Abstract: A semi-automatic suturing device passes a single or double pointed needle back and forth between two needle holders in order to avoid the need for manually grasping and otherwise manipulating the needle after it has passed through body tissue or other material being sewn. The needle holders are provided in the form of respective sets of vise-like jaws on a pair of arms which are pivotally attached to each other. The holders are thereby manually movable into and out of proximity with each other. The needle holding jaws are automatically alternatingly actuated to open and close when they are pivoted into proximity with each other, such that a hand-off of the needle can occur. Actuation of the needle gripping jaws is power driven, e.g., by a solenoid, and automatically initiated by a proximity switch which detects when the jaws have been brought together.

Abstract: An endoscopic apparatus for suturing vascular tissue including a body portion having a first and a second jaw mounted for movement on a distal end thereon and moveable between an open position spaced apart to a closed position wherein the first and second jaws are in close cooperative alignment and a handle member for moving the first and second jaws to move them between the open and closed positions. The apparatus further includes a reciprocating mechanism associated with the first and second jaws and movable between a first position securing a surgical needle within the first jaw and a second position releasing the surgical needle from the first jaw and a cam actuating lever engagable with the reciprocating mechanism such that the cam actuating lever cams the reciprocating mechanism between the first and second positions in response to predetermined movement of the handle member.

Abstract: A suturing instrument (10) is disclosed having a handle (11) with finger rings (16, 17), a surgical needle (14) pivotably mounted to the handle, and grasping jaws (12, 13) for securing the pivotal position of the needle. The needle has a suture receiving recess (26) and a latch (27) pivotable between a closed position overlying the recess and an open positioning unobstructing the recess.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Abstract: An endoscopic intracorporeal suture tying aid allows a suture to be looped around itself multiple times and cinched, enabling a throw of a surgeon's knot to be easily made. The tying aid includes a needle holder connected to a proximal end of a shaft for releasably holding a needle; a hook that slides longitudinally with respect to the beaks; and the shaft being axially rotatable with respect to the hook.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Abstract: A surgical instrument for holding a suture needle is disclosed. The instrument is of scissors configuration with elongated arms having finger loops at one end and jaws at the other end to grasp a suture needle. This improved instrument has specialized jaws containing a transverse channel that securely holds a suture needle at a right angle to the axis of the needle holder. The width of the transverse channel automatically adjusts to the size of the suture needle as it is being placed in the needle holder. This improved configuration significantly reduces the long standing problem of suture needle twisting or rotation in the needle holder jaws as the surgeon passes the needle through tissue.

Abstract: A wound closure device which maintains pneumoperitoneum while allowing a surgeon to capture an mount of tissue which is substantially wider than the diameter of a trocar cannula through which the device is inserted. The wound closure device includes, an elongated guide member, a hook shaped needle and a retracting mechanism for moving the needle from an open position to a closed position. In the closed position, the tip of the needle is positioned within the guide member so that the needle can be easily inserted into a body. In the open position, the needle tip is positioned outside of the guide member at a distance from the guide member which is greater than the diameter of the guide member.

Abstract: A suture tensioning device is described that comprises first and second jaws in facing relationship and oriented in parallel to each other. The first and second jaws are disposed in relative slidable engagement so that one of the jaws is adapted for parallel movement towards and away from the other jaw to define a variable gap between them. A suture retainer is engaged with a surface of the second jaw to enable a suture to be tied so that the suture exerts a variable tension on the surface caused by the variable gap between the first and second parallel jaws. Preferably, the first jaw has defined therein a shape designed to engage with a surface from which a suture emanates. Methods for adjustably tensioning a suture and a kit for performing suspension of a tissue are described.

Abstract: A surgical apparatus for suturing body tissue comprising first and second jaws relatively movable between an open and closed position, a first needle retaining section having a first securing mechanism mounted therein removably mounted to the first jaw, and a second needle retaining section having a second securing mechanism mounted therein removably mounted to the second jaw. The surgical needle is transferable between the first and second sections upon closing of the jaws such that the surgical needle can be retained in either of the first and second sections by the respective securing mechanism.

