Abstract: Delivery systems, methods and associated devices for management of an elongate element having sections with differing mechanical properties, in particular, for management of a loop of suture-wire element extending proximally from a delivery catheter for deployment of a heart implant. Such management devices can include an inner feature (e.g. outward facing groove or series of tabs) along an inner circle about which a suture can be coiled and an outer feature (e.g. inward facing groove or tabs) to engage and constrain a wire section having increased stiffness within a coil having a larger diameter than the coiled suture. Such devices can be provided separately or can be integrated within a handle of the delivery catheter. Methods of loading suture-wire management devices and utilizing such devices during deployment of an implantable anchor are also described herein.

Abstract: This disclosure relates to surgical devices and methods. The disclosed surgical device and method may be used to resect, cut or otherwise remove tissue during an orthopaedic procedure. The surgical device may be reconfigured to reduce a size of the surgical device during placement in the patient.

Abstract: A medical device includes a clevis, a first jaw, and a second jaw. The first jaw includes a first proximal gripping portion and a first distal gripping portion, and the first proximal gripping portion includes a first needle alignment portion. The second jaw is coupled to the clevis and includes a second proximal gripping portion and a second distal gripping portion, and the second proximal gripping portion includes a second needle alignment portion. The first and second needle alignment portions are located opposite each other when in the closed orientation. The first and second needle alignment portions define a clamp path when in the closed orientation within which the curved portion of the needle is received when the second jaw is in the open orientation. The first and second needle alignment portions are configured to rotate the needle when moving to the closed orientation.

Abstract: The present invention is a group of surgical instruments with improved function and design for dental and craniofacial surgery, especially subperiosteal tunneling and related procedures. The instruments include surgical elevators for vestibular incision or incisions in the gingival sulcus. The instruments have varying angles and shapes to create a mucosal tunnel in any oral or maxillofacial region. The instrument suite also optionally includes specially designed forceps for introduction of graft material inside the subperiosteal tunnel and to assist with suturing of the graft to surrounding tissue.

Abstract: A suture anchor comprising a footing with a base defining a first, a second, a third, and a fourth base suture passage, a first and a second primary suture passage aligned with a primary level and fluidly connected to the first and second base suture passage for a first suture, a suture channel aligned with a secondary level spaced further from the base than the primary level, and fluidly connected to the third and fourth base suture passages a second suture, and a suture course for the first suture along a tertiary level defined by a top that is spaced further from the base than the secondary level.

Abstract: A method for surgical repair of an Achilles tendon may include positioning an instrument proximate the Achilles tendon. The instrument may include a handle and a plurality of tendon guides. The method may also include maneuvering the instrument such that the plurality of tendon guides is positioned anteriorly, posteriorly, laterally, and medially of the Achilles tendon, actuating the plurality of tendon guides to retain the Achilles tendon between the plurality of tendon guides, and using the instrument to insert a suture through the Achilles tendon along one or more trajectories, each of which is offset at least 10° from a coronal plane.

Abstract: A system and method for completing one or more stitches without withdrawal and reloading of an inserter. A suture passer includes a distal end having a body with a gripping portion and a suture holding portion. The gripping portion and the suture holding portion are spaced, defining a recess in the body there between. A tube of the gripping portion extends toward the suture holding portion and maintains a needle therein. The needle is slidable within the tube between a retracted position and an extended position. The needle has a notch at its distal end for catching and securing a limb of suture. In the retracted position, the distal end of the needle is within the tube of the gripping portion and in the extended position, the distal end of the needle extends into the suture holding portion.

Abstract: A tissue suturing system includes: a first roller, a second roller, a first power unit, a second power unit and a suture needle. The suture needle is inserted and clamped between the first and second rollers, having parallel axes, at least one of the two rollers offering active rotation and the two rollers applying a force to the suture needle at the position where it is clamped. The first power unit is configured to provide a position where the first and second rollers are relatively close to each other so that their axes are parallel and the suture needle is clamped. The second power unit provides rotation power for the active rotation, and the suture needle is in form of a curved structure and driven by the active rotation to enter and exit the tissue following a curved direction, having an external exposed position for clamping by the two rollers.

