Abstract: A treatment device rotates a second rotation portion by operating an operation element. The second rotation portion switches between a first rotation position and a second rotation position. A direction of the end effector relative to the distal end of the sheath is changed in the first rotation position. A position of the end effector relative to the distal end of the sheath is maintained in the second rotation position.

Abstract: An end effector assembly for a surgical stitching device is provided. The end effector assembly includes an end effector, a housing, and a needle. The end effector includes a first jaw member and a second jaw member. The housing is movable relative to the end effector. The needle is releasably coupled to the housing and movable relative to the housing between a first, insertion position and a second deployed position. The needle is adapted, when in the second, deployed position, to releasably couple to one or both of the first jaw member and the second jaw member of the end effector.

Abstract: An anchoring device includes (a) a flexible member extending from a proximal end to a distal end and (b) an elongated anchor member extending from a first end to a second end and attached to the distal end of the flexible member such that the anchor member is movable between an insertion configuration in which the anchor member is substantially parallel to the flexible member and a locked configuration in which the anchor member is substantially perpendicular to the flexible member in combination with (c) a flexible removal element extending from a proximal end to a distal end attached to the first end of the anchor member.

Abstract: A suture device is provided with a longitudinal member; a pair of grasping members; a suture needle; a power transmitting member; an opening-closing operating portion; a pair of needle locking portions having a first needle locking member and a second needle locking member and locking or releasing the suture needle to or from the pair of grasping members; a pair of wire members connected to the pair of needle locking portions; a needle locking and operating portion that operates the pair of wire members; a link member having a first end and a second end connected to the pair of wire members; and rotatable support portions that rotatably support the link member.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably connected, to the filament engagement feature of the anchor. The first and second noose limbs emerge from the anchor as first and second free filament limbs which are capable of being passed through tissue to be repaired and then passable through the noose. The noose, such as one or more half-hitches, is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after the anchor is fixated. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs at least through the tissue as a single unit.

Abstract: A suture manipulation device with a snare is provided. The snare includes a receiving end adapted to provide support to tissue and to ensnare a portion of suture passed through the tissue and the receiving end. The receiving end further adapted to secure the portion of the suture while removing the support of the tissue. The receiving end still further adapted to remove the portion of the suture.

Abstract: A surgical tool adapted for placement of a cuff of an artificial urinary sphincter around a portion of a urethra includes a head attached to a handle. The head has a recess formed in a first end surface of the head and two pads. The recess is sized to receive an inferior portion of the urethra. A first pad is located on a first side of the recess, and a second pad is located on a second side of the recess and spaced a gap distance away from the first pad. A piercing mechanism is located in and movable out of one of the first pad or the second pad. The piercing mechanism is movable across the gap distance between the first pad and the second pad to form a channel in tissue superior to the urethra.

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 tissue fixation system including a delivery tube and an elongated fastener with a loop at a proximal end and a distal end. A proximal end of an elongated curved needle is attached to the delivery tube. A distal end of the needle is configured to penetrate tissue. The needle includes an open channel sized to receive the elongated fastener with the loop located near the proximal end of the elongated curved needle and the distal end of the elongated fastener located near the distal end of the elongated curved needle. A capture needle is slidably positioned in the delivery tube to slide through the loop in the proximal end of the elongated fastener. The capture needle is configured to grasp the distal end of the elongated fastener and pull the distal end of the elongated fastener through the loop to cinch the elongated fastener.

Abstract: The present invention relates to devices for closing a passageway in a body, for example a patent foramen ovale (PFO) in a heart, and related methods of using such closure devices for closing the passageway. The method includes introducing a mechanical closure device into an atrium of the heart and transeptally deploying the closure device across the interatrial septum to provide proximation of the septum secundum and septum primum.

Abstract: An anvil assembly suitable for trans-oral delivery includes an anvil head configured to receive a retrieval suture that is separable from the anvil head following delivery of the anvil assembly. An anvil delivery assembly includes the anvil assembly, a delivery assembly secured to the anvil assembly, and a retrieval suture selectively secured to the anvil assembly for retrieving the anvil assembly.

