Abstract: A one-way knot pusher and/or locking device is provided and can be used for the adjustment of soft tissue anchoring components that create or improve continence. The device can be generally button- or disc-shaped and can include a carrier and a pin. When the device is pushed in the free sliding direction it acts as a knot pusher. However, when reversed the suture (e.g., the knot) jams or wedges inside of the cavity of the carrier, restricting or preventing motion in the opposite direction.

Abstract: A one-way knot pusher and/or locking device is provided and can be used for the adjustment of soft tissue anchoring components that create or improve continence. The device can be generally button- or disc-shaped and can include a carrier and a pin. When the device is pushed in the free sliding direction it acts as a knot pusher. However, when reversed the suture (e.g., the knot) jams or wedges inside of the cavity of the carrier, restricting or preventing motion in the opposite direction.

Abstract: An implant and needle delivery system including a needle selectively releasable from a handle assembly is provided. The needle is selectively connectable with an elongate sling and the needle is selectively releasable from the handle assembly an implantation procedure to treat a pelvic disorder or condition, such as incontinence.

Abstract: Systems and methods are provided and adapted to engage and pull (e.g., pull up) or reposition paraurethral support tissue, such as the perineal membrane. The perineal membrane intersects the urethra and vagina at the midurethra or distal location and can thus be stabilized or controlled in a manner that helps restore continence. As such, the implants can be utilized to eliminate the need for mesh or other supportive structures under the urethra that is common with other incontinence slings.

Abstract: Systems and methods are provided and adapted to engage and pull (e.g., pull up) or reposition paraurethral support tissue, such as the perineal membrane. The perineal membrane intersects the urethra and vagina at the midurethra or distal location and can thus be stabilized or controlled in a manner that helps restore continence. As such, the implants can be utilized to eliminate the need for mesh or other supportive structures under the urethra that is common with other incontinence slings.

Abstract: Devices and related methods to engage tissue layers to access the space between the layers are provided. The access devices include engagement arms that can be deployed and retracted to easily engage the top tissue layer and allow it to be separated from the underlying layer. The engagement arms are coupled to an actuation rod that is in turn coupled to a switch or lever that allows a user to control the actuation from outside the patient. The engagement arms and coupling to the actuation rod are unique and compact to ensure the entire mechanism fits in a small diameter shaft.

Abstract: An implant and anchoring system is provided. The implant can include a perineal anchor, and an obturator anchor or retropubic anchor. One or more sutures or suture loops can extend between and operatively connect the anchors. In certain embodiments, the anchors are introduced and deployed via a percutaneous transobturator procedure.

Abstract: An implant and suture locking system is provided. The implant can include a lateral or distal anchor, and a medial or proximal anchor. One or more suture loops can extend between and operatively connect the anchors. A medial suture loop can extend through apertures in the medial anchor to provide efficient and easily adjustable tensioning and suture locking for the implant.

Abstract: Various embodiments of a trocar or needle system for use in inserting and deploying pelvic implants are provided. The needle device can include a solid or hollow shaft portion with a non-circular cross-section. A grip element can be provided to slide along a length of the needle shaft to further facilitate handling.

Abstract: An implant and needle delivery system including a needle selectively releasable from a handle assembly is provided. The needle is selectively connectable with an elongate sling and the needle is selectively releasable from the handle assembly an implantation procedure to treat a pelvic disorder or condition, such as incontinence.

Abstract: An insertion assisting device includes a rotary body in the form of toroid, and a support and drive part for supporting the rotary body in a rotatable manner and rotating it. The support and drive part has an approximately cylindrical supporting member for supporting the rotary body in a rotatable manner. The rotary body is provided with a convex portion for increasing the thickness to improve the strength thereof. A concave portion having a shape corresponding to the shape of the convex portion is formed on a portion of a front end surface of the supporting member, which is made in contact with the convex portion. The concave portion prevents the rotary body from stopping rotating, which may be caused by point contact between the convex portion and the supporting member.

Abstract: A one-way knot pusher and/or locking device is provided and can be used for the adjustment of soft tissue anchoring components that create or improve continence. The device can be generally button- or disc-shaped and can include a carrier and a pin. When the device is pushed in the free sliding direction it acts as a knot pusher. However, when reversed the suture (e.g., the knot) jams or wedges inside of the cavity of the carrier, restricting or preventing motion in the opposite direction.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: A propellable apparatus comprises one or more rotatable membranes. The rotatable membranes include an inner surface at least partially defining an encircled region and a continuous outer surface that turns outward to engage a cavity or lumen wall, for example, and turns inward to at least partially encompass a central region defining a longitudinal path. The membranes are powerable to provide movement relative to the cavity or lumen wall. The apparatus further comprises an inflatable and deflatable support structure, configured to bias the outer surface of the membranes outward to engage the cavity or lumen wall at a first outer diameter, and be deformable inward in response to a compressive force or operator command to provide a second outer diameter that is less than the first outer diameter. In some examples, the rotatable membranes include belt-like membranes, and the inflatable and deflatable support structure includes at least one impermeable bladder.

Abstract: Systems and methods are provided and adapted to engage and pull (e.g., pull up) or reposition urethral support tissue, such as the portion of the perineal membrane above or below the urethra. The perineal membrane intersects the urethra and vagina at the midurethra or distal location and can thus be stabilized or controlled in a manner that helps restore continence.

Abstract: Various embodiments of a trocar or needle system for use in inserting and deploying pelvic implants are provided. The needle device can include a solid or hollow shaft portion with a non-circular cross-section. A grip element can be provided to slide along a length of the needle shaft to further facilitate handling.

Abstract: A cylinder portion is inserted into a gap fanned between an outer peripheral surface of a tip end rigid portion of an endoscope and an inner peripheral surface of a self-propelled device from the side of a tip end face of the tip end rigid portion. A ring portion is disposed at a front end side of the cylinder portion, and a handle portion is disposed at a rear end side thereof. A position regulating portion for receiving the tip end face of the tip end rigid portion to define an insertion position of the tip end rigid portion is disposed in the cylinder portion. In some instances, the self-propelled device moves to a fixed position on the tip end rigid portion, and is fixed thereto by the ring portion. The cylinder portion is separated from the ring portion, and pulled out from the tip end rigid portion.

Abstract: An attachment jig includes a cylinder portion at one end of which a ring portion for fixing a self-propelled device to an endoscope is provided, and a handle portion which is provided at the other end of the cylinder portion and is gripped so as to rotate the cylinder portion. An O ring is brought into press-contact with the outer periphery of an insertion section of the endoscope, such that the self-propelled device is fixed to the insertion section. When the handle portion is further turned, a thin-walled breaking portion is broken, and the ring portion is separated from the cylinder portion. When the handle portion is rotated in an opposite direction, the cylinder portion is taken out from the insertion section, while the ring portion remains in the fixed position.