Abstract: A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

Abstract: An implant manipulator may have a distal end that retains an implant, a proximal end, and an intermediate portion between the ends. The intermediate portion may have a cross-sectional shape that extends along a nonlinear pathway. The intermediate portion may have a selectively bendable portion in which the cross-sectional shape varies to facilitate bending when desired. The implant manipulator may be a needle for a suture passer, with a suture capture feature at the distal end. The suture capture feature may have first and second members that flex apart to permit entry of the suture into a suture capture hole wherein the suture is retained until released. A suture passer may receive the needle in a bore shaped to change the cross-sectional shape to facilitate or restrict bending of the needle, as needed.

Abstract: A rotational driver that comprises a interactive portion, wherein each interactive portion comprises a first extended member and a second extended member, a rotational system and a linear motion system, wherein the rotational driver permits a left or right handed surgeons to perform the surgical suturing procedure in a less complicated and more secure way by allowing more control over the suturing needle and the area to be stitched, even when the suturing area is small, deep, and/or restricted.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: Devices and methods for gastrointestinal bypass are described. A gastrointestinal bypass device includes a gastrointestinal cuff and a gastrointestinal sleeve. The cuff may be configured to be attached in the esophagus, and may be sufficiently flexible to expand and collapse to conform with the inside of the esophagus to allow the esophagus to function substantially normally. The sleeve is configured to be coupled to the cuff, and may be made of a material that is floppy or flaccid but does not substantially expand radially.

Abstract: The present disclosure includes vessel closure devices, systems, and methods. A closure system configured to close a body lumen opening may include a handle member. A tube set configured to deliver and/or deploy a closure element may be coupled to the handle member. The closure system may also include an inner lumen with an anchor member at least partially disposed in the inner lumen. A plunger member may be movably coupled to the handle member.

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 improved method of securing body tissue may be performed with a robotic mechanism. The robotic mechanism may be utilized to tension a suture with a predetermined force and urge a suture retainer toward body tissue with a predetermined force. Ultrasonic vibratory energy may be transmitted to the suture retainer to effect a gripping of the suture by the suture retainer. The body tissue may be secured with a staple. Legs of the staple may be bonded together to secure the staple. The legs of the staple may be bonded together by transmitting ultrasonic vibratory energy to the legs of the staple. A tissue positioning assembly may be used to hold the body tissue in a desired position. Images of the body tissue being secured may be obtained using various known devices including one or more endoscopes, a fluoroscope, a magnetic resonance imaging device, and/or other known imaging devices.

Abstract: The present invention provides instrumentation and associated methods for suture-based soft tissue repair. The disclosed instrument is configured to pass suture through tissue, relocate the instrument, and retrieve the suture, thereby creating a stitch. These steps can be repeated any number of times to create multiple stitches through the tissue.

Abstract: An endoscopic tissue apposition device that includes a vacuum chamber configured to securely hold a portion of tissue therein, the vacuum chamber being defined by a proximal wall and a distal wall opposite to the proximal wall. Working and vacuum channels are provided in communication with the vacuum chamber. A portion of tissue may be held in the vacuum chamber when vacuum is applied in the vacuum chamber through the vacuum channel. A carrier needle is disposed on a proximal side of the vacuum chamber and is longitudinally advanceable into and across the vacuum chamber, while a punch needle is disposed on a distal side of the vacuum chamber and is configured to receive the carrier needle therein. A hold and release mechanism holds and releases the punch needle to facilitate joining portions of tissue together.

Abstract: According to a first configuration, a hand tool is configured to include a shaft, a handle disposed at a proximal end of the shaft, and a tubular tip disposed on a hinge at a distal end of the shaft. The tubular tip pivots about the hinge, providing a way to steer a resource to a specific location in a medical site. In accordance with a second configuration, a hand tool includes a flexible section of tube, a flexible sheathing, and a link. The flexible sheathing encases the flexible section of tube. At least a portion of the link resides between an outer surface of the flexible section of tube and an inner surface of the flexible sheathing. One end of the link is affixed to a distal tip of the flexible section of tube. Pulling on the link causes the flexible section of tube to arc.

