Abstract: A suturing device is made of two hypodermic needles allowing one or more sutures (at the same time) and a retrieval probe to be advanced into a cavity (e.g., a stomach cavity) of the patient. Both the suture and retrieval probes comprise magnets of opposite polarities on their leading ends. Thus, after the suture and retrieval probe are inside the stomach cavity, the suture and retrieval probe may mate and the suture may be transferred from one hypodermic needle to the other using magnetic attraction. In doing so, the suture forms a loop through the stomach. Once removed, this loop, having two ends that are positioned outside the patient's body, can be pulled tight in order to pull the stomach wall closer to the surface of the patient's body. With the stomach wall close to the surface of the patient's body, it is easier to insert a gastrostomy device.

Abstract: A method and device for anchoring a length of self-retaining suture. The method of anchoring includes providing for an assembly having a length of self-retaining suture and a suture insertion device. The length of suture includes at least a portion of the length having a plurality of retainers thereon extending in a first direction. The insertion device has a length and a recess to receive a portion of the suture length. The method further includes placing a portion of the suture length in the recess and inserting the device into the body of a mammal until the recess reaches a predetermined location thereby forming an insertion pathway. The method further includes retrieving the insertion device from the body by moving the insertion device in a direction substantially opposed to the insertion pathway.

Abstract: A system for securing a device in tissue, having a sheath having a plurality of side openings; a rotatable element disposed within the sheath; and a plurality of curved projections extending from the rotatable element, wherein rotation of the rotatable element within the sheath pushes distal ends of each of the curved projections outwardly through one of the plurality of openings and into the tissue.

Abstract: Systems and methods for ligation of a blood vessel are disclosed. In some embodiments, the systems and methods include the following: a delivery device including a needle; a space creating mechanism for creating space outside near and far walls of the vessel; a suture ligator including a far wall buttress that is positioned outside the far wall of the vessel via the needle; a near wall buttress that is positioned and secured along the suture ligator outside the near wall of the vessel via the needle; and a plunger for positioning the near wall buttress downwardly at a position along the suture ligator so that the near wall buttress compresses the vessel but is not joined with the far wall buttress; and a locking mechanism for securing the near wall buttress to the suture ligator at a position proximate to the far wall buttress thereby ligating the vessel.

Abstract: The present disclosure describes a suture passer device that includes a handle, a shaft extending from the handle, and a suture carrier secured to the handle and moveable through a distal end of the shaft. According to one aspect of the present disclosure, one of the shaft and the suture carrier includes a sharp tip and the other one of the shaft and the suture carrier includes a blunt tip. According to another aspect of the present disclosure, the suture carrier includes an inner tube extending through the shaft and a flexible arm extending through the inner tube. Methods of using a suture passer device are also disclosed.

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: Devices and methods for forming and securing a tissue plication are disclosed herein. In one aspect, a tissue manipulation device is described that includes a first jaw member pivotally coupled to a distal end of an elongate shaft and having an articulating portion located distal to the proximal end of the first jaw member. The device also includes a second jaw member pivotally coupled to the first jaw member such that the jaws move in a first plane, and a fastener delivery member attached to the second jaw member. The articulating portion of the first jaw member is configured to move the first and second jaw members between a straight configuration in which a longitudinal axis of the elongate shaft is contained within the first plane and an articulated configuration in which the longitudinal axis of the elongate shaft is transverse to the first plane.

Abstract: A method of suturing tissue includes driving a needle from a tool through tissue to form a channel in the tissue; inserting the needle into a capsule that is connected to a first length of suture attached to the capsule; engaging the needle with a second length of suture that is inserted through the capsule; and pulling both the first length of suture and the second length of suture through the channel formed in the tissue.

Abstract: Suture clips and suture clip loading, delivery, locking and severing devices in both catheter and endoscopic embodiments are disclosed that permit the delivery and application of suture clips directly in contact with or in close approximation to sutured tissue. The catheter or endoscopic versions incorporate a collet cage with a plurality of flexible collet fingers that captivate a suture clip ring and a suture clip plug for assembly with a suture. An outer sliding sleeve constrains the collet fingers when distally advanced to minimize potential trauma during delivery and assembly of the suture clip in close proximity to the stitched tissue. Proximal retraction of the sliding sleeve coupled with the distal advancement of a pusher against cam surfaces on the inner walls of the collet fingers causes the collet fingers to open. The catheter is designed to hold and assemble the suture clip in a first position and release the suture clip and sever the suture ends proximal to the suture clip in a second position.

