Abstract: A suture passer comprising: a hollow tube, the hollow tube comprising a distal end, a proximal end, a lumen extending from the distal end to the proximal end, and a window formed in the sidewall of the hollow tube, the window communicating with the lumen; and a clamping rod slidably received in the lumen of the hollow tube, the clamping rod comprising a distal end and a proximal end, the distal end being bifurcated into a first arm and a second arm, one of the first and second arms extending distally of the other of the first and second arms and including a clamping surface, and at least one of the first and second arms being outwardly biased such that when the clamping rod is moved distally so that the distal end of the at least one outwardly biased arm is adjacent to the window, the distal end of the at least one outwardly biased arm extends outwardly through the window.

Abstract: A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a foot portion having one or more feet slidably mounted relative thereto. The feet are movable between a deployed position and a delivery position. The feet include cuffs removably mounted therein, with sutures connected between the cuffs. When the feet are in the deployed position and the needles are advanced, the needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.

Abstract: The invention includes a needle loader that may be used with a suturing device. The needle loader includes a generally planar needle supporting surface, a hub configured and adapted for receiving a generally toroidally shaped suturing needle around the hub, and means for retaining a suturing needle in a fixed toroidal rotational position with respect to the hub about a center axis of needle rotation. Generally, a needle mounted around the hub is selectively disposable on and removable from the hub. In accordance with a further aspect, the loader may further include an opening for retaining suture material attached to a suturing needle. The opening may include a groove defined through the needle supporting surface. The needle loader may further include a guard for preventing access to the point of a suturing needle to protect the needle and/or to prevent accidental needle sticks.

Abstract: A medical device includes an elongate member having a proximal end portion and a distal end portion. The distal end portion is configured to be inserted into a body of a patient. The elongate member is configured to be associated with a bodily implant. The distal end portion of the elongate member is configured to move from a first position to a second position such that distal end potion of the elongate member may be inserted into the body of the patient in its second position and is moved to its first position while disposed within the body of the patient.

Abstract: A method for delivering a closure element to an opening formed in a wall of a body lumen. The method includes inserting a distal end region of an apparatus into the opening in the wall of the body lumen, moving a third grasping portion toward the first grasping portion to limit movement of the distal end of the apparatus relative to the opening in the wall of the body lumen, and moving a second grasping portion toward the first grasping portion to advance the closure element distally. The second grasping portion and third grasping portion are movable toward the first grasping portion.

Abstract: A suture loop is used in combination with a grasp-and-retrieve suture passer to pass a racking hitch through tissue in one step.

Abstract: A surgical device with a shaft having a distal end to which a surgical instrument is mountable and a proximal end equipped for handling the instrument, wherein the shaft is hollow and the surgical instrument is mountable on inserts that are longitudinally movable in the shaft parallel to the longitudinal axis and that are diametrically opposed to each other. The shaft comprises outer and inner tubes rotatable in opposite directions with respect to the longitudinal axis, and the inserts are coupled to the outer and inner tubes to convert rotational movement of the tubes into longitudinal movement of the inserts.

Abstract: An arterial closure device includes an elongated catheter having a proximal end, an opposing flexible distal end, and a lumen extending between the proximal end and the distal end. An externalization needle and an internal catheter are disposed within the lumen. The externalization needle is in communication with a first plunger. A first threading needle and a second threading needle are positioned in separate threading channels and in communication with a second plunger. A suture has a first end attached to the second end of the first threading needle and a second end attached to the second end of the second threading needle. A primary aperture extends through a wall of the elongated catheter. A first threading aperture and a second threading aperture extend through the wall of the elongated catheter at opposing sides of the primary aperture.

Abstract: A surgical needle is adapted for use with a circular needle applier having a needle driver. The surgical needle comprises an elongate body curved along a circular arc in a plane. The elongate body has a leading end, a trailing end, a longitudinal axis between the leading and trailing ends, a cross-sectional circumference, an upper face, a lower face, a medial face, and a lateral face. A pair of recessed features on the body are adapted to be engaged by a needle driver. A pair of protuberances are adjacent each recessed feature. The protuberances are longitudinally coincident with the respective recessed feature and circumferentially offset from the respective recessed feature. The protuberances project outwardly from the body.

