Abstract: Disclosed herein is a surgical instrument having a cylindrical tube affixed thereto. A guidewire can be threaded through the cylindrical tube to allow for advancement of the surgical instrument to a surgical site.

Abstract: The suture passer includes a body from which two mechanisms protrude: a hollow needle through which a suture is guided, the suture exiting at the surgical site; and a sliding hollowing tube with a distal opening, exposing a resilient member. When gripping of a suture is required, the resilient member is intentionally over-extended, causing the resilient member to bow and protrude from the distal opening. A suture is then passed into the resulting gap between the sliding hollowing tube and resilient member, the resilient member then allowed to retract back into place, thereby clamping the suture.

Abstract: The present invention discloses a suturing method and system 10 for repairing hernia. The method comprises applying multiple layers of sutures for closing a primary defect 101. The invention comprises a suturing means for strengthening the repair by securing the primary defect to non-damaged tissue 120 The method of the present invention can decrease the chances of recurring hernia.

Abstract: A buttressed anvil assembly is provided for use with a surgical stapling instrument. The buttressed anvil assembly generally includes an anvil member having a strip of buttress material attached thereto by a pair of sutures. A tensioning mechanism is provided to secure or tension the buttress material to the anvil member prior to use and allow for release of the buttress material after stapling of tissue. The tensioning mechanism includes a cinch track engageable with one of the pair of sutures.

Abstract: A suture retention device is described. The suture retention device has various uses, one being for a gastropexy. A gastropexy may use a suture to hold the stomach against the abdominal wall of a patient. According to one example, a suture retention device is described that may have a shell having a thickness and an upper surface and a lower surface spaced apart by the thickness, the shell having an outer diameter that is greater than the thickness, the shell defining an internal chamber. A spring may be mounted within the internal chamber. The shell may be movable relative to a suture that passes through the shell and engages the spring.

Abstract: In one embodiment, the present invention include a method of securing tissue using a filamentary construct, the method including the steps of passing a length of filament through or around tissue; implanting a filamentary sleeve, formed of filament, into tissue; and passing at least a portion of the length of filament at least partially through the filamentary sleeve to form a one-way cleat. The present invention also provides for various devices, systems, assemblies, kits and methods of use, assembly and manufacture thereof.

Abstract: A surgical instrument comprising a loading unit and an end effector is disclosed. The end effector comprises a first jaw, a second jaw, an anvil, a staple cartridge, a firing member, a first adjunct, a second adjunct, a first pair of restraint members, and a second pair of restraint members. The staple cartridge comprises a staple cartridge deck, staple cavities, staples, and staple drivers. The staple cartridge deck comprises a stepped profile. The first adjunct comprises a strain relief portion. The second adjunct comprises a strain relief portion configured to extend over the staple cartridge deck and a stepped profile that is fitted to the stepped profile of the staple cartridge deck. The first pair of restraint members are configured to releasably attach the first adjunct to the anvil. The second pair of restraint members are configured to releasably attach the second adjunct to the staple cartridge.

Abstract: Devices and methods for inserting an implant into skin or other tissue of a patient can include an insertion device having moveable portions that can retain, move, or otherwise control engagement and injection of a hyaluronic thread. The device can include a tubular member and a handle. The handle can include two or more components that each include apertures through which a needle can be placed. The handle can be manipulated to align or offset the apertures with respect to each other to modify a clearance through the apertures and selectively engage or disengage the needle or thread.

Abstract: A suturing device of the present invention is in the form a compact, light-weight handheld device that includes a needle and suture assembly, a mechanism for gripping and releasing the needle/suture (a “needle transfer mechanism” or “needle shuttle mechanism”), safely capturing the needle/suture upon exit from the patient's tissue, and returning the needle to a position such that the process of delivering additional sutures to the patient can be repeated. A safety shield mechanism ensures the user is protected from the needle at all times. The device of the present invention accommodates the right or left-handed user, rests comfortably in the user's hand, allows sufficient visualization of the procedure site, and permits the user to either control penetration depth of the needle or default to a device-determined depth. The present device permits the user to utilize a wrist-rotation (pivoting) suture delivery technique.

Abstract: To arrange surgical end effectors used in minimally invasive surgery, the disclosure provides an instrument holder which can be arranged inside the body of the patient. An instrument holder of this kind has a base part having multiple receptacles. The volume of the base part can be varied for the purpose of inserting the base part into the human body, and removing it therefrom, by way of a trocar. A method is also provided for arranging an instrument holder for surgical end effectors used in minimally invasive surgery inside the patient body.