Abstract: An apparatus includes a housing, a drive gear assembly, and a drive arm. The housing defines a channel that receives a needle such that the needle is movable within the channel. The drive gear assembly is positioned within the housing and includes a first gear, a second gear, and a rack. The rack is translatable relative to the housing and is coupled with the first and second gears to rotate the first and second gears. The drive arm is coupled with the drive gear assembly and engages the needle to move the needle within the channel of the housing.

Abstract: A suture delivery device for insertion into an internal tissue wall opening and delivery of a suturing apparatus to the internal tissue wall is provided. In one embodiment, the suture delivery device comprises at least one carrier tube, at least one leg, and a tensioning device. The at least one carrier tube is configured to house a pusher and a suturing apparatus, the carrier tube having an expulsion end. The at least one leg is coupled to the at least one tube at a first end of the leg. The tensioning device is pivotally coupled to the at least one leg at a second end of the leg. When the at least one leg is in an open position, the tensioning device exerts tension on the leg such that the leg is movably suspended and can pivot about the tensioning device in response to contacting a tissue wall, and the pusher and suturing apparatus are in an delivery configuration for delivery of the suturing apparatus to the internal tissue wall.

Abstract: A suturing device includes a handle, an elongated body, at least one suture snag, at least one pair of needles, and at least one suture pair. The suture snag is moveable between a deployed position in which two distal arm portions thereof radially extend away from the elongated body and a retracted position in which the two distal arm portions are disposed within the elongated body. The suture pair is slidingly disposed through the needle pair. The suturing device deploys the suture snag within a vessel adjacent to an arteriotomy, extends the needle pair through a vessel wall around the arteriotomy and through the deployed suture snag, extends the suture pair beyond the distal ends of the needle pair, and then utilizes the suture snag to capture the extended suture pair by retracting the suture snag to pull first or distal ends of the sutures back into the suturing device.

Abstract: Methods and devices are provided for deploying and applying multiple suture anchors. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body, e.g., through a scoping device, and to deliver a plurality of suture anchors into tissue, preferably without the need to remove the shaft from the body. The shaft can have a plurality of channels, with each of the plurality of channels configured to seat at least one of a plurality of suture anchors. Each of the anchors can be removably seated in a channel such that the anchors can be removed from the device, such as by pulling on sutures attached to the respective anchors.

Abstract: Described are various embodiments of surgical procedures, systems, implants, devices, tools, and methods, useful for treating pelvic conditions in a male or female, the pelvic conditions including incontinence (various forms such as fecal incontinence, stress urinary incontinence, urge incontinence, mixed incontinence, etc.), vaginal prolapse (including various forms such as enterocele, cystocele, rectocele, apical or vault prolapse, uterine descent, etc.), and other conditions caused by muscle and ligament weakness, the devices and tools including devices and tools for anchoring an implant to supportive tissue and adjusting the implant.

Abstract: An instrument for delivering a suture transfascially may include a handle, a shaft extending from the handle, and at least one needle that is moveable to an extended position beyond the end of the shaft. A suture may be delivered transfascially with the instrument. The instrument may include a suture catch associated with each needle for retaining and releasing a suture segment. A shield may be provided to shield the sharp end of each needle when it is moved to the extended position. A method of delivering a transfascial suture may include inserting an instrument into an abdominal cavity and deploying, from within the abdominal cavity, each needle through a soft tissue repair patch and then through at least part of the abdominal wall. A suture or suture segment may be advanced across the fascia with the at least one needle.

Abstract: A handle system usable for controlling medical devices, such as suture delivery devices. In at least one embodiment, the handle system may be directed to an embodiment configured to be used with a suture delivery device. The handle system may enable a suture delivery system of the suture delivery device to be partially actuated to prevent a needle from falling out of the suture delivery device. The needle and components of the handle system may be held in position through use of a position retention arm. By preventing the needle from falling out of the suture delivery device, the efficiency and safety of a medical device to which the handle system is attached is greatly increased. In addition, surgical personnel using a medical device incorporating the handle system are able to use the medical device in any position without risk of the needle falling out.