Abstract: A surgical suture module for a machine constructed and configured for automatic, continuous suturing for reduced or minimized scarring and reduced suturing time. A surgical suture module for continuous, subcuticular suturing. The module includes a generally circular needle with a needle shaft; a supply of thread; a thread guide; a hook with a hook shank, a holding arm mechanism; and a housing. The needle, rotationally movable between a first position and a second position, is configured to introduce the thread into a tissue. The hook is operable for hooking and lifting the thread in coordination with the needle and the holding arm mechanism is operable for pushing and catching the thread in automatic coordination with the hook. The needle, the hook, and the holding arm mechanism are held in position by the housing and the housing operable to attach to a power supply that provides power to the module.

Abstract: A surgical system uses a single entry port in a wide variety of surgeries. To insert multiple surgical instruments into a patient through a single entry port requires that the shaft of at least one of the surgical instruments be bent between the base of the surgical instrument and the point where the shaft contacts a channel in an entry guide. Each surgical instrument is positioned by an instrument manipulator positioning system so that when the shaft is inserted in a channel of the entry guide, any bending of the shaft does not damage the surgical instrument and does not inhibit proper operation of the surgical instrument.

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: Methods and instruments for repairing soft tissues of a skeletal joint, such as, for example, of the foot or hand are presented. Disclosed techniques include techniques for the repair of a palmar plate of a hand or foot, including advancing a foot of a suture passer through, or adjacent to, a joint space and advanced into a flexor tendon sheath a distance to produce an amount of suture purchase on a plantar/palmar plate. The foot of the suture passer can also be moved medially or laterally away from a joint midline but still within the flexor tendon sheath to further locate stitches. The sutures can then be secured to restore the function of the plantar/palmar plate.

Abstract: A method of passing suture through a pledget is disclosed. A first suture tail is passed through a first suture engaging loop extending out of a first aperture in the pledget on a distal side of the pledget. A second suture tail is passed through a second suture engaging loop extending out of a second aperture in the pledget on the distal side of the pledget. The first and second suture tails are drawn proximally through their respective pledget apertures by pulling a handle coupled to the first and second suture engaging loops on a proximal side of the pledget.

Abstract: A knotless self-cinching suture construct device includes a shuttling suture, a continuous loop and a self-cinching suture member. The shuttling suture is configured for insertion into a passage hole in injured soft tissue, such as a torn or damaged meniscus in the knee. The shuttling suture and continuous loop are passed entirely through the passage hole in the tissue, and the self-cinching suture member is inserted through the continuous loop to form a hitch using the continuous loop around the tissue. The self-cinching suture member is then pulled tight, allowing a first strand to slide through both the hitched continuous loop and a self-cinching sleeve on the suture member. When tension is applied, the sleeve tightens around the strand much like a finger trap, preventing inadvertent release of the applied suture tension. The suture construct is configured for use through a transosseous tunnel with a suture button in some embodiments.

Abstract: A dynamic fixation device is provided that allows the vertebrae to which it is attached to move in flexion within the normal physiological limits of motion, while also providing structural support that limits the amount of translation motion beyond normal physiological limits. The present invention includes a flexible portion and two ends that are adapted for connection to pedicle screws. In at least one embodiment of the present invention, the normal axis of rotation of the vertebrae is substantially duplicated by the dynamic fixation device. The flexible portion of the dynamic fixation device can include a geometric shape and/or a hinge portion.

Abstract: A device for making continuous suture stitches including a handle and a device head. The handle including a power source for the device head and a means for attachment to the device head. The device head including a suture thread 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; thereby providing a device for making continuous suture stitches for adjoining a first edge and a second edge of a tissue in an edge-to-edge interface.

Abstract: A tissue resection hood and related method of use for resecting the tissue are described. The tissue resection hood may include a distal end portion having an opening, a proximal end portion, and a cavity defined between the proximal and distal end portions, wherein the proximal end portion defines an opening configured to couple to an end of a sheath. The tissue resection hood may further include a cutting member configured to traverse the opening in the distal end portion and a mechanism configured to control a dimension of the cavity.

Abstract: A device 10 for gathering tissue of a heart valve leaflet 2 may include an outer tube 16 extending in an elongation direction, a capture tool 22 moveable in the outer tube between a contained position and a use position, and a tissue securing component 32 disposed at a distal end 17 of the outer tube and adapted to be applied to tissue 8 captured by the capture tool to hold the captured tissue in a gathered configuration. The capture tool may include a first element 20 and a second element 22 that are moveable relative to one another in the elongation direction. The first and second elements 20, 22 may be operable to capture tissue 8 of the heart valve leaflet 2 therebetween and to draw the captured tissue into the outer tube 16 in the gathered configuration.

