Abstract: A surgical device of suturing vascular vessels is described, as well as methods for suturing tissue employing the surgical device. The device includes at least one needle advanceable through tissue and into a needle capture element within a distal end of the surgical device to draw lengths of suture material which can then be used to close various puncture wounds, particularly in vascular tissue.

Abstract: An ergonomically correct suture needle holder is disclosed. The ergonomically correct suture needle holder comprises a thumb handle having a thumb spinning grip and a ring finger handle having a ring finger grip with a finger holder extending therewith. The ring finger handle and the thumb handle can be pivoted from an open position to a closed position. The needle holder is maintained in the closed position by engaging a first ratchet locking member protruding from the thumb handle with a second ratchet locking member protruding from the ring finger handle. The suture needle holder facilitates the user to twist the user's wrist without moving the user's hand thereof. The thumb spinning grip is custom sized to accommodate a user's thumb and facilitates a swiveling motion of the user's thumb while engaging in surgical movements for allowing the user to suture comfortably without changing the grip on the needle holder.

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

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A suture needle driving instrument comprises a shaft and an end effector. The end effector is located at the distal end of the shaft and includes a pair of needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A suture system includes a plurality of double-stranded needles connected in sequence with a single-stranded needle at each end. The double-stranded suture needles incorporates two suture strands into a single needle. The suture system of the present invention facilitates the implantation of valve prostheses.

Abstract: A medical instrument, especially a uterus manipulator, comprises a shaft, an actuator movable relative to said shaft in order to move a tool and a locking device to lock the actuator relative to the shaft. It is now proposed that the locking device comprises a clamping element which is slidably arranged therein.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing including a cartridge having a suturing needle having a pointed end, a blunt end and notches, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue including placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: An end effector is presented having an elongate body portion having a proximal end and a distal end. The end effector also includes a rotating head configured to be disposed at the distal end of the body portion and an actuation member configured to be disposed at the proximal end of the body portion. The actuation member is in operative cooperation with a handle assembly to enable rotational movement of the rotating head. The rotating head further cooperates with a needle movable relative to the rotating head.

Abstract: A manipulator includes a composite input unit that is manually operable by the fingers, a connector shaft extending from an operating unit, and a working unit mounted on the distal end of the connector shaft. The working unit comprises a rolling mechanism, a tilting mechanism, and an opening and closing mechanism. The composite input unit includes a shuttle ring for actuating the rolling mechanism. The manipulator also includes a gripper for gripping a curved needle. The gripper is placed near a DVC, whereupon the rolling mechanism is actuated to roll the gripper and to pierce a living body with the curved needle, until the point of the curved needle projects outside of the living body.

Abstract: There is disclosed suture manipulating instrumentation having measuring structure to determine the length of suture during a given point in a surgery. The instrument is preferably a surgical suturing instrument capable of manipulating a suture carrying needle at the distal end. The measuring structure in the form of a scale is provided on the suturing instrument at a location remote from the distal end. The length of suture can easily be determined with the use of the scale at any point during a surgery. There is also disclosed a kit for providing the suture measuring structure on other suture manipulating instruments, as well as, methods of using suture manipulating instrumentation having the disclosed measuring structure.

Abstract: A medical needle holder is provided having a handle arranged at the proximal end and a needle receiver arranged at the distal end. The needle receiver has a first and a second clamping surface, which clamping surfaces face toward each other and extend in a direction transverse to the longitudinal axis of the holder. The clamping surfaces are movable relative to each other via the handle, in the direction of the longitudinal axis of the holder.

Abstract: A suture fixation arthroscope apparatus of the temporomandibular joint (TMJ) disk comprises a first suture needle and a first inner core, a second suture needle and a second inner core, and a third suture needle. The tail ends of the first and second suture needles are connected with a big handle via a valve panel, a vertical groove is opened towards the center of a circle of the surface of the big handle, a horizontal groove which is the same size as the vertical groove is vertically set at the place of the big handle connecting the valve panel. The first inner core includes a seamless tube and a top welded with wire snares, the second inner core includes a seamless tube and a top welded with a crochet hook, the radian near the tails of the first and second inner cores is 90 degrees, a small handle is connected at the tails.

Abstract: The present invention relates generally to continue driver device with changeable parameters, more specifically, continues driver with changeable parameters used in surgical procedure such as suturing, wherein said continues driver device is employed in as continuous suture rotational needle driver which enhances the tissue suturing procedure, particularly the one performed on restricted, deep and less accessible locations. The device incorporates a plurality of interactive portion comprising several extended member wherein in said extended members are provided with rotational needle driving points at a distal end into a single device and is operated by the twist of a single knob. The use of the mechanism prevents problems associated with loss of needle control during the suturing procedure as well as the ones associated with the handedness of existing needle drivers.