Abstract: A surgical apparatus and method of use for maintaining tension upon a length of suture material extending from body tissue is provided. The surgical apparatus deforms and compresses a securing member about a length of suture material which is received therethrough so as to maintain a prescribed amount of tension on the suture material which extends from body tissue and is engaged in the compressed securing member.

Abstract: A trocar wound closure device includes an elongated body having a distal end for insertion through a trocar puncture wound, a proximal end, and a first and second retractable needle holders disposed at the distal end of the body. The needle holders are movable between a retracted position and an extended position. An actuator disposed at the proximal end of the body moves the needle holders from the retracted position to the extended position, so that the needle holders can be retracted to allow the device to be inserted through a trocar wound preferably through a cannula inserted into the wound, and extended to position the needles adjacent the wound, to allow the wound to be sutured.

Abstract: A surgical apparatus includes a needle having an outer surface and an anchor bar disposed in sliding engagement with the needle. A suture has a first end attached to the anchor bar and a second end extending laterally of the anchor bar and outwardly of the needle. A pusher is movable coaxially of the needle to engage the anchor bar and to separate the anchor bar from the needle to form an anchor relative to a body wall. The anchor bar may have an outer surface with an inclined relationship to its longitudinal axis in order to facilitate axial insertion of the anchor bar through the body wall. An associated method for anchoring a pair of body walls includes the step of attaching a bolster to the second end of the suture and separating the anchor bar from the needle with the anchor bar and the first end of the suture disposed on one side of the body wall and the second end of the suture disposed on the other side of the body wall.

Abstract: A suturing device includes a first needle retaining member for causing the basal end part of an arcuate needle to be held in place at the leading end of an insertion lever, a second needle retaining member capable of holding the leading end part of said needle, open-close mechanism swingably supporting the first needle retaining member and the second needle retaining member and switching the needle retaining members between the "close" posture in which the leading end of the needle is abutted against the leading end of the second needle retaining member and the "open" posture in which the abutting leading ends are separated to allow insertion of the needle through a trocar, and rotary mechanism for rotating the two needle retaining members in each of the "open" and "close" postures. The insertion lever is provided at the basal end thereof with a manipulating part for effecting remote control of the rotary means and the open-close means.

Abstract: The invention described herein is a device for tying knots intracorporeally during laparoscopic surgery. It is intended to simplify the process of tying intracorporeal knots to the point that the average laparoscopist can quickly learn to suture laparoscopically with confidence. The unique features of this invention include: a driven shuttle; integral grasper or needle driver; the system is reloadable; and the system may have a detachable end effector. The system also may have a multi function handle, and incorporates an integral needle driver mechanism.

Abstract: A surgical instrument for applying sutures including an elongated housing having a proximal end and a distal end, means associated with the distal end of the elongated housing for carrying at least one needle, the needle carrier means being movable between a retracted position and an extended position, at least one needle positioned on the needle carrier means, and means associated with the needle carrier means for moving the needle carrier means to the extended position to deploy the at least one needle such that upon movement of the needle carrier means by the moving means, the needle carrier moves from the retracted position to the extended position whereby the at least one needle is caused to travel through a tissue engaging path in one continuous motion.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Abstract: A surgical instrument provides a simplified method of inserting sutures in laparoscopic surgery. A suture needle is hollow, and the suture thread extends through the needle. A liquid, such as a saline irrigation fluid, is driven through the hollow needle. This liquid carries the suture thread. The suture needle initially passes through the tissue, and the liquid is then actuated to drive the suture thread through the needle. The needle may then be withdrawn, leaving the suture thread in the tissue. The suture thread can then be tied off to complete the suture. In another aspect of this invention, the suture needle, or any other surgical tool, is connected to the body of the surgical instrument through a universal connection such that the angular orientation of the surgical tool relative to the surgical instrument can be universally adjusted in a three dimensional space.