Abstract: Methods and apparatuses for lifting, suspending and stiffening a patient's tissue are disclosed. In an embodiment, a method of lifting and stiffening a patient's tissue includes inserting at least one suture into the patient's tissue in a first direction, pulling the suture in a second direction so as to lift and suspend the tissue in a lifted position and stiffen the tissue in the lifted position, and cutting the suture so that the tissue remains in the lifted position. Preferably, the patient's tissue is the patient's soft palate.

Abstract: Various exemplary methods and devices are provided for passing sutures around anatomical structures. In an exemplary embodiment, a suture delivery device is provided that includes a body portion having a suture delivery member disposed therein and configured to pass a suture around an anatomical structure. The suture delivery member can be movable between a retracted configuration in which the suture delivery member is disposed within the body portion and an advanced configuration in which the suture delivery member extends distally beyond the body portion and assumes an arcurate shape. The arcurate shape can correspond to a shape of the anatomical structure and can extend almost all of the way around the anatomical structure, for example at least around 270° of a circle, thus assisting a user in passing the suture around the anatomical structure without having to manually manipulate the suture delivery device at awkward angles around adjacent tissue.

Abstract: An assembly includes a flexible fixation member, a suture, and a delivery device. The flexible fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the flexible fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

Abstract: Methods and instruments for repairing soft tissues of a skeletal joint such as for example of the foot or hand are presented.

Abstract: A suture collector (100, 200, 300) includes a suture collecting member (111, 112, 211, 212, 311, 312, 411, 412, 511, 512, 611, 612, 711, 712) capable of releasable retaining sutures at a surgical site, and wherein the suture collector (100, 200, 300) is movable relative to the surgical site. Also disclosed herein are method for using the suture collector (100, 200, 300) and a surgical device kit comprising at least one suture collector (100, 200, 300).

Abstract: Suture passer devices and methods for repair tissue using them. In particular, described herein are suture passer devices having a tissue penetrating distal end that can be used to repair tissue such as the hip labrum. In general, such devices may be used to manipulate, including move or align tissues, and to suture them.

Abstract: An adjustable anchor system for securing tissue to bone, including an anchor having at least one passage extending from a proximal end toward a distal end. The passage defines a restriction such as a restricted opening. The anchor has at least one bone-engaging feature disposed between the proximal and distal ends. The system further includes a first material formed as a closed loop and capable of being placed through a portion of the tissue, and a second filament having a terminal end, a post limb and a sliding knot tied between the terminal end and the post limb to establish an elongated, adjustable-length loop which extends beyond the proximal end of the anchor and captures the closed loop of the first material. The knot of the second filament is restrained by the restricted opening when tension is applied as desired to the post limb to shorten the elongated loop to draw the tissue toward the anchor.

Abstract: A tissue puncture closure device includes an anchor, a sealing plug, a compaction member, a suture, and a suture cutting member. The compaction member is configured to compress the sealing plug toward the anchor. The suture is coupled to the sealing plug and anchor, and a portion of the suture extends through at least a portion of the compaction member. The suture cutting member extends through an aperture in a sidewall of the compaction member and is operable to cut the suture at a location within the compaction member.

Abstract: The present disclosure relates to a surgical device including a shaft having an outer member and an inner member slidably received within the outer member, a handle coupled to the shaft, and a combination of a cannulated body having a distal end and a proximal end, a plug including a top portion configured for engagement with the proximal end of the body and a bottom portion coupled to the top portion, a first portion disposed on the bottom portion of the plug, a second portion disposed on the bottom portion of the plug, and a spring located between the first and second portions for providing movement to the inner member coupled to the inner member. A method of tissue repair is also disclosed.

Abstract: A method of closing a tissue wound includes providing a wound closure device having a first fastener, a second fastener, and a flexible member extending between the first and second fasteners and movably attached to the second fastener by a one-way knot formed in the flexible member between the first and second fastener, positioning the first fastener against tissue, passing the flexible member across the wound, positioning the second fastener against tissue, and pulling on a free end of the flexible member to shorten a length of the flexible member between the first and second fasteners, thereby closing the wound.

Abstract: A cleat for securing suture to tissue, the cleat comprising an elongated body having a distal end and a proximal end, the distal end having a distal slot extending proximally into the elongated body, and the proximal end having a proximal slot extending distally into the body; the distal slot comprising a wide section and a narrow section, wherein the wide section has a width such that the suture is slidably accommodated therein and the narrow section has a width such that the suture is bound therein, and further wherein the wide section is disposed distally of the narrow section.

