Abstract: An implantable prosthetic device includes a coaption portion, paddles, and clasps. The paddles have an outer portion and an inner portion. The paddles are extendable from a folded closed position to an open position. A clasp is attached to each of the plurality of paddles. The clasps have a concave upper surface and a convex lower surface. The clasps include a fixed arm attached to the inner portion of the paddle, a moveable arm having a barbed portion, and a hinge portion connecting the fixed arm to the moveable arm.

Abstract: An endoscopic stitching device includes an elongate shaft assembly, a tool assembly coupled with the elongate shaft assembly, and a sealing pack disposed in the elongate shaft assembly. The sealing pack defines a central lumen configured to receive an axial rod therethrough, and first and second lumens dimensioned to receive respective first and second needle receiving blades therethrough. The sealing pack includes a body portion, a plurality of outer lips extending outwardly from the body portion, and a plurality of inner lips extending inwardly from the central lumen. Each outer lip of the plurality of outer lips is configured to engage the elongate shaft assembly in a sealing relation. Each inner lip of the plurality of inner lips is configured to engage the axial rod in a sealing relation.

Abstract: Apparatus for attaching a first object to a second object, the apparatus comprising a distal anchor comprising a generally cylindrical body and a vertical bore extending through the generally cylindrical body; a proximal anchor comprising a generally cylindrical body, a first vertical bore extending through the generally cylindrical body, a second vertical bore spaced distally from the first vertical bore parallel to the first vertical bore, a third vertical bore spaced distally from the second vertical bore parallel to the first vertical bore, and a fourth vertical bore spaced distally from the third vertical bore parallel to the first vertical bore; and a suture having a proximal end and a distal end, with an enlargement formed at the distal end, wherein the suture extends through the vertical bore, through the fourth vertical bore, through the third vertical bore, through the second vertical bore and through the first vertical bore.

Abstract: A surgical fastener deployment system may include a plurality of coil fasteners having a head and coil body. In one embodiment, the head may be larger in diameter than the coil body. The fasteners may also be mounted on a guide rod or mandrel that passes through a through-hole of the head and the coil body. The shaft may also include a guiding element that contacts and stabilizes the coil body as the fastener is deployed from a distal end of the shaft. When the head approaches and contacts the guiding element, the guiding element may deflect to permit the head to pass.

Abstract: A reposable surgical clip applier includes a handle assembly, a shaft assembly releasably engagable with the handle assembly, and a clip cartridge assembly releasably engagable within the shaft assembly. The handle assembly includes at least one handle, a proximal drive member, a proximal pusher, and a handle spring assembly configured to bias the handle(s) towards a spaced-apart position. When the reposable surgical clip applier is assembled, the proximal drive member is positioned proximally adjacent an inner drive assembly of the shaft assembly such that movement of the handle(s) towards an approximated position actuates a jaw assembly of the shaft assembly. When the reposable surgical clip applier is assembled, the proximal pusher is positioned proximally adjacent a distal pusher of the clip cartridge assembly such that movement of the handle(s) towards the spaced-apart position loads a distal-most surgical clip from the clip cartridge assembly into the jaw assembly.

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: Embodiments of the invention provide a surgical snare structure in which the material used for the snare and the deployment mechanism of the snare are configured to improve the cutting efficacy of the snare. In particular, the surgical snare structure of the invention may omit the kink or nib present in the loop of known surgical snares and/or may provide a reaction surface against which the cutting action of the snare is effective. The surgical snare of the invention may be a cold, i.e. mechanical-only effect, snare, or may be used in conjunction with radiofrequency (RF) and/or microwave energy to enhance a cutting or coagulation effect.

Abstract: Apparatus, systems, and methods for endoscopic dissection of blood vessels and control over cavity pressure within an endoscopic procedure are described herein. Apparatus, systems, and methods for harvesting of blood vessels are also described herein.

