Abstract: Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture.

Abstract: Devices and methods for locking and/or cutting tethers during a tissue modification procedure are described. In some variations, a tether may be used to tighten tissue by bringing two pieces or sections of the tissue together. The tether, which may be under tension, may be locked to maintain the tension, and excess tether may be severed, using one or more of the devices and/or methods. The devices and/or methods may be used, for example, in minimally invasive procedures.

Abstract: The instant disclosure is directed to methods and devices for passing suture bi-directionally using a hybrid approach. Embodiments of a method described herein include steps of advancing a suture at least partially through tissue; and retrieving the suture; wherein one of the steps of advancing and retrieving comprises manipulating the suture directly, and wherein the other step of advancing and retrieving comprises manipulating a suture trap to which the suture is coupled.

Abstract: A suture loading assembly for threading suture material through a device comprises a body, an attaching member extending from the body for attaching the body to the device, and a flexible loop extending from a distal end of the body and threadable through a ferrule in the distal end of the device.

Abstract: A surgical suturing device having an axis extending between a proximal end and a distal end is operable to move a suture through body tissue. An actuating rod extends between the handle assembly and the shaft. A needle assembly at the distal end of the actuating rod is movable with the actuating rod between an extended state and a retracted state. Bifurcated portions of the needle assembly define a suture slot, the bifurcated portions have a proximate relationship when the needle assembly is in the retracted state and having a separated relationship when the needle assembly is in the extended state. The needle assembly is biased to the retracted state and the bifurcated portions are biased to the separated relationship. A handle assembly is configured to releasably receive the needle assembly and is operable to move the needle assembly between a free suture state and a captured suture state.

Abstract: A device for assisting in a vascular procedure is provided that includes a handle and one or more legs that are operable to move in response to a force being applied to the handle. The legs are operable to extend and to contract in order to manipulate a conduit. In a more particular embodiment, the device can be used in conjunction with a stand operable to receive the conduit such that the conduit can be removed from the stand by the device. The stand may include one or more graduations that indicate the size of the conduit once it is positioned on the stand.

Abstract: A method of fixing a suture to tissue of a patient includes placing an introducer onto a finger, the introducer including a zip line trailing from a proximal end of the introducer. The method additionally includes identifying a landmark with the finger, guiding a delivery device along the zip line toward the introducer, where the delivery device maintaining an anchor attached to a suture line, and ejecting the anchor from the delivery device and into the tissue of the patient.

Abstract: The present invention generally provides devices and methods for tensioning a length of suture. In one embodiment, a suture tensioning device is provided having a shaft and a suture grasping member. A knotting element can be removably coupled to a distal end of the shaft, and it can be adapted to receive a suture and to lock to engage the suture. The suture grasping member can be movably coupled to the shaft and configured to grasp a suture and pull it through the knotting element to allow the knotting element to lock and engage the suture.

Abstract: The present invention provides devices for safely closing an opening in tissue using suture. In one embodiment, the device includes an elongated main body constructed to permit visualization longitudinally through the main body from the proximal end to the distal end, the distal end defining a support surface to support the suture and protect distal body structures. A flange is connect to the main body adjacent the proximal end and projects laterally therefrom in first and second lateral directions. First and second guide holes extend longitudinally through the flange, and are structured to direct a suturing instrument longitudinally towards the support surface for passing the suture.

Abstract: A surgical kit comprising a suture retriever comprising a handle element coupling with an extending element, wherein the extending element is coupled with a hook portion; wherein the hook portion comprises a spiral structure and a suture collector comprising suture collecting elements forming one or more slits configured to receive a suture from the suture retriever and a base coupling both sides of the suture collecting elements.

Abstract: A surgical apparatus, including an instrument, a shaft part with a jaw opening at its distal end and a thread carrier guided by the shaft part displaceable from a retracted position, in which it exposes the jaw opening, and an advanced position, in which it crosses the jaw opening. A thread supported by the thread carrier can be guided through or around human or animal tissue to form a suture or ligature. The thread has a bulge at its end made of the material of the thread so that when the bulge is pushed through a passage opening of the jaw part it elastically deforms and is retained when the thread carrier is retracted.

