Abstract: A surgical device including a cannula having a base member at a proximal end, a sidewall connected to the base member, and a bore defined by the base member and sidewall. The sidewall further has an opening into the bore between axially-extending edges of the sidewall. A configurable guide insert includes a combination track having a circular opening for insertion of a camera device and a slot opening for insertion of a cutting instrument. The configurable guide insert may be permanently or detachably coupled to the base member and is positionable in a right orientation for a procedure in a patient's right side or in a left orientation for a procedure in a patient's left side. The combination track slidably receives a camera device through the circular opening into the bore and slidably receives a surgical implement through the slot opening and into an action area outside the bore.

Abstract: A gastrocutaneous closure device allows gastrocutaneous fistula closure from external abdominal access through the fistula site. Access through the fistula ensures accurate closure placement on the interior lumen wall of the stomach. A closure or clip has a plurality of prongs defined by a deformable material, such that the prongs extend radially from a central hub in an arcuate or curved, semicircular shape. The arcuate shape converges towards a central point or axis at a distal end, and the proximate end of the prongs attaches to the central hub such that the prongs radiate from the hub and the distal end curves back toward the axis through the hub. The deformable prongs may therefore radially compress or retract to define a larger or smaller diameter. The fistula lies on the axis such that the biased, inserted prongs pull the inner stomach wall closed around the healing fistula.

Abstract: A medical system may include a left atrial appendage closure device including an expandable framework and a proximal hub centered on a central longitudinal axis of the framework. An insert may be disposed within the proximal hub and include a collar configured to engage the proximal hub, a recess extending into the insert from a proximal end, and a post member disposed within the recess. The post member may be radially spaced apart from the collar and may extend proximally from a distal end of the recess to a proximal surface. The insert may include a first connection structure disposed distal of the proximal surface. The medical system may include a delivery catheter having a second connection structure configured to engage the first connection structure in a delivery configuration. The distal end of the delivery catheter includes a hollow portion configured to receive the post member in the delivery configuration.

Abstract: Anchor delivery systems include anchors having a generally cylindrical body with a rail on top for positioning within a delivery device slot. The rail incorporates a side-bulge as a retaining feature which axially extends along a majority of the length of the rail. The bulge interferes with a corresponding hourglass cutout in the delivery device slot to prevent the anchor from stripping out of the delivery device when the delivery device is retracted through tissue. The anchors are symmetrical along a length and width to facilitate loading within the delivery device. The distal portion of the delivery device includes a series of distally-extending barbs that intentionally change the penetration force required to push the device tip through tissue.

Abstract: A suture device includes a suture ring that defines an arcuate channel extending therein. A first arcuate needle passer is slidingly disposed within a first side of the arcuate channel and a second arcuate needle passer is slidingly disposed within a second side of the arcuate channel. An arcuate needle is passable between the first arcuate needle passer and the second arcuate needle passer and includes a first latching feature adapted to releasably secure the arcuate needle to the first arcuate needle passer and a second latching feature adapted to releasably secure the arcuate needle to the second arcuate needle passer.

Abstract: The devices and methods can prevent pulmonary aspiration thereby allowing for procedures, such as an endoscopic procedure, to be performed under sedation without general anesthesia. The device may include a first end, a second end, and a length therebetween. The body may have a central lumen along the length. The device may include a first base member fixedly disposed at the first end and a second base member fixedly disposed at the second end. The device may also include an expandable assembly movable along the length of the body with respect to the first base member. The expandable assembly may be configured to move between a collapsed configuration and an expanded configuration. The expandable assembly may also be configured to expand radially with respect to the body when in the expanded configuration.

Abstract: Devices, methods, and systems for treating an ulcer or skin defect are disclosed. First and second base panels of a closure device are adhered to first and second sides of the ulcer or skin defect, respectively. Lateral ties couple the first and second base panels together and provide a predetermined separation distance or lateral gap between the inner edges of the panel. The predetermined separation distance or lateral gap is sufficient to treat the most common sized ulcers or skin defects, for example, accommodating an ulcer or skin defect with a minor axis of at most 50 mm. The lateral ties have their ends fixed to one panel and their opposite ends adjustably and reversibly attached to the other panel so that the separation distance can be reduced or adjusted to provide a lateral compressive force to the ulcer or skin defect, thereby promoting healing.

Abstract: A suturing device with built-in needle-transfer of a double-ended needle has a first jaw element with a first needle lock device for retaining and releasing a first end of the needle; a second jaw element with a second needle lock device, wherein the jaw elements are movable between an open and closed position; and a needle-transferring mechanism for alternately transferring the needle from one of the jaw elements to the other when the jaws are moved from the open to the closed position. The needle-transferring mechanism includes a first rotatable wheel connected to the first needle lock device, the first wheel having a first wheel inner portion rigidly connected to a first wheel outer portion and a second rotatable wheel connected to the second needle lock device, said second rotatable wheel comprising a second wheel inner portion rigidly connected to a second wheel outer portion.