Abstract: A suturing backstop is disclosed. The suturing backstop has a suturing device receiver configured to receive at least a portion of a tissue bite area of a suturing device. The suturing backstop also has a sewing cuff receptacle. The suturing backstop further has one or more needle guides adjacent the sewing cuff receptacle. The suturing backstop also has one or more alignment stops configured to position said portion of the tissue bite area within the suturing device receiver such that when a needle from the suturing device is extended from a retracted to an engaged position, the needle passes through the sewing cuff receptacle and through a corresponding one of the one or more needle guides. A related method for placing sutures into a sewing cuff of a prosthetic replacement device is also disclosed.

Abstract: A surgical stapling assembly comprising a firing member, an end effector, a closure member, and a shaft including an attachment interface is disclosed. The surgical stapling assembly is configured to be attached to a surgical instrument interface by way of the attachment interface. The end effector comprises a first jaw, a second jaw, and a staple cartridge comprising staples configured to be ejected by the firing member. The second jaw is movable relative to the first jaw between an open position, a fully-clamped position, and a collapsed position. The end effector further comprises an interconnection between the first jaw and the second jaw defining a rotational axis about which the second iaw is movable relative to the first iaw. The rotational axis is shiftable toward and away from the first iaw as the second iaw is moved between the open position, the fully-clamped position, and the collapsed position.

Abstract: A bipolar electrosurgical instrument is provided. The bipolar electrosurgical instrument includes first and second shafts each having a jaw member extending from a distal end thereof and a handle disposed at a proximal end thereof for effecting movement of the jaw members relative to one another. A first conductive lead is adapted to connect to a first electrical potential and a second conductive lead is adapted to connect to a second electrical potential. One of the first and second conductive leads extends through the pivot to connect to a respective jaw member.

Abstract: A novel catheter-based system which ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter positioned inside the left atrial appendage which may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set a ligating element at the neck of the left atrial appendage.

Abstract: An end effector assembly is provided. The end effector assembly includes a pair of first and second jaw members including respective seal plates adapted to connect to a source of electrosurgical energy. The first and second jaw members operable in a first bipolar mode of operation for treating tissue and a second bipolar mode of operation for separating tissue. A dissector translatable through one of the first and second jaw members is in electrical communication with one of the seal plates of the first and second jaw members and activatable in the second bipolar mode of operation for separating tissue when the first and second jaw members are in one of the open and clamping position and tissue is adjacent thereto.

Abstract: An endoscopic stitching device includes a handle assembly and an elongate shaft assembly. The handle assembly includes a main rod, a drive conversion assembly, and an unloading lock. The drive conversion assembly includes a cam wheel, a pivot block, links interconnecting the pivot block with the cam wheel, a pawl configured to engage the pivot block to rotate the pivot block, and a pusher. The unloading lock is transitionable between an engaged position in which the unloading lock engages the pusher to inhibit distal movement of the pusher, and a disengaged position in which the pusher is movable to a distal-most position. The elongate shaft assembly includes first and second blade drive members coupled with the cam wheel and a tool assembly including first and second jaws coupled with the main rod, and first and second blades coupled with the first and second blade drive members, respectively.

Abstract: A steerable surgical device includes a flexible joint positioned between first and second tubular elements, with multiple shape memory alloy wire elements extending across or through the joint being circumferentially spaced relative to one another and independently actuatable to effectuate pivotal movement between the first and second tubular elements (e.g., along at least two or at least three nonparallel planes) to provide enhanced maneuverability relative to single degree of freedom steerable devices. Longitudinal guide structures (e.g., channels or bores) and/or anchor points for shape memory alloy wire elements may be circumferentially spaced in or on the tubular elements to receive the shape memory alloy wire elements.

Abstract: A port closure device includes a pair of jaws that may move repeatably between open and closed positions and repeatably pass a needle therebetween. The jaws are generally perpendicular to a longitudinal axis of the device in the closed position and generally parallel to the longitudinal axis in the open position. The device further includes a jaw control rod for controlling movement of the jaws and a needle control rod for controlling the passing of the needle between the two jaws.

