Abstract: The present invention is directed to a method of securing suture within a patient. The method comprises advancing suture material into the patient, passing a portion of the suture material through tissue of the patient, and advancing a fastener catheter and a suture fastener along the suture material. The fastener catheter includes a catheter main body and a handle. The suture fastener has a generally cylindrical body formed of a shape memory material and a suture fastener inner lumen. The suture fastener has at least one engagement tab biased to extend at least partially into the suture fastener inner lumen to engage against and secure one or more lines of suture passing through the suture fastener.

Abstract: The present invention relates to a surgical device and a medical needle module having an indication function. According to one aspect of the present invention, the medical needle module comprises a medical needle, a light channel unit, and a light radiation unit, wherein the light channel unit provides a light channel for allowing light from the light radiation unit to indicate a position in which the medical needle is to be used.

Abstract: Methods for repairing a meniscus, and particularly a torn meniscus. A method of repairing a meniscus may include using a suture passer to pass a suturing element from the region between the superior surface of the meniscus and the femoral condyle, through the meniscus tissue, into the region between the inferior surface of the meniscus and the tibial plateau, across the inferior surface of the meniscus, and back to the superior surface of the meniscus, without deeply penetrating the posterior capsular region of the knee. Equivalently, the suture element may be passed from the inferior surface of the meniscus to the superior surface and back to the inferior surface.

Abstract: A medical device includes a main body elongated in a vertical direction. A guide section protrudes from a lower end of the main body in a direction crossing the vertical direction and includes first and second guide holes. A first unit includes a first puncture needle slidably supported by the main body near an upper end of the first puncture needle in the vertical direction and having a sharp lower end slidably inserted into the first guide hole from above. The first unit has a first holding plate integrally fixed to the first puncture needle. A second unit includes a second puncture needle slidably inserted into the second guide hole from above and a second holding plate integrally fixed to the second puncture needle. The second holding plate separably abuts on the first holding plate from above. A position of the second guide hole is selectable along the guide section.

Abstract: Apparatus for attaching a prosthetic tether between a leaflet of a patient's heart valve and another portion of the patient's heart to help prevent prolapse of the leaflet and/or to otherwise improve leaflet function. The apparatus can be used with relatively low invasiveness of the patient's body. The apparatus releasably clamps the leaflet during attachment of the tether to the leaflet. The apparatus may include an integrated display for indicating how extensively the leaflet is being clamped. The apparatus may include structure for stabilizing the leaflet for better clamping. The apparatus may enter the heart through an aperture in the wall of the heart, and may include structure for helping to reduce blood leakage from that aperture. The apparatus may be able to enter the heart by following a guide wire. The apparatus may include various means for attaching the tether to the leaflet.

Abstract: A device for tensioning suture which includes a cannulated tube that allows a suture to be fed through at least a portion of the tube. An adjustment device (for example, a wheel or a knob) is actuated to turn a threaded post on the end of the tube. A length of suture passes through at least a portion of the cannulated tube and is secured into a forked pin attached to the adjustment device. Turning the adjustment device draws against the suture, increasing therefore the tension on the suture. The suture tensioning device may be employed in conjunction with a tensiometer.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: A device for peroperative preparation of an implantable patch with suturing according to embodiments of the present invention includes a first element having one or more first through-openings configured to receive a suture, a second element movable with respect to the first element, the second element including one or more second through-openings configured to receive the suture, and a mechanism configured to position the first and second elements with respect to each other in a closed configuration in which at least one of the one or more first through-openings is aligned with at least one of the one or more second through-openings and in which the first and second elements are close enough together to hold the implantable patch between the first and second elements.

Abstract: A surgical needle which is particularly suited for use in limited space applications and a method for its use are disclosed. The surgical needle generally includes an arcuate portion having a first end and a second end. A pointed tip is disposed near the first end. There is a relatively short, straight shank near the second end of the arcuate portion which extends from the arcuate portion at a predetermined angle. The predetermined angle is defined by the intersection of the arcuate portion and the shank. This predetermined angle is within a range of about 23° to about 29°. In a particularly useful embodiment, the predetermined angle is approximately 26°. Further, an extrapolation of a longitudinal axis of the shank intersects the arcuate portion of the surgical needle.