Abstract: An apparatus for assisting in a vascular procedure includes an obturator that interfaces with a surface of tissue, the obturator including a shaft and a groove that can guide one or more tips of a medical device into a targeted region. In more specific embodiments, the targeted region is an aortic hole. The obturator can include a knob that stabilizes the medical device laterally on a surface of the targeted region. The obturator can also include a flange element that extends beyond the knob onto an outside surface of the targeted region. The knob can include a chamfer feature that can provide room for the tips of the medical device to enter the targeted region at an angle without bumping into the knob. In still other embodiments, the tips are sharp needle tips of the medical device and the groove is a V-shaped groove.

Abstract: According to an aspect of the present disclosure, a surgical suture needle assembly is provided including an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. The present disclosure further provides for methods of using the surgical suture needle assembly in anastomotic procedures and the like.

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A centerboard shaped like a long board has width that spreads a vessel opening to a slit with free edges drawn against centerboard. Needle pairs are two shafts temporarily attached to needle noses located in openings at 2 mm intervals across centerboard width. Pushing a wedge between pairs spreads needle noses about 1 mm on either side of centerboard. Suture loops ends are attached to needle noses of each pair. An outboard has legs like long boards on either side of the centerboard with a foot on each leg pointing away from centerboard on either side of slit outside vessel. Needle nose housings in each foot are directly opposite needle noses. Operator turning a screw pushes needle noses through free edges and into needle nose housings where detents hold needle noses and shafts detach. Removing device from body brings suture ends outside with suture loops across slit in ideal 2×2 pattern.

Abstract: A suture passer assembly is used for manipulating a suture with a selectively moveable wire member. The suture passer assembly includes at least one grasping member and a single-body hollow tube. The tube defines a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. The wire member is moveably received within the tube passage. The tube wall includes at least one aperture that is disposed between the first end and the second end. A first portion of the grasping member extends through the tube wall and into the tube passage via the aperture. A second portion of the grasping member remains outside the hollow tube. The first portion is operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the grasping member.

Abstract: Provided is a tissue ligation device for ligating tissues. The tissue ligation device includes a suture thread, and a hook-like member having a connecting portion connected to a suture thread-side of the connecting portion of the suture thread and a groove whose inner wall has a locking surface disposed so as to face the suture thread-side connecting portion and allowed to be brought into contact with the suture thread.

Abstract: An apparatus for passing a suture into a portion of the anatomy. The apparatus can include a handle and a suture advancement mechanism. The suture advancement mechanism can be disposed in the handle and adapted to advance a suture. The apparatus can also include a member coupled to the handle and in communication with the suture advancement mechanism to receive the suture. A cannula can be coupled to the member for receipt of the suture. The cannula can be operable to engage the anatomy. The suture advancement mechanism can contact the suture along a substantial distance of the suture to advance the suture into the member.

Abstract: A bead for stitching, a vacuum cap for suction-holding an internal organ, and an apparatus for stitching an internal organ using the vacuum cap are disclosed. The bead includes a through hole which is formed vertically through the bead so that a stitching fiber passes through the bead. At least one of both ends of the bead is inclined relative to a transverse direction of the bead. The bead is shaped to pass through a hole formed in a stitching needle. That apparatus includes an endoscope tube having a stitching needle which is movable in a longitudinal direction thereof and a suction tube for drawing air, and a vacuum cap having at an end thereof a fastening hole to which the endoscope tube is fastened. A suction hole is formed in the vacuum cap in a direction crossing the fastening hole.

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: A surgical instrument includes first and second members configured to receive tissue therebetween. The first member is adapted to receive suture, the second member is coupled to the first member, and a grasper coupled to the second member engages the suture received by the first member. A method of passing suture includes loading suture into a first member of a suture passing surgical instrument, stabilizing tissue between the first member and a second member of the surgical instrument, passing suture through tissue via the first member of the surgical instrument, holding the passed suture via a suture grasper of the surgical instrument, and removing the first member from the tissue.