Abstract: The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

Abstract: A device suturing device includes a flexbile tubular insertion portion; a suturing portion disposed at a distal end portion thereof holding a tubular anchor through which a suture thread is insertable; an operation portion disposed at a proximal end portion of the insertion portion; and a suture thread grasping portion inserted through the insertion portion and insertable through the anchor, wherein the suturing portion includes an installation surface on which the anchor is held; a pressing member including a convex portion being arranged to face the installation surface for pressing the anchor; and a driver operating the pressing member via the operation portion, wherein a concave portion is formed on the installation surface into which the convex portion is enterable, and the anchor is sandwiched between the concave portion and the convex portion to be swaged and deformed such that the suture thread is fixed to the anchor.

Abstract: The invention provides a heart valve leaflet capture device (250) comprising a cardiac catheter probe having a proximal end for manipulating the device (250) and a distal end terminating in a transvalve element (256). The transvalve element (256) is configured to pass through a heart valve generally parallel to a longitudinal axis of the catheter and includes two or three leaflet gripping elements (252). The leaflet gripping elements (252) are individually movable by operation of an associated actuating mechanism (260) between a radially retracted position, in which they are withdrawn with respect to the transvalve element (256), and a capture position, in which they diverge outwardly at an acute angle from the transvalve element (256). In the capture position, each leaflet gripping element (252) defines a convergent capture zone that is directed towards the edges of a target valve leaflet and in which the target valve leaflet may be captured.

Abstract: A surgical instrument includes a housing, an elongated shaft extending distally from the housing, an end effector assembly, and a trigger assembly. The trigger assembly is disposed in mechanical cooperation with the housing and is configured to longitudinally translate a drive member. The trigger assembly includes a trigger, a gear assembly, a spool, a slider, and a flexible drive member. The trigger is disposed in mechanical cooperation with the gear assembly. The flexible drive member is configured to engage the gear assembly, the spool, and the slider. Movement of the trigger with respect to the housing results in movement of the flexible drive member with respect to the housing and longitudinal movement of the slider with respect to the housing.

Abstract: A reposable surgical clip applier (10) includes a handle assembly (100) and an endoscopic assembly (200, 300, 400). The handle assembly (100) includes a housing (110) defining a body portion (111) and a fixed handle portion (112) extending from the body portion (111) and a trigger (122) pivotably connected to the housing (110) and movable relative to the fixed handle portion (112) between an un-actuated position and an actuated position. The endoscopic assembly (200, 300, 400) includes a proximal hub (210, 310, 410) configured to be selectively engageable with the housing (110) of the handle assembly (100), an elongated shaft (340) extending distally therefrom, an end effector (350) supported at a distal end of the elongated shaft (340), and an inner drive assembly (320) including a proximal portion (323) and a distal portion (325).

Abstract: A system for treating tissue includes a clip assembly including a pair of clip arms, proximal ends of the clip arms slidably received within a channel of a capsule to be moved between a tissue receiving configuration and a tissue clipping configuration, and an applicator releasably coupleable to the clip assembly to move the clip assembly between the tissue receiving configuration and the tissue clipping configuration, the applicator including a control member having a plurality of nodes extending therealong, each node having a cross-sectional are larger than a cross-sectional area of a remaining portion of the control member and configured to be coupled to the proximal end of the clip arms, a distal-most one of the nodes severable from a next immediately proximal one of the nodes, when a force exerted thereon exceeds a predetermined threshold value, to release the clip assembly from the applicator.

Abstract: A knot placement device allows a physician to apply a knot for securing two or more suture ends extending from an incision in a vessel or organ of a patient relative to each other in order to seal an opening in the vessel or organ. The knot placement device has a handle and an elongate shaft and a push rod slidably inserted in said shaft. A knot is disposed in the distal end of the shaft. An actuator on the handle may be depressed to distally advance said push rod relative to said shaft and thereby distally advance said knot. The knot may include a knot body having an inner cavity and a plug sized to fit securely within the inner cavity. In use, the plug may be inserted into the inner cavity of the knot body to fixedly hold two or more suture ends between the knot body and the plug.

