Abstract: A soft tissue tensioning system comprises a manual suture tensioning device having a bar and a finger guard which is orthogonal to the bar. A lateral suture cleat is disposed on each lateral end of the bar, and a primary suture cleat extends about a top and a bottom of each of the opposed lateral ends of the bar.

Abstract: Devices and methods for percutaneously treating and removing aneurysms or other anomalous tissue associated with vascular, intestinal, or other body tissue.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.

Abstract: A perforation suturing method has the steps of: inserting a needle into a wall of a hollow organ at a periphery of the perforation formed in the hollow organ, and piercing the wall; withdrawing the needle from the wall after delivery of an anchor attaching suture thread from the needle, and having the suture thread transit the wall; and tightening the suture thread so that the mated insertion points at the time of insertion of the needle into the wall approximately coincide after having the needle pierce the wall at the periphery of the perforation a plurality of times, and making surfaces of the wall where the insertion points are formed coincide with each other.

Abstract: A ligature device for medical treatment has an operating device that has a ligature tool for medical treatment fitted onto a distal end portion thereof. The operating device is provided with a cutting member that is able to move freely backwards and forwards and is used to cut a ligature wire of the ligature tool for medical treatment. A distal end side of the cutting member has an inclined end portion that is inclined relative to the direction of forward and backward movement, and a blade portion is provided in this inclined end portion.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions through which a ligation is placed and secured into tissue. An objective of this invention is to provide a stable securement platform for the coupling of secondary anchors to the gastrointestinal tract. Specifically, endoscopy is used to insert an anchoring element through the walls of adjacent body cavities. The ends of the anchoring element are coupled together to form a loop. This anchoring element can be used to secure other anchors or devices to the gastrointestinal tract.

Abstract: A tissue fastening device includes a suture clip holder and a suture cutter. A suture clip can be releasably secured to the suture clip holder, and a suture line or lines can pass through the clip and adjacent the suture cutter. A first movement of a control handle causes the suture clip to be released from the suture clip holder, and a second movement of the control handle causes the suture cutter to cut the suture line or lines. The first movement is different from the second movement. The first movement can be rotational, with the second movement being longitudinal. Alternatively, the first movement can be longitudinal, with the second movement being rotational. The device may include a main body, an inner body, and an outer body.

Abstract: The present invention is directed to a method of securing suture within a patient. The method comprises advancing suture material into the patient, passing a portion of the suture material through tissue of the patient, and advancing a fastener catheter and a suture fastener along the suture material. The fastener catheter includes a catheter main body and a handle. The suture fastener has a generally cylindrical body formed of a shape memory material and a suture fastener inner lumen. The suture fastener has at least one engagement tab biased to extend at least partially into the suture fastener inner lumen to engage against and secure one or more lines of suture passing through the suture fastener.

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 first arm, the first arm may have a distal end, a proximal end, and an opening configured to receive a needle therein. The medical device may also include a second arm movably connected to the first arm and configured to alternate between a closed position and an open position relative to the first arm, wherein the second arm is movably connected to the first arm at a pivot point disposed at a location closer to the distal end of the second arm than the proximal end of the second arm.

Abstract: A suturing apparatus comprises a pair of jaws. A bendable needle housed in one of the jaws is adapted to carry a suture. A suture receiver is disposed adjacent to, or integral with, the opposite jaw to help disengage the suture carried by the bendable needle. A transition block curves the needle and directs it in a direction generally unparallel to an axis of the carrying jaw. The jaw housing the needle may include a lateral opening through which the suture may be inserted. The needle may also include a lateral notch which may be aligned with lateral opening to receive the suture. An actuator coupled to the needle enables the user to move the needle proximally to align the notch with the lateral slot.

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 suturing instrument includes an elongate body member, a needle deployment mechanism, and a depth adaptor. The elongate body member includes a distal portion that defines an opening. The needle deployment mechanism is at least partially disposed within the elongate body member and moves the needle out of the suturing instrument and into tissue. The depth adaptor is disposed in the opening at the distal portion of the elongate body member and controls the depth that the needle penetrates into the tissue.

Abstract: An aneurysm treatment device for in situ treatment of aneurysms comprises a collapsible member having a first shape wherein the first shape is an expanded geometric configuration, and a second shape, wherein the second shape is a collapsed configuration that is loadable into a catheter. The aneurysm treatment device is capable or returning to the first shape in the sac of an aneurysm upon deployment, where it occludes the aneurysm. In another embodiment an occlusion device comprises a flexible, longitudinally extending elastomeric matrix member that assumes a non-linear shape to conformally fill a targeted vascular site.

