Abstract: A suture passer for passing a suture through tissue during surgery includes a tissue grasper, a piercing member and a suture retriever. The tissue grasper has a first jaw with a first opening and a second jaw with a second opening. The first jaw and/or the second jaw is/are movable between an open position and a clamped position. The first opening and the second opening align relative to each other when in the clamped position. The first jaw has a suture positioner for positioning a suture across the first opening. The piercing member forms an opening in the tissue. The suture retriever includes a distal end and a hook positioned proximally of the distal end. The suture retriever passes at least partially through the first opening and the second opening and the hook is used to retrieve the suture held across the first opening.

Abstract: A surgical incision suturing device particularly suited for minimally invasive surgical procedures comprising a suturing mechanism built into a trocar stern 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 during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Abstract: An apparatus for suturing tissue includes first and second needles. A first structure associated with the first needle is adapted and configured to pass a leading portion of the suture from a near side of a tissue to a far side of the tissue. A second structure cooperates with the second needle to capture and secure the suture. Proximal movement of the apparatus after the suture is captured moves the suture from the far side of the tissue to the near side of the tissue.

Abstract: A device for placing sutures through thick and/or moving tissue such as the wall of a beating heart. The device includes a tissue welting tip having a trough for forming a welt in a tissue section, an alignment guide having an opening receiving a guide wire and pivotally mounted in the distal end adjacent to the trough, and an elongated sleeve slidably engagable with the guide wire. The device also includes one or more expandable tissue engaging member(s) on the sleeve expandable from a collapsed configuration having a diameter small enough to pass through the opening in the tip to an expanded configuration having a diameter large enough to engage a tissue section and urge it into the trough to form a welt in the tissue section and a retractable needle extendable through at least two portions of a tissue section while the tissue section is engaged with the trough.

Abstract: An endoscopic tissue anchor deployment device includes a handle, an elongated shaft defining an internal lumen, and an end effector attached to the distal end of the elongated shaft. A tissue anchor catheter is removably inserted through the lumen of the elongated shaft, the catheter having a tissue anchor assembly that is deployable from its distal end. The handle may include a pin and track assembly that define a series of handle actuation steps corresponding to deployment steps for the deployment device end effector and the tissue anchor catheter. In some embodiments, the handle includes a catheter stop member that prevents movement of the tissue anchor catheter under certain circumstances, and a handle stop member that prevents actuation of the handle under certain circumstances.

Abstract: A suture assembly configured to load a suture instrument with suture includes a cap attached to an end of the suture, a suture container configured to retain a portion of the suture, and a cap retainer having a wall and a suture channel formed in the wall. The suture channel is configured to receive a length of the suture, and the wall is configured to deny passage of the cap into the suture channel and align the cap with the length of the suture for loading into the suture instrument.

Abstract: A suture fixation system includes a suture assembly having an anchor, an introducer, and a delivery device. The introducer is attachable to a finger of a person and includes a platform attached to an exterior of the introducer and a zip line attached to the platform. The delivery device is movable along the zip line and configured to removably retain the anchor. The introducer allows the finger to identify a target landmark within a patient and the delivery device is movable along the zip line and attachable to the platform to position the anchor for insertion to the target landmark.

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

Abstract: The present invention describes apparatus and methods for tying a filament across subcutaneous punctures. According to some embodiments, the apparatus and methods provide pre-tied knots that are inserted into a bodily lumen. Needles flanking the subcutaneous puncture are inserted into the lumen and grab the pre-tied knots. The pre-tied knots are pulled through tiny holes flanking the subcutaneous puncture by the needles, leaving an internal length of the filament across the subcutaneous puncture. The filament is then externally tied, closing the subcutaneous puncture.

Abstract: Suture passers and methods of suturing tissue to prevent tissue bridging, without requiring a cannula. Tissue bridging involves the capture of non-target tissue within a loop of suture formed around and/or through a target tissue. The devices and methods described herein may include the use of a threading aperture at or near the distal end of the suture passer to guide the device in passing a suture through the tissue along the same pathway that another leg or legs of the loop took to access the target tissue, thereby preventing the inadvertent capture of non-target tissue leading to tissue bridging. In particular, described herein are suture passers and methods of arthroscopically suturing the meniscus of the knee while preventing tissue bridging.