Abstract: A device for making suture stitches for adjoining a first edge and a second edge of a tissue in an edge-to-edge interface. The device includes a handle and a device head. The handle including a motor for the device head and a means for attachment to the device head. The device head including a suture material supply; a needle rotationally movable, operable for moving the thread through a tissue; a hook operable for hooking and lifting the thread in automatic coordination with the needle; and a catcher operable for moving the thread into and out of the hook in automatic coordination with the hook.

Abstract: End effectors with increased clip loading capacity include a housing having a tapered section at a distal end; first and second jaw members protruding distally from the tapered section; a surgical clip feeder arranged within the housing and configured to contain a plurality of surgical clips therein; and a feedbar longitudinally movable between the housing and the plurality of surgical clips, the feedbar having a distal portion engageable with a distal-most surgical clip of the plurality of surgical clips within the tapered section. The plurality of surgical clips is arrangeable within the surgical clip feeder at a non-zero angle with respect to a longitudinal axis of the end effector. Actuation of the feedbar engages and advances the distal-most surgical clip out of the surgical clip feeder and into interposition between the first and second jaw members.

Abstract: A surgical suturing device including a needle assembly having a needle housing and a needle with an elongated rod that slides inside of the needle housing and has a notch at its proximal end. The handle assembly includes a longitudinal handle housing sized and configured to releasably receive the needle assembly, a thumb slide assembly movable longitudinally on the handle housing, a needle latch connected to the thumb slide assembly and having a releasable latching relationship with the notch of the needle rod, a locking lever pivotally connected to the handle housing that releasably engages a depression on an exterior of the needle housing, and a locking lever latch makes contact with the locking lever and holds it the locking position.

Abstract: Systems and methods for mitral valve repair having a docking station and a valve implant. The docking station is an anchoring device having a helix structure. The valve implant is made of an expandable frame and a valve, and is radially expandable to a diameter that is at least the same as an expanded diameter of the anchoring device. The method of delivering the docking station and valve implant is performed by inserting the components through device delivery catheters.

Abstract: A suturing system is provided. In an embodiment, the suturing system includes a sheath having a proximal end and a distal end. A needle is disposed distal the sheath in a pre-deployed configuration with a needle tip of the needle being orientated proximally towards the sheath. A body is disposed within the sheath, the body comprising a guide reducing an outer cross-sectional dimension of the body at the guide and forming a space between the body and the sheath, the guide being configured to receive the needle and direct the needle proximally toward the proximal end of the sheath. A suture is attached to the needle.

Abstract: The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

Abstract: A coupler apparatus for coupling electrical signals between an actuator and an end effector is disclosed. The end effector is disposed at a distal end of an elongate articulated positioner and used to position the end effector for performing surgical operations. The articulated positioner has a central lumen and the apparatus includes an elongate body sized to be slidingly received within the central lumen of the articulated positioner, at least a portion of the body being operable to flex during movement of the articulated positioner. The apparatus also includes a plurality of electrical conductors extending through the body, and a plurality of proximal electrical contacts disposed at a proximal end of the body for removably connecting each of the electrical conductors to respective electrical signal lines at the actuator.

Abstract: Disclosed herein is a tool for removing an implanted item from beneath the skin, the tool comprising: a clamping device configured to engage with the skin to retain the implanted item in a known position relative to the tool; a cutting device for cutting an opening in the skin; and a gripping device configured to move through an opening in the skin and grip an implanted item; such that, in use, the implanted item is retained by the clamping device substantially in the known position and the cutting device creates an opening in the skin through which the gripping device then passes to grip an implanted item. Advantageously, the tool reduces the complexity of an implant removal process and does not require significant operator skill to use. It further reduces the time required and the variation in the outcome of such a procedure.

Abstract: A loading unit for use with a surgical stapling apparatus including a tool assembly and a surgical buttress. The tool assembly includes: a cartridge assembly including a staple cartridge having a tissue facing surface, staple retaining pockets having a plurality of surgical fasteners therein, and a knife slot; and an anvil assembly including an anvil plate having a tissue facing surface defining staple forming pockets and a knife slot. The surgical buttress is attached to the tissue facing surface of at least one of the cartridge assembly or the anvil assembly, and conforms to the tissue facing surface such that the surgical buttress is deformed locally into the staple retaining pockets and the knife slot of the cartridge assembly or the staple forming pockets and the knife slot of the anvil assembly to which the surgical buttress is attached.