Abstract: A suturing device and method of use involve inserting the device into a hole, positioning material around the hole into a notch of the device, passing a needle through a cavity in the device and the material positioned in the notch, and lining up an eye of the needle with a portal for passage of a suture. A suture is then passed through the eye of the needle and the needle is removed from the material (such as skin and fascia) with the suture. The suture is then removed and the process is repeated with another end of the suture at another location through the material, around the hole. When the suture is passed through the second point of penetration, the suture now extends both into and out of the material at different points around the hole and can be tied.

Abstract: Various embodiments of a mesh or implant system are provided. In certain embodiments, a tissue fixation device is included. The tissue fixation device can include an eyelet structure having an opening and one or more teeth adapted to grasp tissue to secure the implant in place.

Abstract: A device for folding an implant having a wing into a an overlapped configuration includes a funnel body comprising: a first portion configured to receive and protect the implant when the wing of the implant is in a flat or relaxed state, a second portion proximal to the first portion and configured to engage and fold opposite first and second side portions of the wing of the implant in a predetermined direction when the implant is retracted proximally from the first portion of the funnel body and into the second portion of the funnel body, and an overlap guide configured to direct the path of a first one of the side portions of the wing such that the first and second side portions of the wing are overlapped in a predetermined manner and to prevent respective edges of the first and second side portions of the wing from butting into each other as the first and second side portions of the wing are guided into the overlapping configuration during proximal retraction of the implant relative to the funnel body.

Abstract: A wound closure system includes a suture member and a suture grasper. The suture member includes a suture and a retention member engaged to an end of the suture. The retention member is at least partially flexible and defines a central opening. The suture grasper includes a needle defining a distal portion configured for insertion through the central opening of the retention member to retrieve the retention member from an internal surgical site. The distal portion of the needle defines a distally-facing feature configured to at least partially flex the retention member upon insertion of the distal portion into the central opening to permit passage of the distal portion therethrough and a proximally-facing feature configured to inhibit proximal withdrawal of the distal portion through the central opening of the retention member.

Abstract: A surgical device including a handle assembly, an elongated body extending from the handle assembly, and an articulation mechanism connected to the handle assembly and configured to selectively articulate and lock an articulable tool assembly in one or more positions is provided. The articulation mechanism includes a main shaft member mounted for rotation and connected to an articulation linkage, a locking member configured to be received about the shaft portion of the main shaft member, the locking member defining a plurality of notches, an articulation handle fixedly secured to shaft portion of the main shaft member and configured for rotation relative to the locking member, and a lug member operatively mounted on the articulation handle and including a locking tab configured to be selectively received within a notch of the plurality of notches formed in the locking member.

Abstract: A method is disclosed for altering an implantable layer for use with a surgical instrument which includes the steps of obtaining an implantable layer comprised at least partially from a material including a glass transition temperature and a melting temperature, wherein the implantable layer includes a first shape, heating the material to a temperature higher than the glass transition temperature and lower than the melting temperature, manipulating the implantable layer to a second shape different than the first shape, allowing the material to cool below the glass transition temperature, and releasing the implantable layer.

Abstract: Apparatus and methods are described for treatment of morbid obesity using minimally invasive techniques. The apparatus includes a system of components that may be used separately or in combination for effectively reducing stomach volume, bypassing a portion of the stomach and/or small intestines, reducing nutrient absorption in the stomach and/or small intestines and/or depositing minimally or undigested food farther than normal into the intestines, thereby stimulating intestinal responses. The components described include an artificial stoma device, a gastric sleeve device, an intestinal sleeve device, a combined gastrointestinal sleeve device and permanent and detachable attachment systems. Also described are devices for delivering and deploying the components of the system.

Abstract: A specialized obturator that has a curved configuration designed specifically for entry through the anterior joint and out the back of the knee in the ideal position for a posterior portal. The curved obturator is shaped to avoid intact knee ligaments and femoral condyles. The obturator is provided with an eyelet located at the tip and may be employed with a cannula similar to a PassPort™ Button cannula, but with one or more sutures placed through the “neck” behind the collar. A standard “inside-out” cannula may be used as well, but dimensioned for the specialized obturator.