Abstract: A surgical needle holder for facilitating safe and efficient surgery. The surgical needle holder has a plurality of grooves to secure a surgical needle at a selected position within the holder.

Abstract: A needle holder which is used in laparoscopic surgeries by being inserted into a trocal tube inserted into a body cavity of a patient includes an elongated insertion rod having a tip portion; a holding member provided at the tip portion of the insertion rod for removably holding the needle; position control mechanism operable from the outside of the body for adjusting the position of the needle to be held by the holding member; fixing members for fixing the holding member with respect to the insertion rod at a state that the holding member has been adjusted by the position control mechanism; and switching mechanism for switching the state of the holding member between a first state in which the holding member is adjustable with the position control mechanism and a second state in which the holding member is fixed with respect to the insertion rod by means of the fixing members. The holding member is formed from a pair of pinch members each having a semi-spherical shape.

Abstract: Endoscopic sewing instrument with a helical-needle which has one or more windings and is Positioned between at least two rolls which drive the needle and the thread in a rotary manner.

Abstract: A suturing instrument for suturing tissue comprises an elongated housing having opposite ends. A curved suturing needle having a pointed end and to which a suture is attached is supported at one end of the housing for rotational motion about an axis. A driver mechanism in the housing rotates said needle about said axis through successive revolutions. There may also be a suture tensioner in the housing which applies tension to the suture to draw the suture toward the other end of said housing following each revolution of said needle. In its operation, the instrument thus emulates the actions of a surgeon suturing manually.

Abstract: The disclosure contemplates a device for cinching surgical sutures, an applicator for applying the device, a dispenser for dispensing the device, an endoscopic kit including the above and a method of use for the same.

Abstract: The invention described herein is a device for tying knots intracorporeally during laparoscopic surgery. It is intended to simplify the process of tying intracorporeal knots to the point that the average laparoscopist can quickly learn to suture laparoscopically with confidence. The unique features of this invention include: a driven shuttle; integral grasper; the system is reloadable; and the system may have a detachable end effector. The system also may have a multi function handle.

Abstract: A method, system and apparatus for suturing tissue in an anatomical cavity during an endoscopic procedure includes a suturing instrument extending through a portal in the anatomical cavity wall for manipulating a needle to penetrate the tissue to form a looped portion of a length of suture material at an exit point in the tissue and to back the needle out of the tissue, and an anchor applier instrument extending through another portal in the anatomical cavity wall for positioning an anchor in engagement with the looped portion of the suture material to allow the suture material to be tensioned and secured to adjustably approximate the tissue.

Abstract: The disclosure contemplates a method for using an endoscopic suturing apparatus to conveniently place various knots in suture such as a square knot, a modified fisherman's knot, a securing knot, an alternative square knot and a surgeon's knot. The knots are formed variously by placing the suture between the jaws or around one jaw and passing the needle from one jaw to the other to be able to draw the suture through loops formed in the suture.

Abstract: A method and device for the placement of sutures and for the purpose of approximating tissue. A particular utility is effected in the approximation of the tissue separated by means of an endosurgical trocar being inserted into a body cavity. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off.

Abstract: A surgical needle holder particularly adapted for use in laparoscopic procedures include a first and a second jaw element which have parallel engaging jaw faces. The first jaw element is stationary relative to the needle holder and the second jaw element is moveable. A rod extends from the moveable jaw element through the body of the needle holder and is spring biased forcing the moveable jaw element into engagement with the stationary jaw element. The jaw elements are opened by the handle which includes a generally V-shaped linkage between two handle members. When the handle members are squeezed together, the linkage is compressed and forced against the spring elements forcing it into compression and opening the jaw elements. Preferably the faces of the jaw elements are at a 30.degree. angle relative to the axis. This allows a needle to be held in the jaws and inserted through the cannula in a laparoscopic procedure.

