Abstract: A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.

Abstract: A suture passer comprising: a shaft having an axis; a first jaw mounted to the shaft in alignment with the axis, the first jaw being configured to releasably support a length of suture thereon; a second jaw movably mounted to the shaft; and a needle movably mounted to the shaft, the needle having a hook and being configured to reciprocate in alignment with the axis so that the hook can selectively pass by the second jaw and engage suture releasably supported on the first jaw; wherein the first jaw comprises a spring for selectively binding the suture to the first jaw, and further wherein the spring comprises a recess for receiving the suture therein.

Abstract: A tissue closure device includes a pusher assembly having a drive arm extending from a drive shaft and a needle driver at a distal end of the drive arm, wherein the needle driver is capable of releasably engaging and rotating a suturing needle having a pointed end and a blunt end about a rotational axis and a cartridge having a protective housing and the suturing needle, the cartridge extending from a distal end of a cartridge holder assembly and releasably attached to the cartridge holder assembly. A pointed end of the suturing needle may be positioned within the protective housing before and after a complete rotation of the suturing needle about the rotational axis. A removable electronic module may be provided controlled by an actuator that mechanically engages the drive shaft to rotate the drive shaft and the needle driver, thereby rotating the suturing needle about the rotational axis.

Abstract: Integrated systems and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device configured to deploy and implant anchoring devices for such purposes.

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

Abstract: Devices, systems, and methods are provided for managing suture filaments when performing soft tissue repair. One exemplary embodiment of a surgical suture management device is in the form of a suture loop management card. The card can generally be configured to hold open a collapsible loop of suture until a force applied to the loop is greater than a threshold tension. The card can include a number of different features that help to keep the loop open until the threshold tension is achieved, including features designed to prevent the filament from being mistakenly offloaded. The card can be configured to be removably inserted into a handle of an inserter tool for use as a surgical tissue repair system. Other devices, systems, and methods for performing soft tissue repair are also provided.

Abstract: A device for surgical ligation is provided, which comprises: a housing, where a pulling portion is provided therein; and an opening portion provided at one end of the housing and connected to the pulling portion, where a line delivery element is provided therein. The line delivery element comprises: a first arc unit having a first coupling portion and a slot thereon; a second arc unit having a second coupling portion corresponding to the first coupling portion; and a gear assembly comprising a plurality of gears engaging with each other, wherein a first gear is engaged with the pulling portion while a second gear is engaged with the second arc unit.

Abstract: A suture manipulating instrument for passing and retrieving suture through a tissue includes a handle mechanism, an elongate shaft extending from the handle, and a working distal end. The working distal end includes a needle body, a lumen defined by the needle body, a tissue penetrating distal tip, and a lateral slot. A preformed inner member is movably disposed within the lumen of the needle. The handle mechanism is used to extend the wire from the lateral slot of the needle, and to retract the wire into the lateral slot, allowing the working end of the instrument to grasp and manipulate suture by pinning and/or trapping the suture against the needle. In embodiments the inner member is further retracted within the needle lumen, drawing a length of suture into the needle lumen. The suture is subsequently ejected from the needle lumen to form a suture loop.

Abstract: A suture assembly, including a button having two apertures and a suture defining a lumen and forming a double loop, formed by a double trap having a first end and a second end, opposed to the button. A first portion of the suture is threaded through the trap from the first end to the second end, and a second portion of the suture is threaded through the trap from the second end to the first end. The assembly further defines a first single trap, in which the first portion of the suture is threaded through the lumen between the second end and the button. Also defined by the assembly is a third trap, in which the second portion of the suture is threaded through the lumen between the first end and the button. Finally, the double loop is threaded through the two apertures of the button.

Abstract: A surgical suture apparatus for open and/or endoscopic surgery is configured to pass a double-ended surgical needle backwards and forwards between a first jaw element and a second jaw element, the jaw elements each including a holding device to hold a respective needle end of the surgical needle, wherein the first and/or second jaw element are biased to an open position with a first biasing force. The apparatus further includes an operating device to operate the first and second holding devices, wherein the operating device includes a first operating organ biased in the normal position by one or more second spring elements with a second biasing force, wherein the first biasing force is smaller than the second biasing force such that exerting an actuation force on the first operating organ first results in movement of the first and second jaw element towards each other, and subsequently in actuation of the operating device.