Abstract: Among other things, there are disclosed embodiments of devices used for minimally-invasive treatments, such as treatment of mitral valves. In a system for placing an annuloplasty belt around the heart, embodiments for tensioning a suture associated with the belt are provided, as are embodiments of a suture lock for holding the suture with the applied tension. A delivery device that permits placement and tensioning of such a belt and activation of the suture lock in one procedure is also disclosed. Methods for making and using these features are also disclosed.

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: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: An anvil-attachable layer for use with a surgical stapler, or fastening instrument, wherein a proximal end portion of the layer is attached to a staple cartridge assembly, for example. The layer may be attached to the staple cartridge assembly by an adhesive, weld, or a staple-cartridge-based clamp, wherein the attachment is weak enough to allow the layer to pull away from the staple cartridge assembly with stapled tissue. Alternatively, the layer can include two or more lateral slits that define a connector region that can be cut by a knife of a surgical stapler to release the layer.

Abstract: A device for suture thread cutting, containing: an external tube having a slot with a distal first edge; an internal cutter having an opening with a second edge, the wherein the slot and opening together form a pathway which guides the suture thread; wherein the internal cutter is positioned and is fitted inside the external tube; wherein the external tube and the internal cutter are movable relative to each other whereby the first and second edges are movable from a first position, in which the first and second edges are spaced a first distance apart, to a second position, in which the first and second edges are spaced a second distance apart, the first distance larger than the second distance, wherein in the first position the suture thread is retained within the slot and wherein in the second position the suture thread is cut between the first and second edges.

Abstract: A surgical stapling system includes a surgical stapling apparatus and a staple cartridge surgical buttress assembly. The surgical stapling apparatus includes a handle assembly, an elongate tubular body extending distally from the handle assembly, and an end effector extending distally from the elongate tubular body. The end effector includes an anvil assembly and a staple cartridge assembly. The staple cartridge surgical buttress assembly includes a surgical buttress and a leash. The surgical buttress includes a body having an annular configuration and legs extending from the body. The body is positioned against a tissue facing surface of the staple cartridge assembly and the legs are positioned against a housing of the staple cartridge assembly. The leash is threaded through at least one of the legs and extends proximally from the surgical buttress towards the handle assembly.

Abstract: A method for closing a wound in a tubular organ using a suture thread attached to a suture needle. The method includes grasping a first part of the suture thread by a grasper inserted in the tubular organ after the suture thread has been passed through tissue surrounding the wound at a first position; moving the first part away from the first position by moving the grasper grasping the first part along a longitudinal axis of the grasper; grasping a second part of the suture thread located between the first part and the first position by the grasper; and moving the second part away from the first position by moving the grasper grasping the second part along the longitudinal axis of the grasper.

Abstract: A surgical instrument. The surgical instrument has an end effector and a trigger in communication with the end effector. The surgical instrument also has a first sensor and an externally accessible memory device in communication with the first sensor. The first sensor has an output that represents a first condition of either the trigger or the end effector. The memory device is configured to record the output of the first sensor. In various embodiments, memory device may include an output port and/or a removable storage medium.

Abstract: Devices and methods for inserting an implant into skin or other tissue of a patient can include a hyaluronic thread coupled with an insertion device that can provide a supportive enclosure for the thread as it is injected into a patient's skin or other tissue. The device can include a moveable member and laterally extending portions, a closed distal portion, and an inner cavity so that the thread can be positioned within the inner cavity and extend along the moveable member. The laterally extending portions can move, relative to the thread, to expose the thread. In use, the moveable member is insertable into a patient and at least a portion of the moveable member is configured to move within a patient to expose the thread.

Abstract: A prosthetic remodeling annuloplasty ring for use in tricuspid or mitral valve repairs to provide support after annuloplasty surgery. The annuloplasty ring includes a relatively rigid core extending around an axis that is discontinuous to define two free ends. A suture-permeable interface surrounding the core includes floppy regions adjacent both free ends of the core. Sutures are used to attach the annuloplasty ring to the annulus, including at least one suture through each of the floppy regions to secure the free ends of the ring and minimize the risk of ring dehiscence, or pull through of the sutures through the annulus tissue. The floppy regions may project from each free end into the gap toward each other, be radially enlarged such as paddle-like extensions, or may comprise outwardly lateral extensions at the free ends of the core.