Abstract: Methods and instruments for repairing soft tissues of a skeletal joint such as for example of the foot or hand are presented.

Abstract: An instrument for performing thorascopic repair of heart valves includes a shaft for extending through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a captured valve leaflet and draw the suture through the leaflet. Proper leaflet capture can be confirmed with a fiber optic imaging system.

Abstract: An endoscopic stitching device includes a tool assembly having a pair of juxtaposed jaws pivotally associated with one another, each jaw defining a needle receiving recess formed in a tissue contacting surface thereof; a drive assembly including a pair of concentric, individually rotatably and translatably supported barrels, each barrel defining a central lumen therethrough; and a pair of axially translatable needle engaging blades slidably supported, one each, in a respective jaw. The stitching device further includes a center rod slidably and rotatably disposed through the lumen of the barrels, a distal end of the center rod being operatively engaged with the pair of jaws.

Abstract: A surgical apparatus for use in endoscopic and/or laparoscopic procedures is provided. The surgical apparatus has an elongated body portion, a first jaw member extending from the body portion, and a second jaw member extending from the body portion and opposing the first jaw member. The second jaw member has a split nest slide coupled thereto that is configured to position a surgical incision member in a folded or unfolded position.

Abstract: A suturing device includes a housing having an elongated tubular member extending from a distal end thereof. A head assembly is disposed at a distal end of the elongated tubular member and is configured to retain a portion of a suture therein. At least one arm member is positioned adjacent the elongated tubular member. Each arm members includes a ferrule assembly disposed at a distal end thereof. Each ferrule assembly is positioned within a recess defined within the elongated tubular member and is configured to releasably retain a ferrule therein. Each ferrule is configured to retain a portion of the suture therein. Each arm member is rotatable to rotate the ferrule assembly disposed thereon between a first position, wherein the ferrule assembly is disposed within the recess, and a second position, wherein the ferrule assembly extends at least partially radially outwardly from the recess.

Abstract: An end effector for use in an endoscopic stitching device includes a fixed jaw, a moveable jaw, a linkage member, needle engaging blades and a rotatable member. The moveable jaw is pivotably associated with the fixed jaw about a first pivot axis. The linkage member is pivotably associated with the moveable jaw about a second pivot axis. The needle engaging blade is slidably supported in each of the fixed and moveable jaws. An axial movement of the linkage member causes the moveable jaw to pivot about the first pivot axis with respect to the fixed jaw, and rotation of the rotatable member causes opposed axial movement of the pair of needle engaging blades.

Abstract: Devices and methods for ligating structures where the loop of the ligation element can be temporarily pre-tightened without locking the loop. This pre-tightening without locking allows the loop of the ligation element to be loosened and repositioned, if necessary, before locking the loop around the anatomical structure.

Abstract: Apparatus for attaching a first object to a second object, said apparatus comprising: a distal anchor comprising a generally cylindrical body, a distal end and a proximal end, wherein said distal end comprises an inclined distal end surface, and a vertical bore extending through said generally cylindrical body, perpendicular to the longitudinal axis of said generally cylindrical body; a proximal anchor comprising a generally cylindrical body, a distal end and a proximal end, a top surface and a bottom surface, a first vertical bore extending through said generally cylindrical body from said top surface to said bottom surface, perpendicular to the longitudinal axis of the generally cylindrical body, a second vertical bore spaced distally from said first vertical bore and extending from said top surface to said bottom surface parallel to said first vertical bore, a third vertical bore spaced distally from said second vertical bore and extending from said top surface to said bottom surface parallel to said fi

Abstract: A tissue fixation system including a delivery tube and an elongated fastener with a loop at a proximal end and a distal end. A proximal end of an elongated curved needle is attached to the delivery tube. A distal end of the needle is configured to penetrate tissue. The needle includes an open channel sized to receive the elongated fastener with the loop located near the proximal end of the elongated curved needle and the distal end of the elongated fastener located near the distal end of the elongated curved needle. A capture needle is slidably positioned in the delivery tube to slide through the loop in the proximal end of the elongated fastener. The capture needle is configured to grasp the distal end of the elongated fastener and pull the distal end of the elongated fastener through the loop to cinch the elongated fastener.

Abstract: The present invention relates to a surgical suture apparatus having a sewing function. In accordance with one aspect of the present invention, there is provided a surgical suture apparatus comprising: a coupling part, a shaft part connected to the coupling part, an operating part, and a suture part connected to the shaft part by way of the operating part, the suture part including a support, a surgical needle and a needle driving part, wherein the surgical needle operates in a direction substantially orthogonal to the support by the needle driving part, and a suture thread from the surgical needle and a suture thread from the support are entangled with each other by the operations.