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.

Abstract: The present invention is directed to an apparatus and method for the stabilization and fastening of two pieces of tissue. A single device may be used to both stabilize and fasten the two pieces of tissue, or a separate stabilizing device may be used in conjunction with a fastening device. After the pieces of tissue are stabilized, they are fastened together using sutures or clips. One exemplary embodiment of a suture-based fastener comprises a needle connected to a suture. The needle enters the blind side of the tissue and exits the front side. The suture is then tied in a knot to secure the pieces of tissue. One example of a clip-based fastener comprises a spring-loaded clip having two arms with tapered distal ends and barbs. The probe includes a deployment mechanism which causes the clip to pierce and lockingly secure the two pieces of tissue.

Abstract: A device for suturing an anatomic valve has an elongate body, a suture catch mechanism and a suture clasp arm. The suture catch mechanism is operatively coupled to the elongate body for movement between a retracted position and an advanced position. The suture clasp arm is pivotally attached to the elongate body for movement between a retracted position and an extended position. The suture clasp arm has a suture clasp configured to releasably retain a suture portion. In some embodiments, the suture clasp is positioned on the suture clasp arm such that the suture catch mechanism retrieves the suture portion from the suture clasp arm while the arm is at least partially retracted. In some embodiments, the suture clasp arm can be closed about a tissue portion without damaging the tissue portion.

Abstract: A medical instrument, such as a surgical device for manipulating and placing a tissue suture and methods of using the same is disclosed. The device comprises a handle, a hollow shaft removably coupled to the handle assembly and a stylet extending within the hollow shaft and longitudinally slideable therein. Preferably, the stylet is not rotationally moveable relative to the shaft. The stylet may be moved between a first position wherein a grasping member formed on the stylet is retracted into a distal end portion of the shaft and a second position wherein the grasping member extends distally beyond the distal end portion of the shaft. Distal movement of an actuation member on the handle correspondingly moves the stylet to the extended position and movement of the actuation member to a proximal position on the handle correspondingly moves the stylet to the retracted position. Lateral movement of the actuation member on the handle does not impart rotational movement of the stylet relative to the shaft.

Abstract: Methods for passing multiple sutures through tissue are provided herein. In particular, the methods described herein allow multiple sutures to be passed through tissue without removing a suture passing instrument from a patient's body. In one embodiment, a method for passing a suture through tissue is provided that includes loading first and second suture limbs into a suture passing instrument, positioning the instrument within a patient's body, actuating the instrument to pass a portion of the first suture limb through the tissue, pulling the first suture limb through the tissue, pulling the second suture limb to reload the suture passing instrument without removing the instrument from the patient's body, actuating the instrument a second time to pass a portion of the second suture limb through the tissue, and pulling the second suture limb through the tissue.

Abstract: A suture passing mechanism is disclosed having an elongated delivery member and a suture capture fitting at a distal end of the delivery member. The suture capture fitting includes a recess for receiving a length of suture. The recess is bounded by a proximal wall and a lateral opening leads therein. An expeller at the recess is adapted to expel suture out of the recess through the lateral opening.

Abstract: A suturing instrument is configured for to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, or endoscopic surgical procedures. The suturing instrument includes an elongate body member, a needle exit port, a needle receiving port, and a needle deployment mechanism. The suturing instrument eliminates the need for a preassembled needle and suture and reduces or eliminates the possibility of needle loss during suturing.

Abstract: Provided is a suturing device for organ which sutures an internal organ in front and rear directions to do a suturing operation once by clenching and unclenching a hand of an operator so that the operator easily sutures the internal organ without requiring advanced training in surgical techniques and simply and conveniently sutures the internal organ only using one hand.

Abstract: Instrumentation and methods facilitate reconstruction of the anulus fibrosus (AF) and the nucleus pulposus (NP). An intra-aperture component is dimensioned for positioning within a defect in the AF, with one or more components being used to maintain the intra-aperture component in position. The intra-aperture component may be porous and flexible while being intentionally non-expandable in cross section following its positioning within the defect. A component used to maintain the intra-aperture component within the defect includes a flexible longitudinal fixation component that passes through the intra-aperture component and a region of the AF apart from the defect. If available, this may be a region of the AF having overlapping layers with intact fibers in different directions. The flexible longitudinal fixation component may be anchored to one of the upper and lower vertebral bodies.