Abstract: An apparatus for repairing a heart valve can comprises a leaflet-plicating mechanism configured to plicate a leaflet of a heart valve and a helical needle comprising a plurality of coils. The needle can be configured to implant a suture to extend helically through plicated tissue of the heart valve. The leaflet-plicating mechanism can comprise first and second leaflet-capture arms, which can be configured to move toward and away from each other between an open position and closed position. The leaflet-capture arms can be configured to plicate the leaflet as the leaflet-capture arms are moved from the open position to the closed position.

Abstract: Tissue stabilizing devices and methods for stabilizing, and optionally closing, a target tissue, such as the left atrial appendage, generally include an elongate body with a first lumen and a second lumen, a suction tip coupled to the elongate body, and an injection tip coupled to the elongate body proximal of the suction tip. The suction tip may define a suction aperture and the suction aperture may be in fluid communication with the first lumen to apply suction to the target tissue. The injection tip may be in fluid communication with the second lumen to dispense a contrast fluid.

Abstract: A loading assembly includes a cartridge having a cartridge body with rows of staple pockets. A carrier includes a platform adapted to releasably retain the cartridge. A shell is laterally spaced from the platform and flexibly coupled thereto. The arm extends through the shell at an acute angle and the shell has a passage that is configured to receive a jaw member of a surgical stapling instrument therethrough. A surgical buttress has a distal region with a first orifice and a cutout and a proximal region with a second orifice. The first orifice is attachable to a peg located in a distal region of the shell and the second orifice is attachable to a post located in a distal region of the cartridge such that a portion of the surgical buttress extends through the passage of the shell. The cutout is configured to receive an arm of the platform therethrough.

Abstract: An apparatus for transferring mechanical energy in a handle to a cartridge to manipulate tissue or anatomical structures within the body of a human or animal subject for the purpose of treating diseases or disorders. The handle and cartridge contain safety interlocks.

Abstract: Embodiments of the invention are directed towards a medical device, method and system thereof for the placement or passage of patches, sutures, anchors, tags, tissue sensors and more particularly to a medical device for repairing female pelvic organ or tissue prolapsed region. The device may be used for the placement of stereotactic markers into tissue near joints or tumors for guidance during orthopedic or neurosurgical procedures.

Abstract: Apparatus and methods for performing a non-invasive procedure to repair a cardiac valve are described herein. In some embodiments, apparatus and methods are described herein for repairing a mitral valve using an edge-to-edge repair to secure the mitral valve leaflets. Implant securing devices are also described that can be used during a procedure to repair a mitral valve. In some embodiments, an implant securing device includes an outer member and an inner member movably disposed within the outer member. The inner member can be used to hold or secure a suture extending from an implant deployed on an atrial side of a leaflet of a mitral valve, and the outer member can be used to push or move a half hitch knot toward a ventricular side of the leaflet, which can be used to secure the implant in the desired position.

Abstract: A method comprises advancing an elongate tube to a target implantation site, the elongate tube having a needle disposed at least partially therein that has a coiled sutureform wrapped around at least a portion thereof, contacting a distal end of the elongate tube to a target tissue, projecting a tip of the needle from the distal end of the elongate tube to pierce through the target tissue such that the tip of the needle and at least a portion of the coiled sutureform project through the target tissue, advancing a pusher device within the elongate tube and over the needle to push the at least a portion of the coiled sutureform off of the tip of the needle, and proximally pulling one or more suture tails associated with the coiled sutureform to form the coiled sutureform into a knot on a distal side of the target tissue.

Abstract: Various systems and methods are disclosed. One or more of the methods disclosed uses machine learning algorithms to predict biophysical responses from biophysical data, such as heart rate monitor data, food logs, or glucose measurements. Biophysical responses may include behavioral responses. Additional systems and methods extract nutritional information from food items by parsing strings containing names of food items.