Abstract: Suturing instruments in accordance with the invention are dimensioned and configured to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, transvaginal, laparoscopic, or endoscopic surgical procedures. In some embodiments, the suturing instruments include a distal portion that is deflectably and/or pivotally coupled to the remainder of the instrument for improved maneuverability and functionality during surgery. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies and/or reloading the needle and suture assembly without removing the instrument from the surgical site.

Abstract: Differential locking systems for a surgical instrument that includes a surgical end effector that is powered by a rotary drive shaft assembly that is movable between a plurality of discrete axial positions. In various forms, at least one retention formation is provided on the rotary drive shaft assembly that corresponds to each one of the discrete axial position. At least one lock member is operably supported relative to rotary drive shaft assembly for retaining engagement with the at least one of the retention formations when the rotary drive shaft assembly is moved to the discrete axial positions associated therewith.

Abstract: Suturing systems may comprise a cartridge and a drive unit which are detachable from each other. The cartridge often has a cartridge body, a plurality of jaws, and a cartridge interface. The drive unit has a drive unit body, a linkage, and a drive unit interface which will typically include a latch. A latch input is coupled to the latch so that a movement of the input moves the latch to the released position. The cartridge interface or the drive unit interface includes a channel while the other includes a shaft which is fittingly receivable in the channel. Opposed motions of the input and cartridge during cartridge removal avoid inadvertent detachment during use.

Abstract: A closure system for closing openings in tissue that includes a closure device and a fastener. The closure device includes shafts that are configured to deploy a fastener to close an opening in tissue. The closure device can deploy the fastener as a knot pusher to close the opening with sutures or as a knot replacement to close the opening with sutures.

Abstract: A system for closure of a fascial opening is disclosed. The system may include a first capture device for pulling one end of a suture through fascial tissue on one side of a fascial opening, and a second capture device for pulling an opposing end of the suture through the fascial tissue on an opposite side of the fascial opening. A trapping device for locating and engaging the first capture device can be used, prior to the capture device being pulled through the fascial tissue, so that the trapping device can subsequently pull the suture to facilitate closure of the fascial opening. Methods and apparatuses for closure of a fascial opening are also disclosed.

Abstract: Provided herein is a two-part coupling assembly for re-connecting a first hollow body part to a second body part and an instrument and method for emplacement. The coupling assembly comprises coupling parts having securement elements that are actuated by separate deployment mechanisms of the instrument and attach to the first and second body parts. The first and second coupling parts having interconnecting elements that couple the two-part assembly together and re-connect the first and second body parts.

Abstract: An apparatus for placement into an opening formed in a wall of a body lumen to deploy a closure element. The apparatus comprising a housing having a handle portion formed at a distal end, the handle portion configured to be engaged by a user when advancing the housing to deploy the closure element. A locator assembly and a carrier assembly are at least partially received in the housing. The locator assembly can have one or more expansion members that can selectably contact the wall of the body lumen and a proximal end configured to cooperate with a portion of a locator control system operable to expand the one or more expansion members. A triggering system cooperates with the locator assembly and is moveable toward the one or more expansion members of the locator assembly upon the locator control system being operated to expand the one or more expansion members.

Abstract: The present invention is directed to a device which is capable of both locating a punctured blood vessel wall and sealing the puncture in the vessel and to the method of using the device as well. In one embodiment, the device includes an elongate deployment member having a sealing element releasably disposed within a distal end thereof, said deployment member being coupled to a first actuator configured to retract said deployment member relative to said sealing element, and an elongated indicator member having a proximal end and a distal end, said indicator member extending through a lumen in said deployment member such that the distal end of said indicator member extends distally of the distal end of the deployment member, and said indicator member being coupled to a second actuator configured to retract said indicator member relative to said deployment member.

