Abstract: An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

Abstract: Minimally invasive methods, systems and devices are provided for qualitatively and quantitatively assessing collateral ventilation in the lungs. In particular, collateral ventilation of a target compartment within a lung of a patient is assessed by advancement of a catheter through the tracheobronchial tree to a feeding bronchus of the target compartment. The feeding bronchus is occluded by the catheter and a variety of measurements are taken with the use of the catheter in a manner which is of low risk to the patient. Examples of such measurements include but are not limited to flow rate, volume and pressure. These measurements are used to determine the presence of collateral ventilation and to quantify such collateral ventilation.

Abstract: A method and apparatus for measuring the intra-abdominal pressure (IAP) within a patient having a naso-enteric tube. The system senses the IAP of the patient by means of a sensing conduit that is filled with a sensing fluid. The sensing fluid in the sensing conduit may be saline, water or feeding solution. After the sensing conduit is filled with the sensing fluid, the sensing conduit is elevated and a portion of the sensing fluid enters the patient. The remaining portion of the sensing fluid is related to the IAP and the IAP may be determined from the height of the sensing fluid within the sensing conduit.

Abstract: A device (302) for sampling and/or analyzing blood or other body fluid of a subject. A housing (306) contains a plurality of lancets (308) and optionally includes test elements (324) to take up a sample of blood, an evaluation system and a display. A complete system that can be handled as a single device, for example in the form of a wristwatch, includes a multiplicity of test elements (324) and lancets (308), which can be brought successively to a working position to perform multiple measurements. A cassette or carrier (320) includes multiple lancets (308) and/or test elements (324), for insertion into the device.

Abstract: This is a composite guidewire for use with a catheter for accessing a targeted site in a lumen system of a patient's body. The guidewire core or guidewire section may be of a stainless steel or a high elasticity metal alloy, preferably a Ni—Ti alloy, also preferably having specified physical parameters. The composite guidewire assembly is especially useful for accessing peripheral or soft tissue targets. The invention includes multi-section guidewire assemblies having super-elastic alloy or stainless steel ribbon braided reinforcements along a least a portion of the core. A variation of the inventive guidewire includes a braid and a tie layer (and one or more lubricious polymers on the tie layer exterior) to enhance the guidewire's suitability for use within catheters and within the interior of vascular lumen.

Abstract: A manipulator is configured with three or more substantially concentric, elongate members configured such that relative rotation and translation of the elongate members adjusts both the spatial position and orientation of the distal end of the manipulator and the spatial positioning of the manipulator along its length. In one arrangement, the elongate members are pre-curved such that the distal end portions of the elongate members have generally arcuate shapes in a resting state. When the three elongate members are combined in a substantially concentric manner, the overall shape of the manipulator is a composite of the individual elongate member shapes. Varying the relative translation and rotational orientation of the component elongate members achieves a family of resulting manipulator shapes as well as a desired spatial position and orientation of the distal end portion of the manipulator.

Abstract: A disposable tissue removal device comprises a “tube within a tube” cutting element mounted to a handpiece. The inner cannula of the cuffing element defines an inner lumen and terminates in an inwardly beveled, razor-sharp cutting edge. The inner cannula is driven by both a rotary motor and a reciprocating motor. At the end of its stroke, the inner cannula makes contact with the cutting board to completely sever the tissue. An aspiration vacuum is applied to the inner lumen to aspirate excised tissue through the inner cannula and into a collection trap that is removably mounted to the handpiece. The rotary and reciprocating motors are hydraulically powered through a foot pedal operated hydraulic circuit. The entire biopsy device is configured to be disposable. In one embodiment, the cutting element includes a cannula hub that can be connected to a fluid source, such as a valve-controlled saline bag.

Abstract: A human spinal column measuring and displaying system includes a spinal column measuring apparatus capable of measuring bending or a circumflex (twist) angle of the spinal column of the human body as a detaching amount measuring data from a reference value, an input apparatus for inputting gender, height data of the measurement subject, an image processing apparatus for inputting the detaching amount measuring data from the spinal column measuring apparatus and data from the input apparatus and generating a three-dimensional spinal column image of the measurement subject based on the detaching amount measuring data and the gender, height data of the measurement subject, and a display apparatus for displaying an image data from the image processing apparatus.

