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 system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.

Abstract: Methods for creating high-density arrays of suture stiches through a tendon into bone for reattachment of a torn tendon, particularly a rotator cuff tendon. The method includes providing a pre-strung plurality of anchors, each anchor having at least one passage therethrough with a continuous length of suture slidably and serially threaded through the at least one passage of each anchor. Each of the anchors further includes a locking assembly for locking the suture within the individual anchor. A first anchor is implanted through the tendon and the suture is locked. A second anchor is implanted a selected close distance from the first anchor, then applying tension to the suture extending from the first anchor and passing through the second anchor the second anchor is locked to create a single suture tensioned and locked stitch between the first and second anchor. This process is repeated for each anchor in the array.

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: A hand operated device, and improvements thereof, for the removal of unwanted hairs from the nose and ears. The device comprised of a handle body and trigger assembly that, when squeezed between the thumb and fingers, remotely compresses a spring at its end. Which spring can be inserted blindly into the cavities of the nose and ears to grasp and remove the hair thereof.

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 disposable ultrasonic handpiece that contains a transducer and a connecting body that is attached to a tube with a cobra work tip at its distal end. The housing that surrounds the ultrasonic transducer does not require waterproofing for repeated autoclaving. Also, the electrical cord that provides power to the transducer is made of very inexpensive wire, along with a low-cost electrical connector. A power cord can be plugged into and unplugged from a socket at the proximal end of the housing and can be reused. Thus, only the housing and its contents need to be disposed of after a procedure, making the disposable part of the handpiece low cost. In addition, the cobra work tip can be provided with a cutting gap that increases its ability to cut.

Abstract: An improved assembly for securing an implantable medical device for retrieval from an implant site includes a plurality of snares, wherein distal openings of a first snare carrier lumen and a second snare carrier lumen have a pre-set offset established therebetween. First and second snare shafts, to which first and second snare loops are coupled, respectively, extend within the corresponding snare carrier lumens such that each loop is located in proximity to the corresponding distal opening of the lumen. The pre-set offset allows an operator to simultaneously position the snare loops around the device; and, when the operator retracts the snare shafts to collapse the snare loops until the loops fit snuggly around the device, the pre-set offset can help to align the device for retrieval.

Abstract: A button inserter apparatus for the insertion of a surgical button includes an inserter handle and an elongated inserter shaft connected at one end to the inserter handle. An inserter head is connected to the inserter shaft at an end opposite to the inserter handle. The inserter head includes opposing engagement projections for engaging and retaining a surgical button there between. One of the engagement projections is longitudinally movable relative to the other of the engagement projections. A button engage and release assembly extends from the inserter handle to the inserter head, and selectively prevents relative longitudinal movement between the engagement projections, and selectively permits relative movement of the engagement projections and thereby release of the surgical button. The engage and release assembly is operable from the inserter handle to cause relative longitudinal movement of the engagement projections and release of the surgical button.

Abstract: A method for securing a strand to a fixation member for arthroscopic fixation, wherein the fixation member includes a channel on an exterior surface and an aperture therethrough. The method includes passing a strand having first and second ends through a flexible sleeve, passing the sleeve through the aperture of the fixation member in a first direction, tensioning the strand, and pulling the sleeve in a second direction different than the first direction to secure the sleeve to the fixation member without tying the strand on the fixation member.

Abstract: A guide extension catheter assembly including a guide extension catheter and a support device. The guide extension catheter includes a shaft and a tubular member. The support device includes a push member and a shuttle member. The guide extension catheter assembly is configured to selectively provide a delivery state in which at least a portion of the shuttle member is disposed within the lumen, a leading end of the shuttle member is distal a distal end of the tubular member, and the shuttle member is directly, physically connected to the tubular member. In the delivery state, a longitudinal distal force applied to the push member is transferred to the tubular member as a longitudinal distal force via the shuttle member. The guide extension catheter assemblies of the present disclosure can promote a two stage guide extension catheter deployment.