Abstract: Surgical suturing apparatus comprises upper and lower jaw elements selectively movable relative to one another between open and closed position. Each jaw element is provided with a respective recess arranged to receive a portion of an elongate incision member or length of surgical thread and securing means is provided arranged to selectively secure the surgical incision member or length of surgical thread in a respective recess. The jaw elements are typically provided at an end of an elongate positioning and operating arm making the device particularly useful for use in laparoscopic surgery.

Abstract: A laparoscopic needle holder comprising a longitudinally extending outer sheath and a longitudinally extending inner rod. The inner rod terminates in a generally J-shaped hook sized to grapple a curved surgical needle.

Abstract: A suturing instrument for suturing tissue comprises an elongated housing having opposite ends. A curved suturing needle having a pointed end and a second end to which a suture is attached and supported at one end of the housing for rotational motion about an axis. A driver mechanism in the housing rotates said needle about said axis through successive revolutions, and a suture tensioner in the housing applies tension to the suture to draw the suture toward the other end of said housing following each revolution of said needle. In its operation, the instrument thus emulates the actions of a surgeon suturing manually.

Abstract: The suturing instrument of the present invention uses an electromagnet to position, orient and hold a needle at the end of an elongated barrel, thereby eliminating the mechanical jaws which are otherwise required. The electromagnet is contained in a barrel and extends along the length of the barrel. One end of the electromagnet emerges at the distal end of the barrel and extends to an end cap, which includes a groove for orienting the needle. Wires extending from the electromagnet and through the barrel connect to a power source which supplies current to the wires. The power source preferably has multiple power settings for supplying different levels of current. When sufficient current is applied to the electromagnet, the electromagnet attracts the needle to it, causing the needle to move to a predetermined position within the groove.

Abstract: A suturing instrument for use in endoscopic surgery includes at one end of an elongated barrel a pair of jaws to grasp and release a needle. Within one of the jaws a recessed magnet properly positions, orients and holds the needle relative to the long axis of the barrel. In a preferred embodiment of an instrument with the magnet embedded in a lower jaw, the instrument includes a wire, which moves in parallel with an upper jaw as that jaw opens and closes, to push the needle out of the contact with the magnet in the lower jaw. The wire fits within a recess, and lies beneath the needle when the needle is in position and the jaws are closed. An alternative embodiment of the instrument includes in one of the jaws a magnet which is magnetized across the diameter. This magnet is oriented, relative to a long axis of the elongated barrel, such that the poles are perpendicular to the axis.

Abstract: A microsurgical needle holder, including first and second elongate members pivotally hinged at their proximal ends and an intermediate member attached to the first elongate member intermediate its ends, and between the first and second members, has a slide and lock actuator for moving the first and intermediate members between a first position wherein the distal ends are spaced apart and a second position wherein the distal ends are engaged, so that a needle can be securely held therebetween. The needle holder can be hand held and the actuator fingertip controlled.

Abstract: An instrument for closing trocar puncture wounds having a handle assembly with a stationary portion and a movable portion; an elongated portion attached at a proximal end thereof to the stationary portion of the handle assembly; and needle deploying means associated with the elongated portion. The needle deploying means includes: an actuator member having a proximal end operably connected to the movable portion of the handle assembly and a distal end disposed adjacent a distal end of the elongated portion, the actuator member being slidable between a first position and a second position; and at least one needle carrier member mounted adjacent the distal end of the actuator member, the needle carrier being slidable relative to the actuator member upon movement thereof, between a retracted position substantially within the elongated portion and an extended position substantially without the elongated portion.

Abstract: In a surgical stitching apparatus for endoscopically performing sutures of tissue or vessels having a drive mechanism including concentric tubes with an operating handle structure at one end and a stitching head mounted at the distal end thereof, the stitching head includes a stationary and a movable mouthpiece each with clamping structures for engaging the tips of a needle each comprising movable and stationary halves with the movable half on the stationary mouthpiece being operatively connected to one of the concentric tubes and the movable mouthpiece being connected to another of the concentric tubes which is hand-operable by a movable handle on the operating handle structure, and the one concentric tube is operable by a pedal switch-controlled mechanism mounted on the operating handle structure for foot operation of the clamping structure on the stationary mouthpiece.