Abstract: Herein is provided an anastomosis device which includes a cylindrical support housing having a tapered section being formed of a plurality of compliant fingers integrally formed around the circumference of an end of the cylindrical section which can flex at their connection point to the cylindrical section. Each compliant finger holds a suture needle. The device includes a push rod having a cam head at one end of the rod section. The cam head is located adjacent to the tapered portion. In operation the anastomosis device is aligned with the anatomical tubular structure undergoing an anastomosis process. When a back end of the push rod is pushed towards the tapered section of the support housing, the cam head section bears against an inner surface causing each compliant finger to flex radially outwards forcing the suture needles to simultaneously pierce the wall of the anatomical tubular structure.

Abstract: A suturing device that sutures tissues by releasing a suture unit includes: a first anchor and a second anchor included in the suture unit; a hollow needle receiving the first and second anchors inside of the needle; a tube which is fixed to a proximal end of the needle; a wire inserted into the tube and the needle; a first sheath through which the tube and the needle are inserted; an operating portion main body fixed to a proximal end of the first sheath; a slider fixed to a proximal end of the tube and configured to move forward and backward freely in a sliding manner with respect to the operating portion main body; a slider control portion configured to regulate movement of the slider with respect to the operating portion main body at all times; a handle portion provided in the slider; and a deactivation member.

Abstract: A device for performing minimally invasive repair of mitral valve leaflets in a beating heart through the delivery and implantation of artificial chordae tendineae includes a handle for positioning the device into a chest cavity of the patient, a capture assembly adapted to capture a valve leaflet between distal an proximal tip portions, a needle adapted to penetrate the valve leaflet, and a capture confirmation system for verifying capture of the valve leaflet between the distal and proximal tip portions.

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

Abstract: A knot pusher device for deploying a plurality of pretied knots to a surgical site is provided. In one embodiment, the knot pusher device comprises a shaft, an inner tubular member, and an inner rod, each having a proximal end and a distal end. The inner tubular member is provided within the shaft and is radially translatable with respect to the shaft. The inner rod is provided within the inner tubular member and is slidably coupled to the inner tubular member and is axially translatable with respect thereto.

Abstract: A suturing device includes an elongate shaft defining a longitudinal axis, a trajectory guide translatably mounted on the elongate shaft and an introducer guard member operatively coupled to a distal portion of the elongate shaft. The introducer guard member includes at least one arm member which is movable between a first position in which the arm member is retracted, substantially in alignment with the longitudinal axis and a second position in which the at least one arm member is deployed. The introducer guard member includes an attaching member for releasably retaining a suture. The trajectory guide defines at least one bore therethrough. The bore obliquely extends through the trajectory guide and defines an angle with respect to the longitudinal axis. The bore aligns with the attaching member when the introducer guard member is in the second position.

Abstract: A surgical system for performing gastrointestinal procedures is disclosed. The system includes an elongated body defining an endoscope lumen. The body is adapted to be inserted into the esophagus with a proximal end extending from a body orifice. A working member includes at least one side disposed suction cavity and a cutting device configured to excise a surface layer from the tissue that is captured in the suction cavity. One or more needles are also provided in the working portion, which can be used to apply suture to the captured tissue and/or to inject fluid into the captured tissue prior to excision. Particular applications may be to treat Barrett's esophagus, to treat GERD, or for performing gastroplasty in the stomach.

Abstract: A suturing device includes a housing; a helical needle rotatably mounted relative to the housing; and a drive assembly for rotating the needle relative to the housing whereby the helical needle carries a suture through tissue to be sutured. The needle rotates relative to the housing in an axially fixed position and carries a suture for rapid and reliable deployment to close a wound or incision.

Abstract: Provided is a surgical instrument that is substitutable for an operation of placing each stitch with a threaded needle or a stapler. It is confirmed that, in a tissue suturing device including a clamping section, and a protruding section including a central conductor and/or an external conductor for applying a microwave, the protruding section and the clamping section bring fragmentary portions of tissues to be sutured into contact or overlap with each other, and coagulate and/or fix contact or overlap portions with the microwave, to thereby stitch the tissues to be sutured.

Abstract: A surgical instrument for surgically joining a tissue is disclosed. The surgical instrument comprises a handle assembly, an elongate portion extending distally from the handle assembly, a pair of opposed jaw members, and a tissue stop. The tissue stop is mechanically engaged with a first jaw member and is configured to retain the tissue between jaw members. The tissue stop is movable between a first position, where a stopping portion of the tissue stop is disposed between a tissue-contacting surface of the first jaw member and a tissue-contacting surface of the second jaw member, and a second position, where the stopping portion is between the tissue-contacting surface of the first jaw member and a lower surface of the first jaw member. A portion of the tissue stop is made of stamped metal section and a portion of the tissue stop is made of an overmolded plastic section.