Abstract: Methods and anchor devices for repairing soft tissue with a suture are provided. An anchor device comprises an elongate body having a proximal end, a distal end, and a first lumen extending from the proximal end, the first lumen having at least one face which is sloped relative to the central axis of the elongate body such that the cross-sectional area of the first lumen decreases in the proximal direction. The anchor device also comprises a suture locking wedge movably disposed at least partially within the first lumen.

Abstract: An apparatus for transferring mechanical energy in a handle to a cartridge to manipulate tissue or anatomical structures within the body of a human or animal subject for the purpose of treating diseases or disorders. The handle and cartridge contain safety interlocks.

Abstract: A method and apparatus are disclosed for cutting a strand of suture. The apparatus comprises a solid outer member defining a lumen there-through. An inner member is received at least partially within the lumen, a portion of the inner member defining a curve. The inner member further defines a feature for retaining a strand of suture. At least one of the inner and outer members are moveable with respect to the other of the inner and outer members for cutting the strand of suture.

Abstract: An apparatus includes an elongate shaft, a dilation balloon, and a fitting member. The elongate shaft includes an inflation lumen, an irrigation lumen, and at least one irrigation opening. The at least one irrigation opening is in fluid communication with the irrigation lumen. The dilation balloon is at the distal portion of the shaft. The dilation balloon is in fluid communication with the inflation lumen. The fitting member is at the proximal end of the shaft. The fitting member includes an inflation fluid port, an irrigation fluid port, and a blocking structure. The inflation fluid port is in fluid communication with the inflation lumen. The irrigation fluid port is in fluid communication with the irrigation lumen. The blocking structure is adjacent to the irrigation fluid port and defines a gap around the irrigation fluid port.

Abstract: A clipping device includes a capsule and a pair of clip arms, proximal ends of the clip arms slidably received within the channel of the capsule such that the clip arms are movable relative to the capsule between an open configuration and a closed configuration. The clipping device also includes a pair of jaws, each of the jaws pivotally coupled to a corresponding one of the clip arms and movable relative to the clip arms between an insertion configuration, in which longitudinal axes of the pair of jaws are substantially aligned with longitudinal axes of the clip arms, and a tissue-receiving configuration, in which the longitudinal axes of the pair of jaws extend transverse to the longitudinal axes of the clip arms, the pair of jaws movable toward the tissue-receiving configuration when the pair of clip arms are in the open configuration.

Abstract: A surgical instrument can manipulate and pass suture through tissue. The device can easily pass suture through tissue with the suture fixed to the mechanism or where the suture is captured by the mechanism and allowed to slide. Along with this ability to control suture in one of two ways is a feature to provide a large amount of suture on the other side of the tissue that will be relatively easy for the surgeon to grab and pull out of the arthroscopic portal. The device includes a handle with a hollow shaft extending therefrom and a set of fingers movable into and out of the shaft. The fingers can be designed to capture suture, permit the suture to slide while captured, and optionally hold the suture in the device.

Abstract: Methods and apparatuses for repairing a tear in soft tissue are disclosed. A method according to the principles of the present disclosure includes connecting an intermediate member to a bone anchor and placing the intermediate member on the soft tissue. The method further includes inserting a first suture through the intermediate member and the soft tissue to attach the intermediate member to the soft tissue and fixing the bone anchor to bone to secure the soft tissue to the bone.

Abstract: An endovascular anastomotic connector and method of using the same. The endovascular anastomotic connector includes a vascular conduit and a supply conduit. The vascular conduit has proximal and distal ends that reside within a vascular structure. The supply conduit extends at an angle from the vascular conduit. The proximal end of the supply conduit is configured to be attached to an auxiliary device.

Abstract: A dual functioning instrument set, comprising a needle and guide, has not only the capabilities to enter and insufflate the abdominal cavity but also the ability of a suture passer to carry and retrieve suture for closure of the incision sites at the end of the procedure. The needle contains a deployable snare that is used to pass and retrieve suture. The guide is used to repeatedly locate the needle relative to the inner abdominal wall allowing for consistent placement of sutures. For insufflation purposes, obturator tips having different distal structures are provided for shielding the sharp needle tip after insertion through a body wall.