Abstract: A method for suturing a perforation comprises the steps of: observing an area around the perforation from an inside of a hollow organ by an observation device inserted from a natural opening of a living body; observing the area around the perforation from a body cavity side of the hollow organ by an observation device inserted from the natural opening of the living body; thrusting a needle of a suture unit inserted from the natural opening of the living body into a tissue around the perforation of the hollow organ to make a suture thread puncture the tissue via the needle; and closing the perforation by tightening up the suture thread puncturing the tissue.

Abstract: The present disclosure relates to an anchor delivery system. The system includes a guide and an anchor delivery tool disposed within the guide. The tool includes a shaft and a handle coupled to a proximal portion of the shaft. The handle includes a hub and a nose cone coupled to the hub. In an embodiment, the tool further includes a knob coupled to the hub and located between the handle and the nose cone. In an embodiment, the system further includes an anchor, such as a suture anchor, coupled to a distal portion of the shaft. An anchor delivery tool and a method of repairing soft tissue are also disclosed.

Abstract: A suture loading assembly for threading suture material through a device comprises a body, an attaching member extending from the body for attaching the body to the device, and a flexible loop extending from a distal end of the body and threadable through a ferrule in the distal end of the device.

Abstract: A surgical suturing device comprises an arced needle track. An arced needle is positioned in the needle track, the needle having a leading end, a trailing end, a medial face, and a lateral face. A length of suture is connected to the needle. An arced carrier track is spaced from the needle track. A reciprocating needle driver has a carrier positioned in the carrier track and a driver positioned in the needle track and is operative to engage and move the needle in the needle track. A transmission is operative to reciprocate the carrier in the carrier track.

Abstract: A clamping and ligation device, comprising a ligation unit (10), a conveying unit (20), a protective sleeve (30), a connecting unit (40), a operation unit (50), and a traction unit (60); the connecting unit (40) connects the conveying unit (20) with the ligation unit (10), and can be disengaged to separate the conveying unit (20) from the ligation unit (10); the traction unit (60) controls the ligation unit (10) via push and pull movement; the end of the traction unit (60) connected to the ligation unit (10) is breakable, so that the traction unit (60) can be broken away from the ligation unit (10) under a definite force; the protective sleeve pipe (30) can accommodate the whole ligation unit (10) therein, thus, during endoscope penetration, avoiding the damage to the endoscope tube wall and the increase of penetration force.

Abstract: A surgical suturing system comprises a shaft having a proximal end, a distal end, a longitudinal axis between the proximal and distal ends, and receiver on the distal end with a rotary drive. A cartridge is selectively attachable to and detachable from the receiver. The cartridge has a surgical needle, a length of suture connected to the needle, a needle driver operative to engage and move the needle relative the cartridge, a transmission operatively connected to the needle driver, and a torsional interface rotationally coupling the rotary drive to the transmission.

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: A living tissue ligation device, comprising a clamp (10), an operating device (20) and a conveying device (30); the clamp (10) comprising an elastic clip (11) and a tightening tube (12) to receive the elastic clip (11) therein; the operating device (20) comprise a handle (21) and a slider (22) capable of sliding on the handle (21); and the conveying device (30) comprises an outer connecting mechanism (31) and an inner connecting mechanism (32). The device can be widely used at various positions in the alimentary canal, can be repeatedly opened and closed, and is simple to operate.

Abstract: A clip for securing suture to tissue includes a generally tubular body, with at least one bend area along the length of the generally tubular body and one or more tabs cut from the wall of the generally tubular body. The clip in the open configuration is generally straight along the length of the generally tubular body, and the tabs are in general alignment with the tab out wall. The tab in a closed configuration assumes a shape having at least one bend along its length, and the tabs are bent or otherwise positioned to extend into and at least partially obstruct the inner lumen. The clip can be formed from memory material such as nitinol, and the clip may be biased toward its closed configuration.

Abstract: This disclosure may disclose, inter alia, devices, systems, and methods for cleaning or removing contamination from a lens, or for increasing visibility of a lens during surgery. For example, a device with a handle actuated element is disclosed. The device includes a shaft that includes a rod, an element coupled to a distal tip of the rod, and a handle coupled to a proximal end of the rod. Actuation of the handle into a first position may cause the handle to be configured in a substantially hexagonal shape and may cause deployment of the element from the shaft. Actuation of the handle into a second position may cause the handle to be configured in a substantially rectangular shape and may cause retraction of the element into the shaft. The device may be introduced into an abdomen, and an element on the device can be deployed during surgery.

Abstract: A suture applying device includes a shaft which carries a pair of needles near its distal end. The needles are joined by a length of suture, and the shaft is used to both introduce the needles into a lumen of a body structure and to draw the needles back through tissue on either side of the puncture site. After the needles have passed through the tissue, they are captured by a needle receiver and drawn outward through the tract, leaving a loop of suture behind to close the puncture site near the body lumen. The suture can then be tied or otherwise secured to close the puncture site.