Abstract: An endoscopic closure device comprises: a coupling member; a helical needle mounted to the coupling member and carrying a suture; and a plurality of grasping needles, each of said plurality of grasping needles moveable between a storage position and a deployed position. The plurality of grasping needles is configured to be (a) advanced in the storage position into a luminal defect, (b) moved into the deployed position, and (c) then refracted from the luminal defect, thus pulling and drawing tissue surrounding the luminal defect together. Then, upon rotation of the coupling member and the helical needle, the helical needle is driven into and pierces the tissue, carrying the suture through the tissue.

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. The instrument preferably decreases the upward tension applied to the flexible sutures over the duration of the application of twisting. 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: The present disclosure relates to a tissue repair device. The device includes a handle, a knob coupled to the handle, and a needle coupled to the handle. The needle includes a proximal end and a distal end, the distal end including a slot, wherein a first anchor is housed within the distal end and a second anchor is housed within the slot and located proximal to the first anchor. An actuator disposed within the needle and operatively coupled to the knob, wherein advancement of the knob allows for engagement of the actuator with the first anchor and subsequent advancement of the first anchor via the actuator. A method of tissue repair is also disclosed.

Abstract: An apparatus includes an elongate member, an actuator, and a thread member. A portion of the elongate member defines a central axis. The elongate member defines a slot which extends along an axis parallel to the central axis. The actuator is coupled to the elongate member and is accessible through the slot. The actuator is moveable from a first position to a second position different than the first position. The thread member is coupled to the actuator and has a receiving portion. The thread member is moveable from a first position to a second position different than the first position when the actuator is moved from its first position to its second position.

Abstract: A method of repairing soft tissue of a joint of a human extremity, such as a hand or foot. The method includes maintaining a metapodial bone intact; inserting a suture passing instrument into a space adjacent the metapodial and phalangeal bones; passing the suture through a volar ligament near a distal end of the metapodial bone and reattaching the volar ligament to the proximal phalanx. The method also includes making an incision on the dorsal aspect of the extremity to expose the dorsal aspect; inserting the distal portion of the suture passer instrument through the incision on the dorsal aspect of the extremity; inserting the distal portion of the suture passing instrument into a tendon sheath connected to a volar plate; and passing a portion of a suture through the volar plate.

Abstract: An endoscopic surgical stapler for applying a suture to tissue including an elongated tubular member, a first jaw positioned at the distal end portion of the tubular member and having a longitudinal axis, and a second jaw disposed in substantially parallel relation to the first jaw at the distal end portion of the tubular member. The second jaw is movable in a direction substantially perpendicular to its longitudinal axis toward the first jaw, while maintaining the substantially parallel relation between the first and second jaws. A stapling assembly is disposed in each of the first and second jaws and configured to apply surgical staples to the tissue such that a suture, in combination with the surgical staples, forms a purse string with the tissue when the surgical stapler is activated.

Abstract: Described here are closure devices and methods for ligating tissue, such as the left atrial appendage. The closure devices may comprise a snare loop assembly comprising a snare and a suture loop releasably attached thereto, and a snare control. The closure devices may further comprise one or more reference markings, wherein the relative positioning between a portion of the snare control and the reference markings provides an indication of the diameter of the snare loop assembly. In some variations, when the snare loop assembly is closed around a tissue such as the left atrial appendage, the measured diameter of the snare loop assembly may help a user determine whether the snare loop assembly has been properly positioned relative to the tissue, as well as the approximate size that a suture loop may have when released from the snare loop assembly.

Abstract: An endoscopic suturing device that can be employed to suture tissue using endoscopic techniques to place one or more stitches in tissue during a single intubation of an endoscope. The suturing device may include a suturing capsule with a suction chamber that is configured to capture tissue that is to be sutured. A needle is movable along a pathway across the suction chamber to penetrate and place stitches in the captured tissue. A catch is located distal to the suction chamber to receive and retain the suture during a stitching sequence. The catch may be movable along the needle pathway and configured to release the suture when the catch moves a predetermined distance along the pathway. The catch may be configured so that a predetermined amount of force is required to move the catch the predetermined distance required to release 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. The method includes the steps of maintaining the metapodial bone intact; forming a bone tunnel through the proximal phalanx between volar and dorsal aspects of the proximal phalanx; passing a repair suture through the soft tissue to be repaired; passing the repair suture through the bone tunnel; and securing the suture. The method may be used for the repair of soft tissue, such as a volar ligament and/or a collateral ligament.

Abstract: The invention generally relates to devices and methods for suturing tissue. The invention provides methods and devices for suturing by pushing two ends of a suture through tissue from a proximal side of the tissue and fastening the two ends together on a distal side of the tissue through one operation of a trigger.