Abstract: A vascular closure system includes a body portion, an anchor, at least one suture member, and a plurality of needles. The anchor assembly includes a hub and a wire assembly. The hub has at least one aperture defined in a sidewall thereof. The wire assembly includes an actuator member extending proximally through the body portion and hub, and at least one pre-formed wire having a free proximal end and a distal end that is connected to the actuator member. Withdrawing the actuator member extends the proximal end of the at least one pre-formed wire out of the at least one aperture to capture a portion of the vessel wall between the pre-formed wire and the body portion. The plurality of needles extend through the vessel wall adjacent to the vessel puncture and are configured to connect to the at least one suture member.

Abstract: The present invention provides a circular bone tunneling device, comprising: a hollow elongate body comprising a hollow elongate body head, said hollow elongate body head defining a rigid circular arc, comprising a surgical needle; an extendable and retractable support element, reconfigurable from an extended configuration to a retracted configuration; said support element, in said extended configuration, adapted to be located along said path formed by said rigid circular arc; said support element and said hollow elongate body head are adapted to grasp said bone from at least two points along the circumference of said bone; a stabilizing element.

Abstract: The present disclosure provides a cutting assembly for cutting an object, such as a suture, within the body of a patient. The cutting assembly includes a housing, a proximal cutting element, a distal cutting element, and an actuating member. Both the proximal and distal cutting elements have a cutting surface or blade. The blades face each other within the housing and actuate towards each other to cut the suture. The housing further includes a plurality of slots that house the blades and maintain them in the orientation desired for cutting. The housing further includes openings to guide the suture through the cutting assembly. The cutting assembly provides sufficient flexibility to be oriented at the suture location, but maintains its rigidity to effectuate a sufficient, clean cut.

Abstract: A surgical instrument includes an end effector assembly having first and second jaw members movable between a spaced-apart position and an approximated position. A trigger assembly is movable between an un-actuated position and an actuated position. An energizable member is selectively movable relative to the jaw members between a first storage position and a first deployed position. At least a portion of the energizable member extends distally from the jaw members in the first deployed position. A selector is operably associated with the trigger assembly and the energizable member. The selector is transitionable between a first state, wherein the energizable member is decoupled from the trigger assembly, and a second state, wherein the energizable member is coupled to the trigger assembly such that movement of the trigger assembly from the un-actuated position to the actuated position effects movement of the energizable member from the storage position to the deployed position.

Abstract: A suture passer and method for passing suture in tissue repair and other surgical procedures. The suture passer has an outer stiff tube component and a flexible tube component which is both cannulated and retractable. The inner tube (i.e., the cannulated, flexible, retractable tube) is preferably made of NiTi and has a predefined curve. The inner tube is deployed and retracted from the outer stiff tube. The configuration of the inner tube allows the instrument to be introduced into a space through a small portal and then deployed to provide leverage and improved reach (without creating large portals).

Abstract: A laparoscopic forceps comprising a handpiece including a distal end portion; a tubular member protruding from the distal end portion of the handpiece, the tubular member having a distal end, a pair of jaws having legs that are disposed within the tubular member and partially protruding from the distal end of the tubular member, the pair of jaws and the tubular member being movable relative to each other in a direction parallel to a longitudinal axis of the tubular member; wherein each of the pair of jaws has an arcuate section, and the pair of jaws are closable by advancing the tubular member over the arcuate section of the jaws; and an operable mechanism for creating relative motion between the pair of jaws and the tubular member along a direction parallel to the axis of the tubular member, wherein at the distal end portion of the tubular member there is a profile shape that is non-circular.