Abstract: A patient support having real time pressure control. The patient support includes a plurality of sensors located beneath a bladder including a plurality of upright cylindrical elements. The pressure within the bladder is controlled based on the pressure or force sensed by the plurality of sensors.

Abstract: A stability augmentation system for stabilizing human limbs from against limb tremors. The stability augmentation system includes: and arm brace; a plurality of piezoelectric sensors fixed on said arm brace for sensing angular motion about a first axis of a limb induced by alternating perturbations; and a plurality of piezoelectric actuators coupled to the limb and piezoelectric sensor, said piezoelectric actuator being responsive to the piezoelectric sensors for selectively applying a torque to the limb representative of the sensed angular motion such that the angular motion about the first axis induced by the perturbation is cancelled, said plurality of piezoelectric actuators concurrently applying a reactive torque, equal and opposite to the applied torque, to the limb.

Abstract: A motion monitoring apparatus and method for monitoring a patient under medical care. A sensor arrangement is provided in the form of a pad which the patient lies on. The sensor arrangement provides a signal which can be monitored to observe motion of the patient and provide an alarm should the motion meet certain predetermined conditions. The invention is particularly applicable for monitoring patients under sedation, recovering from anaesthesia, or in intensive care. The device is particularly useful for veterinary patients.

Abstract: Device for miniinvasive ultrasound treatment of disc disease. A therapeutic ultrasound tranducer (2) is provided for treatment of the disc (5), of a patient (4) by generating an ultrasonic field (3), of which the temperature focus (F) is located in the disc (5), for heating thereof. The device comprises an optical navigating device (20) with a signal receiving or signal sending unit (32). A reference device (28) has a set position relative to the disc (5). The Therapeutic ultrasound transducer (2) is provided for insertion through the skin of the patient (4) and engagement of the disc (5), preferably anulus fibrosus (8), and it has a flexible wall with an ultrasound transmitting element provided within the flexible wall.

Abstract: The method of stimulating a substance is disclosed. The method has the steps of activating an acoustic shock wave generator or source to emit acoustic shock waves; and subjecting the substance to the acoustic shock waves stimulating said substance wherein the substance is positioned within a path of the emitted shock waves and away from a geometric focal volume or point of the emitted shock waves. In one embodiment the emitted shock waves are divergent or near planar. In another embodiment the emitted shock waves are convergent having a geometric focal volume of point at a distance of at least X from the source, the method further comprising positioning the substance at a distance less than the distance X from the source. The substance is a tissue having cells. The tissue can be an organ of a mammal. The mammal may be a human or an animal. The organ may be a heart, a brain, skin, a liver or a kidney or any other organ. The tissue may be muscle, cartilage, tendon, bone, teeth or gums.

Abstract: A control device and a control program of a walking assisting device, wherein a desired assist ratio, which is a desired value of the ratio of a force to be supplied by a walking assisting device (1) in a total tread force of a user (A) relative to the total tread forces is set, the shares of a lifting force to be applied to the user (A) from a seating part (2) which are to be borne by the leg links (3L, 3R) are determined from the desire assist ratio and the tread forces of the legs of the user (A) measured on the basis of outputs of force sensors (38, 38, 39, 39), and actuators (27, 27) of the leg links (3L, 3R) are controlled such that the determined shares of the lifting force are generated from the leg links (3L, 3R).

Abstract: A belt exercising and massaging device includes a cushion, and a massaging belt unit mounted on the cushion and including two massaging belts each extending from a surface of the cushion and each movable relative to the cushion. Thus, the massaging belt unit is operated to drive the massaging belts to move and swing rightward and leftward so as to provide a massaging effect to a user. In addition, the massaging belts surround the user's body in a planar manner so that the force applied by the massaging belts is distributed on the user's body smoothly and evenly without producing an excessive vibration and a stress concentration, thereby providing a comfortable sensation to the user, and thereby preventing the user's body from being hurt.