Abstract: An endoscopic stitching device is provided including a handle assembly supporting a manually operated suture needle loading assembly; a tool assembly operatively supported on and connected to the handle assembly; a suture needle operatively associated with the tool assembly, wherein the tool assembly includes a pair of juxtaposed jaws pivotally associated with one another; and an actuation cable extending between the handle assembly and the tool assembly, wherein axial displacement of the actuation shaft results in opening and closing of the jaws and rotation of the actuation cable results in selective retention of the suture needle in the jaws. A proximal end of the actuation cable is connected to the suture needle loading assembly such that actuation of the suture needle loading assembly imparts rotation to the actuation cable to selectively engage the suture needle in one of the jaws.

Abstract: The present invention provides a suturing device for internally forming a knot in a suture within a body cavity, during surgeries, wherein said device comprising a flexible pre-shaped helical lumen having two opposite ends, said lumen comprising n loops; n is a real number higher than or equal to 1; said helical lumen is adapted to accommodate at least a portion of said suture, such that said knot is obtained by threading by at least one end of said suture through at least one of said loops.

Abstract: A device for use with a trocar in suturing trocar wounds with flexible needles. The device includes a ring encompassing the trocar positionable adjacent to a body wall. The ring, often a split ring, has a pair of guide channels passing through it, each channel including an entry hole and an exit hole. These guide holes are disposed symmetrically on the ring such that the two entry holes and the two exit holes form lines passing through the longitudinal axis of the trocar. The channels are curved near their respective entry holes. The guide channels are angled in the region of the exit holes so that when the needles exit the channels into the body wall and then the body cavity they are at a predetermined distance from the nearest point on the trocar. The above described device forms a suturing system with the trocar.

Abstract: Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue.

Abstract: An implement for manipulating a knotted suture during a surgical procedure, includes an elongated shaft having a proximal end engageable by the user for manipulating the instrument, and a distal end engageable with the knotted suture to be manipulated. The distal end of the elongated shaft has an end face formed with a recess for receiving the knot of the suture. The distal end of the elongated shaft is formed with an open slot starting from a location spaced from the end face and leading to the recess in the end face, such as to enable the knotted suture to be introduced into the slot and the recess by effecting a sidewise movement. The implement further includes a tubular cutter member enclosing the elongated shaft and formed with an annular cutting edge engageable with a suture in the open slot of the shaft upon movement of the elongated shaft with respect to the tubular cutter member, or by vice-versa.

Abstract: A member of a rigid flexible elastic material, the member including a body portion and an aperture portion with the member adapted for delivery through an axial longitudinal channel of a percutaneous delivery subsystem, the aperture portion including an expanded mode having a lateral dimension greater than an inner diameter of the channel when the aperture portion extends outside the channel and a collapsed mode wherein the lateral dimension is not greater than the inner diameter of the channel when the aperture portion is within the channel, the channel including a first axial opening and a second axial opening with the aperture portion transitioning from the expanded mode to the collapsed mode when inserted into the openings and the aperture transitioning from the collapsed mode to the expanded mode when exiting from the openings.

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

Abstract: A method for passing suture through tissue and a suture passing instrument having a first jaw coupled to an end of an elongated shaft, a second jaw coupled to the first jaw, and formed with a holder for supporting a suture, and a needle slidably disposed within the first jaw, having a hook on a side for releasably capturing a portion of a suture, is provided. The first jaw defines a channel for receiving the needle and a ramp for deflecting the needle transversely of the shaft when advanced to an extended position.

Abstract: A medical instrument for grasping surgical suture material, with a shaft on whose proximal end a handle is positioned consisting of at least two gripping members and on whose distal end a tool is positioned consisting of a rigid jaw member and a pivotable jaw member and where the pivotable jaw member can be pivoted with respect to the rigid jaw member for opening and closing with a moveably configured gripping member of the handle, for which purpose the pivotable jaw member and the moveable gripping member are in active connection with one another by means of an actuating element mounted in the shaft. To create a medical instrument that is both easy to operate and makes possible a safe grasping and guiding of the suture material, it is disclosed that in the rigid jaw member there should be configured an indentation that opens toward the pivotable jaw member and that can be covered, with the tool in closed position, only in the center area by the pivotable jaw member.

Abstract: The Ergonomic Surgical Instrument Handle described herein is designed to efficiently grasp, maneuver and clamp tissues, objects and vessels within the surgical site. Surgical Instruments with the improved handle are ergonomically designed to be in line with the surgeon's wrist and hand as they relate to the surgical site. This novel design makes it easier to maneuver the instrument within the surgical site without awkward angles to the wrist and hand which reduces muscle fatigue and cramping.