Abstract: A surgical device includes a forceps and a blade. The forceps includes a first working jaw and a second working jaw. The blade extends along a longitudinal axis and includes a notched section. The blade is located between the first working jaw and the second working jaw. A first therapy current can be connected to the first working jaw, the second working jaw, or both so that tissue gripped between the first working jaw and the second working jaw and within the notched section can be coagulated. While the tissue is gripped between the first working jaw and the second working jaw, the blade is moveable along its longitudinal axis so that the tissue is cut with the notched section without repositioning the first working jaw, the second working jaw, or both.

Abstract: Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Abstract: A suture-less pelvic implant system and method is provided for treating pelvic conditions, such as incontinence or vaginal prolapse. The implant can include a fixation portion, which may be rectangular or suture line, having a plurality of fixation elements, e.g., barbs, extending therefrom to fixate within target pelvic tissue, such as the vaginal apex. In a sacralcolpopexy, an opposing end or anchor of the implant is fixated within the sacrum or like structure to stabilize, raise, support or reposition the vaginal apex.

Abstract: A suture needle has: a flexible elongated shaft member; a passing mechanism for passing a suture needle between two gripping members, wherein the passing mechanism has fitting hole portions that are provided in the respective gripping members and that hold the suture needle in a fitting manner, a holding member movable in a direction intersecting the axis of each fitting hole portion and having a pressing surface which can press an outer circumferential surface of the suture needle held in the fitting hole portion, and a tensile-force-transmitting member coupled with the holding member and which can move along the longitudinal axis of the elongated shaft member, wherein the outer circumferential surface of the suture needle is pressed by the pressing surface against the inner circumferential surface of the fitting hole portion by the motion of the tensile-force-transmitting member.

Abstract: Anchored suture line (ASL), comprising a suture thread upon which is located a plurality of anchor structures permanently attached to said suture thread at predetermined intervals, may be advantageously employed for surgical suturing procedures. An ASL suturing device may be employed to sequentially implant the anchors, still tethered to the suture line. As they are implanted, the anchors expand thereby becoming secured in the tissue. The process may be repeated without cutting the suture line until the wound is sealed.

Abstract: An adjustable suture passer for use in arthroscopic surgery is disclosed. In a preferred embodiment, the adjustable suture passer comprises a head that describes a semicircular arc, an elongate body, a support element, and driving and control mechanisms. The head is adapted to accommodate a surgical needle and a guide wire. When the adjustable suture passer is activated, the needle is driven with sufficient force to penetrate bone. Use of the adjustable suture passer thus enables surgical attachment of soft tissue to bone without any necessity for a separate anchor.

Abstract: A curved surgical fastener for anchoring medical devices to tissue includes a curved member having a proximal end and a distal end. The distal end of the curved member has a tissue penetrating end including an insertion tip with a distal point. The curved member has a total curvature of less than 360 degrees between the proximal and distal ends of the curved member. The curved member comprises a compound curve. A proximal section of the curved member has a first radius of curvature and a distal section of the curved member has a second radius of curvature that is different than the first radius of curvature.

Abstract: An arthroscopic surgical device for tunneling through hard tissue including an arcuate tunneling needle driver and a bone engagement element, the arcuate needle driver and the bone engagement element being joined together to provide a joined needle driver and bone engagement element having at least two different operative orientations including an arthroscopic operative orientation wherein the joined arcuate needle driver and bone engagement element has a trans-incision insertion cross-sectional footprint and a tunneling operative orientation suitable for tunneling, wherein the joined arcuate needle driver and bone engagement element has a tunneling cross-sectional footprint which is substantially greater than the insertion cross-sectional footprint.

Abstract: A method of placing a suture through tissue includes placing a band on a finger of a user, where the band is attached to a head of a suturing device, and employing the finger and the device in identifying an intracorporeal tissue landmark and placing the head of the suturing device at the intracorporeal tissue landmark. The method additionally includes engaging a throat of the head of the suturing device with the intracorporeal tissue landmark, and ejecting a needle out of a needle exit port and through the tissue. The needle exit port is located on a proximal portion of the head of the suturing device.