Abstract: A restraint device includes first and second restraint and/or support portions adapted to extend around part of a person. First and second connector portions are used to secure the first and second restraint and/or support portions to the person. In one aspect, a lock member is used to selectively prevent disconnection of the first and second connector portions. A removable tag or other information element may be carried on at least one of the first and second restraint and/or support portions and may indicate the individual or individuals that placed the restraint device on the person or that removed the restraint device from the person, and/or what time the restraint device was placed or removed. A plurality of removable tags or other elements may be carried on at least one of the first and second restraint and/or support portions and may have a unique identifier to indicate whether or not the restraint device had been previously removed from the person after an initial placement.

Abstract: A conformable pad (100) for use under an orthopedic brace includes an upper edge (101) having a straight dimension and a lower edge (108) having an uneven dimension with at least one wide section (101) and at least one narrow section (115). The pad (100) further includes a first edge (117) having a straight dimension and positioned adjacent to the at least one wide section (101) and a second edge (119) also having a straight dimension and positioned adjacent to the at least one narrow section (115) such that the first edge (117) is longer than the second edge (119). The invention is advantageous for use with orthopedic braces in order to prevent friction and irritation created by the brace against the user's skin.

Abstract: Described herein are transdermal delivery devices composed of at least one re-sealable injection port and at least one local anesthetic reservoir. The device effectively delivers anesthetic to the skin of the subject prior to puncturing the skin by syringes, needle sticks, or other instruments intended to be inserted into the skin. In addition, this device can be used to deliver various therapeutic agents for either locally or systemically.

Abstract: Described herein are transdermal delivery devices composed of at least one resealable injection port and at least one local anesthetic reservoir. The device effectively delivers anesthetic to the skin of the subject prior to puncturing the skin by syringes, needle sticks, or other instruments intended to be inserted into the skin. In addition, this device can be used to deliver various therapeutic agents for either locally or systemically.

Abstract: The invention concerns a device (1) for irrigating and pressurizing a body cavity (2). Said device comprises a circuit consisting of at least one source (3), wherefrom flows a fluid under pressure, connected to a supply conduit (3) emerging in its downstream end into the cavity (2), a discharge conduit (20) for said fluid exiting from said cavity (2) and means for regulating (30) said fluid. Said regulating means (30) include first pumping means (31) capable of being temporarily engaged with the supply conduit (10), second pumping means (32) engaged with the discharge conduit (20). The two pumping means (31, 32) are operated at the same speed and in the same direction when they are engaged with their respective conduits (10, 20).

Abstract: Syringe systems for mixing and delivery of particles into the body are disclosed. In some embodiments, a mixing and delivery medical syringe system can include a barrel including first and second detachable sections, and first and second compartments communicable through a conduit.

Abstract: A multilayer film including a layer of sealing film, having main top and bottom surfaces, and a layer of thermoplastic polymer film, laminated to the layer of sealing film, on at least one of the main top and bottom surfaces. The sealing film has a composition and thickness imparting gas barrier character to the multilayer film, of which the layer(s) of thermoplastic polymer film by themselves lack such gas barrier character. Such multilayer film is usefully employed to form biologically compatible therapeutic articles such as medical balloons that are constructed to be inflated in vivo.

Abstract: A catheter for administering a substance into body tissues includes an elongated catheter body that has at least one portion of the length of the catheter body that expands after the catheter is inserted in the patient's body. The portion that expands provides a seal against backflow of the substance along the outer surface of the catheter body and away from the intended treatment area.

Abstract: A trocar is provided with a cannula and a housing and valve assembly disposed in the housing which forms a housing seal, and instrument seal, and in some cases a zero seal. A gel material is included in the valve and provides the valve with superior flotation properties for maintaining the instrument seal even when the instrument is moved off-axis In order to accommodate movement of the gel material, voids can be formed within the valve housing and even within the gel material.

Abstract: An apparatus for cleansing wounds in which irrigant fluid from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are moved by a device (which may be a single pump or two pumps) for moving fluid through a flow path which passes through the dressing and over a biodegradable scaffold in contact with the wound bed (which encourages healing tissue growth from the wound bed). The apparatus has means (which includes the device(s)) for providing simultaneous aspiration and irrigation of the wound. A dressing assembly including the dressing and the scaffold, and the dressing and a method of treatment using the apparatus.

