one another using the tissue approximation device as a surgical stapler to create an end-to-end anastomosis.

Abstract: Apparatus and methods for endoscopic colectomy are described herein. A colectomy device having a first and a second tissue approximation device is mounted on a colonoscope separated from one another. During deployment of the colectomy device, a diseased portion of the colon is positioned inbetween the tissue approximation devices. The tissue approximation devices are radially expanded such that they contact and grasp the colon wall at two sites adjacent to the diseased portion of the colon. The diseased portion is separated from the omentum and is transected using a laparoscope or is drawn into the colonoscope for later removal. The tissue approximation devices are then urged towards one another over the colonoscope to approximate the two free edges of the colon into contact together where they are fastened to one another using the tissue approximation device as a surgical stapler to create an end-to-end anastomosis.

Abstract: A device for holding a blood vessel (and corresponding method of operation) includes a mandrel having a proximal end opposite a distal end. A tube houses a portion of the mandrel. A tip assembly, which is operably coupled to the distal end of the mandrel, comprises a sheath having a tapered portion and a cylindrical portion. The sheath is adapted to be inserted into a lumen of a blood vessel such that an end of the blood vessel is supported by the tapered portion. The elastic nature of the blood vessel holds the end of the blood vessel in place with respect to the tip assembly. The tapered portion includes an exterior surface with a plurality of needle-guide-grooves that extend along such exterior surface. A needle is driven through the blood vessel while being guided by a needle-guide groove such that the needle is driven through the blood vessel near the end of the blood vessel.

Abstract: A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to be movable relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. The system further includes a tissue suturing instrument and a suture securing instrument. Each of these instruments has a distal end coupled to a partially flexible shaft locatable through the accessory tube.

Abstract: Tissue approximation devices for the minimally invasive approximation of muscle or fascia, such as approximation of the rectus muscles in the abdomen (abdominoplasty), or hernia repair and other such applications using minimally invasive methods to access and perform the procedures thereby reducing or eliminating visible scars.

Abstract: A tape for use in closing a tissue opening including a substrate and a plurality of sutures sewn directly into the substrate. The tape may have serrated edges in order to facilitate closure of a nonlinear tissue opening. Moreover, the tape may include windows in order to facilitate viewing of the tissue opening during closure and wound healing thereof. The sutures may be sewn laterally across the tape or not, and they may be imbedded individually into each side of the substrate, or they may be disposed under bridges between the windows in the substrate. The tape may have an adhesive affixed to one side thereof. Also disclosed is a method for closing a tissue opening by first cleaning the tissue; applying a layer of adhesive to the tissue adjacent to the opening; applying the tape over the opening; and, then tying each of the sutures together in order to pull the opening in the tissue closed.

Abstract: A heart valve and tissue repair device for independently, selectively and sequentially grasping heart valve leaflets and independently, selectively and sequentially applying one or more fasteners thereto is disclosed. The device includes a leaflet engaging tip having one or more graspers capable of individually and sequentially grasping leaflets, and one or more deployable fasteners capable of fastening the leaflets. An actuation system for the device individually and selectively controls the graspers and deploys the one or more fasteners. Vacuum pressure from an external vacuum source can be used to grasp the leaflets via a selector system that controls the actuation system so as to individually and sequentially apply vacuum force to the graspers.

Abstract: A triceps for anastomosis, the triceps having two outer legs on opposing sides of a middle leg. A latch is located on one outer leg and the middle leg to hold the respective legs in a clamped position. An alignment post extends through the middle leg and cooperates with holes in the outer legs to allow the post to enter the holes and ensure alignment of the legs in use. The post has an enlarged base portion that does not pass through the hole and thereby limits movement of the outer legs relative to the inner legs and thereby limits clamping pressure at the free ends of the legs. The free ends of the legs have various cooperating shapes to facilitate everting and aligning tubular vessels and body tissue for anastomosis.