Abstract: Surgical methods for closing a gastrotomy. The surgical method for closing an opening in an organ wall comprises positioning a distal end portion of a steerable overtube adjacent a portion of the organ wall through which the opening extends. The surgical method further comprises inserting a flexible clip magazine into the steerable overtube. The surgical method comprises grasping tissue through which the opening extends and drawing a portion of the grasped tissue into a clamping position between upper and lower clip arms of a distal-most tissue apposition clip supported within a distal end of the clip magazine. The surgical method further comprises advancing the distal-most tissue apposition clip onto the portion of grasped tissue.

Abstract: A surgical delivery instrument for delivering a vascular hole closure device having a hole covering member. The delivery instrument comprises a housing, a plunger and an advancer movable within the housing, the advancer having a first portion and a distal portion hingedly connected to the first portion and forming a casing for supporting the hole covering member. Distal movement of the advancer pivots the casing from an angled position to a more linear position to change the orientation of the covering member from a transverse position to a more aligned position. The plunger is advanceable to advance the covering member into the vessel.

Abstract: A method of cannulating vasculature includes inserting the vasculature through a first clamping surface of a cannula and rotating a second clamping surface of the cannula around the first clamping surface to move from an open position towards a closed position. Additionally, the method includes securing the vasculature between the first clamping surface and the second clamping surface.

Abstract: A method can include forming a bore in a bone of a patient and positioning a first anchor in the bore. The first anchor can have a self-locking adjustable suture construct extending therefrom that can include first and second adjustable loops. The first adjustable loop can be positioned about a first portion of the soft tissue and the second adjustable loop can be positioned about a second portion of the soft tissue different than the first portion. A coupling element carried by the second adjustable loop can be coupled to the first adjustable loop. An end of the adjustable suture construct can be tensioned to reduce a size of the first and second adjustable loops to couple the soft tissue to the bone.

Abstract: A surgical delivery instrument for delivering a vascular hole closure device having first and second flexible members and a first and second engagement members extending from the respective flexible member. The delivery instrument includes a housing having first and second longitudinally extending openings and first and second projecting surfaces, the first projecting surface extending into the first opening for engagement by the first engagement member and the second projecting surface extending into the second opening for engagement by the second engagement member. The first engagement member is held by the first projecting surface until a predetermined force is applied to the first engagement member during placement of the closure device at a target site.

Abstract: A system for use in graft fixation in a knee reconstruction procedure can include a first femoral fixation member adapted to be retained relative to a first end of a femoral tunnel and a first self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops. The first flexible member construct can be interconnected to the first femoral fixation member. A second femoral fixation member can be coupled to the first flexible member construct and can be adapted to be positioned in the femoral tunnel relative to a second end of the femoral tunnel adjacent a joint space between the femur and a tibia. A second self-locking adjustable flexible member construct having a passage portion with a pair of free ends and a pair of self-locking adjustable loops can be interconnected to the second femoral fixation member.

Abstract: Skin graft harvesting systems and methods are disclosed that utilize sensors to automate the harvesting of skin grafts or assist a user in deciding when the skin graft is ready to be harvested. Such systems and methods can reduce the burden of visual observation and ensure greater reliability and consistency of the grafts. The invention is particularly useful with harvesters that rely upon suction and/or heating to raise a plurality of small or “micro” blisters simultaneously.

Abstract: An apparatus can include a first flexible member having first and second ends and a first body extending therebetween, where the first body defines a first passage portion. A second flexible member can have first and second ends and a second body extending therebetween, where the second body defines second and third passage portions. The first end of the first flexible member passes into and through the second passage portion such that the first end extends outside of the second passage portion, and the second end of the first flexible member passes into and through the third passage portion such that the second end extends outside of the third passage portion. The first and second ends of the second flexible member pass into and through the first passage portion to form a self-locking adjustable flexible member construct.

Abstract: Disclosed herein are systems and methods for protecting a subject from embolisms during TAVR percutaneous valve procedures. Various embodiments include an intravascular embolism protection device that includes an elongated, compliant wire frame made from a material having a shape-memory function, and a mesh sleeve coupled to the compliant wire frame, the mesh material having a pore size selected to allow blood to pass therethrough while retaining potential emboli. In some embodiments, the embolism protection device has a collapsed state wherein device fits within the lumen of a deployment/retrieval catheter and an expanded state wherein the embolism protection device expands to span the width of the aorta and the distance between the aortic valve and the puncture site in the femoral artery.

Abstract: A tissue closure device includes a pusher assembly having a drive arm extending from a drive shaft and a needle driver at a distal end of the drive arm, wherein the needle driver is capable of releasably engaging and rotating a suturing needle having a pointed end and a blunt end about a rotational axis and a cartridge having a protective housing and the suturing needle, the cartridge extending from a distal end of a cartridge holder assembly and releasably attached to the cartridge holder assembly. A pointed end of the suturing needle may be positioned within the protective housing before and after a complete rotation of the suturing needle about the rotational axis. A removable electronic module may be provided controlled by an actuator that mechanically engages the drive shaft to rotate the drive shaft and the needle driver, thereby rotating the suturing needle about the rotational axis.