Abstract: A system for implanting an implantable penile prosthetic includes a tube with a bore formed in the tube, a first suture attached to a proximal portion of a needle, with the needle inserted in the bore, and with system characterized by an absence of a plunger inserted into the bore.

Abstract: A suturing device is disclosed. The suturing device includes an end effector assembly disposed on a distal end of the suturing device. The end effector assembly includes at least one guide tube housing at least one elongated member, a guide rack, and an anchor configured for disposal in a tubular tissue circumferentially offset from the guide rack. The anchor includes at least one guide tube attached to a suture having a first end and a second end. The at least one elongated member is deployed to puncture tubular tissue and mate with the at least one aperture of the anchor such that extraction of the at least one elongated member simultaneously draws out the suture through the punctured tubular tissue.

Abstract: An apparatus comprises an end effector, a shaft assembly, and a drive assembly. The end effector comprises needle receiving arms operable to grasp a needle. The drive assembly comprises drive members that are rotatable about respective drive axes that are perpendicular to the axis of the shaft assembly. The drive assembly is operable to drive the needle receiving arms to selectively engage and disengage the needle; and to selectively pass the needle from one needle receiving arm to the other needle receiving arm. The drive assembly provides an interface to a controller that is operable via a remote user interface. The drive assembly may include helical gears, clutch assemblies, a rack and pinion, or other components to convert motion of the drive members into motion at the end effector.

Abstract: A device that facilitates the placement of one or more needles and their attached sutures in the body of a surgical patient is disclosed. The device contains one or more needle guide channels in which one or more needles may be backloaded. The device also contains one or more lumens extending though the body of the device. One or more sutures may be coupled to the one or more needles, and threaded through the lumen. The one or more needles may then be advanced out of their respective needle guide channels by pulling on one end of one or more sutures. When one end of a suture is pulled, the attached needle is advanced out of the device and will pierce and be positioned in the tissue that is located adjacent to the device.

Abstract: A needle cartridge is adapted to be attached to a receiver on a surgical suturing device. The cartridge comprises an arced needle having a leading end, a trailing end, and a length of suture. A body has a track receiving the needle and defining a circular path. A needle driver is operable to rotate the needle along the circular path. A cover captures the needle in the track. A cage engages and retains the needle cover against the body. The cage may slide relative the body to disengage with a portion of the cover allowing the cover to deflect and release the needle from the track.

Abstract: An apparatus for loading suture needles into a surgical instrument comprises a body, a drive member, a needle, and a button. The body has a channel configured to receive a surgical instrument. The drive member is configured to open a cover of a surgical instrument upon insertion of a surgical instrument into a channel of the body. The button is configured to deliver the suture needle to a surgical instrument after a surgical instrument has been inserted into the channel and the cover has been opened. The apparatus may further comprise a plate member configured to either prevent downward movement of the button before insertion of a surgical instrument, or participate in the delivery of the needle to a surgical instrument.

Abstract: Method and surgical instrument for treating prostate tissue including a surgical instrument having a main body, a needle deployment port, a needle, first and second handles and a lockout release mechanism to limit needle extension. Additionally, a kit includes the surgical instrument, together with a cystoscope, and optionally a syringe and reservoir of ethanol. The method includes needle-less injection and visualizing the ethanol injection by delivering both an echogenic agent and ethanol either by needle or needle-less injection or by providing an ultrasonically visible marker near the tip of the ethanol delivery cannula. The method also includes extending the needle transversely of the instrument housing using a link assembly.

Abstract: A device is provided to assist in closing an incision through body tissue that comprises a tubular body sized for introduction through the incision and carrying a plurality of stabilizer elements at the distal end thereof. The stabilizer elements are configured to be deployed within the body cavity to engage the lowermost tissue layer. In one method, the device is pulled with the stabilizer elements deployed to retract the body tissue away from adjacent body structure. In another method, a plurality of needle tips carrying sutures are guided through the body tissue to a retention device at the ends of the stabilizer elements. With the needle tips captured in the retention devices, the device is withdrawn from the incision so that the sutures form ligatures that can be tied off to close the incision.