Abstract: A suturing assembly configured to place suture in tissue includes a handle having an actuator, a shaft coupled to the handle, and a head coupled to the shaft. The head includes a proximal portion housing a needle movable through a needle exit port and a distal end spaced apart from the proximal portion by a throat, the distal end defining a cavity. The actuator is configured to move the needle out of the needle exit port formed in the proximal portion of the head and across the throat to engage a capsule disposed in the cavity formed in the distal end of the head, the capsule attached to the suture.

Abstract: An apparatus for manipulating tissue during a surgical procedure is provided. The apparatus includes a housing including a movable handle and a release mechanism operatively coupled to a distal end of a shaft extending from the housing. The shaft defines an axial passageway configured to support at least a portion of the release mechanism. The present disclosure also provides a detachable clamp assembly operatively connectable to the distal end of the shaft and the release mechanism such that a pair of pivotally connected opposing jaw members are movable from a closed configuration for clamping tissue therebetween to an opened configuration for positioning tissue therebetween when the movable handle is moved from a first position to a second position. The clamp assembly includes a proximal end operatively coupled to a first end of a suture having a second end connected to a needle.

Abstract: Methods and apparatus are provided for closing incisions within biological tissue. In one embodiment, a device and method are provided for suturing biological tissue, such as, for example, an organ or blood vessel. The suturing apparatus is particularly well suited for suturing an incision made in an artery, such as the femoral artery, following a catheterization procedure. The device eliminates the need to apply pressure to a patient's thigh for an extended period of time, and eliminates many of the complications and costs associated with the creation of a thrombus patch. In addition, the device comprises an improved handle portion which enables the physician to quickly and easily apply suture. The handle portion is very reliable and easy to manipulate. The suturing may be used in combination with existing catheter sheath introducers.

Abstract: The present invention is a device having a rigidly linked jaw that is decoupled from an articulating wrist. The device provides for articulating motion as well as actuation that may be used in grasping, cutting, suturing or the like.

Abstract: A system for transdermal repair of soft tissue includes an instrument comprising a proximal actuator portion, a fixed needle having a lumen and extending distally from the proximal actuator portion, and a movable needle having a lumen and extending distally from the proximal actuator portion. The movable needle is movable axially between an advanced position and a retracted position relative to the proximal actuator portion. A suture needle is disposed within the lumen of one of the fixed and movable needles, and has a length of suture connected thereto. Needle graspers are disposed in the lumen of each needle, for securing the suture needle and assisting in the transfer of the suture needle from one needle to the other to complete a suture passing step.

Abstract: The inventive sewing device for overcasting a mechanical twisted suture comprises a body (1) provided with a spiral needle (12) which is rotatable and translationally displaceable and is connected to a drive for rotating it, clamping jaws (6, 7) which are arranged on the distal end of the body for fixing the tissue parts to be sewed and provided with a unit for controlling the relative position thereof. The spiral needle (12) is designed in the form of an atraumatic or a hollow needle, is provided with a thread arranged therein, comprises at least two complete turns and is positioned in such a way that it is displaceable in a direction along the clamping jaws (6, 7) at a distance equal to or greater than the entire length of the spiral. The device comprises a nest (17) for catching the pointed end of the needle and/or the thread at the end of the suture and means for extracting the needle from the tissue.

Abstract: A device for suturing an anatomic valve can comprise an elongate body, a suture catch mechanism and a suture clasp arm. The suture catch mechanism can be operatively coupled to the elongate body for movement between a retracted position and an advanced position. The suture clasp arm can be attached to the elongate body for movement between a retracted position and an extended position. The suture clasp arm can comprise a suture clasp configured to releasably retain a suture portion. In some embodiments, the suture clasp is positioned on the suture clasp arm such that the suture catch mechanism retrieves the suture portion from the suture clasp arm while the arm is at least partially retracted. In some embodiments, the suture clasp arm can be closed about a tissue portion without damaging the tissue portion.

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

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A manipulator includes a composite input unit that is manually operable by the fingers, a connector shaft extending from an operating unit, and a working unit mounted on the distal end of the connector shaft. The working unit comprises a rolling mechanism, a tilting mechanism, and an opening and closing mechanism. The composite input unit includes a shuttle ring for actuating the rolling mechanism. The manipulator also includes a gripper for gripping a curved needle. The gripper is placed near a DVC, whereupon the rolling mechanism is actuated to roll the gripper and to pierce a living body with the curved needle, until the point of the curved needle projects outside of the living body.