Abstract: A medical device for the delivery of pelvic floor repair implants within a pelvic region of a body includes a handle, an elongated shaft member, and a head. A method of delivering a pelvic floor repair implant in a transvaginal implant procedure includes inserting and deploying at least a portion of the medical device into a pelvic region of a body.

Abstract: A needle for use with an endoscopic stitching device includes a first end portion that is movable relative to a second end portion to allow the needle to convert from a first, mis-aligned orientation to a second, aligned orientation, thereby allowing the length of the needle in the aligned orientation to exceed the height of an end effector.

Abstract: A needle cartridge is adapted to be attached to a receiver on a surgical suturing device. The cartridge comprises a body having a length, a width, and a height. The length is at least twice the width, and the width is less than 3.5 times the height. The cartridge comprises an arced needle and a suture, and a needle driver operable to drive the needle in a circular path. The length may be less than 5 times with width, and the width may be greater than the height.

Abstract: The invention relates to a surgical instrument, in particular a sliding shaft instrument, with a main part, and a moveable part relative thereto, with a handle attached to the main part, comprising a fixed grip and a grip actuating the moveable part, with at least one guide, through which, in relation to the main part, the moveable part is moveable between an initial position and a working position, and with a sliding surface attached to the movable part and pointing towards the main part, the sliding surface being slid along a guide surface attached to the main part and pointing towards the sliding surface, with at least the sliding surface or the guide surface are assigned to each other for the formation of a washable gap.

Abstract: Provided is a tissue excision method that excises a partial tissue within an excision region set in a hollow organ over an entire thickness direction. The tissue excision method includes a first process of gripping a peripheral edge portion of the excision region from the inside of the hollow organ; a second process of moving the portion and drawing the folded hollow organ into a slit with a predetermined width; a third process of suturing a part located outside the excision region so as to be integral over the thickness direction; and a fourth process of cutting the portion of the drawn hollow organ along the peripheral edge of the excision region. In the second process, a portion of a fluid within the hollow organ is moved out of the hollow organ to keep the internal pressure within a fixed range while drawing the portion of the hollow organ.

Abstract: The present invention relates to a suturing bead, a suturing needle, a side suction cap and to an endoscopic organ suturing implement using same. More specifically, the present invention relates to an endoscopic organ suturing implement comprising a suturing bead which can be naturally rested lying against the organ wall during discharge, a suturing needle by means of which it is possible to control discharge of the suturing bead, and a side suction cap constituted in such a way as to be able to prevent damage to other organs during surgery.

Abstract: An incisionless fully endoscopic method of reducing the capacity of the stomach is provided to surgically treat obesity. The method is directed to endoluminal tissue approximation of a portion of the stomach, including at least a portion of the greater curvature thereof. The method includes a pattern of stitching in which a portion of the stomach is closed off. One stitching pattern causes the lateral portion of the stomach to be drawn to reduce the usable volume of the stomach while maintaining a pathway from the esophagus to the pylorus. As the stitching pattern advances, the fundus is automatically drawn downward so that it may be endoscopically approached for stitching in a facilitated manner. According to another aspect of the invention, another stitching pattern extends from the antrum to the fundus between the anterior and posterior portions of the stomach.

Abstract: There is provided a method of attaching an end effector to a surgical instrument having a center rod with a distal tip. The method includes providing an end effector having a base and a coupler defining a pocket and movably mounted within the base. The end effector is moved over the center rod such that the distal tip of the center rod is seated within the pocket of the coupler. There is also disclosed an end effector including a base having a slot, a coupler movably mounted within the base and defining a pocket for receipt of a moving member of a surgical instrument and an operative member movably mounted on the base and connected to the coupler.