Abstract: Systems for tissue repair are described where an elongate tissue repair device may be introduced into a single incision to access the damaged tissue. A suture delivery assembly may be sized for insertion through a single incision and positioned into proximity with a damaged or ruptured tissue region. A first portion of the damaged tissue region may be positioned within or along a channel defined along the suture delivery assembly and one or more lengths of suture may be secured to the first portion via the device. A second portion of the damaged tissue region may be similarly positioned within or along the channel and one or more additional lengths of suture may be secured to the second portion via the device. The first and second portions may then be approximated and secured to one another via the sutures to facilitate healing of the damaged tissue region.

Abstract: Systems for tissue repair are described where an elongate tissue repair device may be introduced into a single incision to access the damaged tissue. A suture delivery assembly may be sized for insertion through a single incision and positioned into proximity with a damaged or ruptured tissue region. A first portion of the damaged tissue region may be positioned within or along a channel defined along the suture delivery assembly and one or more lengths of suture may be secured to the first portion via the device. A second portion of the damaged tissue region may be similarly positioned within or along the channel and one or more additional lengths of suture may be secured to the second portion via the device. The first and second portions may then be approximated and secured to one another via the sutures to facilitate healing of the damaged tissue region.

Abstract: An endoscopic stitching device is provided including an end effector configured and adapted to perform at least a pair of functions; and a single actuation cable operatively connected to the end effector, wherein the actuation cable is capable of effecting operation of at least the pair of functions. The actuation cable is capable of effecting a first operation of the pair of functions upon an axial translation thereof, and a second operation of the pair of functions upon a rotation thereof.

Abstract: A method of improving elasticity of a tissue of a living body, the method including: forming a through-hole in the living body; inserting an insertion path forming unit, which includes a pipe member including a pipe and a support member including a support rod, into the through-hole in a state where the pipe member and the support member are assembled; removing the support member from the insertion path forming unit; coupling a medical thread supply unit to the pipe member; pushing the medical thread from behind by using a push unit; and removing the push unit, the medical thread supply unit, and the pipe member.

Abstract: This gastric therapy system includes a loop-forming member that forms a loop along a lesser-curvature-line and a greater-curvature-line in a stomach; a guide member that introduces the loop-forming member into the stomach; and a therapy section that cerclages a part of the gastric wall after looping the loop-forming member.

Abstract: A suture passer device is provided including a jaw configuration that grasps targeted tissue such as tendons or muscles in a similar manner as existing suture passer devices; however, the device introduces the needle and the attached suture along the axis of the shaft of the device. After grasping the targeted tissue, the needle is deployed by manipulating the handle of the device similar to conventional suture passers however, the needle is deployed in between the opposing jaws and the needle is advanced into tissue along the axis of the shaft as opposed to perpendicular to the shaft as in prior art devices. The invention further includes methods of deploying sutures and anchors. The invention also includes embodiments of jaw designs, and various embodiments of suture passing needles, sutures constructions, and anchor designs. Therefore, the invention also comprises the device in combination with the needles, sutures, and anchors, as well as the needles, sutures, and anchors in separate sub combinations.

Abstract: A tissue ligating device for ligating a tissue includes a suture having an elastic restoring force, and a hook-shaped member including a groove portion, connected to a first end of the suture, and disposed in a direction along a derivation direction of the suture and in a direction opposite to the derivation direction of the suture with respect to the first end of the suture.

Abstract: A surgical apparatus, including an instrument, a shaft part with a jaw opening at its distal end and a thread carrier guided by the shaft part displaceable from a retracted position, in which it exposes the jaw opening, and an advanced position, in which it crosses the jaw opening. A thread supported by the thread carrier can be guided through or around human or animal tissue to form a suture or ligature. The thread has a bulge at its end made of the material of the thread so that when the bulge is pushed through a passage opening of the jaw part it elastically deforms and is retained when the thread carrier is retracted.

Abstract: Described are methods, implants, insertion tools, and related systems and kits, for placing an implant to treat urinary incontinence; the implants include soft tissue anchors that are capable of engaging needles of the insertion tools, and the implants are designed to place a central support portion at a location to support a urethra with extension portions and soft tissue anchors extending to tissue at regions of an obturator foramen.