Abstract: A disposable absorbent article with an associated polymer film that is positioned to be activated by contact with bodily fluids, wherein the polymer film can release odor control and/or skin wellness agents upon contact with such bodily fluids. The polymer film can release the odor control and/or skin wellness agents immediately, gradually over a period of time after contact with such bodily fluids, or a combination of both. The polymer film can also be used for household cleaning applications, in which the polymer film can similarly contain and subsequently release household cleaning agents upon contact with water.

Abstract: A novel system for coloring tissues of the human eye, especially methods of coloring the iris, includes drying the tissue surface, applying colorant to the dried surface, and then drying the applied colorant. The system avoids tattooing, implanting, and corneal modification. Permanent results may be obtained. Colorants may be coatings or stains.

Abstract: An absorbent article includes an absorbent structure. The edge portions in the absorbent structure's middle portion have a first mean pore size, and the central portion in the middle portion of the absorbent structure has a second mean pore size, the first mean pore size being greater than the second mean pore size. The absorbent article can be folded along the longitudinal centre axis so that a part of the article on one side of the longitudinal centre line and a corresponding part of the article on the other side of the longitudinal centre line are brought together to lie against one another at a plane of the longitudinal centre line on the upper surface of the article. The edge portions which have the greater, first mean pore size thereby form an area of the absorbent article that is first wetted during use.

Abstract: Absorbent articles suitable for use as diapers or other hygiene products are provided. The absorbent articles have one or more closure system features including dual elasticity, rear closure, and the use of co-adhesives for the fasteners. Products according to the invention may provide any of several benefits, including a high level of comfort in use, resistance to tampering by the wearer, and relatively quiet attachment and detachment of the closures.

Abstract: In certain embodiments, a vial adaptor for removing liquid contents from a vial includes a piercing member and a bag. The bag can be contained within the piercing member such that the bag is introduced to the vial when the vial adaptor is coupled with the vial. In some embodiments, the bag expands within the vial as liquid is removed from the vial via the adaptor, thereby regulating pressure within the vial. In other embodiments, a vial includes a bag for regulating pressure within the vial as liquid is removed therefrom. In some embodiments, a vial adaptor is coupled with the vial in order to remove the liquid. In some embodiments, as the liquid is removed from the vial via the adaptor, the bag expands within the vial, and in other embodiments, the bag contracts within the vial.

Abstract: A method and apparatus for prevention and reduction of myocardial infarct expansion and heart remodeling by infusion of fluid into the pericardial space of the heart to created a hydraulic heart constraint. As a result of the constraint ventricular stress and dilation is reduced. Pressure in the pericardial sac is maintained at a safe level for the duration of treatment. Apparatus consists of a catheter and a fluid infusion system.

Abstract: A double syringe delivery system is disclosed for holding a pair of syringes in a manner so as to accommodate the simultaneous activation of the plunger of each syringe in order to effect simultaneous delivery of the contents of each syringe. The delivery system includes a delivery mechanism for delivering the contents of both syringes to a site of application. The delivery system further includes a support member that is positioned between the two syringe bodies. The elongated support member has resilient, C-shaped clamps on one end of the support member. The clamps are designed to be removably clamped onto the applicator so that the syringe barrels will be held together in a parallel manner. The elongated support member further comprises finger grips. A plunger connects the two syringe plungers so that they can also be simultaneously activated.

Abstract: A catheter connector system for a subcutaneously placed catheter. The catheter connector system permits proximal trimming of the placed catheter, which is a procedure that provides numerous advantages over traditional methods of trimming catheter distal ends prior to implantation. The catheter connector system can be configured for a single lumen catheter or a multiple lumen catheter. The catheter connector system facilitates precise positioning of both distal and proximal ends of a catheter, providing enhanced functionability and patient comfort.

Abstract: A directionally limited illuminating balloon catheter includes a multi-lumen shaft having a distal end and a hollow balloon portion disposed at the distal end and inflated through the shaft, the balloon portion having a light source illuminating only a portion of the environment outside the balloon portion. The balloon portion can be have a directionally limited light source directing substantially all illumination towards the shaft. Also provided is a directionally illuminating balloon catheter kit including a set of illuminating catheters each having the light source with different sized illuminating areas to illuminate a different sized partial portion of the environment outside the balloon portion.