Abstract: A surgical system for small-pit closure in hollow organs is provided. The surgical system is provided with a surgical device for small-pit closure in hollow organs, with the surgical device including the following components: a suture-member cartridge in which a pair of parallel tubular members that accommodate respective suture members are feedably connected to the rear ends of a pair of arrow-shaped members that latch into tissue in a hollow organ; an auxiliary shooting unit having plungers respectively provided in a pair of cylinders open at both ends; a hollow-organ-insertable unit configured of a pair of flexible air tubes; and a gas shooter that sequentially discharges compressed air or high-pressure gas into the open-ended cylinders in response to operations of a trigger, for sequentially ejecting the arrow-shaped members and driving the same into tissue in the hollow organ on both sides of a small pit site.

Abstract: A surgical instrument may be used to apply tension to a flexible suture to close and secure a broken or cut bone (e.g. a sternum following a sternotomy). The device preferably applies an adjustable tension to the flexible suture in order to secure the bone together. Multiple instruments may be used together to ensure the desired tension is applied to the entire bone structure being secured with the flexible sutures. Once the desired tension is achieved, the device preferably provides a mechanism to apply a uniform twist to the flexible suture to lock the flexible suture in place and maintain the tension previously achieved. The device may automatically cut the flexible suture, or the flexible suture may be cut by the surgeon once the twisting action has been performed.

Abstract: A treatment device for endoscopic therapy of the present invention includes a suturing-ligating member having a distal end portion and a proximal end portion, that carries out at least one of suturing and ligation of biological tissue, a stopper provided to be movable forward or backward on an proximal end side of the suturing or ligating member, and stoppable by friction on the suturing-ligating member to maintain the biological tissue in a sutured or ligated state by the suturing-ligating member, and a suturing-ligation releasing member provided movable with relative to the suturing-ligating member to release the suturing-ligation state maintained by firctional stopping between the suturing-ligating member and the stopper by moving the releasing member to the proximal end portion side of the suturing-ligating member.

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: 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 linear cutting element (1) with an E-shaped guiding element (16) enables the suture and cutting of surgery to be simultaneously conducted when being loaded in a linear cutting anastomat (2). The linear cutting element (1) comprises a knife underlaying plate (10), a nail abutting seat (11), an assembly cover (12), suture nails (13), a nail cartridge (14), a push sheet (15), a guiding element (16), a pin (17) for the guiding element, a cutting knife (18), a knife stand (19), a positioning needle (20), a positioning needle holder (21) and a blank cap (22). The knife underlaying plate (10) and the nail abutting seat (11) are fixedly connected through a front-end groove (101) and rear-end agnails (102, 103) of the knife underlaying plate (10). The nail abutting seat (11) is fixedly connected to the guiding element (16) through the pin (17) for the guiding element.

Abstract: One embodiment is directed to a system for closing a wound created at least partially across a tissue structure wall, comprising: a helical needle; a suture member coupled to the helical needle and configured to be pulled along a helical pattern with helical movement of the helical needle; an outer delivery member rotatably coupled to the helical needle; a drive shaft axially movably coupled to the outer delivery member; and a plurality of suture guide struts projecting distally from the outer delivery member; wherein upon helical insertion of the helical needle relative to the outer delivery member, the helical needle is advanced such that it becomes disposed around the guide struts, such that the guide struts prevent radial migration of the suture as it is helically wound into the tissue structure.

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: A suture device including a hollow shaft; a pair of jaws disposed at an end of the hollow shaft, at least one of the jaws being actuated by an actuation arm coupled to an actuation mechanism, and each of the jaws including a channel formed therein for carrying a suture; a locking device disposed in the hollow shaft operable to grip an end of the suture; a cutting device disposed in the hollow shaft operable to cut an opposing end of the suture; and a heating device configured to remove the suture from the channels of the pair of jaws, and fuse the suture. The suture can include a core surrounded by an outer coating, wherein the outer coating has a melting point less than a melting point of the inner core.