Abstract: A medical device is provided comprising a suture thread coated with a stiffening agent and having a shape of a coil having a plurality of windings. The suture thread may be used to reconnect soft tissue to bone tissue. The suture thread may be used in conjunction with a suture sheath which is inhibited from movement relative to the suture thread.

Abstract: A suture includes an elongate body and a filler material. The elongate body includes a distal end having first and second overlapping sections forming a loop. The filler material is disposed within at least a portion of a seam defined between the first and second overlapping sections of the elongate body to reinforce the first and second overlapping sections. A method of forming a reinforced looped suture includes providing a suture including an elongate body including a distal end having first and second overlapping sections defining a loop, and applying a filler material to a seam defined between the first and second overlapping sections.

Abstract: Vessel wound closure systems and method for sealing a puncture wound in a target vessel, such as those puncture wounds that occur from prior interventional procedures. A sealing member is deployed intravascularly into the target vessel, and an anchor member is deployed extravascularly of the target vessel. The sealing member and the anchor member are connected by a suture that may be drawn to tighten the sealing member and the anchor member relative to one another in order to effect the seal of the puncture wound. After tightening, the suture is secured to maintain the sealing member and the anchor member relative to one another in order to maintain the seal. Preferably, the anchor member, the suture and the sealing member are comprised of biocompatible, bioresorbable materials that are absorbed into the body after the sealing of the puncture wound has been achieved.

Abstract: Methods and devices are provided for deploying and applying multiple suture anchors. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body, e.g., through a scoping device, and to deliver a plurality of suture anchors, each having a suture attached thereto, into tissue, preferably without the need to remove the shaft from the body. The shaft can be configured to penetrate tissue and to deploy one or more of the suture anchors through the tissue such that the sutures extending from the deployed suture anchors extend through the tissue to allow the anchors to engage the tissue. The surgical device can also include a knotting mechanism configured to secure the sutures attached to the deployed anchors, thereby securing the anchors to the tissue.

Abstract: Apparatus and methods are provided, including a plurality of anchoring elements, each of the anchoring elements being an elongate element that is curved to define an opening. A housing holds each of the anchoring elements. A mandrel is reversibly disposable through the openings defined by the anchoring elements. The anchoring elements are configured such that, in response to removal of the mandrel from the openings, ends of the anchoring elements automatically move outwardly, and diameters of the openings decrease, due to elastic loading of the anchoring elements. Other embodiments are also described.

Abstract: A surgical instrument, e.g. forceps, and method to be used for suturing tissue are provided, the surgical instrument comprising a first arm and a second arm that are spring-connected at a proximal end, while at a distal end the first arm and the second arm can be moved towards each other, and wherein at least the first arm and/or the second arm can be provided with a bullet that is suitable for receiving and affixing a surgical needle, wherein the bullet is designed for being positioned at the distal end, at an inside and/or lower side of the end of an arm.

Abstract: Suturing instruments in accordance with the invention are dimensioned and configured to apply sutures to approximate; ligate, or fixate tissue in, for example, open; mini-incision, trans-vaginal, laparoscopic, or endoscopic surgical procedures. In some embodiments, the suturing instruments include a distal portion that is deflectably and/or pivotally coupled to the remainder of the instrument for improved maneuverability and functionality during surgery. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies and/or reloading the needle and suture assembly without removing the instrument from the surgical site.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot of the device can be inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot can carry suturing attachment cuffs with one end of the cuff adapted to receive a needle, while the other end receives suture. A portion of the foot and/or lumen of the shaft can receive a portion of the suture and can include friction reducing structure that aid with movement of the sutured during removal of the cuffs from within the penetration.

Abstract: A tissue fastening device includes a suture clip holder and a suture cutter. A suture clip can be releasably secured to the suture clip holder, and a suture line or lines can pass through the clip and adjacent the suture cutter. A first movement of a control handle causes the suture clip to be released from the suture clip holder, and a second movement of the control handle causes the suture cutter to cut the suture line or lines. The first movement is different from the second movement. The first movement can be rotational, with the second movement being longitudinal. Alternatively, the first movement can be longitudinal, with the second movement being rotational. The device may include a main body, an inner body, and an outer body.

Abstract: The invention relates to a suture manipulation device. The suture manipulation device includes a body and a snare. The snare is operatively connected to the body and is adapted to protract from the body, and after protracting from the body, rotate independent of the body. The snare is further adapted to ensnare a portion of suture passed through tissue while rotating, and secure the portion of the suture.