Abstract: The invention provides a device for a percutaneous absorption preparation, provided with a solution storage container which can exhibit good solution migration independently of the level of force. The device for a percutaneous absorption preparation comprises an electrode film comprising a base member (1) and an electrode layer (2) and having a dissolution liquid passage hole (9), a drug impregnation member (3) mounted on the electrode layer (2) side of the electrode film, and a dissolution liquid storage container (5) bonded to the base member (1) side of the electrode film via a lid member (7) covering the solution passage hole (9). The dissolution liquid storage container (5) comprises a bottom and a sidewall. A protrusion (5b) which faces the dissolution liquid passage hole (9) is provided at the center of the bottom, and the sidewall is provided with a vertically folded part (5c).

Abstract: A wavefront sensor is integrated with a surgical microscope for allowing a doctor to make repeated wavefront measurements of a patient's eye while the patient remains on an operating table in the surgical position. The device includes a wavefront sensor optically aligned with a surgical microscope such that their fields of view at least partially overlap. The inclusion of lightweight, compact diffractive optical components in the wavefront sensor allows the integrated device to be supported on a balancing mechanism above a patient's head during a surgical procedure. As a result, the need to reposition the device and/or the patient between measuring optical properties of the eye and performing surgical procedures on the eye is eliminated. Many surgical procedures may be improved or enhanced using the integrated device, including but not limited to cataract surgery, Conductive Keratoplasty, Lasik surgery, and corneal corrective surgery.

Abstract: A tissue treatment device comprises an insertion sized and shaped for insertion into the body via a trocar and a diagnostic element coupled to the insertion section, the diagnostic element illuminating tissue with the light of a wavelength selected to facilitate identification of target tissue in combination with an ultrasound element coupled to the insertion section for delivering to a portion of tissue illuminated by the diagnostic element ultrasound energy.

Abstract: Methods and apparatus for delivering, monitoring, balancing, and/or dispersing high-frequency current flow in monopolar electrosurgery. The methods generally include positioning an active electrode in or on target tissue, positioning at least two dispersive electrodes on tissue remote from the target tissue, establishing electrical current flow from the active electrode through the dispersive electrodes, and individually adjusting the current through at least one of the dispersive electrodes to balance the current through the dispersive electrodes. By adjusting and balancing the current through two or more dispersive electrodes, safety of electrosurgical systems may be enhanced by preventing unwanted patient burns.

Abstract: A catheter assembly for pressure-sensitive control of ablation treatment is disclosed. The assembly includes a conductive element, an electrode, and a pressure sensitive conductive composite member positioned between the conductive element and the electrode. At least one of the conductive pin, the pressure sensitive conductive composite element and the ablation electrode are moveable to create an engagement position and a non-engagement position. In the engagement position, the elements are electrically coupled such that ablation energy may be delivered from the conductive pin to the ablation electrode via the pressure sensitive conductive composite element. In the non-engagement position, the elements are electrically decoupled such that ablation energy is not delivered to the ablation electrode. A related method for pressure-sensitive control of ablation is also disclosed.

Abstract: Systems, devices and methods are disclosed for treating fractures. The systems, devices and methods may include one or both of an implant, such as an intramedullary nail, and a fastening assembly, such as a lag screw and a compression screw assembly. The implant in some embodiments has a proximal section with a transverse aperture and a cross-section that may be shaped to more accurately conform to the anatomical shape of cortical bone and to provide additional strength and robustness in its lateral portions, preferably without requiring significant additional material. The fastening assembly may be received to slide, in a controlled way, in the transverse aperture of the implant. In some embodiments, the engaging member and the compression device are configured so that the compression device interacts with a portion of the implant and a portion of the engaging member to enable controlled movement between the first and second bone fragments.

Abstract: Implantable vertebral staples and tools for use with the same are provided. In general, an exemplary vertebral staple according to the present invention includes a staple body having at least one long spike formed thereon for allowing rotation of the body when the long spike is partially inserted in bone. The staple body can also include one or more short spikes formed thereon and adapted to prevent rotation of the body when the long and short spikes are fully inserted into bone. The present invention also provides an inserter tool that can be used to implant the vertebral staple, and also a drill guide that can be used, preferably in combination with the inserter tool, to drill holes through the bone in alignment with one or more holes formed in the vertebral staple.