Abstract: A suture tool for fixing the gastric wall to the abdominal wall includes a first puncture needle for insertion, a suture thread, a second puncture needle for removing the suture thread, a linear grasping member and one or more anchor member. The tip end portion of the suture thread is inserted into the first puncture needle and a hook of the linear grasping member is inserted into the second puncture needle for removing the suture thread inserted into the first puncture needle for securing the gastric wall to the abdominal wall.

Abstract: A meniscal repair device includes a handle with a thumbslide and a needle cartridge extending therefrom, the needle cartridge having distal tips having a specific directional orientation suited for a particular procedure. The meniscal repair device includes a needle rack and an obturator rack. A quantity of suture material is included in the meniscal repair device. The distal ends of the needle cartridge are adapted for penetrating soft tissue.

Abstract: An apparatus for anulus fibrosus repair includes a shaft, a pair of curved suturing needles mounted in parallel on the shaft, and a rotational driving mechanism connected to the shaft, which is configured to rotate the shaft and the pair of needles about a rotation axis of the shaft. Each needle includes a substantially semi-annular body having a proximal end, a distal end, an inner periphery, and an outer periphery, and an arm extending radially inward from the proximal end, in which a concavity is formed in the body proximate to the distal end extending in a direction away from it. Also disclosed is a suturing technique associated with use of the repair apparatus.

Abstract: An apparatus includes a carrier configured to be movably disposed within a channel defined by an elongate member. The carrier includes a proximal end portion and a distal end portion. The proximal end portion is configured to be coupled to an actuator. The distal end portion includes a protrusion and an engagement surface. The protrusion has a tip configured to bodily pierce tissue. The protrusion is configured to be received within a lumen defined by a connecting portion of an implant, such as, for example, a pelvic floor implant, such that the tip extends through the lumen defined by the connecting portion of the implant. The engagement surface is configured to engage a portion of the connecting portion of the implant to limit movement of the connecting portion of the implant relative to the protrusion.

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

Abstract: A deployment instrument for deploying a closure device for sealing a percutaneous puncture in a wall of a body passageway, the deployment instrument including a carrier assembly, wherein the carrier assembly is configured to hold the closure device in a pre-deployment state, and a tensioner assembly, wherein the filament is fixedly attached to the tensioner assembly, wherein the deployment instrument is configured to increase the tension in the filament upon linear movement of the deployment instrument away from the wall of the body passageway when the closure device is anchored to the wall via the anchor such that the tension is gradually increased as the deployment instrument is moved between a first linear distance and a second linear distance greater than the first linear distance from the wall of the body passageway.

Abstract: A suture device includes a needle operating device movable longitudinally with respect to a housing between at least an insertion position and a needle transfer position. The needle operating device includes an elongate operating element arranged extending from a distal end of the housing to or near a housing proximal end. A needle holder connected at a distal end of the operating element holds two or more needles, with free ends directed in proximal direction. The holder is movable with respect to a protection device between at least a protecting position shielding the free ends, and a non-protecting position for the same. A needle receive device at a distal end of the housing receives the free ends when the operating device is moved to the transfer position. In at least the insertion position the holder and the protection device are spaced longitudinally from the housing to receive a tissue therebetween.

Abstract: An apparatus for suturing body lumens is provided. The apparatus includes a flexible elongated member that has a proximal end, a distal end, a central passage and multiple needle lumens extending from the proximal end toward the distal end. The flexible elongated member further includes an elongated subsection spanning from the end of the needle lumens in the elongated member to a barrel portion that includes corresponding needle lumens on the proximal end of the elongated member. The elongated subsection provides sufficient space between the needles and the barrel portion to allow transapical insertion of the elongated member into a body lumen. The apparatus further includes needles disposed within and advanceable from the needle lumens. The apparatus also includes a handle disposed at the proximal end of the elongated member. The handle is operable to retract the needles through the needle lumens toward the handle at the proximal end.

Abstract: A method is disclosed for facilitating tissue puncture of a portion of biological tissue using a device, the device comprising a tissue supporting member that is adapted to be placed in a proximal position relative to a portion of the biological tissue and a tissue puncturing member that is adapted to be placed in a distal position relative to the portion of the biological tissue, so that the portion of biological tissue is between the tissue supporting member and tissue puncturing member, the method comprising: supporting the portion of biological tissue using the tissue supporting member; and advancing the tissue puncturing member in a distal direction such that the tissue puncturing member passes through the portion of the biological tissue, thereby puncturing the portion of biological tissue.

