Abstract: An insertion instrument is configured to eject a pair of anchor bodies across an anatomical gap so as to approximate the gap. The insertion instrument can include a single cannula that retains the pair of anchor bodies in a stacked relationship, or a pair of adjacent cannulas that each retain respective anchor bodies. The insertion instrument can be actuated so as to eject the anchor bodies into respective target anatomical locations.

Abstract: An intravascular device delivery system includes an elongated member with a distal end cap and a delivery disc that are longitudinally movable using a disc handle. A main body of the disc handle is configured to move the distal end cap and a movable body of the disc handle is configured to move the delivery disc. The movable body is movable relative to the main body, and the main body and movable body are movable together.

Abstract: A suture delivery system is described. The system includes an anchor and a cooperating driver, the driver facilitating a delivery of the anchor into the abdominal cavity. The system allows for the deployment of a suture internally into an abdominal wall.

Abstract: A suturing system including apparatus and methods for disposing stitches in a substrate comprising a thread carrier which inserts a thread in the substrate at a first location and withdraws the thread from the substrate at a second location.

Abstract: A surgical fastener is provided for various surgical fastening applications, including attaching an implantable prosthesis, such as a soft tissue repair fabric, to tissue and/or muscle. The surgical fastener may include a coil body and a separate head that is attached to the coil body. The head may include two or more radial wings extending in an outward radial direction from the head body. Each wing may include an external thread to engage with a corresponding internal thread of a delivery device. Each wing may be spaced from an adjacent wing by an opening therebetween to receive a drive member for driving the surgical fastener. The coil body may be attached to the center of the head. A proximal-most coil of the coil body may be spaced from a distal face of the head to form a gap therebetween.

Abstract: A fetus delivery assisting device (10) for assisting with the birth of a fetus. The device (10) comprises a shaft (16). At one end of the shaft (16) is a rigid base (18) to which an inflatable balloon (12) is mounted. The rigid base (18) and the inflatable balloon (12) are configured to accept a fetal head. The inflatable balloon (12) is configured to displace the fetal head from a pelvic cavity when inflated. The shaft (16) is configured for manipulating the inflatable balloon (12) to displace the fetal head from the pelvic cavity.

Abstract: Devices and methods for deploying self-cinching surgical clips. A device can access at least two layers of tissue or material from only one side of the tissue or material and puncture through the two layers of tissue or material. The various configurations of clips disclosed herein can be made of a superelastic material such as Nitinol, and have a constrained and a relaxed state, and no sharp edges or tips so as to reduce tissue irritation following deployment. The clip can be disposed within the housing of the delivery device and held in a constrained state until deployment wherein the clip assumes its relaxed state, where the ends of the clip can be brought into close approximation, thereby securing the layers of tissue or material together.

Abstract: An end effector for a surgical clip applier includes a housing, opposed first and second jaw members extending past a distal end of the housing and each comprising an independent structure movable relative to the other, a first cam track provided on the first jaw member and a second cam track provided on the second jaw member, and a cam providing first and second cam surfaces slidably engageable with the first and second cam tracks, respectively. A biasing device continuously urges the cam in a distal direction relative to the first and second jaw members, wherein the first and second cam surfaces and the first and second cam tracks are angled such that axial movement of the cam in the distal direction relative to the first and second jaw members causes the jaw members to close.

Abstract: An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The tissue grasper is advanced through a working channel of an endoscope, engaged relative to tissue, and retracted to pull tissue into a path of a movable needle coupled at a distal end of the endoscope so that the needle can be passed through the tissue. The needle is preferably provided with a suture so that as the needle is passed through the tissue a stitch is formed.

Abstract: A staple cartridge comprising a cartridge deck, a firing member, and a longitudinal slot within the staple cartridge and configured to receive the firing member is disclosed. The firing member moves within the staple cartridge during a firing stroke. The staple cartridge further comprises staple cavities defined in the deck, staples removably stored in the staple cavities, staple drivers configured to support the staples within the staple cavities, and a firing drive comprising a plurality of ramps configured to engage the staple drivers and a cutting edge. The staple cartridge further comprises a tissue thickness compensator configured on the cartridge deck. The tissue thickness compensator comprises protrusions extending upwardly from the tissue thickness compensator in areas which overlay the staple cavities.