Abstract: A surgical stapler is provided that includes a first jaw and a second jaw. The first jaw includes a proximal end portion and a distal end portion. The second jaw includes a proximal end portion and a distal end portion. The proximal end portion of the first jaw is pivotally mounted to the proximal end portion of the second jaw. A flexible guide is secured to the distal end portion of the first jaw.

Abstract: A minimally invasive device and method for suturing papillary muscles includes drawing a suture through a first papillary muscle using a needle, drawing the suture through a second papillary muscle, and tightening the suture to move at least one of the first papillary muscle and the second papillary muscle towards the other of the first papillary muscle and the second papillary muscle.

Abstract: A surgical fastener comprising a generally flat, circular body and a generally cylindrical post fixedly coupled to a center of the body extending perpendicular to the body. Both of the body and the post include through holes configured for passage of a suture. A length of the post is selected to extend through both of a bone graft and at least a portion of bone for providing shear and/or anti-rotational support to the surgical fastener across a fracture line in the bone.

Abstract: An artificial chordae tendineae implantation system includes a clamping device, a puncture device, a pushing device, and a detection device. The pushing device includes a pushing shaft. The clamping device includes a clamping push rod that receives an artificial chorda tendineae, and a distal clamp and a proximal clamp for cooperatively clamping a valve leaflet. The detection device includes one probe that is movably disposed in the pushing shaft. A probe outlet is provided at one of a clamping surface of the proximal clamp and a clamping surface of the distal clamp, and a probe accommodation chamber corresponding to the probe outlet is provided at the other one. When the clamping device is closed, the distal end of the probe protrudes from the probe outlet and is accommodated in the probe accommodation chamber, and whether the valve leaflet is clamped is detected.

Abstract: A device is described. The device includes a suture guide and a tissue retracting surface to enable accurate and safe delivery of sutures through tissue.

Abstract: A method cinches a suture. The method provides a cinch having a suture capturing portion configured to capture a suture, a cinch lock coupled with the suture capturing portion, and a cinch anchor having a lumen. The suture capturing portion is extended out of the lumen to capture the suture. The suture is captured by the suture capturing portion. The suture capturing portion is retracted into the lumen of the cinch anchor. The suture is cinched between the cinch lock and the cinch anchor.

Abstract: A reconstruction system and associated techniques for soft tissue repairs and repair augmentation. The reconstruction system is an internal soft tissue brace formed of at least one fixation device (for example, anchors or screws) and a replacement/reinforcement construct (for example, a suture construct in the form of a suture tape such as FiberTape® or a collagen tape or a suture with biological material or a collagen coated material, or a collagen patch, or a biological construct such as Arthroflex). The reinforcement construct and fixation devices may be used as a suture repair alone (to replace the ligament or tendon), or in conjunction with other traditional soft tissue repair procedures, acting as a reinforcement system for the repaired soft tissue.

Abstract: A device for treating hemorrhoids includes a housing sized and shaped for insertion to a target site within a rectum. The device also includes an inner member received within the housing such that the member may move longitudinally relative to the housing. In addition, the device includes a ligating mechanism at a distal end of the member which includes grasping arms movable between a receiving configuration in which distal ends of the arms are separated from one another and a grasping configuration in which the distal ends are drawn together to grasp tissue. The mechanism includes a ligating band received around the arms that is movable distally off of the arms to constrict around tissue grasped by the arms.

Abstract: An apparatus is provided for guiding the subcutaneous placement of a puncture indwelling drainage tube. The apparatus includes a cannula having a first puncture needle core with a first engagement portion that matches a second engagement portion of a second puncture needle core. The apparatus also includes a third puncture needle core having a third engagement portion that matches a fourth engagement portion of a fourth puncture needle core. Front ends of the four puncture needle cores all protrude from a front end of the cannula and four handles all protrude from the rear end.