Abstract: The present invention relates to apparatus and methods for performing valvuloplasty. In some embodiments, the apparatus includes an expandable braid valvuloplasty device. In some embodiments, the methods and apparatus may be used as an adjunct to percutaneous heart valve replacement. In some embodiments, the apparatus and methods may provide a medical practitioner with feedback, monitoring or measurement information, e.g., information relevant to percutaneous transcatheter heart valve replacement.

Abstract: A surgical instrument comprising a shaft (1) on which a first handle (3) is formed, a pushing part (2) which is actuated by a second handle (4), and a force accumulator for returning the pushing part (2), wherein the force accumulator and the pushing part (2) are integrally formed.

Abstract: An imaging connector includes a proximal side and a distal side. The proximal side includes a light input opening and an image output opening. The distal side includes a light output opening and an image input opening. The imaging connector is operable to (i) transmit light from the light input opening to the light output opening, and (ii) transmit an image from the image input opening to the image output opening.

Abstract: A suture system including a suture construct having a first reduction construct configured to be selectively arranged in an expanded state and a reduced state. The first reduction construct includes a first locking limb, a first contractible loop, and a first opposed loop disposed generally opposite to the first contractible loop, wherein reduction of the first opposed loop contracts the first contractible loop from the expanded state into the reduced state and secures the suture construct in the reduced state. The suture construct may also include a second reduction construct. Optionally, the suture system includes a first and a second pusher tube defining a first and a second lumen, respectively, wherein each pusher tubes are advanced over portions of opposed loops, respectively, and wherein distal portions of opposed loops extend beyond the pusher tubes, respectively.

Abstract: Utilities (e.g., systems, methods, etc.) for reducing or limiting slack in stitching or suture constructs secured to tissues in a manner that limits the need for surgeons to physically pull on patients' muscles to remove such slack and that may ultimately reduce recovery time for patients. In one aspect, a method of creating or anchoring a suture construct (e.g., a method of stitching) in tissue in a manner that produces first and second opposite portions of the construct that can be pulled apart in any appropriate manner to apply a tension in the construct to remove slack therein substantially free of pulling on patients' muscles to remove such slack is disclosed. The present utilities also describe a tool that can be used to automatically apply a predetermined level of tension to a suture construct to remove slack therein.

Abstract: A surgical fastener deployment system may include a plurality of coil fasteners having a head and coil body. In some embodiments, the head is comprised of a bioabsorbable polymer. In one embodiment, the coil body may be comprised of a shell and a core and one of the shell and the core may be comprised of one of a magnesium alloy or a bioabsorbable polymer, and the other of the shell and core is formed of the other of the magnesium alloy and the bioabsorbable polymer. The coil body may also include an internal channel which may have a support coil disposed within.

Abstract: A positioning and retrieval device manipulated by carrying element coupled to an handle and driven by an actuator that allows for axial movement and rotational movement of a capturing portion on the carrying element.

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: An electrosurgical device comprises a body, an end effector, a cutting member, and a shaft. The end effector includes a pair of jaws that are operable to deliver RF energy to tissue that is clamped between the jaws. The cutting member is operable to sever tissue that is clamped between the jaws. The shaft extends between the body and the end effector. The shaft includes an articulation section that is operable to selectively position the end effector at non-parallel positions relative to the longitudinal axis of the shaft. Some versions include a rotation section that is distal to the articulation section. The rotation section is operable to rotate the end effector relative to the articulation section.

Abstract: A rectal band ligation device and a method of operating the band ligation device. In one embodiment, the band ligation device includes: (1) a handle having a trigger associated therewith, (2) an extension tube extending from the handle and terminating in a head, (3) at least two openings in the head, (4) hollow pistons located in the openings and configured to move relative thereto between an extended position in which ends of the pistons are exposed through the openings and a retracted position, gaps between corresponding openings and hollow pistons being less than cross-sectional widths of elastic members stretched around the ends and (5) an actuating rod coupling the trigger and the pistons and configured to cause the pistons to move from the extended position to the retracted position.