Abstract: A guide member is configured for guiding a suture passer through a cannula and tissue surrounding the cannula to facilitate closure of an opening in tissue. The guide member includes a guide housing and an elongated guide shaft. The guide housing is configured for releasably engaging the guide member with the cannula and defines an entry aperture. The elongated guide shaft extends distally from the guide housing and defines an annular exterior surface. An exit aperture is defined through the annular exterior surface. The guide member defines a lumen extending from the entry aperture, through the guide housing and the elongated guide shaft, to the exit aperture. The entry aperture, lumen, and exit aperture cooperating to define a passageway extending through the guide member.

Abstract: A fastener delivery tool configured to deliver a fastener into tissue of a patient including a shaft, a handle assembly connected to a proximal end of the shaft, one or more prongs connected to a distal end of the shaft, and a fastener push rod received at least partially within the shaft, wherein the fastener push rod is connected to the handle assembly, wherein the fastener push rod is moveable relative to the shaft, and wherein the fastener push rod includes one or more detents configured to be received within a passageway of a fastener and secure the fastener to the fastener push rod with friction.

Abstract: The present invention provides minimally invasive subdural evacuating systems and methods of use thereof. The subdural evacuating systems include a cutting component and a rod component, wherein the rod component provides an external physical indicator that the surface of the dura mater has been reached, permitting the cutting component to accurately pierce the dura mater with minimal to no risk of damaging any adjacent anatomy.

Abstract: A distal biceps tendon repair device is disclosed. The device allows for anatomically correct biceps tendon repair using a single incision anterior approach without the risk associated with a double incision posterior approach. The distal biceps tendon repair device eliminates the necessity of cutting supinator muscle and greatly reduces the risk of contact or damage to vital structures such as arteries or nerves. The device has a bone drill guide mechanically coupled to a cannulated bone hook. A retrieval wire passes through the cannulated bone hook to grasp a suture or suture guide that has passed through a cannulated drill bit retained by the bone drill guide. The retrieval wire brings the suture through the cannulated bone hook, thus bringing the suture through and around the bone for subsequent anatomically correct attachment and placement of sutures used to reattach the distal biceps tendon to the bone.

Abstract: A stitching device includes a handle assembly and an elongate shaft assembly. The handle assembly includes a main rod and a drive conversion assembly including a cam wheel, a pivot block, first and second links, and a pawl. The pawl is operatively coupled to the main rod, wherein the pawl is configured to engage the pivot block to cause rotation of the pivot block which, in turn, causes reciprocating displacement of the first and second links. The elongate shaft assembly includes first and second blade drive members coupled to the cam wheel. The tool assembly includes first and second jaws and first and second blades. The first and second blades are operatively coupled with the respective first and second blade drive members, wherein axial displacement of the main rod transitions the first and second jaws between open and closed positions and causes reciprocating axial displacement of the first and second blades.

Abstract: Improved medical suturing devices, systems, and methods for loading a needle in a suturing device, particularly standard surgical needles. An exemplary device includes a body having one or more clamps for grasping a needle and a needle loader supporting the needle in a delivery position suitable for advancing through a minimally invasive aperture and a needle loading position suitable for grasping with a clamp of the device. Preferably, the needle loader includes an elongate body having a rotatable needle holding member and is releasably coupleable with the device body such that the needle is moveable between positions from a proximal portion of the device. Methods includes selecting a standard surgical needle, advancing the needle loader device into a body of a patient, and moving the needle to a needle loading position for grasping and suturing with one or more clamps of the device.

Abstract: A method of delivering a rigid intravascular device to a target location in a patient's heart includes positioning a distal tip of an elongated member of the intravascular device delivery system in a right atrium of a heart and moving the distal tip of the elongated member into a left atrium of the heart. The method includes advancing an inner steerable catheter of the elongated member longitudinally distally relative to an outer sleeve of the elongated member a first longitudinal distance; deflecting at least a portion of the inner steerable catheter a first deflection amount; then advancing an inner steerable catheter of the elongated member longitudinally distally relative to an outer sleeve of the elongated member a second longitudinal distance; and then deflecting at least a portion of the inner steerable catheter a second deflection amount.

Abstract: A system for implanting a repair device onto a native valve of a natural heart to repairing the native valve of a patient during a non-open-heart procedure. The system includes a surgical delivery instrument, a valve repair device, and a gripper control mechanism. The surgical delivery instrument has at least one lumen. The valve repair device is configured to be delivered through the lumen of the surgical delivery instrument and to be attached to a native valve of a patient. The valve repair device includes a pair of paddles, and at least four gripping members. The paddles are movable between an open position and a closed position, and the paddles and the at least four gripping members are configured to attach to the native valve of a patient. The gripper control mechanism is configured to independently move each of the at least four gripping members.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

Abstract: A surgical instrument system is disclosed comprising a plurality of outputs driven by an input. The input is selectively engaged with the outputs by a shifting system.