Abstract: The invention provides a method and a kit for administering bone cement to the interior cavity of a bony member to enhance bone strength, stabilizing an existing fracture thus reducing susceptibility of the bone to further fracture and/or collapse. The method and kit may include additional components, such as, bone growth enhancing agents, radiopaque components or the like.

Abstract: An apparatus for the application of bone cement is described having a housing that comprises a cylinder for the reception of the bone cement. The apparatus further comprises a piston arranged in a longitudinally displaceable manner in the cylinder, by which the bone cement can be pressed out of an exit aperture formed in the cylinder, wherein the piston is longitudinally displaceable in the cylinder by a screw movement to apply the bone cement under high pressure. The apparatus can be switched between the displacement of the piston by the screw movement and a direct displacement in the longitudinal direction without a screw movement. Furthermore, a cannula for such an apparatus is described.

Abstract: A polyaxial drill guide includes a body, a collet and a stem. The collet includes a collet shaft having distal and proximal ends and a longitudinal bore. The body includes a conical bore having narrow and wide ends. The distal end of the collet shaft rotatably mounts within the narrow end of the conical bore, with the collet shaft extending toward the wide end of the conical bore, such that the collet shaft (and consequently the longitudinal bore) can be angled within the conical bore at a plurality of angles. The stem includes a shaft having distal and proximal ends and a longitudinal bore. The distal end of the stem shaft mounts to the proximal end of the collet shaft such that the longitudinal bores are co-linear and a drill bit can be inserted into and rotated within the longitudinal bores during a drilling procedure.

Abstract: For attaching an intraocular implant having pincher like clamping arms forming a pinching area between end portions of the clamping arms to an iris of an eye, the implant is positioned against a surface of the iris in the anterior chamber of the eye, a passage in a distal end portion of an ophthalmologic surgical instrument in the anterior chamber of the eye is positioned against a surface portion of the iris closely adjacent the pinching area, and suction is applied to the passage and at least one of the end portions of the clamping arms is urged towards the iris, causing a tuck of iris material adhered to the passage to be inserted into the pinching area. Thus, a tuck adhering to the passage can easily be introduced into the pinching area between the clamping arms. An instrument and an implant specifically adapted for this method are described as well.

Abstract: A stone retrieval suction device facilitates the retention and then relocation and/or removal of objects disposed in a patient's urinary system. The device includes an elongated member for placement in a channel of a flexible ureteroscope. The elongated member defines a suction passageway which extends longitudinally therethrough. The elongated member is flexible enough to bend with the flexible ureteroscope, and it is strong enough to prevent collapse of the suction passageway when suction is provided through the suction passageway by a vacuum source. The elongated member includes a distal portion for contacting and retaining an object when the suction is provided.

Abstract: Occluding structures may be created within a body lumen by advancing a length of material distally through the body lumen. By drawing a distal location on the advanced length of material in a proximal direction, the material may be compacted into a structure which at least partially occludes the lumen. The occluding structure may be used to remove kidney stones from the ureter in conjunction with lithotripsy and irrigation.

Abstract: A surgical device for suturing vascular vessels is described, as well as methods for suturing tissue employing the surgical device. The device includes a distal member for insertion into a vascular vessel puncture wound. The distal member contains a suture and needle engaging fitting. At least one needle is advanced through tissue adjacent the puncture wound and into the needle engaging fitting to draw lengths of suture material which can then be used to close the puncture wound.

Abstract: A length of suture is provided, and a knot is partially tied in that suture around a tube. The partially-tied knot includes a noose portion connected to a loosely-tied barrel portion. The knot is tied by holding a standing end of the suture substantially stationary and pulling the running end of the suture through the noose. The knot locks upon tightening, making it suitable for surgical applications.

Abstract: A suture manipulating instrument, includes: first and second handles manually movable relative to each other to open and closed positions; an elongated shaft having a proximal end fixed to the first handle, and a distal end defining a first jaw engageable with a suture to be manipulated; a second jaw movably mounted to the distal end of the elongated shaft to open and closed positions with respect to the first jaw; and a coupling between the second handle and the second jaw for moving the second jaw to its open and closed positions with respect to the first jaw upon movement of the second handle to open and closed positions with respect to the first handle. The first and second jaws are formed with confronting surfaces configured to firmly grasp a suture between them in the closed position of the second jaw with respect to the first jaw.