Abstract: A needle attachment for a surgical sewing instrument has a proximal-side connector for connecting to a sewing instrument. The needle attachment has a hollow shaft-like body which has a curved hollow needle on the distal side. A thread can be guided through the needle attachment. The cross-section of the curved hollow needle is oval.

Abstract: The present invention is a device having a rigidly linked jaw that is decoupled from an articulating wrist. The device provides for articulating motion as well as actuation that may be used in grasping, cutting, suturing or the like.

Abstract: To provide a medical needle puller that allows an easy pulling operation as well as safety improvement. The engaging stepped part 14 was formed at the back side of the puncture part 12 in the medical needle 10 in which the connection part 13 for connecting the drainage tube 16 was formed at the rear end part and the puncture part 12 was formed at the tip part. Furthermore, the puller 20 to which the medical needle 10 is attached was provided with the needlepoint coating part 21 coating the puncture part 12 and the engaging narrow part 25 engaging the engaging stepped part 14. In addition, the puller 20 was provided with the grippers 22a, 22b for pulling out the medical needle 10 together with the puller 20 from the wound site by hand.

Abstract: The invention relates to a surgical needle holder for stitch suturing. The inventive needle holder is designed to facilitate suturing in areas that are difficult for the surgeon to access. The invention comprises two arms (1 and 2), namely a mobile arm (2) and a longer fixed arm (1). When actuated, the mobile arm acts on a gear mechanism (8) which actuates a lateral pulley (21) which, in turn, transmits the movement to a pulley (5) that is provided at the head (4) of the free end of the fixed arm (1). In addition, a clamp (6) is laterally mounted to the aforementioned head in order to secure the corresponding needle (9). The clamp (6) is opened and closed by actuating a pawl (10) that can be locked by means of teeth (13) forming a ratchet (11) which is mounted to the mobile arm (1) and toothing (14) on the actual pawl (10). Said pawl is released by manually moving the ratchet (11) counter to a spring (12) which meshes the ratchet teeth (13) and the toothed segment (14) together.

Abstract: A hand-held surgical instrument is well-suited to fluoroscopic x-ray imaging. In needle-positioning forceps, an instrument according to the invention preferably exhibits a length of 8 inches or greater, and is constructed substantially from a radiolucent material, thereby enabling a user to navigate the article without being exposed to the beam. The radiolucent material may include a plastic such as a thermoplastic polymer or carbon fiber, and may be presterilized and disposable for one-time use. In the preferred embodiment, the length of the instrument is on the order of 12 inches or thereabouts, and is lordotically shaped for better conformance to patient curvature. The distal tip of the instrument, which is sufficiently strong to reliably grip a needle, may include a needle-dimensioned indent and/or a pair of opposing resilient pads. A radiopaque pointer may be provided to indicate the distal tip, and the pointer may be provided in the form of a removable adhesive strip.

Abstract: An improved needle driver, wherein the needle driver includes an elongated body having a substantially hollow interior portion and a first and second ends. An actuator extending from the first end of the elongated body is included and is in communication with the substantially hollow interior portion. A selectively compressible air reservoir is included and positioned within the substantially hollow interior portion and is in communication with the actuator. A pair of mechanically actuated opposing jaw members extending from the second end of the elongated body into the substantially hollow interior portion are included, the pair of opposing jaw members are generally in communication with the actuator. An inflatable air reservoir is included and annularly positioned about the pair of opposing jaw members and is in communication with the selectively compressible air reservoir.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. The invention relates to devices for approximation, ligation and fixation of tissue using a suture, to various constituent parts comprising said devices, and particularly to the placement of sutures into certain difficult to access ligamental structures, to the approximation of tissue separated by means of an endosurgical trocar being inserted into a body cavity, and to approximation, ligation, and fixation of body tissue using both traditional open surgical and endosurgical techniques and instruments.

Abstract: A connector assembly for connecting a surgical saw blade to a housing of a surgical instrument. The connector assembly allows a surgeon to align, insert and lock the surgical blade in the collet of the surgical instrument without any special tools, and further provides a stable and robust platform for mounting the surgical saw blade thereto. The connector assembly includes a cam lever assembly for allowing the user to apply a clamping force to the surgical saw blade with minimum actuation force.