Abstract: A suture trimmer including an elongate shaft including an elongate lumen extending proximally from a distal end of the elongate shaft, a transverse through-opening disposed proximal the distal end of the shaft, and a groove extending proximally from the distal end of the shaft to a distal end of the opening. A fitting is disposed within the elongate lumen at the distal end of the shaft and extends distally therefrom. A cutting member is slidably received within the lumen of the shaft and configured to move between a proximal end of the opening and the distal end of the opening and cut a suture disposed within and extending from the opening.

Abstract: A system and method for the surgical correction of a bunion deformity allows for correction of a bunion deformity. The method includes: drilling a hole across a first metatarsal and through a second metatarsal; placing a tube from outside the first metatarsal through the hole across the first and second metatarsals; pushing a first button through the tube until the first button exits the tube through a medial side of the second metatarsal; flipping the first button to engage the first button against the second metatarsal and applying a lateral tension on the suture strand; manually pushing the first metatarsal and the second metatarsal together to correct intermetatarsal angular deformity; pulling free ends of the suture strand of the suture-button construct to advance a second button of the suture-button construct and to engage the second button against the first metatarsal; and securing the second button against the first metatarsal.

Abstract: A device for suturing tissue includes a handle including a housing and a suturing needle for advancing a suture through the tissue. The device also includes a first needle gripper that is configured to both grasp and release the suturing needle. A second needle gripper is also configured to both grasp and release the suturing needle. An actuator is coupled to the housing and is operatively coupled to: (a) a first linkage that pivots the second gripping gripper between a fully extended position and a retracted position relative to the housing; and (b) a second linkage that is operatively coupled to the first and second needle grippers and configured to alter a state of each of the first and second needle grippers. The second linkage can include a one-way clutch.

Abstract: Disclosed is a wire knot delivery device, and more particularly, a wire knot delivery device for delivering and maintaining a knot of a medical wire in a medical procedure. The wire knot delivery device includes a first body, a second body parallel to the first body and moving relative to the first body, a first catching part connected to a side of the first body and caught by a side of the knot during the delivery of the knot, and a second catching part connected to a side of the second body and caught by another side of the knot during the delivery of the knot. As the second body moves, a distance between the first catching part and the second catching part is adjusted.

Abstract: A medical device including an elongate member having a proximal end, a distal end, and a lumen extending therebetween. The medical device may further include an end-effector disposed at the distal end of the elongate member. The end-effector may include a plurality of arms pivotally connected to one another, wherein each arm includes a tissue-contacting surface, a first portion of the tissue-contacting surface including a plurality of ridges configured to grasp tissue. Further, the tissue-contacting surface may include a channel oriented substantially parallel to a longitudinal axis of the medical device.

Abstract: A deployment mechanism for selectively deploying and retracting an energizable member and/an insulative member relative to an end effector assembly of a surgical instrument includes one or more actuators, a clutch assembly, and a drive assembly. The clutch assembly is configured to couple to the actuator(s) to provide rotational motion in the first direction in response to such rotation of the actuator(s) and to decouple from the actuator(s) in response to rotation thereof in the second direction. The drive assembly is operably coupled to the clutch assembly and is configured to convert the rotational motion provided by the clutch assembly into longitudinal motion to translate the energizable member and/or insulative member from a storage position to a deployed position and to translate the energizable member and/or the insulative member from the deployed position back to the storage position.

Abstract: Devices, systems, and methods are disclosed for relocating a meniscus horn in a knee. The invention may be deployed during an arthroscopic procedure to apply external forces to a meniscus horn to pull the meniscus into a load bearing area of the knee, which may reduce contact stresses on articular cartilage in the knee and thereby ameliorate pain associated with an osteoarthritic joint. In one embodiment, the system includes a guide needle, suture thread, plug, elongate member, and bone anchor.

Abstract: An arthroscopic meniscal tear repair device includes a catch needle and a transfer needle, which are pierced into a torn meniscus and advanced past the tear. Suture is transferred by a suture needle from the transfer needle through the meniscus and into the catch needle. The catch needle has an internal mechanism that retains the suture. The suture needle is then retracted back to its home position inside the transfer needle, leaving the free end of the suture across the meniscus and in the catch needle. The device is then retracted out of the meniscus, leaving behind a stitch across the meniscal tear inside the meniscus. A pre-tied knot of suture is then slid down the device and cinched up using a knot pusher having a dilation tip, thus completing the repair.