Abstract: A needle driving device (1) includes a pivotally mounted needle holder (3) for a curved suturing needle (12). Following the initial pivot the needle driving member (16) is actuated for pushing the needle out of the holder. The pointed end of the needle (14) is thereby pushed to the surface of the sutured tissue. The needle is drawn outside the aperture by a pair of tongs and a surgeon may bind an initial knot on the thread. Slots (51) arranged at the ends of two V-shaped prongs enable the knot to come into contact with the tissue. The knot is then completed and brought into contact with the tissue. As the thread guides are separated an outward pull is effected which makes it possible to tie a knot even in very deep surgical apertures.

Abstract: A needle driver (100) for fixedly positioning a curved suture needle (101) in a channel (114) of an inner rod (109) thereof and in a preferred 90 degree orientation with respect to the longitudinal axis of the inner rod. The needle driver includes an outer tube (102) with a beveled edge (110) positioned transversely at the distal end thereof. The beveled edge includes a substantially straight segment (119) inclined at a preferred angle with respect to the longitudinal axis of the outer tube. The channel of the inner rod includes an undercut surface (116) and an intermediate surface (117) extending longitudinally therefrom. The undercut surface is formed at a preferred angle with respect the longitudinal axis of the inner rod, whereas the intermediate surface is substantially parallel to the axis.

Abstract: A laparoscopic suturing device includes a suturing needle and a driver for manipulating the needle. The suturing needle features a helically-wound front-end portion with a needle point at its proximal end for penetrating tissue and a rear-end portion connected to the driver. The slender design of the suturing device is ideally suited for minimally-invasive surgery.

Abstract: An instrument for delivering a pre-tied suture assembly, having a needle carrying a thread with a noose thereon, into a body cavity. The needle has a pointed free end to puncture a tissue and guide movement of the needle and thread therethrough. The instrument has an elongate body with proximal and distal ends. Structure is provided on the body for holding the needle in a transfer position with the pointed free end of the needle shielded to prevent inadvertent puncture of a tissue as the suture assembly is introduced into a body cavity through the instrument. The body has a noose receiving portion to be surrounded by the noose with the needle in its transfer position to prevent the noose from closing upon itself.

Abstract: An improved suture threading apparatus is provided which includes an elongated rod having a handle at one of its ends and a needle holder adapted to receive the gripping end of a needle pivotally attached to its other end. The attachment is such that the needle holder may be moved by an actuator between a first position wherein a needle received by the needle holder is held substantially in alignment with the longitudinal axis of the elongated rod, and a second position wherein a needle received by the needle holder is held substantially transverse to the longitudinal axis of the rod. The actuator connects the needle holder to a finger grip substantially adjacent to the handle and includes biasing means which tend to hold the needle holder in its first position in the absence of a force applied to the finger grip overcoming the biasing force to move the needle holder to its second position. A method for using this apparatus to thread suture through tissue also is provided.

Abstract: Needle holder having an elongate tubular member serving as a shaft and having a bore extending therethrough and having proximal and distal extremities. A push-pull rod is slidably mounted in the bore in the tubular member and has proximal and distal extremities. First and second jaws are carried by the distal extremity of the elongate tubular member. The first jaw is secured to the distal extremity of the tubular member in a fixed position. The second jaw is connected to the push-pull rod to cause the second jaw carried thereby to be moved between a closed needle-clamping position and an open position upon relative movement between said push-pull rod and said tubular member. One of said first and second jaws consists of first and second jaw portions having a slot extending therebetween. The other of said first and second jaws overlies and is disposed in the slot.