Abstract: A medical device and method for treating a heart valve. In one embodiment, the medical device has a catheter, at least one needle disposed within the catheter, and a nonadjustable fastener ejectable from the needle.

Abstract: A surgical clamp for occluding a body conduit includes first and second jaws moveable relative to each other in a generally parallel relationship. A handle assembly is operable to move the jaws relative to each other between a space position and proximate position. The first jaw has an elongate configuration characterized by a length and a width. First portions of the first jaw have in cross section a first shape which remains generally constant in area along the first jaw, while second portions have in cross section a second shape which varies in area along the length of the first jaw. The resulting clamp has a low profile jaw design which dimensional-shaped cross section which provide increased stiffness and reduced flexibility.

Abstract: A suturing apparatus comprises an elongated body, at least one arms movable relative to the elongated body and at least one needle movable relative to the elongated body. The arm releasably holds an end portion of a length of suture. The arm has a sharp end portion adapted to pierce an inner surface of a wall of a biological structure and pass an end portion of the suture through the inner surface. The needle is adapted to pierce the inner surface of such biological structure at a location proximal to the location where the end portion of the suture was inserted. The needle captures an end portion of the suture from the arm and draws the end portion of the suture back through the inner surface. The end of the suture is then drawn out of the biological structure by removing the elongated body.

Abstract: A suturing device allows a physician to remotely seal an incision in a blood vessel or other biological tissue. The device comprises an elongated tubular body having a distal portion which is adapted to be inserted percutaneously through the incision and into the blood vessel. The distal portion has first and second retractable arms which extend from the distal portion of the body and releasably hold a suture within the blood vessel. First and second retractable needles, each of which is configured to catch the suture from a respective arm, are provided along the body proximal to the retractable arms. The arms and the needles are remotely movable by the physician using a handle or other control mechanism provided at a distal portion of the device. In operation, the arms are initially deployed within the blood vessel to hold the ends of the suture beyond the circumference of the tubular body.

Abstract: A vascular suturing device is disclosed which includes an elongated tubular body defining opposed proximal and distal end portions and having a longitudinal axis extending therethrough, the body including an inner tubular member, an outer tubular member and a central tubular member disposed between the inner and outer tubular members. The inner tubular member and the central tubular member are mounted for movement relative to the outer tubular member about the longitudinal axis of the body for sequentially driving a pair of suture needles through the wall of a blood vessel to close an incision formed therein.

Abstract: An apparatus for safely removing a needle from a subcutaneous septum, comprising a pair of blades, each having corresponding first and second ends, pivotally jointed together at their first ends whereby the blades are pivotal between a closed position in which the blades are substantially overlapped and an open position in which the second ends of the blades are spaced apart; and a concave groove in an edge of each blade at the second ends thereof positioned such that each groove is directly opposite the other in a mirrored relationship when the blades are in the open position.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. The invention relates to devices for approximation, ligation and fixation of tissue using a suture, to various constituent parts comprising said devices, and particularly to the placement of sutures into certain difficult to access ligamental structures, to the approximation of tissue separated by means of an endosurgical trocar being inserted into a body cavity, and to approximation, ligation, and fixation of body tissue using both traditional open surgical and endosurgical techniques and instruments.

Abstract: A surgical instrument for use in laparoscopy is provided, comprising a tubular member having a proximal end and a distal end, a first end effector piece pivotably mounted to the tubular member near the distal end of the tubular member, a second end effector piece disposed near the distal end of the tubular member and being slidable relative to the tubular member, wherein a surgical item, such as a suture needle, may be received between the first end effector piece and the second end effector piece and may be rolled substantially axially by axial translation of the second end effector piece with respect to the first end effector piece. In one embodiment, the end effector pieces may be provided with depressions in their face surfaces. In another embodiment, the surgical instrument may also include a handle assembly having a control lever and a rotation actuator. The tubular member may also be rotatably mounted on the handle.

Abstract: A suturing device allows a physician to remotely seal an incision in a blood vessel or other biological tissue. The device comprises an elongated tubular body having a distal portion which is adapted to be inserted percutaneously through the incision and into the blood vessel. The distal portion has first and second retractable arms which extend from the distal portion of the body and releasably hold a suture within the blood vessel. First and second retractable needles, each of which is configured to catch the suture from a respective arm, are provided along the body proximal to the retractable arms. The arms and the needles are remotely movable by the physician using a handle or other control mechanism provided at a distal portion of the device. In operation, the arms are initially deployed within the blood vessel to hold the ends of the suture beyond the circumference of the tubular body.