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: The present invention relates generally to medical apparatuses and methods and more particularly to devices and methods for positioning and anchoring a lining to a hollow body organ, such as a stomach, intestine or gastrointestinal tract.

Abstract: Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

Abstract: A wound closure system includes a device, a sleeve, and a needle assembly. The device includes a shaft and one or more arms movable relative to the shaft between a retracted position and a deployed position. The sleeve is removably positionable about the shaft and is slidable about the shaft to retain tissue between the distal end of the sleeve and the arms when the arms are in the deployed position. The needle assembly includes a base one or more needles insertable through respective needle lumens of the sleeve. The base defines a central aperture for removably positioning the base about the shaft. The base is slidable relative to the shaft and sleeve between a proximal position, wherein the needles are disposed within respective needle lumens, and a distal position, wherein the needles extend from respective needle lumens towards respective arms.

Abstract: A wound closure device includes a shaft and a tubular member disposed about the shaft. A plurality of arms are coupled to the shaft in a distal region of the shaft. A plunger is slidably disposed within the shaft and coupled to the plurality of arms. The plunger is selectively translatable relative to the shaft for moving the plurality of arms between a retracted position and a deployed position. A plurality of needles is disposed within needle lumens defined within the tubular member. An actuator sleeve is slidably disposed about the tubular member and coupled to the plurality of needles. The actuator sleeve is translatable between an un-actuated position, wherein the distal end of each needle is disposed within its respective needle lumen, and an actuated position, wherein the distal end of each needle extends distally from its respective needle lumen into a respective one of the plurality of arms.

Abstract: A system includes a wound closure device having a shaft, proximal and distal arms coupled to the shaft, and one or more linkages coupling the proximal and distal aims. The arms are pivotable relative to the shaft between a linear position, wherein the arms and shaft are linearly aligned, a first pivoted position, wherein the proximal arm is pivoted in a first direction to pivot the distal arm in a second, opposite direction, and a second pivoted position, wherein the proximal arm is pivoted in the second direction to pivot the distal arm in the first direction. A suture including a first portion disposed about a first surface of the distal arm and a second portion disposed about a second surface of the distal aim is also provided.

Abstract: A suture grasper for retrieving a suture from an internal surgical site includes an inner shaft defining a tissue-penetrating tip, an intermediate shaft disposed about the inner shaft, and an outer shaft disposed about the intermediate shaft. The intermediate shaft defines a plurality of spring fingers movable between a spread position, wherein the spring fingers extend radially outwardly from the inner shaft, and a compressed position, wherein the spring fingers are approximated about the inner shaft. The outer shaft is selectively translatable relative to the inner shaft and the intermediate shaft for moving the spring fingers between the spread position and the compressed position.

Abstract: A wound closure system includes a suture member and a suture grasper. The suture member includes a suture and a retention member engaged to an end of the suture. The retention member is at least partially flexible and defines a central opening. The suture grasper includes a needle defining a distal portion configured for insertion through the central opening of the retention member to retrieve the retention member from an internal surgical site. The distal portion of the needle defines a distally-facing feature configured to at least partially flex the retention member upon insertion of the distal portion into the central opening to permit passage of the distal portion therethrough and a proximally-facing feature configured to inhibit proximal withdrawal of the distal portion through the central opening of the retention member.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: A biological tissue is sutured or ligatured, a suture and ligature member such as a ligature wire is cut, and then a holding member is reliably recovered from the body. In a holding member of a medical ligature tool, a protrusion is disposed between distal lateral holes, and proximal lateral holes, so that it protrudes outward in a diameter direction thereof. On the other hand, a concave portion is formed in the inner periphery of a cutting member. When the cutting member is extended to cut a ligature wire, the concave portion is fitted to the protrusion to allow the holding member to engage the cutting member.

Abstract: A medical apparatus that includes a distal member, a needle disposed in the distal member and proximally advanceable from the distal member, and a needle capture portion positioned proximal to the distal member and which includes a through-hole to direct the needle from the needle capture portion towards a graspable member at a trajectory narrower than a trajectory of the needle from the distal member to the needle capture portion.