Abstract: Among other things, there are shown embodiments of locking mechanisms for holding sutures in tension. Such devices may be used with implants that use or require sutures, and are easily locked remotely. In particular embodiments, a lock includes a housing member, a pin member at least partially within the housing member, and a spring biasing the pin member into the housing member. The pin member includes a gripping portion, and has a retracted condition and a locked condition. When retracted, a suture can move through the housing member and around the gripping portion of the pin member. When locked, the gripping portion of the pin member engages the suture and presses it against the interior of the housing member.

Abstract: A surgical stapling apparatus includes a jaw assembly including an anvil assembly and a staple cartridge assembly, at least one which includes a surgical buttress retention system, and a surgical buttress releasably secured to a tissue facing surface of the anvil assembly or the staple cartridge assembly via the surgical buttress retention system. The surgical buttress retention system includes proximal guide slots defined in opposed sides of the anvil assembly or the staple cartridge assembly that have a generally U-shaped configuration that are mirror images of each other, a plug coupled to a distal portion of the anvil assembly or the staple cartridge assembly, and a retention member including a central portion extending across a proximal portion of the surgical buttress, second portions positioned within the proximal guide slots, third portions extending across a distal portion of the surgical buttress, and end portions coupled to the plug.

Abstract: An end effector for a surgical stapling apparatus is provided which includes an anvil assembly and a surgical buttress. The anvil assembly includes an anvil body and an anvil plate. The anvil plate includes a bottom surface that defines a plurality of staple forming pockets. The anvil body and the anvil plate are selectively connectable. The surgical buttress includes a buttress body and a plurality of arms extending from the body. The arms are disposable between a top surface of the anvil plate and a bottom surface of the anvil body to support the buttress body against the bottom surface of the anvil plate when the anvil plate and the anvil body are connected to one another.

Abstract: A suture placement system is disclosed. The suture placement system has a plate defining a first opening spaced from a second opening. The suture placement system also has a first lumen having proximal and distal ends, wherein the distal end of the first lumen is coupled to the first opening. The suture placement system further has a second lumen having proximal and distal ends, wherein the distal end of the second lumen is coupled to the second opening. The suture placement system also has a guide coupled to the plate. A method of minimally invasive suture placement is also disclosed.

Abstract: Described herein are systems and methods for securing sutures that obviate the need for tying knots. Instead of tying two ends of a suture or two sutures together with a knot, two or more suture portions can be fused or cauterized together using heat. A device can be applied to adjacent suture portions that heats the suture portions and causes the suture portions to fuse together, effectively securing the suture portions together without a knot. Such devices can include a shaft, a heating element positioned within the shaft, and a suture holder at the distal end of the shaft. The holder in an open position receives sutures and in a closed position holds the sutures. Actuation of the device causes the heating element to apply heat and fuse together sutures held by the holder. The holder can separate from the fused sutures after the sutures are fused together.

Abstract: A surgical stapling device includes an elongate member and a loading unit. The loading unit includes a tool portion and a body portion including a first portion having a first length, a second portion having a second length, and a third portion having a third length. The first portion is configured to be releasably secured with the elongate member. The second portion is distal of the first portion and dimensioned to be received in the elongate member. The third portion is distal of the second portion. At least the second or third portion is configured to engage the elongate member in a sealing relation. The second length is greater than the first and third lengths. The third portion of the body portion is dimensioned to be flush with the elongate member when the first and second portions are received in the elongate member.

Abstract: Surgical closure devices, surgical systems, and methods of endoscopically closing tissue tears are disclosed. The surgical closure device includes a housing and a grasping member. The grasping member is configured for movement relative to the housing. The surgical systems include such a surgical closure device and an endoscope including an insertion tube and a cable. The methods of endoscopically closing a tear in a tissue include passing such a surgical closure device through an endoscope to the tear, engaging a portion of tissue on one side of the tear using the grasping member, positioning the receiving section of the housing on another side of the tear, and moving the grasping member toward the receiving section of the housing and position the grasping member and the receiving portion of the housing in a relatively closed relationship, thereby closing the tear in the tissue.