Abstract: An instrument and method for suturing anatomical tissue with a suture needle includes a barrel having two needle holders therein which can be manipulated from a proximal end of the barrel to cause the needle to pass through tissue and to pass the needle from one needle holder to the other. The needle holders are operative to move the needle through a path in a plane not perpendicular to a longitudinal axis of the barrel. The angle of the plane with respect to the longitudinal axis can be adjusted.

Abstract: In accordance with the present invention there is provided a device for use with a needle with a suture attached to it. The device is used for suturing bodily tissue and comprises a handle, a right arm and a left arm extending distally from the handle. The distal end of the right arm has a right gripper attached to it for gripping and releasing the needle. The distal end of the left arm has a left gripper attached to it for gripping and releasing the needle. The device further comprises an electrically powered means for operating the left gripper and the right gripper. The left gripper and the right gripper exchange gripping of the needle. One of the left gripper and the right gripper moves near to the other to exchange gripping of the needle and moves apart from the other when not gripping the needle. The device further comprises a control unit for controlling the electrically powered means.

Abstract: A suturing instrument having needle holders for passing a needle through anatomical tissue. Needles are dispensed from an integral portion of the instrument and loaded into a needle holder prior to suturing. When a suturing procedure is completed, the needle is collected into an integral portion of the instrument.

Abstract: A needle clamp is used to clamp and manipulate a suturing needle having a given radius of curvature. The clamp includes a pair of opposed arms that have an open position for insertion of the needle and a closed or clamping position. The arms are rotatable together about a rotational axis, and the needle is held in a curved convex groove positioned from the rotational axis at a distance approximately equal to the radius of curvature of the needle, so that the needle rotates about its curvature. The replaceable clamp is held along the rotational axis by an instrument handle that includes opposed clamp-engaging members, with the clamp and instrument handle having mating projections and recesses. The instrument also includes a manipulator to rotate the clamp about the rotational axis. The needle clamp may be permanently affixed on the clamp-engaging members or may be releasibly engaged such that various different needle clamps may be interchangeably affixed on the instrument handle engaging members.

Abstract: The present invention provides laparoscopic forceps which can grasp surgical and/or laparoscopic implements and automatically orient the surgical and/or laparoscopic implements to a predetermined orientation. The forceps are fashioned specifically for grasping the laparoscopic implement, and include grasping mechanisms located at one end of the shaft. The grasping mechanisms include orienting mechanisms effective to orient the implement in a predetermined orientation with respect to the forceps. In favorable embodiments, the grasping mechanism is effective to orient the implement automatically in the predetermined orientation, and consists of two jaws, each jaw including a flat surface and a recessed seat for receiving a portion of the implement defined on the flat surface of at least one of the jaws.

Abstract: The present invention is a device having a rigidly linked jaw that is decoupled from an articulating wrist. The device provides for articulating motion as well as actuation that may be used in grasping, cutting, suturing or the like.

Abstract: A suturing device allows a physician to remotely seal an incision in a blood vessel or other biological tissue. The device comprises an elongated tubular body having a distal portion which is adapted to be inserted percutaneously through the incision and into the blood vessel. The distal portion has first and second retractable arms which extend from the distal portion of the body and releasably hold a suture within the blood vessel. First and second retractable needles, each of which is configured to catch the suture from a respective arm, are provided along the body proximal to the retractable arms. The arms and the needles are remotely movable by the physician using a handle or other control mechanism provided at a distal portion of the device. In operation, the arms are initially deployed within the blood vessel to hold the ends of the suture beyond the circumference of the tubular body.

Abstract: Apparatus for needle grasping and performing a second modality comprising a sheath axially extending between distal and proximal ends thereof. The device includes an inner hollow tube with a slot formed therein for receiving a needle at the distal end. Retraction and extension of the inner tubular member relative to the sheath enable the grasping and releasing of a suture needle received in the slot. A handle is provided at the proximal end of the apparatus for selectively extending and retracting the inner tube relative to the sheath and for retaining the inner tube in its extended and retracted positions. A second switch can be provided in the handle to actuate a catheter slidably inserted through the inner tube to perform a second therapeutic modality. The catheter preferably includes a distal bight that forms a loop when extended from the distal end of the sheath for facilitating intracorporeal knot tying thereat.

Abstract: An instrument and method for suturing anatomical tissue with a suture needle and typing a knot in the suture material includes a barrel having two needle holders therein which can be manipulated from a proximal end of the barrel to cause the needle to pass through tissue and to pass the needle from one needle holder to the other to tie a knot in the suture material.