Abstract: A machine constructed and configured for automatic continuous suturing for reduced or minimized scarring and reduced suturing time, including methods of using the same. A device for continuous suturing. A device, method and suture for subcuticular suturing.

Abstract: A magnet insertion tool for use with an implantable device includes an upper part having an insertion member and an alignment member movably coupled to the insertion member. The insertion member includes a positioning surface configured to position the implantable device between the insertion and alignment members, a magnet socket extending from the positioning surface and configured to hold an implant magnet, and an alignment surface configured to align the implantable device relative to the magnet socket. The alignment member includes an engagement surface configured to engage the implantable device during insertion of the implant magnet. The alignment member is configured to contact a portion of the insertion member such that the engagement surface and the positioning surface are spaced apart from one another. The tool further includes a lower part, movably coupled to the upper part, that has a platform that is configured to move within the magnet socket.

Abstract: An insertion instrument is configured to eject at least one anchor body into respective target locations, and subsequently apply a predetermined tensile force at least one actuation member of the at least one anchor member so as to actuate the at least one anchor body from a first configuration to a second expanded configuration. The insertion instrument can include a tension assembly that applies the predetermined tensile force to the at least one actuation member. The predetermined tensile force can be defined by a distance of travel, a predetermined failure force of a fuse, or a combination of distance of travel and a predetermined failure force of a fuse.

Abstract: A method and apparatus for securing a suture to bone can include grasping a first suture portion with a grasping member on a positioning tool. The first suture portion can be located into a first cannulation defined in the positioning tool. A cutting member can be advanced through a second cannulation defined on the positioning tool and out through a distal opening defined on the positioning tool. A first bone hole can be cut into the bone with the cutting member. A flexible member advancing tool can be advanced through the first cannulation. The first suture portion can be urged out of the distal opening and into the first bone hole.

Abstract: The present invention includes a method of assembling an anchor for use in tissue comprising an anchor body, a continuous closed suture loop and an insert, the method comprising positioning a portion of the continuous closed suture loop through an opening in the anchor body; positioning the insert adjacent the portion of the continuous closed suture loop which was passed through the opening; and securing the insert to the anchor body such that the continuous closed suture loop is secured to the anchor body by the insert.

Abstract: Suturing devices and systems used to close openings into a biological structure. The suturing device can comprise an elongate member having a proximal end, a distal end, one or more arms, and one or more needles. One or more sheaths may be used with the device to maintain or substantially maintain haemostasis while the device is used and while a procedure is performed in the biological structure.

Abstract: Devices, systems and methods for passing a suture. In general, described herein are suturing devices, such as suture passers, as well as methods of suturing tissue. These suture passing devices are dual deployment suture passers in which a first distal jaw member is moveable at an angle with respect to the longitudinal axis of the elongate body of the device and the second distal jaw member is retractable proximally to the distal end region of the elongate body and/or the first jaw member. Methods of suturing tissue using a dual deployment suture passer are also described.

Abstract: A suture device includes: a longitudinal member extended along a longitudinal axis; a first grasping member and a second grasping member provided at a distal portion of the longitudinal member and configured to enable opening-closing movement; an opening-closing mechanism configured to open and close the first grasping member and the second grasping member; a delivery mechanism configured to deliver a distal member between the first grasping member and the second grasping member, the distal member to which a suture thread is fixed; and an engage portion supported by one of the first grasping member and the second grasping member so as to protrude from a distal end of at least one of the first grasping member and the second grasping member and having an engaging-surface capable of engaging the suture thread.

Abstract: Described herein are methods and devices for the correction and reduction of bone deformities, such as metatarsus primus adductus, using a tethering technique which does not require drilling into the stable bone. In some embodiments, a bone plate has an elongate plate body and wings extending laterally from the plate body. The wings may be configured to generally follow the circumferential contours of the bone when placed on the bone in use. The bone plate can further include means for positioning cerclage material on the bone plate such that the cerclage material extends circumferentially over the wings rather than on the bone, thereby reducing the total contact area between the cerclage material and the bone.

Abstract: A suture passer instrument is disclosed that contains two opposing needles positioned adjacent to each other on the end of a hollow handle. The needles are at least partially hollow and the hollow in the needles is of a sufficient size so that a suture can be passed through an entry point near the tip of the needles through the hollow of the needles to the hollow in the handle of the instrument. Two suture ports are located toward the sharp end of the needles such that when the needle pierces through tissue the suture can be grasped and its end pulled through the hollow central chamber of the device.