Abstract: Instruments and methods for passing suture in tissue repair and other surgical procedures are disclosed.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: A surgical suturing device comprises an arced needle comprises a length of suture. An elongate shaft comprises a proximal end and a distal end. A needle driver is on the distal end of the elongate shaft operable to engage and rotate the needle in a circular path. The needle driver reciprocates between a drive stroke wherein the needle is rotated and a return stroke. A trigger is on the proximal end of the elongate shaft. A drive rod in the elongate shaft operably connects the trigger and the needle driver. Moving the trigger in a first direction actuates the needle driver through its drive stroke, and moving the trigger in a second direction actuates the needle driver through its return stroke. A spring is operably connected to the drive rod limiting a load transmitted through the drive rod. The spring may limit the load transmitted through the drive rod when the trigger is moved in a first direction.

Abstract: In one embodiment, a system for repairing a meniscus includes a suture including a first anchor, a second anchor, and a flexible portion connecting the first anchor and the second anchor. The flexible portion includes a self-locking slide knot between the first anchor and the second anchor. The system also includes a needle having a longitudinal extending bore, an open end, and a slot adjacent the open distal end, the first anchor and the second anchor are positioned entirely within the bore and slot. The system further includes a pusher configured to be movable within the bore of the needle. The pusher is configured to discharge the first anchor and the second anchor individually and sequentially through the open distal end of the needle.

Abstract: Apparatus for applying a patch to a subject, the patch having a number of projections thereon, the apparatus including opposable jaws movable between open and engaging positions, wherein in the open position the jaws can receive at least part of the subject, and in the engaging position the jaws can engage the at least part of the subject and a patch support for supporting a patch, and wherein the patch support is for urging the patch against the at least part of the subject.

Abstract: A suture manipulating instrument for passing and retrieving suture through a tissue includes a handle mechanism, an elongate shaft extending from the handle, and a working distal end. The working distal end includes a needle body, a lumen defined by the needle body, a tissue penetrating distal tip, and a lateral slot. A preformed inner member is movably disposed within the lumen of the needle. The handle mechanism is used to extend the wire from the lateral slot of the needle, and to retract the wire into the lateral slot, allowing the working end of the instrument to grasp and manipulate suture by pinning and/or trapping the suture against the needle.

Abstract: A suturing device is provided. The suturing device may include a firing aperture having at least one needle and a stripper plate, the needle being rotatable relative to the stripper plate and the firing aperture, and configured to engage a suture for deployment; and a drive mechanism operatively coupled to the needle and configured to advance the needle from a retracted position to an extended position during engagement, and retract the needle from the extended position to the retracted position during disengagement.

Abstract: Systems and methods for separating an object such as a pacing lead from a patient tissue involve a flexible and torqueable shaft having an internal lumen sized to receive the object, and a hard separating mechanism for separating the object from the tissue. Typically the shaft and separating mechanism are advanced along or toward the object, and the separating mechanism is contacted with the tissue. The shaft is rotated to effect separation between the object and the tissue. The systems and methods are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: In a general aspect, a medical device can include an external arm having a receiving mechanism, and an internal arm coupled to the external arm such that the receiving mechanism of the external arm is movable with respect to the internal arm. The medical device can also include a sliding component including a needle configured to be coupled to a portion of an implant and configured to slidably move the needle toward the receiving mechanism of the external arm.

Abstract: A surgical device is disclosed. The surgical device includes: a jaw assembly including a first jaw and a second jaw moveable relative to the first jaw; and an articulating assembly removably coupled to the proximal end of the jaw assembly, the articulating including a distal joint member, a proximal joint member, and a pivot pin fixedly coupled to the distal joint member and rotatably coupled to the proximal joint member, wherein the jaw assembly and the distal joint member define a first longitudinal axis extending between a proximal end of the jaw assembly and a distal end of the distal joint member, and the proximal joint member defines a second longitudinal axis.

Abstract: A suturing instrument using a curved needle is presented. The suturing instrument includes an elongated body, which has a lumen at its distal end. The suturing device also includes a curved needle which has a hook at its distal end to capture a suture from a suture staging area coupled with the suture. The rotational movement of the curved needle can be operated by a linear movement of a controlling element via a compound pivots that are configured to move the needles out from the lumen, couple the needle to the suture, and pull the suture away back toward the lumen.

Abstract: Novel tissue wound closure devices and applicator instruments are disclosed. The tissue wound closure devices have a filament or strap and a capture device that locks the filament or strap in place after application to approximate a wound in tissue. The applicator instruments have a curved insertion needle.