Abstract: The present disclosure relates to a hub assembly for use with an endoscopic assembly of a reposable surgical clip applier having an outer housing, a drive assembly, and a clip counting apparatus rotatably and translatably supported within the outer housing. The drive assembly is supported within the outer housing and includes an inner shaft supporting a tab. The clip counting apparatus includes an elongate body defining a throughbore therethrough configured to slidably receive the inner shaft. A plurality of grooves is radially defined within an inner surface of the throughbore and each is configured to slidably receive the tab of the inner shaft. A lockout groove is defined within the inner surface of the throughbore disposed adjacent a final groove of the plurality of grooves and configured to receive the tab of the inner shaft and inhibit distal translation of the inner shaft relative to the elongate body.

Abstract: The disclosure describes implantable bioprosthesis and constructs having an implantable woven ribbon with at least one integrated suture.

Abstract: Apparatus and methods for performing a non-invasive procedure to repair a cardiac valve are described herein. In some embodiments, apparatus and methods are described herein for repairing a mitral valve using an edge-to-edge repair to secure the mitral valve leaflets. Implant securing devices are also described that can be used during a procedure to repair a mitral valve. In some embodiments, an implant securing device includes an outer member and an inner member movably disposed within the outer member. The inner member can be used to hold or secure a suture extending from an implant deployed on an atrial side of a leaflet of a mitral valve, and the outer member can be used to push or move a half hitch knot toward a ventricular side of the leaflet, which can be used to secure the implant in the desired position.

Abstract: An anastomosis prosthesis comprising a tubular member with a leading end comprising a leading edge, and a trailing end comprising a trailing edge, wherein the leading end of the tubular member is reversibly, radially compressible, and the leading edge of the tubular member is provided with one or more radially outwardly directed flexible, substantially linear anchoring members. The anchoring members are initially arranged at an angle in relation to a longitudinal axis of the tubular member such that the anchoring members point in the direction of the trailing end of the tubular member.

Abstract: A suturing device includes a housing, a rod, a ferrule assembly, and a needle. The housing defines a guide lumen extending longitudinally therethrough. The rod is engaged with the housing and extends distally therefrom. The ferrule assembly is disposed at a distal end of the rod and is configured to releasably retain a ferrule therein. The ferrule is adapted to retain of a portion of a suture therein. The needle is configured for translation through the guide lumen defined within the housing. A distal end of the needle is configured to engage the ferrule within the ferrule assembly for removal of the ferrule from the ferrule assembly.

Abstract: Systems and methods are provided for percutaneously suturing tissue. An elongated deployment member having a guide member coaxially disposed over a shaft member may be used to carry a needle deployment member. The needle deployment member may be carried at a distal end of the elongated deployment member and include a plurality of needles releasably secured to the needle deployment member, wherein each needle is routed coaxially within the distal end of the needle deployment member. The needle deployment member may further include a needle pusher driven by a link coaxially disposed within the shaft member, wherein the needle pusher is configured to advance each needle through the distal end of the needle deployment member and coaxially over the proximal end of the needle deployment member to position the plurality of needles at a piercing angle in a proximal direction.

Abstract: A suture passing apparatus including an elongated body having opposite ends. A head is located on one end with a retainer assembly located at the other end. A recess extends from the aperture along the elongated body. A loop of a flexible member is placed in the aperture and over a projection extending into the aperture. The flexible member is placed in the recess extending from the aperture along the elongated body.

Abstract: A surgical suture and method of suturing is described. The surgical suture includes a pair of matched fastening elements connected by a length of suture. The fastening elements have interlocking components, allowing a surgeon to adjust the tightness of the suture. Fastening element holding devices are also provided to guide the use the surgical suture. The method includes placing the fastening elements in the holding devices, threading one or both of the fastening elements through the body of the patient, and securing the surgical suture, and removing the holding devices.