Abstract: A suture apparatus having a housing, actuator and capture rod, the actuator being engaged to the capture rod to form an actuator-capture rod assembly, an elongated cannula shaft having a lumen that extends through the shaft, and capture rod retraction means, the housing including an internal region that is configured to receive and support the capture rod retraction means, actuator proximal end and actuator rod distal end therein, wherein said capture rod retraction means is in communication with said actuator. The actuator-capture rod assembly and capture rod retraction means being positioned and configured to transition from a retracted position to an extended position when an actuation force is applied to the actuator and return the retracted position by the retraction means when the actuation force is released.

Abstract: Apparatus and methods for Achilles tendon repair are described where an elongate tendon repair assembly may be introduced into a single incision to access the damaged tissue. The assembly may define a channel for receiving a portion of the tendon and which may provide support to the tissue during repair. One or more retractable needles each carrying a length of suture may be deployed within the channel for piercing through the tendon and a cinching member may secure each of the suture lengths for tensioning the suture against the damaged tendon. Once the suture lengths have been deployed, the needles may be retracted and the device removed from the incision.

Abstract: A surgical instrument includes a housing supporting first and second actuators thereon, and an elongated shaft extending distally from the housing. First and second drive members extend through the elongated shaft to operatively couple respective actuators to respective jaw members such that independent manipulation of one of the actuators may induce pivotal movement of an individual jaw member. A locking member is operatively associated with the first and second drive members, and is selectively movable between locked and unlocked positions. When the locking member is in the locked position, the first and second drive members are coupled to one another and move concurrently to drive the jaw members in a bilateral manner. When the locking member is in the unlocked position, the drive members are decoupled from one another and move independently to permit operation of the instrument in a unilateral manner.

Abstract: A method of placing a suture through tissue includes placing a band on a finger of a user, where the band is attached to a head of a suturing device, and employing the finger and the device in identifying an intracorporeal tissue landmark and placing the head of the suturing device at the intracorporeal tissue landmark. The method additionally includes engaging a throat of the head of the suturing device with the intracorporeal tissue landmark, and ejecting a needle out of a needle exit port and through the tissue. The needle exit port is located on a proximal portion of the head of the suturing device.

Abstract: The invention relates to a device (1) and method for selecting the size and shape of a prosthesis and/or for determining the location of marks to be made on the external face of the skin of a patient intended to receive such a prosthesis, for example for repairing a hernia, comprising a sheet (2) of transparent material, the said sheet comprising:—a plurality of graphical representations (3a, 3b, 4a, 4b, 5a, 5b, 5c, 5d) concentrically embodying the respective outlines of various shapes and sizes of prosthesis,—a plurality of first holes (6a, 6b, 6c, 6d, 6e, 7a, 7b, 7c, 7d, 7e) arranged along the transverse line passing through the centre of the said sheet, and—a plurality of second holes (8a, 8b, 8c, 8d, 8e, 8f, 8g, 9a, 9b, 9c, 9d, 9e, 9f, 9g) arranged along the longitudinal line passing through the centre (C) of the said sheet.

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 during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing.

Abstract: Devices and methods for ligating anatomical structures are provided herein. In particular, the devices and methods provided herein can be used to ligate, the left atrial appendage. The ligating devices (10, 110, 210, 310, 410) comprise a ligating element (30, 130, 230, 330, 430) and a control element (40, 140, 240, 340, 430) which controls the opening of the ligating element in a loop or lariat shape. Some embodiments comprise also a positioning element (50, 150) which help position the ligating element. In some embodiments a conduit (250) is provided for deploying the ligating element by inflating control.

Abstract: Embodiments of the present invention encompass systems and methods to prevent complications from atrial fibrillation by preventing or reducing the likelihood of blood flow out of the left atrial appendage, to eliminate a possible source of aberrant electrical circuits, or both. Accordingly, techniques are provided for delivering ligature loops or closure means to the left atrial appendage, and to other anatomical structures of a patient which may be desirable in other surgical procedures.

Abstract: A method and apparatus for securing soft tissue to bone can include loading a suture through an eyelet of a suture anchor. The suture anchor can have a longitudinal axis and a distal tip. An anchor inserter assembly can be positioned in contact with the suture anchor. The anchor inserter assembly can include a sleeve portion and an impacting portion. The suture can be engaged with a suture engaging member on the suture inserter assembly at a location adjacent to the eyelet. The sleeve portion can be translated relative to the impacting portion from an alignment position to an insertion position thereby moving the suture a first distance offset from the eyelet in a direction away from the distal tip. The anchor insert assembly can be advanced to a driven position thereby advancing the suture anchor into the bone. The suture engaging member can be released from the suture.