Abstract: A method for performing a gastrectomy (stomach reduction surgery).

Abstract: Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically.

Abstract: Sutures can be placed in difficult to access areas of the human body with devices, and related methods, utilizing a needle carrier. The devices and methods can be used in conjunction with both endosurgical and traditional open surgery procedures.

Abstract: This invention generally relates to devices and methods that allow an operator to position an implant into the body of a patient without the need for direct-vision of the operator or the need to hand-guide a needle in order to capture an implant. In one aspect, a multi-arm delivery device includes a receiving arm that releasably holds an implant in place for capture and a clamping arm that includes a needle deployment mechanism for advancing a needle directly to the implant for capture and for retracting the needle with the implant attached to deliver the implant into the desired location. In one embodiment, the needle includes a plurality of retaining slots. In another embodiment, an end portion of the implant is configured to receive a needle into the end portion and at least some of the end portion of the implant is configured to be retained into one or more retaining slots of the needle.

Abstract: An insertion instrument is configured to eject a pair of anchor bodies across an anatomical gap so as to approximate the gap. The insertion instrument can include a single cannula that retains the pair of anchor bodies in a stacked relationship, or a pair of adjacent cannulas that each retain respective anchor bodies. The insertion instrument can be actuated so as to eject the anchor bodies into respective target anatomical locations.

Abstract: This invention relates to a surgical implant system for repairing abdominal hernias and is particularly useful for repairing ventral hernias. In particular, the present invention relates to an implant, a delivery device and a method for implanting the implant. The implant is implanted in a substantially slackened condition relative to the ventral wall.

Abstract: A suture removal tool grabs, cuts, and removes a suture. The tool includes two arms, a first arm including a single fixed grasping and cutting tip, and the second arm having a fixed cutting tip and a springed grasping tip. When the arms are closed, the grasping and cutting tip of the first arm first contacts the springed grasping tip of the second arm to grasp the suture. As the arms are further closed, the suture is held by the grasping tips, and the cutting tip of the second arm slides past the cutting tip of the first arm, cutting the suture. The cut suture remains grasped between the grasping tips, and may be pulled free. In one embodiment, the suture removal tool is made by cold stamping two mm thick stainless steel, producing burred cutting and/or grasping edges.

Abstract: A surgical device is disclosed which includes a handle assembly, an elongated member and a disposable loading unit. The handle assembly includes a mode selection mechanism configured to alternate the surgical device between a first grasping mode of operation and a second clamping mode of operation. The handle assembly includes a rotation control member and an articulation lever. The rotation control member is configured to facilitate rotation of the elongated member with respect to the handle assembly. The articulation lever is configured to facilitate articulation of the tool assembly about an axis substantially perpendicular to the longitudinal axis of elongated member. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly configured to clamp and staple tissue in the second clamping mode of operation of the device.

Abstract: A suture passer includes an elongate tube defining a central lumen and having a beveled distal end region and a grasping member comprising a first elongate member and a first jaw extending distally from the first elongate member. The grasping member is sized to be disposed within the elongate tube and is capable of being extended from the elongate tube in a manner such that the first elongate member and the first jaw are disposed at least partially distal to the beveled distal end region of the elongate tube. The grasping member is further capable of being retracted within the elongate tube in a manner such that the first elongate member is located substantially within the central lumen of the elongate tube and the first jaw substantially covers an opening of the beveled distal end region of the elongate tube.

Abstract: In one general aspect, a medical device can include a base having a guide and a handle. The medical device can also include a needle member that has a curved portion and a handle portion. The curved portion of the needle member can be configured to slidably move within the guide of the base from a first position to a second position different than the first position when the handle portion of the needle member is moved towards the handle of the base.

Abstract: A wound closure device for repairing perforations and tissue wall defects is disclosed herein. The wound closure device has a barbed elongate body and a plug member. The wound closure device may further include a foam structure. The wound closure device may also include an inner member which may be a tissue scaffold. A method for closing tissue is also disclosed.