Abstract: A knot delivery device for securing a suture comprises an elongated body having a proximal end and a distal end, a pre-configured knot disposed at the distal end of the elongated body, a suture snare having a snare configured to capture suture material, wherein the snare extends through the pre-configured knot and a suture locker secured to one end of material forming the pre-configured knot, wherein tension applied to the suture locker tightens the pre-configured knot.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for guiding a needle to facilitate suturing, such as in surgical anastomosis. In an illustrative embodiment, an apparatus includes a frame configured to counter-rotatably support two generally parallel rollers. A first roller supported by the frame has a flat surface configured to rollably engage a first face of a shaft of a helically-shaped needle. A second roller supported by the frame has a grooved surface defining a helical groove is configured to at least partially receive a second face of the shaft. The second roller further defines a correcting recess bounded by lateral surfaces at a forward end of the groove that tapers to a width of the groove at the forward end. When the leading end is received into the correcting recess, at least one of the lateral surfaces engages and guides the leading end into the forward end of the groove.

Abstract: Methods and devices are provided for protecting the cerebrovascular circulation from embolic debris released during an index procedure. An embolic protection filter is delivered in a reduced profile configuration via an access catheter, and positioned in the aorta spanning the ostia to the three great vessels leading to the cerebral circulation. An index procedure catheter is thereafter advanced through the same access catheter to conduct the index procedure. The index procedure may be a transcatheter aortic valve replacement. A pore distribution in the filter blocks passage of debris greater than a predetermined threshold, minimizes total cumulative volume of debris passing through the filter and minimizes blood pressure drop across the filter.

Abstract: Surgical instruments and their methods of use are disclosed. In some embodiments, the surgical instrument may include a handle and an elongated shaft extending distally from the handle. The surgical instrument may also include a fastener deployment system for deploying fasteners from the elongated shaft including a reciprocating driveshaft disposed within the elongated shaft. In other embodiments, the fastener deployment system may include a follower disposed within the elongated shaft for displacing one or more fasteners within the elongated shaft towards a distal fastener deployment position. In some embodiments, the surgical instrument may include a removable preload lock-out attached to the elongated shaft to prevent the follower from applying a preload to the fasteners.

Abstract: An in-vivo indwelling instrument in which a stretch resistant member or a resin tip at a distal end part of a coil does not easily stray from the coil, a delivering system for the in-vivo indwelling instrument, and a method for producing the in-vivo indwelling instrument is disclosed. An in-vivo indwelling instrument includes: a coil that is formed by winding a wire; a resin tip connected to a distal end part of the coil; and a stretch resistant member that is provided in a lumen of the coil and is connected to the resin tip. The coil includes a gap portion, and a part of the resin tip exists in the gap portion.

Abstract: Anchor delivery systems include anchors having a generally cylindrical body with a rail on top for positioning within a delivery device slot. The rail incorporates a side-bulge as a retaining feature which axially extends along a majority of the length of the rail. The bulge interferes with a corresponding hourglass cutout in the delivery device slot to prevent the anchor from stripping out of the delivery device when the delivery device is retracted through tissue. The anchors are symmetrical along a length and width to facilitate loading within the delivery device. The distal portion of the delivery device includes a series of distally-extending barbs that intentionally change the penetration force required to push the device tip through tissue.

Abstract: Methods and devices are provided for protecting the cerebrovascular circulation from embolic debris released during an index procedure. An embolic protection filter is delivered in a reduced profile configuration via an access catheter, and positioned in the aorta spanning the ostia to the three great vessels leading to the cerebral circulation. An index procedure catheter is thereafter advanced through the same access catheter to conduct the index procedure. The index procedure may be a transcatheter aortic valve replacement. A pore distribution in the filter blocks passage of debris greater than a predetermined threshold, minimizes total cumulative volume of debris passing through the filter and minimizes blood pressure drop across the filter.

Abstract: A gastrocutaneous closure device allows gastrocutaneous fistula closure from external abdominal access through the fistula site. Access through the fistula ensures accurate closure placement on the interior lumen wall of the stomach. A closure or clip has a plurality of prongs defined by a deformable material, such that the prongs extend radially from a central hub in an arcuate or curved, semicircular shape. The arcuate shape converges towards a central point or axis at a distal end, and the proximate end of the prongs attaches to the central hub such that the prongs radiate from the hub and the distal end curves back toward the axis through the hub. The deformable prongs may therefore radially compress or retract to define a larger or smaller diameter. The fistula lies on the axis such that the biased, inserted prongs pull the inner stomach wall closed around the healing fistula.