Abstract: Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.

Abstract: A system for implanting a repair device onto a native valve of a natural heart to repairing the native valve of a patient during a non-open-heart procedure. The system includes a paddle and a gripping member. The paddle is movable between an open position and a closed position. The gripping member has a weakened portion and a barbed portion. The barbed portion is configured to secure the gripping member to valve tissue of the native valve of the patient. A gripper control mechanism is configured to move the gripping member between an open position and a closed position. The gripper control mechanism comprises a suture removably attached to the gripping member at a first connection point and a pushing member configured to engage the gripping member at a second connection point. The weakened portion is between the first and second connection points.

Abstract: Methods for repairing a meniscus, and particularly a torn meniscus. A method of repairing a meniscus may include using a suture passer to pass a suturing element from the region between the superior surface of the meniscus and the femoral condyle, through the meniscus tissue, into the region between the inferior surface of the meniscus and the tibial plateau, across the inferior surface of the meniscus, and back to the superior surface of the meniscus, without deeply penetrating the posterior capsular region of the knee. Equivalently, the suture element may be passed from the inferior surface of the meniscus to the superior surface and back to the inferior surface.

Abstract: Various devices, systems, and methods are provided for securing soft tissue to bone. In one exemplary embodiment, a two-piece inserter tool is provided that includes a tip portion that is configured to be removably coupled to a handle portion. A distal portion of the tip portion can be configured to be coupled to a suture anchor, and the tip portion and the anchor can be passed through a continuous suture loop prior to mating the tip portion to the handle portion.

Abstract: This disclosure relates to a surgical device configured to deliver implants and a method of repairing damaged tissue, such as meniscus tears. One exemplary surgical device includes a cannula and a pusher moveable within the cannula to deploy a plurality of implants. Movement of the pusher in the distal direction deploys a distal-most implant and moves any additional implants distally within the cannula. Thus, multiple implants can be loaded into the cannula and deployed using one pusher. The disclosed arrangement is easy to use and has fewer component parts compared to prior devices, which in turn increases the ease of manufacture and reduces cost.

Abstract: The present invention relates to surgical instruments and methods for enhancing properties of tissue repaired or joined by surgical staples and, more particularly to surgical instruments and methods designed to enhance the properties of repaired or adjoined tissue at a target surgical site. The present invention further relates to hypothermic linear stapling instruments configured to pre-cool the tissues being joined by staples.

Abstract: A z-shaped surgical device including a handle and a rod secured to the handle having: a first elongate segment at a proximal end thereof; a second elongate segment angled with respect to the first segment; and a third elongate segment angled with respect to the second segment. In the illustrative application, the invention provides an arthroscopic meniscus tissue repair suture passer device that penetrates tissue with its distal tip in one direction and utilizes a needle or similar part to penetrate tissue in the opposite direction placing a suture around the torn tissue. The device has an extended z-shaped shape distally that facilitates placement of a suture around torn meniscus tissue with a novel single stroke relative to the prior art.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for positioning electrodes within a body. In an illustrative embodiment, an apparatus for slidably moving multiple features relative to a sheath inserted into a body and positioned relative to a reference point includes a primary actuator configured to move a primary electrode, a secondary actuator configured to move a secondary electrode, and a control mechanism. The control mechanism is configured to selectively prevent movement of at least one of the primary actuator based on a position of the secondary actuator and of the secondary actuator based on a position of the primary actuator and lock positions of the primary actuator and the secondary actuator.

Abstract: Embodiments of a leaflet clip device and method of reducing regurgitation through a native heart valve are disclosed. A leaflet clip device can include an elongated clipping member having a first end portion and a second end portion and a tensioning mechanism coupled to the clipping member. The leaflet clip device can further include one or more tensioning members disposed within a lumen of the clipping member, wherein the one or more tensioning members are operatively connected to the tensioning mechanism to transform the clipping member from a delivery configuration to an implantation configuration.

Abstract: A surgical staple cartridge configured for use with a surgical stapler including a firing member that is configured to progressively axially engage an anvil and channel of the stapler. The cartridge includes a cam assembly that is configured to operably interface with the firing member such that axial movement of the firing member in a distal direction drives the cam assembly from a starting position to an ending position. A cutting member is movably supported by the cam assembly between a deployed position wherein at least a portion of the cutting member extends above the deck surface and a recessed position wherein the cutting member is below the deck surface.