Abstract: Provided is a suture apparatus for selecting an appropriate suture from among various sutures and supplying the selected suture. In accordance with one aspect of the present invention, there is provided a suture apparatus including: a suture keeping unit for keeping at least two types of sutures, and a suture supply unit for selectively supplying at least one of the at least two types of sutures.

Abstract: A modification to a standard needle driver in the form of a deployable and retractable projection at the working end of the needle driver with which the operator can control the suture in order to facilitate tying a knot in the suture. This modification solves the difficult problem of controlling the suture during the rate-limiting step of knot tying allowing for faster, easier knot tying in laparoscopic and single port surgery.

Abstract: A surgical knot setter includes an elongated shaft having a long axis and proximal and distal portions. A tip is provided at the distal end of the shaft. The tip has a loop with an interior loop opening and a gate opening for permitting ingress and egress of a suture into the loop opening. The loop is laterally offset from the long axis and distal to the distal end of the shaft, such that the loop is laterally and longitudinally offset from the distal end of the shaft. A closure is provided for selectively opening and closing the gate opening between open and closed positions to selectively permit or prevent the suture from passing through the gate opening. An actuator moves the closure between the open and closed positions. A method for tying suture knots is also disclosed.

Abstract: An apparatus includes a carrier configured to be movably disposed within a channel defined by an elongate member. The carrier includes a proximal end portion and a distal end portion. The proximal end portion is configured to be coupled to an actuator. The distal end portion includes a protrusion and an engagement surface. The protrusion has a tip configured to bodily pierce tissue. The protrusion is configured to be received within a lumen defined by a connecting portion of an implant, such as, for example, a pelvic floor implant, such that the tip extends through the lumen defined by the connecting portion of the implant. The engagement surface is configured to engage a portion of the connecting portion of the implant to limit movement of the connecting portion of the implant relative to the protrusion.

Abstract: An apparatus includes a flexible fixation member having a body with a longitudinal extent and a width, the body defining a plurality of openings through the body, each of the plurality of openings formed substantially cross wise through the width of the body, and a suture having two terminal ends, the suture being interwoven through each of the plurality of openings in the body of the fixation member such that multiple portions of the fixation member are slidably coupled to the suture and configurable to form a cluster within a surgical site.

Abstract: A mitral cerclage annuloplasty apparatus comprises a tissue protective device and a knot delivery device. The tissue protective device comprises a first protective tube and a second protective tube. The knot delivery device comprises a tube wherein a loose knot is looped around its distal end through a hole and wherein tight knot is formed when the distal end of the tube is cut open. Alternatively, the knot delivery device comprises an inner tube and outer tube. The inner tube is insertable and rotatable inside the outer tube. When the tubes are in a closed position by rotating either the outer tube or the inner tube, a hole is created near its distal end. When the tubes are in open position by rotating either the outer tube or the inner tube, the hole joins the opening of the outer tube and lengthens.

Abstract: A suture instrument includes: a therapeutic insertion section having a suture section for suturing tissue; a cylindrical main operation unit; a rod section in the main operation unit, for discharging a suture thread and end section members connected to the suture thread; a pusher's distal end section for pressing the end section member; and a guide mechanism for rotating the rod section after linear movement of the pusher's distal end section at a position where one of the end section member is fed from a distal end of the suture section, the rod section being rotated in the circumferential direction to a position where the other one of the end section members is fed from the distal end of the suture section, so that each one of the end section members is discharged one after another and so that the end section members can be separated finally.

Abstract: The present invention is various systems for repairing tissue within the heart of a patient. The system of the present invention includes a guide catheter, a therapy catheter, and a fastener catheter. The therapy catheter and the fastener catheter are capable of traversing the internal lumen of the guide catheter. The fastener catheter is capable of introducing a suture clip to a desired position along suture line, deploying the suture clip to secure the suture and cutting excess suture. In addition, the present invention discloses various methods for repairing tissue.

Abstract: An endoscopic stitching device is provided including an end effector configured and adapted to perform at least a pair of functions; and a single actuation cable operatively connected to the end effector, wherein the actuation cable is capable of effecting operation of at least the pair of functions. The actuation cable is capable of effecting a first operation of the pair of functions upon an axial translation thereof, and a second operation of the pair of functions upon a rotation thereof.