Abstract: A medical device insertion system, and a method of using the system, to mate trocars inside a patient during a medical procedure, the system including a first trocar having a first end to insert into a patient, and a second end at which a first user control is provided, and a second trocar having a first end to insert into a patient, and a second end at which a second user control is provided, wherein the respective first ends of the first and second trocars are formed so as to mate to one another inside the patient to form a continuous path between the respective second ends.

Abstract: A suture device comprises a shaft and a needle which creates a curved pathway for delivery of a suture. The curved needle is rotatably movable from a retracted to an extended configuration. The suture is housed in a feed channel within the shaft. The shaft also houses a suture receiving channel with an open distal end. A suture cutter is located adjacent to the suture feed channel distal end for cutting the suture, when required. The device also comprises a rotatable twisting element having a rotating shaft and a pair of radially extending arms, having through suture-receiving through holes. A heating rod in the form of a heating element is also provided to heat meld a twist when formed in the suture.

Abstract: Injection devices are provided which include a handpiece capable of housing a cartridge containing an injectable composition, and a head coupled to the handpiece and housing a plurality of retractable needles and a dosing mechanism. Methods of treating skin surfaces are also provided.

Abstract: Described herein are tissue repair implants comprising at least a first layer of peritoneal membrane. The first layer of peritoneal membrane can be located adjacent to a second layer of peritoneal membrane and can be in direct contact with the second layer of peritoneal membrane. Additional layers (e.g., a third or fourth layer) can be included. Where more than one layer is present, the layers can be affixed to one another. For example, a first layer of peritoneal membrane can be attached to the second layer of peritoneal membrane by an adhesive bond, suture, or staple. One or more of the peritoneal membranes can be non-crosslinked, partially crosslinked, or substantially fully crosslinked. Any of the layers of peritoneal membrane may be attached to a wall (e.g., an interior or exterior wall) of an abdominal tissue by an adhesive, suture, and/or staples.

Abstract: Bronchus sealants and methods of sealing bronchial tubes are provided. In general, the bronchus sealants and methods of sealing bronchial tubes can facilitate sealing of stapled bronchial tubes. In some embodiments, a reinforcement material can be introduced into a bronchial tube, and then the bronchial tube and the reinforcement material can be stapled using a surgical stapler. A sealant can be introduced into the bronchial tube and can harden therein, thereby helping to seal the bronchial tube where the bronchial tube was stapled. The sealant can be introduced into the bronchial tube before and/or after the stapling of the bronchial tube and the reinforcement material.

Abstract: Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

Abstract: A suturing assembly including a first puncture element including a sharp distal end for puncturing tissue, a second puncture element including a sharp distal end for puncturing tissue, the distal ends of the first and second puncture elements being spaced from each other by a gap, and a spacer arranged for sliding distally and proximally on at least one of the first and second puncture elements.

Abstract: A wound closure device for positioning within a wound gap defined between at least two tissue segments has an effect of drawing the at least two tissue segments to a state of proximity that closes the wound gap. The wound closure device includes a tubular collapsible member having an expanded configuration and a collapsed configuration. The wound closure device further includes tissue engaging structure for attaching the tissue segments to the tubular collapsible member.

Abstract: An active annuloplasty ring holder having a template that can be folded or pivoted to the side allowing the template to align longitudinally with the handle and enter the patient's chest through a small incision. The holder may include a mechanism to remotely detach sutures fastening the ring to the holder, thereby detaching the ring while avoiding the risk associated with introducing a scalpel into the operating field. A detachment mechanism may include a movable pin actuated by a pull wire that releases a plurality of holding sutures, or a hot wire, knives, or pull wire that severs the sutures. The holder may have a built-in light source for better visualization of the ring inside the heart. The holder may also have an optical means of visualizing the inside of the heart from the proximal end of the handle.

Abstract: A suture bridge to accommodate many common types of sutures, including a first leg and a second leg, where first leg and second leg include a patient contacting surface configured to contact a patient's skin. A first support connects to the first leg and second support connects to the second leg. A traversing member connects to the first support and the second support, and the first support and the second support elevate the traversing member away from the patient contacting surfaces of the first leg and the second leg creating a wound eversion void below the traversing member. This forms a wound eversion void which is a void configured to accept an everting wound. In some examples, the suture bridge includes notches on the first leg and the second leg to accommodate more types of sutures.

Abstract: A suturer may include a base mechanism. The base mechanism may include a first arm having a first driving member. The base mechanism may include a second arm having a second driving member. The suturer may be configured to selectively pass a needle from an enclosed position within the first arm to an enclosed position within the second arm.