Abstract: A suturing assembly includes shaft attached between a handle and a head. The handle includes a brace and an actuator attached to the handle, where the actuator has a neutral position that is distal the brace. The shaft defines a longitudinal axis of the assembly. The head includes a proximal portion housing a needle that is movable through a needle exit port, and a distal end spaced apart from the proximal portion by a throat. The distal end is radially offset from the longitudinal axis and defines a cavity. Movement of the actuator from the neutral position to the brace moves the needle both in a first direction out of the needle exit port into the cavity and in a second direction out of the cavity and into the needle exit port.

Abstract: An apparatus for assisting in a vascular procedure includes an obturator that interfaces with a surface of tissue, the obturator including a shaft and a groove that can guide one or more tips of a medical device into a targeted region. In more specific embodiments, the targeted region is an aortic hole. The obturator can include a knob that stabilizes the medical device laterally on a surface of the targeted region. The obturator can also include a flange element that extends beyond the knob onto an outside surface of the targeted region. The knob can include a chamfer feature that can provide room for the tips of the medical device to enter the targeted region at an angle without bumping into the knob. In still other embodiments, the tips are sharp needle tips of the medical device and the groove is a V-shaped groove.

Abstract: A device for the transosseous insertion of suture threads comprises:—a main body (1), equipped with a grip (2), supporting a protruding cannula (3) provided with an active end (30);—a flexible thread-like element (4) which is housed in a coaxially sliding manner inside the cannula (3) and is suitable, on command, for exiting from the active end (30) of the cannula (3). The thread-like element (4) is made of a super-elastic, shape-memory material and thus has the property of freely assuming, at least in an adequate temperature range for which its operative use is foreseen, a natural and predetermined curved form at least in a determined portion of the terminal part thereof. Means are provided for producing the coaxial movement of the thread-like element (4) in the two directions relative to the cannula (3).

Abstract: A barbed suture including a body with barbs on the periphery, a pointed end, and an anchor at one end to resist movement of the suture in the direction of the pointed end is provided. One or more limbs on the anchor may be provided, which may be arcuate, of varying lengths, and of varying distribution about the periphery of the suture body. Other anchor designs are provided. Methods of placing single-directional and bi-directional barbed sutures to approximate the tissue on each side of a wound and to position and support tissue in the absence of a wound, as in cosmetic surgery, are provided, and may include terminal J-stitches or S-stitches. Methods of placement may be made with sharp, pointed ends, which may be needles, or insertion devices. Sinusoidal patterns of sutures that have amplitudes generally perpendicular to the resultant holding force of the suture are provided.

Abstract: A delivery device (suture passer or suture snare) that may be used in both open and endoscopic surgical procedures. The delivery device is designed with an internal member terminating in a snare and a retractable outer sheath (sleeve). The device is passed through tissue, and the outer sheath is retracted (moved back), allowing the snare to open. The suture is captured by the snare, and the outer sheath is then released so that it returns to its distal position, closing the snare and securing the captured suture. Since the snare is exposed by retracting the outer sheath (sleeve), rather than advancing the snare, the space requirement for the device is reduced, as is the possibility that the snare will undesirably contact sensitive tissue.

Abstract: Self-locking knotless sutures and associated methods are disclosed. A system for securing tissue includes a monofilament and a braid having a fixed end and a capture end. A first end of the monofilament is connected to the fixed end of the braid. A second end of the monofilament opposite the first end is a free end. The capture end of the braid has a first opening and a second opening. The monofilament and braid are structured and arranged for the free end of the monofilament to be inserted into the first opening, passed through a tunnel formed by the braid, and passed out of the second opening, all while moving in a first direction. After insertion of the monofilament into the braid, the braid prevents movement of the monofilament in a second direction opposite the first direction to prevent the monofilament from being pulled out of the braid.

Abstract: An automatic suturing apparatus comprises triggers that activate suturing and securing of the tissue of a patient. An automatic suturing apparatus also comprises triggers that activate suturing and securing of a valve to tissue of a patient. The automatic suturing apparatus can be used in systems and kits. An automatic suturing apparatus can be used in methods of suturing a tissue or a valve to tissue.

Abstract: A suturing device including an elongated body, a distal tip, at least two support arms, and at least two extendable and retractable needles. The distal tip is moveable between an extended position in which the distal tip distally extends from a distal end of the elongated body and a retracted position in which the distal tip is disposed within the elongated body. The support arms are pivotally coupled to the distal tip. When the distal tip is in the extended position, each support arm is in a collapsed position disposed within the elongated body, and when the distal tip is in the retracted position, each support arm is in a deployed position extending radially away from the elongated body. Each needle includes a distal end configured to penetrate through a vessel wall and capture a suture releasably held within a portion of a support arm.