Abstract: A surgical stapling apparatus is disclosed which comprises cartridge body and a layer. The layer is implantable against tissue by staples deployed from the cartridge body and deformed by an anvil. The cartridge and the layer comprise co-operating features which reduce relative movement between the cartridge and the layer. Such co-operating features can also releasably retain the layer to the cartridge body. In addition to or in lieu of the above, the anvil and the layer comprise co-operating features which reduce relative movement between the anvil and the layer. Such co-operating features can also releasably retain the layer to the anvil. In certain instances, the layer can be positioned against the anvil, but releasably attached to the cartridge. The layer can comprise buttress material and/or a tissue thickness compensator, for example.

Abstract: Improved medical suturing devices, systems, and methods for maintaining a position and orientation of a suture needle at a fixed location relative to a suturing device. An exemplary device include a clamp having opposing grasping surfaces for grasping the needle at a first location, and a needle contacting surface for contacting the needle at a second location, the second location a distance axially away from the first location so as to inhibit unintended movement of the needle relative to the device, which may include rotation of the needle about the first location and rotation of the needle about its axis. In many embodiments, the device includes a first and second clamp and a mechanism for alternating grasping of the needle between the first and second clamp. The device may also be incorporated into a single-clamp needle grasping device.

Abstract: A device for cardiac surgery is disclosed. The device for cardiac surgery includes an aortic root retractor frame, an introducer, and one or more suture locking apparatuses. The device for cardiac surgery also includes an actuator for releasing the aortic root retractor frame, as well as a deployment mechanism for fully expanding the aortic root retractor frame. Multiple suture locking apparatuses used for releasable locking and unlocking of suture during a cardiac surgery procedure may be included in the device for cardiac surgery.

Abstract: 2D and 3D cell culture containers formed from blends of poly-L-lactide and poly-D-lactide provide growth surfaces for adherent cells and do not require surface treatment or coating to support mammalian cell growth. The cell culture containers are transparent, heat tolerant, and are environmentally degradable and suitable for composting in landfills.

Abstract: Surgical suturing constructs, suture anchor assemblies, and methods of tissue fixation are disclosed. The suturing construct includes a bumpy suture. A suturing construct may include one or more small loops on a distal end. A suturing construct may include a splice terminating into a tapered portion/region at a proximal end. A bumpy suture of a suturing construct may form a knotless, closed, self-locking loop around tissue.

Abstract: A suture passer comprising: a hollow tube, the hollow tube comprising a distal end, a proximal end, and a lumen extending from the distal end to the proximal end; and a clamping rod slidably received in the lumen of the hollow tube, the clamping rod comprising a distal end and a proximal end, the distal end being bifurcated into a first arm and a second arm, one of the first and second arms extending distally of the other of the first and second arms and including a clamping surface; wherein at least one of the first arm and the second arm comprises a friction-enhancing surface for facilitating manipulation of a suture via engagement of the suture with the friction-enhancing surface.

Abstract: A bone anchor includes a flexible strand defining a first adjustable loop and a friction knot coupled to a proximal end of the first adjustable loop. The friction knot is configured to allow adjustment of the first adjustable loop in a first configuration and is configured to prevent adjustment of the first adjustable loop in a second configuration. A knot capsule includes a body defining an internal knot cavity. The friction knot and a portion of the first adjustable loop are positioned within the internal knot cavity. The internal knot cavity defines one or more impingement surfaces configured to maintain the friction knot in a fixed position within the internal knot cavity when the friction knot is in the second configuration.

Abstract: A surgical suturing apparatus includes an end effector including a jaw assembly and a needle assembly. The jaw assembly includes first and second jaws movable between open and closed positions. Each of the first and second jaws includes a tissue facing surface having an elongated rail and a longitudinal row of teeth. Each tooth of the longitudinal rows of teeth of the first and second jaws includes a needle channel extending therethrough. The elongated rails and the longitudinal rows of teeth of the first and second jaws are disposed in opposed relation relative to each other. The needle assembly includes a first needle, a second needle, and a suture coupled to the first and second needles. The first needle is slidable through the needle channels of the first jaw and the second needle is slidable through the needle channels of the second jaw.