Abstract: Devices and systems to fit around a tissue or organ and methods of using the same. In at least one embodiment of an implantable device of the present disclosure, the implantable device comprises a first engaging component comprising a first rigid inner plate at least partially surrounded by a first flexible coating, a second engaging component comprising a second rigid inner plate at least partially surrounded by a coating selected from the group consisting of the first flexible coating and the second flexible coating, a first c-ring and a second c-ring coupled to the engaging components, and a cover flap coupled to either the first engaging component or the second engaging component and capable of either further coupling to the second engaging component when initially coupled to the first engaging component or further coupling to the first engaging component when initially coupled to the second engaging component.

Abstract: A device for closing an aperture in a vessel wall comprising an elongated member having a longitudinal axis and positionable inside the vessel against the internal opening of the aperture. The elongated member has a dimension to prevent egress of fluid through the aperture. A material forms two curved legs having ends positionable external of the vessel. The legs curve in different directions and a retention portion is formed in the material to retain the legs during placement of the elongated member inside the vessel.

Abstract: The present invention relates to closing an opening within a subcutaneous bodily vessel by using a spiral closure device to engage tissue around the opening. The spiral closure device is adapted to be threaded into the vessel wall surrounding the opening in the bodily vessel. A deployment mechanism may be used to rotate the spiral closure device. As the deployment mechanism is rotated the spiral closure device is rotated such that a tip of the spiral closure device engages the vessel wall around the opening in the bodily vessel. Continued rotation of the spiral closure device threads the closure device through the tissue around the opening. The closure device may have a tapered configuration in which the distal end is larger than the proximal end. As the distal end is threaded through the vessel wall, the narrowing closure device pulls the vessel wall tissue together, thereby effectively closing the opening.

Abstract: A tissue closure device includes a pusher assembly having a drive arm extending from a drive shaft and a drive mechanism at a distal end of the drive arm, wherein the drive mechanism is capable of releasably engaging and rotating a suturing needle having a pointed end and a blunt end about a rotational axis and a cartridge having a protective housing and the suturing needle, the cartridge extending from a distal end of a cartridge holder assembly and releasably attached to the cartridge holder assembly. A pointed end of the suturing needle may be positioned within the protective housing before and after a complete rotation of the suturing needle about the rotational axis. A removable electronic module may be provided controlled by an actuator that mechanically engages the drive shaft to rotate the drive shaft and the drive mechanism, thereby rotating the suturing needle about the rotational axis.

Abstract: A basket apparatus is described that assists in removing objects from within a patient. The apparatus includes a number of pull wires, each pull wire physically coupled to a different capstan that individually actuates one of the pull wires. The apparatus also includes an outer support shaft itself including a number of channels through which the pull wires traverse. The portions of the pull wires extending out of the outer support shaft form a basket of adjustable size, shape, and position. The pull wires are attached together at a tip located at a distal end of the basket apparatus. By controlling the actuation of the various pull wires, the basket's shape, position size can be manipulated to reposition the basket around an object located within a patient, independent of or in conjunction with motion of the remainder of the apparatus or an associated endoscope.

Abstract: In one embodiment, a system for repairing a meniscus includes a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor. The flexible portion includes a self-locking slide knot between the first anchor and the second anchor. The system also includes a needle having a longitudinal extending bore, an open end, and a slot adjacent the open distal end, the first anchor and the second anchor are positioned entirely within the bore and slot. The system further includes a pusher configured to be movable within the bore of the needle. The pusher is configured to discharge the first anchor and the second anchor individually and sequentially through the open distal end of the needle.

Abstract: Novel bioabsorbable, universal kits used to form nasal implants are disclosed. The implants are useful in rhinoplasty and nasal reconstruction surgical procedures. The kit devices have a universal configuration and can be converted by the surgeon in the field into one or more individual nasal implant devices having different configurations and applications. The kits may have outlines of nasal implants thereon.

Abstract: A method for capturing an object in a cavity in a patient is described. The method includes advancing a ureteroscope into the cavity containing the object. A basket is advanced through a working channel of the ureteroscope. The basket is opened within the cavity and is positioned so as to enclose the object. Then, two actions are performed simultaneously. The basket is collapsed while simultaneously the basket tool is advanced forward so that the object remains within the basket, ideally near the center of the basket, as the basket closes around the object. Once the object is captured, the basket is retracted to remove the object out of the cavity. Further, this process may be automated by having the method carried out by robotic arms acting in tandem, with one or more robotic arms advancing the basket tool or ureteroscope, and another robotic arm collapsing the basket.

Abstract: Disclosed is an adjustable occlusion device for use in a body lumen such as the left atrial appendage. The occlusion device is removably carried by a deployment catheter. The device may be enlarged or reduced to facilitate optimal placement or removal. Methods are also disclosed.

Abstract: A device for closing an aperture in a vessel wall, the aperture having an external opening in an external region of the vessel wall and an internal opening in an internal region of the vessel wall. The device includes a covering member positionable inside the vessel against the internal opening of the aperture and having a dimension to prevent egress of fluid through the aperture. First and second retainers are positionable external of the vessel and have a tip of a smaller transverse dimension and facing in a direction toward the covering member for advancement toward the covering member. A flexible connecting member operatively connects the covering member and the first retainer and moves the first retainer toward the covering member.