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: A trocar wound closure system includes a suture passing needle and a guide for directing the needle through the wound site. A distal portion of the needle includes a capture rod with a slot. An obturator tube with a cutout section can be axially actuated to align the cutout section with the slot, and then moved out of alignment so as to capture the suture. The guide includes at least two tracks for directing the needle through the tissue track. A snare loop is located adjacent to the exit of each track, and configured to be actuated from a radially extended configuration to a retracted configuration so as to capture the suture section inserted through each loop. Radially expandable arms at distal section are movable between an expanded configuration and a slender configuration.

Abstract: A method is provided, including positioning an annuloplasty structure along an annulus of an atrioventricular valve of a subject, the annuloplasty structure including a sleeve having a lumen. The annuloplasty structure is fastened to the annulus. Thereafter, an elongate member is advanced into the lumen, such that an elongate contraction-restricting element of the elongate member occupies a longitudinal contraction-restricted portion of the sleeve. Thereafter, a contractible portion of the sleeve is contracted, while the contraction-restricting element restricts contraction of the contraction-restricted portion of the sleeve.

Abstract: A surgical incision suturing device particularly suited for minimally invasive surgical procedures comprising a suturing mechanism built into a trocar stem that enables a surgeon to stitch a patient by utilizing controls on the exposed top portion of the trocar.

Abstract: Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

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

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: An apparatus comprises a body, a shaft assembly, an end effector assembly, and a drive assembly. The body may include a handpiece with an integral motor. The shaft assembly may include two pairs of concentric shafts. The end effector assembly may include arms that selectively grasp and release a suturing needle. The drive assembly is operable to drive the end effector assembly via the shaft assembly. The drive assembly is operable to convert a single rotary input into at least two rotary outputs. In some versions, the drive assembly comprises a plurality of shaft assemblies that include an input shaft, a first output shaft, a second output shaft, and a third output shaft. The drive assembly is operable to selectively rotate and hold the shaft assemblies in accordance with a predetermined sequence, such as to perform tissue suturing through a trocar in a minimally invasive surgical procedure.

Abstract: A system includes a tool and a suture connected to a needle. The tool includes a bore formed in a tube, and a suture slide communicating with the bore. The suture slide has a curved surface formed between an exterior surface of the tube and the bore of the tube. The needle is disposed in the bore. A segment of the suture is disposed within the bore and alongside the needle. The suture is in contact with the suture slide, and a proximal portion of the suture extends out of the bore at the suture slide. The suture slide is located forward of the back end the needle. Tension applied to the suture ejects a pointed distal end of the needle out of the distal end of the tube.

Abstract: Suture clip deployment devices for applying suture clips to sutures are described. Some embodiments can include a generally tubular main body and a vacuum port located at the distal end, a hollow inner body longitudinally slidable within the main body and extending from the main body at its distal end, and a suture recess located in the generally tubular main body. At least one suture clip configured to frictionally fit on an outer surface of the inner body is deployed during use. Clip deployment can occur after a vacuum source is applied to the device so as to draw the suture into the device. The suture lines can be retrieved through the suture recess, and the device can be actuated so as to deliver the suture clip off the delivery device and onto the suture, locking the suture in place.

Abstract: An apparatus for tissue repair, comprising first and second fixation members, a flexible coupling member coupling the first and second fixation members, the flexible coupling member having two terminal ends, one of the two terminal ends terminating adjacent one of the first and second fixation members, the flexible coupling member slidably coupled to at least one of the first and second fixation members such that when the other of the two terminal ends of the flexible coupling member is pulled, a length of the flexible coupling member between the first and second fixation members is shortened, and a Chinese trap formed in the flexible coupling member through which a portion of the flexible coupling member slides when the flexible coupling member is pulled.

Abstract: A method for suture lacing includes providing a suture with a needle attached thereto, inserting the needle and suture into an organ through a passageway, throwing a single stitch through a first tissue member, throwing a single stitch through an opposed and spaced apart second tissue member, repeating the preceding step at least once, bringing the first and second tissue members in contact by tensioning the suture, whereby suture drag is minimized during the tensioning and even tissue compression substantially achieved, and securing the suture.