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: 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: 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: 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: 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: 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: 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: 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 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: 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.

Abstract: Described here are closure devices and methods for ligating tissue, such as the left atrial appendage. The closure devices may comprise a snare loop assembly comprising a snare and a suture loop releasably attached thereto. The snare may be releasable from an elongate body of the closure device. In some instances, the closure device may comprise one or more markers to allow a user to determine whether the snare loop assembly is twisted.

Abstract: Suture clip deployment devices for applying suture clips to sutures are described. Some embodiments can include a generally tubular main body and a vacuum port located at the distal end, a hollow inner body longitudinally slidable within the main body and extending from the main body at its distal end, and a suture recess located in the generally tubular main body. At least one suture clip configured to frictionally fit on an outer surface of the inner body is deployed during use. Clip deployment can occur after a vacuum source is applied to the device so as to draw the suture into the device. The suture lines can be retrieved through the suture recess, and the device can be actuated so as to deliver the suture clip off the delivery device and onto the suture, locking the suture in place.

Abstract: A tool for feeding a fishing line through the eyelets of a fishing rod has a loop of filament attached to an elongated guide and twisted across itself at a distal overlap to form a figure-eight with proximal and distal portions wider and narrower, respectively, than the eyelets. The wider portion facilitates insertion of a free end of the line into the loop. The loop is resiliently flexible so that the overlap separates and then recovers as the inserted line is passed transversely through the gap into the narrower portion of the figure-eight. The passed line is then transversely wedged in the narrower portion of the figure-eight. The loop is also resiliently flexible so that, as the guide leads the loop and the line through each eyelet, the wider portion of the loop compresses and then expands, inhibiting inadvertent withdrawal of the tool from an eyelet.

Abstract: Suturing techniques and sutures capable of reducing the incidence of incisional herniae, including but not limited to subcutaneous surgical sutures performed after laparotomy. Such a suture includes a circular suture having at least first portions that are within a first region of tissue of a suture area that further contains rows of puncture sites aligned approximately parallel to an incision on opposite sides of the incision. The first region of tissue is located between the rows of puncture sites and surrounds the incision, and the first portions of the circular suture extend along the rows of puncture sites. The suture further includes a continuous suture in the suture area that penetrates the puncture sites and traverses the incision. The circular suture disperses stresses induced by tension in the continuous suture to inhibit tearing of tissue at the puncture sites.

Abstract: A suture passer includes a handle assembly, a shaft extending distally from the handle assembly, an end effector assembly coupled to a distal end portion of the shaft, and an overstroke assembly. The overstroke assembly effects an opening and a closing of the end effector assembly while also preventing an overstroke of the handle assembly from damaging components of the suture passer.

Abstract: A rack and an apparatus for suture management are disclosed. The apparatus for suture management includes one or more racks, each rack including a plurality of cassette locations, each cassette location having an inside suture holder, an outside suture holder, and a cassette receiver. The apparatus for suture management also includes a plurality of suture grooves. The apparatus for suture management further includes a plurality of rack connection points. The apparatus for suture management also includes an attachment feature which may accept another surgical tool or mounting adapter.

Abstract: A suture-securing device includes a first tubular element, shaped to define a first lumen therethrough, and having first and second ends; and a second tubular element, shaped to define a second lumen therethrough, and having first and second ends. The suture-securing device is configured to have (a) an unlocked configuration in which the first end of the second tubular element is disposed closer to the first end of first tubular element than is the second end of the second tubular element, and the sutures are disposable within and slidable through the first and second lumens, and (b) a locking configuration in which the second end of the second tubular element is disposed closer to the first end of first tubular element than is the first end of the second tubular element, and the sutures are inhibited from sliding through the first and second lumens. Other embodiments are also described.

Abstract: The present disclosure relates to the technical field of medical equipment and discloses an anastomotic/occlusion reinforcing and repairing composite member which includes a reinforcing and repairing portion, a protection portion and a connecting thread, wherein two ends of the reinforcing and repairing portion are detachably connected by the connecting thread; and the protection portion penetrates into a space enclosed by the two ends of the reinforcing and repairing portion. The present disclosure also provides a preparation and application method of the anastomotic/occlusion reinforcing and repairing composite member.

Abstract: Methods and devices are disclosed that enable safe, rapid and relatively short and straight access to the cerebral arteries for the introduction of interventional devices to treat acute ischemic stroke. In addition, the disclosed methods and devices provide means to securely close the access site to the cerebral arteries to avoid the potentially devastating consequences of a transcervical hematoma.

Abstract: A reduction and fixation tool has two principle component parts—an intra-articular spoon with a blade, and a handle that docks with the spoon. The spoon has a proximal hub onto which the handle docks. In one example of the tool as it would be used with a fractured scaphoid, the spoon has a distal blade, curved and narrow to slip beneath the undersurface of the scaphoid and to lift the distal fragment of the bone back into proper alignment (fracture reduction). The handle, docked to the spoon, serves as a lever to easily accomplish the reduction, and as a guide for the central insertion of a guide wire into the scaphoid across the fracture site.

Abstract: A method of percutaneously creating a fistula includes inserting percutaneously a medical instrument to a target location having a first blood vessel and a second blood vessel. A fastener is then deployed via the medical instrument to the target location. The fastener is in a first configuration before the deploying and a second configuration after the deploying. The fastener limits relative movement between the first blood vessel and the second blood vessel when in the second configuration. An anastomosis between the first blood vessel and the second blood vessel is percutaneously produced.