Abstract: A surgical suturing device comprises a needle having a leading end, a trailing end, an arced body between the leading and trailing ends, and two steps located at antipodal positions on the body. A length of suture is connected to the needle. A needle driver reciprocates at least 180 degrees between a driven position and a returned position. The needle driver is adapted to engage the needle steps to rotate the needle in a circular path in first rotational direction. A pawl is positioned adjacent the driven position of the needle driver. The pawl is adapted to engage the needle steps to prevent the needle from rotating in a second rotational direction opposite of the first rotational direction.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A laparoscopic suturing device includes a handle and a shaft mounted to the handle. A toggle knob is adapted to rotate the shaft about its longitudinal axis. A pair of opposed jaws, each having a hollow structure, open and close relative to one another. A needle carrier and a needle holder are respectively slideably disposed in a lumen of a first and a second jaw. A needle has first and second pointed ends and is adapted to be press fit into the lumen of the first jaw with the first pointed end exposed and alternatively into the lumen of the second jaw with the second pointed end exposed. A spring-loaded pusher advances and retracts the needle carrier when the toggle knob is in a first position and advances and retracts the needle holder when in a second position. The tool assists a surgeon in suturing tissue captured between the jaws.

Abstract: A surgical instrument includes a needle extending between a proximal end and a distal end. The needle defines a longitudinal axis. The needle includes an elongated cavity that defines an opening disposed proximal to the distal end. A wire extends between a proximal end and a distal end configured for fixation with tissue. The wire is configured for movable disposal within the cavity. The distal end of the wire includes a retainer configured to prevent advancement of the retainer within the tissue. Methods of use are disclosed.

Abstract: Surgical instruments and cartridges for cutting and fastening tissues and organs such as vessels are disclosed. In various non-limiting forms, the surgical instrument includes a first jaw that operably supports a substantially flexible elongated tissue closure assembly therein. A second jaw is movably supported relative to the first jaw and is selectively movable between open and closed positions in response to opening and closing motions applied thereto. A closure retraction assembly is configured to selectively apply cinching motions to the substantially flexible elongated tissue closure assembly.

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 capture valve leaflet and draw the suture therethrough. The suture is thus fastened to the valve leaflet and the instrument is withdrawn from the heart chamber transporting the suture outside the heart chamber. The suture is anchored to the heart wall with proper tension as determined by observing valve operation with an ultrasonic imaging system.

Abstract: An apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis. The distal end portion of the elongate member defines a notch having a face defining an axis. The axis of the face and the longitudinal axis define an acute angle with respect to a first direction along the longitudinal axis. The notch is configured to retain a loop of a suture when the elongate member is moved through a tissue of a patient in the first direction along the longitudinal axis. The notch is configured to release the loop of the suture when the elongate member is moved through the tissue of the patient in a second direction different than the first direction. The suture has at least one tissue anchor configured to be disposed within the tissue of the patient.

Abstract: A suturing device includes an elongated body having an outer wall defining an interior space of the body, a shaft located in the interior space, and a needle mounted on a distal end of the shaft. The needle has a distal section transverse to a longitudinal axis of the shaft. The distal section of the needle terminates in a first jaw and a second jaw forming a forceps defining a piercing tip. The first jaw and second jaw have a grasping position wherein the first jaw and second jaw grasp a suturing material, and a release position wherein the first jaw and second jaw release the suturing material. After grasping the suturing material with the needle, the shaft rotates the needle to advance the needle and suturing material through tissue and mesh placed on the tissue. Spaced apart portions of the suturing material are then fused to create a suture.

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

Abstract: A replaceable suturing head (3) for a suturing device (1) comprising a control assembly (8-11). The suturing head comprises a suturing portion (4). The suturing portion comprises a curved suturing needle (16) arranged to move around a circular path defined by a plurality of rollers (35,36,37,38,39,40,44,45,46,47) mounted on roller shafts (41,42,43) within the suturing portion, at least one of the plurality of rollers being a drive roller driven by the drive motor (10) to move the suturing needle (16) around the circular path. One or more of the roller shafts is mounted within the suturing portion so that it can pivot around its base.

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: A bi-directional suture passing instrument configured to approach soft tissues perpendicularly, enables safer and more efficient surgical repairs and minimally invasive techniques to be employed, useful in areas such as annulus repair, meniscal repair, shoulder arthroscopy, hernia repair, laparoscopic repair, and wound closure.

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 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 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: A suturing device provided. The suturing device may include at least a firing aperture, a drive mechanism and an autoloading mechanism. The firing aperture may include at least one needle rotatably disposed therein configured to engage a suture for deployment. The drive mechanism may be operatively coupled to the needle and configured to advance the needle from a retracted position to an extended position during engagement, and retract the needle from the extended position to the retracted position during disengagement. The autoloading mechanism may be operatively coupled to the drive mechanism and configured to slidably retrieve and position a suture to be deployed over the firing aperture during disengagement of the drive mechanism.

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.