Abstract: Disclosed herein are minimally invasive systems and methods for intravascularly accessing the heart and performing a transcatheter repair of a heart valve by inserting a suture as an artificial chordae into a heart valve leaflet. In various embodiments, such systems and methods can be employed in other heart valve repair procedures such an edge to edge repair to coapt leaflets by inserting one or more sutures that retain the leaflets in a coapted positioned or inserting a suture to repair a tear in a leaflet, for example.

Abstract: Disclosed herein are suture clip delivery devices that can be loaded with several flat, disk-shaped suture clips and can deploy the suture clips one after another onto respective sutures without reloading the device with additional suture clips. An exemplary device includes a handle portion with an actuation mechanism that is coupled to a shaft portion that holds and deploys the suture clips. The shaft portion includes a mandrel on which the suture clips are mounted and a retainer that restricts the suture clips from moving proximally when the actuation mechanism pulls the mandrel proximally, which causes a distal-most suture clip to slide off the mandrel and be deployed onto one or more suture. The mandrel and remaining suture clips can them move distally to prepare to deploy the next suture clip.

Abstract: A device for delivering an implant (e.g., an embolic micro-coil) to a vascular disorder of a patient includes a delivery pusher, a moveable element, and first and second elongate members. The delivery pusher defines a lumen between its proximal and distal ends. The moveable element (e.g., a floating tube or a floating coil) defines a passageway therethrough and is disposed within the lumen of the delivery pusher. The first and second elongate members (e.g., core wires) are also disposed within the lumen of the delivery pusher. A portion of each elongate member passes through the passageway of the moveable element. Movement of the first elongate member in a first direction (e.g., retraction of the first elongate member from a locked to an unlocked configuration) causes a time-delayed or lost motion movement of the second elongate member in the same (i.e., first) direction, which releases the implant from the delivery pusher.

Abstract: A pair of paddles are moved laterally away from one another in an exemplary method of repairing a native valve of a patient during a non-open-heart procedure. After the paddles are moved laterally away from one another, first and second gripping members are moved from an open position to a closed position to grasp valve leaflets. The paddles are then moved laterally toward one another. A cam can be used to move the paddles away from one another.

Abstract: Described herein are tissue closure devices and methods for ligating a target tissue, such as the left atrial appendage. The tissue closure devices may have an elongate body, a snare at least partially housed within the elongate body, a suture at least partially housed within the elongate body, and a tightening element coupled to the suture. The suture may have a suture loop, and the tightening element may be configured to decrease the size of the suture loop when the area of a tissue within the suture loop decreases.

Abstract: A device for percutaneous venous valve repair generally including a catheter and a retractable and extendable member for deploying an object that affixes a portion of a venous valve leaflet to an adjacent vein wall. A related method for percutaneous venous valve repair is revealed to include percutaneously inserting a device as described herein into a peripheral vasculature of a living subject so as to affix at least a portion of a leaflet of a venous valve to an adjacent vein wall.

Abstract: A method for repairing a perforation in a tympanic membrane comprising attaching a single patch to an undersurface of the tympanic membrane covering the perforation.

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: A suture anchor includes a material having thermoplastic properties and is fixated in a hard tissue opening by liquefying at least part of this material and letting it penetrate into walls of the hard tissue opening. During the named fixation and preferably towards the end of it, the suture being held in a distal suture conduit is locked relative to the hard tissue by being clamped between the suture anchor and the wall of the hard tissue opening or by being clamped or braked through collapse of the suture conduit.

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: A surgical suturing device has an elongate shaft has a proximal end, a distal end, and a longitudinal axis between the proximal and distal ends. An actuator is connected to the proximal end of the elongate shaft. A circular needle applier is on the distal end of the elongate shaft. The circular needle applier has an arced needle and a needle driver operatively connected to the actuator to rotate the arced needle in a circular path. A joint is positioned between the proximal and distal ends of the elongate shaft. The joint is operatively connected to the actuator to selectively articulate the shaft. A bearing is on the shaft positioned distally of the joint. The bearing is operatively connected to the actuator to selectively rotate the circular needle applier about the longitudinal axis.

Abstract: Devices, systems and methods are provided for deployment of one or more functional devices, such as therapeutic and/or diagnostic medical devices and/or positioning devices, at various locations relative to a defined operative path. The devices, systems, and methods can include a guide system and a positioning element. The guide system defines the operative path when deployed within a patient's body. The positioning element cooperates with the guide system to define one or more positions relative the defined operative path from which the one or more functional devices are deployed. The present inventions allow for the accurate and reliable placement of the one or more functional devices at the one or more positions relative the operative path. In one embodiment, the functional device is an ablation device adapted to ablate cardiac tissue for the treatment of cardiac arrhythmias, such as atrial fibrillation.