Abstract: A method of fixating an implantable material in a patient includes forming an incision in the patient. The method includes inserting an anchor into a bore of a cannula, with the anchor attached to a support by a suture that is looped through an eyelet of the anchor and engaged through the support. The method includes inserting the cannula into the incision and along a cannula path into soft tissue, and ejecting the anchor out of the bore of the cannula and into the soft tissue. The suture is pulled in a direction away from the patient, moving the anchor to position a length of the anchor transverse to the cannula path. The method includes tying a knot in the suture, driving the knot against the support, and fixating the support in the patient.

Abstract: A multiple-firing crimp device comprises crimps, a shaft, a crimp movement assembly, and a snare. Each crimp has an internal hollow. The shaft has a distal crimping location, an exterior surface, and an interior with the clips stacked therein, the crimps moving therein along a longitudinal axis. The shaft defines a lateral opening proximal to the crimping location and communicates the interior to the environment outside the exterior surface. The crimp movement assembly within the shaft delivers the first crimp to the distal crimping location by moving the first crimp longitudinally from a first proximal position into the distal crimping location and returning to a second proximal position without the first crimp. The snare pulls at least one cord from distal of the first crimp through the first crimp and through a portion of the shaft and out the side of the shaft through the lateral opening.

Abstract: A handle assembly for operating a surgical instrument is provided and includes a housing; a trigger operatively supported on the housing; and an articulation assembly supported on the housing for effectuating an articulation of an end effector operatively connected to the housing, the articulation assembly being operable to effect articulation of the end effector in a first pair of opposed directions and a second pair of opposed direction which is substantially transverse to the first pair of opposed directions.

Abstract: A stent delivery system includes a wire collection device which is constructed with a thumbwheel coupled to a collection spindle that is rotatable to collect a retraction wire about a varying collection diameter of the collection spindle. A proximal end of an outer stent-constraining sheath is coupled to the collection spindle by the retraction wire and a distal end of the outer sheath retractably surrounds a distally-disposed self-expanding stent. The collection spindle includes a substantially constant outer diameter greater than the varying collection diameter, and the varying collection diameter increases from a first end of the spindle towards a second end of the spindle along a spiral groove formed between the varying collection diameter and the substantially constant outer diameter in a manner that provides substantially constant rotating force on the thumbwheel, thereby accommodating changing resistance as the outer sheath is retracted and releases binding force of the stent.

Abstract: Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.

Abstract: In a method of manufacturing a surgical implant, a flexible areal basic structure having a first face and a second face is provided. At least one linear marking thread is placed, in a floating manner, onto one of the faces of the basic structure and mechanically fixed (e.g. by stitching) to the basic structure at a first location and at a second location which are spaced from each other. Thereafter, the linear marking thread is thermally fixed to the basic structure in an area between the first location and the second location by a melt-fusing process.

Abstract: A treatment catheter system for treatment of a heart valve includes a circumferential valve tissue structure and an elongate catheter member, and has an inner lumen, proximal and distal end portions. The system includes a catching component which can be positioned at the distal end portion of the catheter member to be non-separable from the catheter member. An outer member extends circumferentially around the catheter member. The circumferential valve tissue structure is correspondingly arranged between the catheter member and the outer member. A catching mechanism reduces a radial distance between the catheter member and the outer member to catch the valve tissue between the outer member and the catheter member via a catching opening to immobilize and treat the caught valve tissue on the distal end portion of the catheter member.

Abstract: A medical cutting instrument for cutting muscles and tendons, having a shaft on whose distal end a tool is mounted consisting of two jaw members, such that one jaw member can be moved with respect to the other jaw member, and on whose proximal end a handle is mounted, such that the movable jaw member and the handle operatively interact by way of an actuation element, in such a way that the movable jaw member can be shifted by actuating the handle between a closed position and an opened position. The other jaw member is U-shaped such that the two parallel legs of the U are disposed diagonally to the instrument longitudinal axis and the opening of the U points toward one side of the other jaw member, so that the other jaw member can be pushed from the side onto the muscle/tendon tissue that is to be severed.

Abstract: A system for treating a diverticulum in a body lumen includes a tubular member including a lumen and an elongate member in an elongated state within the lumen of the tubular member. The elongate member is configured to form a coiled state when removed from the tubular member.

Abstract: A telescopic wire guide is disclosed. The telescopic wire guide comprises an outer wire having a proximal end and a distal end. The outer wire has a lumen formed from the proximal end through the distal end. The telescopic wire guide further comprises a core wire disposed within the lumen and slidably movable therealong relative to the outer wire for distally telescopically extending the wire guide a predetermined length.