Abstract: A suture deployment system is disclosed including a surgical needle having a flexible suture fixedly attached thereto and a target suture releasably secured to the flexible suture. A collar is positioned between the flexible suture and the target suture and is fixedly secured to the flexible suture. The target suture is releasably secured to the collar is such that the target suture may detach from the collar once a surgical procedure has been completed. The surgical needle is a double pointed surgical needle specifically configured to be manipulated by a surgical suturing apparatus.

Abstract: The suturing instrument includes an elongate member having a distal end, a distal portion coupled to the distal end of the elongate member, and an actuation mechanism. The distal portion is movably coupled to the elongate member such that the distal portion is configured to move from a first position to a second position.

Abstract: Methods and devices for treating female stress urinary incontinence are disclosed. The methods include transvaginally accessing the pelvic cavity and introducing a suburethral sling into the retropubic space. In some embodiments the ends of the sling are attached to an anatomical support structure. In other embodiments, the ends of the suburethral sling are not attached to an anatomical support structure. The devices include a surgical instrument for blunt dissection of the pelvic cavity which includes a curved shaft and a blunt distal end. A hook deployment device may optionally be attached to the surgical instrument.

Abstract: An apparatus for suturing body lumens is provided. The apparatus includes a flexible elongated member that has a proximal end, a distal end, a central passage and multiple needle lumens extending from the proximal end toward the distal end. The flexible elongated member further includes an elongated subsection spanning from the end of the needle lumens in the elongated member to a barrel portion that includes corresponding needle lumens on the proximal end of the elongated member. The elongated subsection provides sufficient space between the needles and the barrel portion to allow transapical insertion of the elongated member into a body lumen. The apparatus further includes needles disposed within and advanceable from the needle lumens. The apparatus also includes a handle disposed at the proximal end of the elongated member. The handle is operable to retract the needles through the needle lumens toward the handle at the proximal end.

Abstract: An endoscopic stitching machine, including a housing for mounting the actuators for the stitch-forming tools (needle, gripper and pressure pad), and a housing shaft to house one or more devices for the transmission of the movements generated by the actuators to the stitch-forming tools, whereby the housing shaft (3) and the transmission devices (9, 12, 13) are divided into two shaft parts (14, 15) and lower and upper transmission devices (9a, 12a, 13a and 9b, 12b, 13b), in a plane perpendicular to the longitudinal direction thereof, detachably connected to each other by means of a corresponding coupling piece (26), whereby the coupling pieces (26) may be introduced into and positively housed within corresponding recesses (32, 33) of the lower and upper transmission means (9a, 12a, 13a and 9b, 12b, 13b), parallel to the section plane and running in the longitudinal direction of the transmission devices (9, 12, 13).

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: 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 suturing assembly is provided that is configured to pull a capsule attached to a suture through tissue. The suturing assembly includes a shaft aligned on a longitudinal axis of the suturing assembly, and a head coupled to the shaft. The head includes a proximal portion and a distal end spaced apart from the proximal portion by a throat. The proximal portion houses a needle that is movable through a needle exit port. The proximal portion of the head and the needle exit port are both aligned on the longitudinal axis. A proximal side of the distal end of the head defines a cavity adapted to receive the capsule and a distal side of the distal end of the head defines a slot adapted to allow the suture to pass through the distal end of the head and into the cavity.

Abstract: A method of transfascial suturing may include delivering a suture assembly into an abdominal cavity of a patient, passing a suture anchor, from within the abdominal cavity, through a soft tissue repair prosthetic provided in the abdominal cavity and then through the abdominal wall to a location either above or below the skin, and tightening the suture assembly. An instrument for transfascial suturing may include a handle, a shaft extending from the handle, and a drive system for advancing a suture or suture assembly out of the instrument and across the fascia. The instrument may advance a suture anchor and a suture from within the abdominal cavity and across the abdominal wall to present the suture anchor on the opposite side of the fascia. The instrument may be adapted to present the suture anchor either above or below the skin surface for subsequent tightening of the suture assembly.

Abstract: A suture passing device includes a notchless tubular needle having a preformed curved shape. One or more cleats are disposed within the needle to help secure suture engaged by the sharp distal tip of the needle and to prevent further bifurcation of the suture. The deformable needle is housed in a channel of a lower jaw having a curved guidepath that approximates the curved geometry of the preformed needle, thereby facilitating the consistent return of the needle to its preformed shape each time the needle exits the channel. A dual needle suture passing device is also provided having a second notchless needle to enable a mattress stitch. Methods of loading a suture onto a notchless needle in a suture passer are also provided.