Abstract: An anchor arrangement is provided for surgical tissue repair, such as in particular for repair of a meniscus tear, having at least one first anchor and one second anchor, which are movable along a hollow needle for placement on a tissue to be repaired and connected to each other via a seam element. The first anchor and the second anchor each extend between a distal end and a proximal end and form a guide surface on the outside thereof for contacting an inside of a hollow needle at least in part. In addition, there are deflectors on the anchors, via which a torque can be applied at least in part to the anchors during or after setting. At least one of the anchors has at least two anchor sections, which are movable relative to each other and which can be pivoted relative to each other between a folded position, in which the guide surface spans a cross-section deviating from a circular profile, and an unfolded position.

Abstract: A system for implanting a repair device onto a native valve of a natural heart to repairing the native valve of a patient during a non-open-heart procedure. The system includes a surgical delivery instrument, a valve repair device, and a gripper control mechanism. The surgical delivery instrument has at least one lumen. The valve repair device is configured to be delivered through the lumen of the surgical delivery instrument and to be attached to a native valve of a patient. The valve repair device has a pair of paddles, and first and second gripping members. The paddles are movable between an open position and a closed position. The paddles and the first and second gripping members are configured to attach to the native valve of the patient. The gripper control mechanisms each include a suture and a wire having a loop at a distal end. The suture extends from the surgical delivery instrument and through the loop of the wire. The suture is removably attached to the gripping member.

Abstract: A medical device may include a stabilizer configured to be coupled to a port of an insertion device. The medical device may further include a shaft configured for telescopic translation within the stabilizer and a grip coupled to the shaft. Further, the medical device may include an actuator coupled to the grip. The actuator may be axially moveable relative to the grip so as to selectively actuate a distal assembly of the medical device.

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: Apparatus and methods for forming pilot holes in bone and deploying a staple therein for fixing a sheet-like implant to the bone. A pilot hole forming trocar assembly including a trocar and a position retention sleeve can be included. The trocar can be releasably coupled to the position retention sleeve and slide in keyed arrangement within the sleeve when uncoupled. The trocar can include a distal portion having a retractable blade and a pair of pilot hole forming spikes extending distally from the trocar shaft. Once the pilot holes are formed, the position retention sleeve maintains the position relative to the pilot holes while the trocar is removed and a staple delivery device can be inserted in the lumen of the position retention sleeve to deploy a staple in the pilot holes.

Abstract: A staple cartridge is disclosed. The staple cartridge can comprise a cartridge body comprising a deck and a bottom surface opposite the deck. The staple cartridge can comprise a plurality of staple cavities, wherein each staple cavity extends into the cartridge body from the deck to the bottom surface. Additionally, a plurality of wells can be defined into the staple cartridge from the deck to a lowermost surface of the well. A plurality of staples can be removably positioned in the staple cavities. The staple cartridge can comprise a tissue thickness compensator releasably secured to the cartridge body, wherein the tissue thickness compensator comprises a compensator body and a plurality of extensions extending from the compensator body into the wells, wherein at least one extension is compressed within one of the wells. Each well can surround at least one staple cavity and/or can extend between at least two staple cavities.

Abstract: An exemplary valve repair device for repairing a valve of a patient has a paddle, and a clasp. The clasp has a fixed arm attached to the paddle and a moveable arm. The moveable arm includes barbs that are spaced apart from a connection between the moveable arm and the fixed arm. The moveable arm is movable between open and closed positions relative to the fixed arm. The moveable arm has a weakened portion between the barbs and the connection between the moveable arm and the fixed arm. Applying tension to the movable arm in a retraction direction stretches the moveable arm and moves the barbs in the retraction direction.

Abstract: Disclosed are an auricle clamp (101) and a delivery device thereof. The auricle clamp (101) includes two parallel clamp arms (202, 302); and two springs (201, 301) located at two ends of the parallel clamp arms (202, 302) respectively and are used for connecting the two ends of the two clamp arms (202, 302) to form a closed-loop structure and providing a clamping force enabling the two clamp arms (202, 203) to be located close to each other; and at least one of the two clamp arms (202, 302) is divided into a first segment and a second segment, and the first segment and the second segment are pivotally connected or connected via a flexible material.