Abstract: Medical devices for cutting and suturing biological tissue generally include a shaft and first and second guide members each including a first portion coupled to the shaft at a first location and a second portion coupled to the shaft at a second location. The first portions are movable along the shaft relative to the second portions, and the first and second guide members define an arcuate profile and are configured to flex in response to such movement. When used to cut tissue, the medical device may further include a blade positioned between the first and second guide members. When used to suture tissue, one or more suture guides may be provided on the first guide member for directing a suture needle through tissue proximate the first guide member. Methods of repairing and replacing a meniscus using the medical devices are also provided.

Abstract: In accordance with the present invention there is provided a suture trimmer, the suture trimmer including a shaft having a proximal end and a distal end and an axis therebetween, the shaft having a groove formed in the side thereof, the groove in communication with an opening formed in the side of the shaft, the opening disposed proximal the distal end. The suture trimmer further including a cutting member slidably disposed within the shaft, and a suture retainer slidably disposed within the shaft. Wherein the suture trimmer in accordance with the present invention may be additionally utilized to position knots formed within a suture loop prior to trimming the free end(s) of the suture loop.

Abstract: A system for securing a device in tissue, having a sheath having a plurality of side openings; a rotatable element disposed within the sheath; and a plurality of curved projections extending from the rotatable element, wherein rotation of the rotatable element within the sheath pushes distal ends of each of the curved projections outwardly through one of the plurality of openings and into the tissue.

Abstract: A hand instrument for retrieving suture and advancing a suture knot within a patient. The instrument has a shaft with proximal and distal ends. A hinged jaw in the form of a crabclaw disposed on the distal end of the shaft captures suture within a closed aperture formed by the jaws or is used to pinch the suture between the jaws. A hand mechanism disposed on the proximal end of the shaft opens and closes the jaw.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element has can have shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: Implantable electrical stimulation leads, lead anchors and suture sleeves, as well as methods of making and using the leads, lead anchors, suture sleeves and electrical stimulation systems are described. The lead anchors and suture sleeves present a number of strategies for anchoring a lead within tissue of a patient.

Abstract: Methods and systems for AC joint repair using a fixation device having a specific “dog bone” configuration in a minimally invasive approach. One AC fixation system is formed of dog bone shaped buttons and at least one suture tape used to secure the buttons during an AC joint repair. The buttons are provided with openings that allow the passage of suture/tape limbs. Another AC joint fixation system is formed of a metal button inserted over a fused/joined construct having multiple flexible strands. The fused/joined construct is formed of multiple independent and separate suture strands and/or suture tapes that are joined (fused together) at about the midpoint of the tapes and/or sutures, resulting in multiple independent limbs of suture/tape. A suture tape loop construct having an integrally formed eyelet at one end of the loop may also be used in the fixation systems.

Abstract: A suturing device and method allows a physician to remotely suture biological tissue. The device includes an elongate body, first and second arms operably connected to the elongated body, whereby each arm mounts an end portion of a suture, and first and second needles, each needle having a distal end and being mounted such that the distal end of the needle is movable to engage respective end portions of said suture. The suturing apparatus further includes an actuator which drives the needles to engage the suture. The suturing apparatus further includes an occluding device operably connected to the elongate body such that the occluding device may be advanced from the distal end of the elongate body to temporarily occlude the incision to be sutured.

Abstract: A knot placement device allows a physician to apply a knot for securing two or more suture ends extending from an incision in a vessel or organ of a patient relative to each other in order to seal an opening in the vessel or organ. The knot placement device has a handle and an elongate shaft and a push rod slidably inserted in said shaft. A knot is disposed in the distal end of the shaft. An actuator on the handle may be depressed to distally advance said push rod relative to said shaft and thereby distally advance said knot. The knot may include a knot body having an inner cavity and a plug sized to fit securely within the inner cavity. In use, the plug may be inserted into the inner cavity of the knot body to fixedly hold two or more suture ends between the knot body and the plug.

Abstract: A suture passer including a longitudinally-extending hollow cannula having a central passage slidingly receivable of a surgical suture; a manually graspable handle connected to the hollow cannula for manipulation thereof, the handle having an upper surface; first guide means, connected to the upper surface of the handle, proximate a distal end of the handle, for releasably, guidingly holding the surgical suture; and second guide means, connected to the upper surface of the handle, proximate to the first guide means, for releasably, guidingly holding the surgical suture. The suture passer can be provided in a kit, for use in the suturing of internal tissue, along with a cannula bender, various hollow surgical needles and surgical suture material. The suture passer finds particular use in the suturing of internal tissues which are at least partially accessible through a body cavity, e.g. arthroscopic surgery.