Abstract: A surgical instrument having a surgeon operable control handle for grasping surgical needles or other objects. The instrument has a moveable jaw opposed to a fixed jaw. The control handle engages a clamping spring which closes the jaws and exerts a grasping force which is proportional to the size of the object located between the jaws.

Abstract: A self-orienting laparoscopic needle holder having a shaft suitably sized for laparoscopy. The shaft has a jaw assembly at one end and a mechanism for opening and closing the jaws at the other end. The gripping surfaces of the jaws are curved to correspond to the curve of a curved surgical needle. One jaw has a convex shape while the other jaw has a corresponding concave shave. The shape of the curved gripping surfaces of the jaws automatically orients the curved surgical needle into a desired suturing position. The shape of the jaw assembly also makes it possible to easily release and regrasp the curved surgical needle during the suturing process of a laparoscopic operation.

Abstract: A suture needle holder is described with a ratcheting mechanism and a optimized set of jaws. These jaws have nitinol inserts for deformability around a suture needle. The shaft of the endoscopic suture needle holder is rotatable to allow placement of the jaws. Also, operation may take place along only one axis, by making the handles parallel to the shaft axis and the jaws which grip the suture needle.

Abstract: The present invention provides a deep suturer suitable for suturing a deep portion and a narrow portion which are difficult to be applied by a normal direct hand operation such as transoral operation. The suturer comprises an end needle-holding portion (B) for holding a suture needle, a holder portion (A) for operating the end needle-holding portion (B) and a connection portion (C) for operatively connect the end needle-holding portion (B) and holder portion (B) is provided with a disk head (4) which is rotated integral with a needle-holding portion (5) the holder portion (A) is provided with a handle (2), and the connection portion (C) is provided with a rod (7) having one end connected to the handle (2) through a connecting mechanism (18) and the other end connected to the disk head (4), the rod (7) being axially slidably inserted by of a spring force.

Abstract: An endoscopic surgical instrument for releasably grasping a curved needle, the instrument employing a handle at a first end of a shaft, the handle for operating a set of opposed jaws at a second end of the shaft. The jaws are serrated and have a channel through the top jaw and an arcuate groove in the top surface of the bottom jaw. The nose of the jaws is slotted to receive the forward portion of the curved needle while the central portion of the curved needle rests in the groove in the top surface of the bottom jaw, and the rear portion of the curved needle extends through the channel. With the jaws compressed and holding the needle in place, the surgeon may then insert the combination through a canulus to suture the tissue at a remotely-located operation site.

Abstract: A suturing device includes a shaft with a pair of axial passages extending through the shaft. A length of suture passes through the first axial passage, the suture having a surgical needle attached to its distal end, and a preformed knotted loop disposed at a distal end of the first axial passage. The second axial passage includes a gaseous seal and is configured to receive a surgical instrument for manipulating tissue to facilitate application of the suture. In the method of the invention, the suturing device is inserted through a cannula and a surgical instrument is introduced through the second axial passage. Tissue is manipulated using the surgical instrument to facilitate application of the suture. A needle holder introduced through a separate cannula is used to pass the needle through the wound and through the knotted loop. Tension is then applied to the suture to close the knot and bind the wound.

Abstract: An endoscopic surgical instrument is designed for axial elongation by incorporating a manually operated mechanism which elongates the instrument upon manual rotation. The manually operated mechanism is joined to an internal rod and tube, which are likewise extended and which support a functional element at the tip of the instrument. Operation of the functional element at the distal tip of the instrument is achieved by manipulations at the proximal end of the instrument, and is not impaired by the extension.

Abstract: A suture applier comprises a shaft having proximal and distal ends and carrying a length of suture along its axis. The suture has a surgical needle at its distal end and a knotted loop formed proximally of the needle. The knotted loop is carried at the distal end of the shaft, and a slidable handle is provided at the proximal end for applying axial tension on the suture. In this way, the needle may be used to suture a wound in tissue and may be tied by passing the needle through the knotted loop and closing the loop by pulling on the slidable handle.