Abstract: A suture passer comprising: a hollow tube, said hollow tube comprising a distal end, a proximal end, and a lumen extending from said distal end to said proximal end; and a suture manipulation rod slidably received in said lumen of said hollow tube and selectively projectable out said distal end of said hollow tube, said suture manipulation rod comprising a distal end and a proximal end, said distal end of said suture manipulation rod being bifurcated into a first arm and a second arm, wherein said first arm includes a hook comprising a proximally oriented hooking surface and a return extending proximally of said hooking surface; wherein said hollow tube and said suture manipulation rod are sized so that said suture manipulation rod may capture a suture disposed adjacent to said distal end of said hollow tube and draw the suture into said lumen of said hollow tube, and further wherein, after a suture has been drawn into said lumen of said hollow tube, distal movement of said suture manipulation rod causes t

Abstract: A method for repairing a mitral valve, the method comprising: positioning a crossing guidewire across the mitral valve, the crossing guidewire passing through the annulus of the mitral valve at a first location and passing through the annulus of the mitral valve at a second location; using the crossing guidewire to position a spanning implant across the mitral valve, with the spanning implant extending from the first location to the second location; anchoring the spanning implant at the first location; tensioning the spanning implant so as to draw the first location and the second location together; and anchoring the spanning implant at the second location.

Abstract: A system for implanting a catheter in a urethra. The system includes a catheter having a valve disposed at a distal portion of the catheter. The valve may be operable in response to an external magnetic field. The system also includes a tool having a tip member extending into an opening at the distal portion of the catheter to couple the tool to the catheter. the system also includes an element extending from the tool. The catheter has an internal path that provides a conduit for the element to be extended through the valve to engage a proximal portion of the catheter. The tool is adapted use the element to stress the catheter and stiffen the catheter along the length of the catheter. Stiffening the catheter facilitates implantation of the catheter in the urethra by enabling pull forces, push forces, and torque forces to be transmitted from the tool through the catheter to the proximal portion of the catheter without undue stress on the urethra.

Abstract: Described herein are suture passers that may be used for repair of the meniscus of the knee. These suture passers typically include an elongate body having a pair of arms. One or more of the arms may be radiused at the distal end region relative to the long axis of the device, to better fit between a target tissue and a body non-target tissue (e.g., the curvature of the femoral condyle). The arms may form a distal-facing opening that is configured to fit the target tissue. One arm may be movable in the axial direction (e.g., the direction of the long axis of the device), while the other arm may be bendable. A tissue penetrator may be housed within one of the arms to extend across the distal opening between the arms. Thus, a suture may be passed from a first side of the tissue to a second side.

Abstract: A suture-based vessel closure device can perform the dilation of an arteriotomy puncture and does not require previous dilation of the arteriotomy puncture by a separate device or by a procedural sheath dilator. The suture-based vessel closure device can place one or more sutures across the vessel access site such that, when the suture ends are tied off after sheath removal, the stitch or stitches provide hemostasis to the access site.

Abstract: Devices for closing a passage through tissue communicating with a body lumen. The device may include an elongate body, a sheath disposed at the distal end of the device for disposition within a body lumen, a hollow needle disposed within a needle lumen of the body, the needle being selectively advancable through the needle lumen, a suture-anchor ejection mandrel disposed within the hollow needle that is also selectively advancable through the hollow needle, a suture-anchor and suture disposed within the hollow needle, a distal end of the suture attached to the suture anchor for ejection out the hollow needle by the mandrel. A needle guide disposed between the sheath and proximal end of the body may include a needle port through which the needle can exit. A hemostatic plug is disposed over the needle port so as to be penetrated by the needle upon exiting the port.

Abstract: A device and method of promoting tissue adhesion to reinforce tissue apposition that may include collecting advancing a tissue apposition device to a body cavity having cavity calls, collecting tissue from the cavity walls, passing at least one tissue securement device through the tissue, applying energy to the collected tissue to produce injury to the tissue, and apposing the collected tissue and securing the one or more tissue securement devices. In this illustrative embodiment, the device and method promotes tissue adhesion between one or more portions of tissue, wherein the tissue adhesion may reinforce a tissue apposition.