Abstract: A wound dressing for use in the application of negative pressure to a wound, comprising a support member and a cover member positionable over the wound in use. The support member can have a first support element having a first portion aligned with a first axis and a body portion coupled with and extending away from the first portion, and a second support element having a first portion aligned with the first axis and a body portion coupled with and extending away from the first portion of the second support element. At least the body portion of each of the first support element and the second support element can be independently rotatable about the first axis. The support member can support at least a middle portion of the cover member above a surface of the wound so as to define a space between the wound cover and the wound.

Abstract: A system for closing an aperture in a biological tissue includes at least one clip connected to at least one frame arm and for releasably retaining a surgical implant to the frame arm. The clip includes at least one locking structure for engaging a lock bar. A portion of the lock bar selectively engages or contacts the locking structure of the at least one clip to lock the at least one clip in a closed position by inhibiting rotation of the at least one clip when the lock bar is in a locked position. The lock bar allows the at least one clip to rotate to an open position when the lock bar is in an unlocked position. Methods for utilizing the system are also disclosed.

Abstract: Disclosed is an apparatus and method for facilitating the implantation and secure positioning of implantable medical devices within a subcutaneous pocket formed by a surgeon within the patient. Such apparatus and method are configured to address the above-described challenges of containing implantable medical devices within such subcutaneous pockets, and the spring-like leads or catheters that may be attached to them, during implantation.

Abstract: This invention is an advanced tissue gripping forceps with novel design of forcep's jaw best suitable for medical surgery. The novel tissue holding forceps has first and second arms with two ends each i.e Head and rear end; and jaws at the heads of each arms of the forceps. The rear ends of two arms of the forceps are coupled together. The second ends, the head of the First and Second arms of the forceps form opposing First and second jaws which are resiliently biased apart. The First and second jaws each include a plurality of sharp, directly opposing sharp elongated teeth to grip the tissue firmly during the use. The both jaws has a deep “CUT” in the center which makes jaw as “U” shape. This novel design enable fast and easy surgical operations by reducing the time of operation by facilitating the stitching and other surgical operations.

Abstract: An anvil-attachable layer and a retainer for aligning and attaching the layer to an anvil of a surgical stapler. Embodiments of the anvil-attachable layer can include one or more attachment features extending from the layer. A retainer can push the attachment features into a knife slot in the anvil so that the fit between the attachment features and the slot hold the anvil-attachable layer in place. Other embodiments of the anvil-attachable layer can include deployable attachment features formed in the layer. The deployable attachment features can be deployed from an undeployed position substantially in a plane defined by the layer to a deployed position extending out of the plane. In the deployed position, the deployable attachment features can extend into a slot in an anvil. A retainer can include features to push the deployable attachment features into the deployed position.

Abstract: One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising: a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein the proximal end of the suture member extends proximally beyond the deployed suture pattern into a local suture length storage reservoir coupled to the delivery member, the reservoir containing an additional length of suture and being configured such that upon rotation of the delivery member in the first direction, the anchor member pulls along the distal portion of the suture member c

Abstract: A laparoscopic port closure device is described. The device allows for the deployment of a suture internally into an abdominal wall and the subsequent use of that deployed suture to effect a closing of the wound that was used for the port. The deployed suture may be used during the surgical procedure to effect a securing or anchoring of the device.

Abstract: A system and method for passing an end portion of a needle system from a body cavity to an outer environment through a laparoscopic port is provided. The system comprises a seal bridge which comprises an elongated body. The seal bridge is telescopically introducible at a first proximal end, through a first lumen in the port and bypassing a seal mechanism of the laparoscopic port. The seal bridge is adapted to be inserted through the proximal opening port to be deployed in the lumen of the port and thereby bridging across and/or deactivating the seal of the port. The method comprises positioning a distal portion of a needle shaft from within the body cavity into the port lumen and across the seal opened by the seal bridge.

Abstract: A surgical instrument includes a handle assembly, an elongate body, a tool assembly, and an electrical energy source. The handle assembly includes an actuation knob. The elongate body extends distally from the handle assembly and defines a longitudinal axis. In particular, tool assembly is operatively coupled to the handle assembly and extends from a distal end of the elongate body. The tool assembly includes first and second jaw members each including an electrically conductive cutting element. The cutting elements are operatively coupled to the actuation knob. In particular, the cutting elements are movable between a first position in which the cutting elements are disposed within the respective jaw members and a second position in which the cutting elements extend out of the respective jaw members and are in general vertical registration with each other such that electrical energy can be transferred from the first jaw member to the second jaw member.