Abstract: A method and device for wound closure is provided. One advantage of wound closure devices and methods shown includes a simple and inexpensive modified suture with increased pullout resistance to close wounds in eyes and prevent leakage. Another advantage includes a visualization tool to aid in locating the wound on the eye.

Abstract: Methods and devices for driving a suture assembly employing elastically pre-shaped needles for piercing a tissue. The pre-shaped needles are held in a constrained state and can revert to a natural pre-shaped state prior to or during ejection from the device before entry into tissue allowing for the suture to follow a defined path similar to the pre-shaped needle such that removal of the needle allows for subsequent securing of the suture in or around tissue.

Abstract: The present invention provides a medical suturing device structured with a retrieval puncturing needle formed with through-hole; a retrieval member able to be inserted through through-hole; an insertion puncture needle formed with through-hole; a hollow tube that can be inserted through insertion through-hole, and the distal tip of which is formed into a deformable bent portion; and a suture that can be inserted through the inside of hollow tube. The retrieval member is structured with an annular engagement member that can be deformed into a straight shape, a rod member that is connected to annular engagement member, and a grip that is provided with a mark. The mark is furnished on hollow tube, such that when retrieval puncturing needle and insertion puncture needle are in a condition where mark and mark are facing each other, the upper supporter and lower supporter can be detachably attached.

Abstract: Suturing systems and needle removal devices for more efficiently removing needles from suturing systems are provide. In some embodiments, a suturing system guide body includes one or more needle lumens that transfer corresponding needles circumferentially around the guide body. Thus, when the needles exit the needle lumens at the proximal end of the guide body, the needles are in closer proximity to one another for removal. Other embodiments include various needle capture devices tools used for removing needles from a suturing system. Needle capture devices and tools can include needle receptacles positioned and configured to generally correspond to the needle lumens of the suturing system. The needle receptacles may be further configured to selectively receive and grasp onto one or more needles extending proximally from the needle lumens of the suturing system.

Abstract: A device for closing an opening in tissue includes a shaft having a proximal end, a distal end, and at least one pin associated with a distal end the shaft. A flexible guidebody extends from the distal end of the shaft, while a foot associated with the device is movable with respect to the shaft through the pin connected to at least one slot of the foot. Another device for closing an opening in tissue includes a shaft having a proximal end and a distal end. A plurality of feet are disposed proximate the distal end of the shaft, the plurality of feet being movable with respect to the shaft. The device further includes a flexible guidebody extending from the distal end of the shaft.

Abstract: An apparatus and method for passing suture in tissue repair and other surgical procedures. The apparatus includes a pair of jaws mounted on a distal end of a shaft, a handle assembly mounted on a proximal end of the shaft, and a needle mounted on the handle assembly and through a cannulation of the shaft. A suture is placed in a slot at the tip of the lower jaw. By advancing the needle relative to the body of the instrument, the needle is pushed forward to capture the suture and to pull it through the tissue to be sutured in a direction about parallel to the longitudinal axis of the shaft.

Abstract: Various embodiments relate to a surgical instrument. The surgical instrument includes a first handle member having a first handle portion and a first shaft portion; a first end member connected to the first handle member having a first instrument portion and a tab; a second end member connected to the tab of the first end member having a second instrument portion and a shaft portion; a second handle member connected to the shaft portion of the second end member; and a lock that releasably connects the second handle member to the shaft portion of the first handle member.

Abstract: Insertion tool for a medical closure device for the sealing of an opening in a wall of a bodily organ, comprising a tamping force source adapted to deliver a first member to a position at the opening on one side of the wall subsequently to a second member being positioned at the opening on the opposite side of the wall. The tamping force source, which is energized prior to the tamping procedure, can be for example a spring, an elastic band or a pressurized gas container. A tamping spring can be compressed or extended upon loading. The tamping force source can be released in response to a manual operation or be triggered by retraction of the insertion tool.