Abstract: Implantable materials for use with end effectors like surgical stapling devices, and methods for using the same, are generally provided. In some embodiments, adjunct materials for use with surgical staplers are provided. For example, a kit for stapling tissue is provided that can include a surgical stapler having an end effector. The end effector can have first and second jaws. The kit can include an adjunct material having hydrophobic surface regions and hydrophilic surface regions and the adjunct material can be configured to mate to at least one of the jaws of the end effector. Other implants, devices, and methods for surgical stapling are also provided.

Abstract: A surgical instrument includes a first jaw and a second jaw serving as grasping parts, a first joining part, a first dissecting part, a second joining part, a second dissecting part, and a tissue preservation part disposed between the first joining part and the second joining part and configured to preserve a non-joining region between the first joining part and the second joining part when the first joining part and the second joining part join living body tissue.

Abstract: Knotless, adjustable anchor systems that allow for knotless tensioning of tissue (such as the rotator cuff) after anchor implantation. The knotless, adjustable anchor system includes knotless anchors (for example, swivel and/or screw-in suture anchors and/or push-in suture anchors) that are modified to carry a self-locking, adjustable construct (for example, a suture assembly with a spliced suture loop) and to position the self-locking, adjustable construct at the repair site. The system allows for knotless tensioning of the tissue after the knotless anchors have been implanted. The medial row anchors are implanted and passed through tissue in a similar fashion as the current Corkscrew® or SwiveLock® C anchors are. The lateral row anchors are similar to a knotless SutureTak® but modified to accommodate a larger suture to hold a larger load. The suture is interconnected to the medial row and returned back to the lateral row for loading into the splice.

Abstract: A suturing device includes an elongate shaft defining a longitudinal axis, a trajectory guide translatably mounted on the elongate shaft and an introducer guard member operatively coupled to a distal portion of the elongate shaft. The introducer guard member includes at least one arm member which is movable between a first position in which the arm member is retracted, substantially in alignment with the longitudinal axis and a second position in which the at least one arm member is deployed. The introducer guard member includes an attaching member for releasably retaining a suture. The trajectory guide defines at least one bore therethrough. The bore obliquely extends through the trajectory guide and defines an angle with respect to the longitudinal axis. The bore aligns with the attaching member when the introducer guard member is in the second position.

Abstract: A clip applying apparatus is described for applying clips seriatim to tissue. The apparatus includes a lockout member for limiting distal movement of the camming member after the proximal-most clip has been applied to tissue. In one embodiment, the apparatus includes a jaw locking member for preventing approximation of the jaw members of the apparatus. In one embodiment, a latch assembly is provided to releasably engage a clip pusher of the apparatus to the camming member of the apparatus.

Abstract: The present disclosure describes a suture passer device that includes a handle, a shaft extending from the handle, a suture carrier secured to the handle and extending through the shaft, and a suturing head extending from the shaft and configured to retain tissue. The handle is operable to advance the suture carrier through the suturing head to pass a suture through tissue retained in the suturing head. According to one aspect of the present disclosure, the suture passer device includes a quick-connect mechanism releasably connecting the shaft to the handle. According to another aspect of the present disclosure, the shaft includes a first shaft and a second shaft pivotally coupled to the first shaft, and the first shaft defines a first channel for receiving the second shaft. Methods of disassembling the suture passer device are also described.

Abstract: Devices and methods are presented for securing a suture to facilitate a surgical procedure.

Abstract: A suture locking device includes a carrier member, a locking assembly, a suture path, and an actuator assembly. The locking assembly includes a first locking member having an outer surface portion, and a second locking member having an inner surface portion. The suture path is receptive of a suture and defined at least partially through the first locking member, between the outer and inner surface portions, and at least partially through the carrier member. The actuator assembly is operable to move the first and second locking members together to lock the suture relative to the lock assembly.