Abstract: A method for elongating a tendon including by moving a cutting blade along the tendon in a helical path so as to make a helical cut in the tendon which allows elongation of the tendon.

Abstract: A medical device and a method for manipulating a tissue. The medical device includes two or more bars, a snare loop and a constricting element. Each bar includes a proximal end, and one or more distal ends, such that the bars are in close proximity at the proximal end. The snare loop maybe coupled to the distal ends of the bars. The constricting element maybe movably coupled to the bars, such that the constricting element expands the snare loop when positioned at the proximal end of the plurality of bars while the constricting element collapses the snare loop when positioned at the distal end of the plurality of bars, thus, keeping the distal end of the snare loop stationary with respect to the tissue.

Abstract: A combination medical includes a first arm and a second arm interconnected to the first arm. The first arm and the second arm are biased towards each other by a closing force. A biasing member is disposed between the first arm and the second arm. The biasing member has a first position that biases the first arm and the second arm away from each other against the closing force and a second position that does not oppose the closing force. The combination medical device may be an electrosurgical device with a mono-polar and bi-polar configuration.

Abstract: A prosthetic heart valve reinforcement ring is disclosed. The prosthetic includes an outer ring sized and dimensioned to fit around an annulus of a heart valve and an inner ring configured and arranged to couple to the outer ring. The inner ring and the outer ring have complimentary mating formations configured and arranged to grip sutures therebetween. A method of reinforcing heart valve is also disclosed. Sutures are provided around an annulus of a heart valve. The sutures are corralled within an outer sizing ring. The outer sizing ring is placed around the annulus of the heart valve. An inner sizing ring is inserted within the outer ring, locking the sutures. The sutures are adjusted and the heart valve is tested for a proper fit. The outer sizing ring is removed and a prosthetic ring is placed over the inner sizing ring, locking the sutures. The sutures are tied.

Abstract: Embodiments are described for creating and closing tissue access ports or defects, such as transapical access ports, which involve placement of an elongate prosthesis in a helical configuration across the tissue structure site to be crossed, and confirmation that such helical suture configuration is positioned appropriately, before further interventional steps. A plug member may be included to assist with closure of the ports of defects. The elongate prosthesis and plug member may comprise bioresorbable materials.

Abstract: Embodiments of the present disclosure relate to apparatuses, systems, and methods for safely delivering and deploying an intravascular device. An apparatus for controlling an intravascular device may include a body having rotating assembly disposed through the body. The rotating assembly may be configured to hold a proximal end of an elongate mandrel. The rotating assembly may be rotationally connected to the body by a one-way bearing.

Abstract: A surgical buttress for use in a surgical stapling apparatus is provided and includes an elongate rectangular body portion defining a width; a neck portion integrally formed with and extending from a distal end of the body portion, the neck portion defining a width; a head portion integrally formed with and connected to a distal end of the neck portion, the head portion defining a width; and a tail portion integrally formed with and extending from a proximal end of the body portion, the tail portion defining a width. The width of the tail portion is less than the width of the body portion.

Abstract: A target needle assembly can include a needle having a sharp tip, a cannula configured to receive the needle, and an outer sheath. The outer sheath is configured to receive the cannula. The target needle assembly includes a depth stop mechanism, and the outer sheath is configured to limit or inhibit further advancement of the needle into the bone once the needle has been advanced the desired distance to a target location.

Abstract: In one embodiment, a medical device includes an elongate member, a fixation device and a driving member. The elongate member defines a lumen and includes a proximal end and a distal end. The distal end of the elongate member has an opening. The fixation device is at least partially disposed within the elongate member and includes a tissue piercing portion at a distal end of the fixation device. The driving member is at least partially disposed within the elongate member and is configured to move the fixation device from a position within the lumen to a location outside of the lumen through the opening. The opening at the distal end of the elongate member is angled to insert the fixation device in a tissue of a patient at an angle to a plane of the tissue of the patient to fasten a bodily implant to the tissue.

Abstract: A laparoscopic wound closure device includes an elongated body portion including a proximal end, a distal end, and a pair of vertical suture channels. Each vertical suture channel has an entrance at the proximal end and an exit near the distal end for passing a suture needle through, and travels parallel to the longitudinal axis of the body portion of the device. The vertical suture channels are designed to cause a suture needle to deflect laterally as it exits the wound closure device. The wound closure device can be an obturator or a sheath of a trocar assembly, and can be used to inject local anesthetic at the conclusion of surgery.