Abstract: A suture manipulation device with a snare is provided. The snare includes a receiving end adapted to provide support to tissue and to ensnare a portion of suture passed through the tissue and the receiving end. The receiving end further adapted to secure the portion of the suture while removing the support of the tissue. The receiving end still further adapted to remove the portion of the suture.

Abstract: A method for manipulating a suture is provided. The method includes protracting a snare from a body of a suture manipulation device through an opening in the body. The snare includes, at a distal end, a hook. The method further includes ensnaring a portion of the suture passed through tissue with the snare and securing the portion of the suture. The method further still further includes retracting the hook into a slot located distally in the body to prevent the snare from retracting into the body through the opening in the body.

Abstract: A method for manipulating a suture is provided. The method includes providing support to tissue using a snare of a suture manipulation device and ensnaring, using the snare and without moving the snare, a portion of the suture when the portion of the suture passes through the tissue and is released by a needle. The method further includes securing, while removing the support to the tissue, the portion of the suture with the snare. The method further still includes removing the snare with the portion of the suture from the tissue.

Abstract: A surgical system for performing gastroplasty is disclosed. The system includes an elongated body adapted to be inserted into the esophagus with a proximal end extending from a body orifice. A working member includes a pair of elongated suction cavities that capture and excise portions of the anterior and posterior stomach walls and apply sutures to the captured tissue, which, when drawn tight, serve to create a modified lumen in the stomach.

Abstract: A delivery system is disclosed having an implant retainer configured to releasably hold an implant unit and maintain the implant unit in a fixation location relative to target tissue in a subject's body during an implantation procedure. A first suture guide portion may be disposed on a first side of the implant retainer and configured to guide a suture needle during the implantation procedure. A second suture guide portion may be disposed on a second side of the implant retainer, opposite the first side, and configured to guide the suture needle after the suture needle exits the first suture guide portion.

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 suturing system includes a tool employed to pull at least two sutures through tissue. The tool includes a head having a proximal portion housing a needle movable through a needle exit port of the head and a distal end spaced apart from the proximal portion by a throat. The distal end of the head defines a cavity. A first suture is durably connected to a capsule that is sized for placement in the cavity. The capsule defines a through-hole sized for engagement with the needle and A second suture is removably insertable into the through-hole. The needle is movable from the proximal portion of the head across the throat to form a channel in tissue and to frictionally engage with the second suture and is retractable into the needle exit port to draw the capsule and the first and second sutures through the channel formed in the tissue.

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic or open surgeries, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft. Portions of the devices may be disposable, replaceable, and/or reusable, with different needle-grasping jaws and/or different elongate extension bodies having different configurations optionally being selectably coupleably to an articulatable handle and housing so as to allow the user to configure the device for a particular procedure.

Abstract: A suture puller includes a tubular body member with a first end and a second end. First and second conical end members are coupled to the first and second ends of the tubular body member, respectively. The first conical end member and the tubular body member define a slot, configured to receive a suture, that extends through the first conical end member and a portion of the tubular body member along a central axis of the suture puller.

Abstract: An apparatus, system and method for joining a first length of suture with a second length of suture are provided. The apparatus includes a substantially cylindrical body have a first end and a second end, a first cavity formed in the first end for receiving an end of the first length of suture, and a second cavity formed in the second end for receiving an end of the second length of suture, wherein the ends of the first and second lengths of sutures are welded within respective first and second cavities. The first and second lengths of suture may include the same or different diameters. The first and second cavities may be separated by a divider, or instead, may be continuous. The end of the first length of suture may abut the end of the second length of suture within the cylindrical body.

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: A soft tissue defect repair system for approximating defects, such as defects in the annulus fibrosus of an intervertebral disc, includes a cannulated rod through which is disposed a suture retrieval device. A strand of suture includes a locking or ratcheting knot pre-tied around the outside of the cannulated rod and a free end that is guided in and out of the soft tissue. A knot pusher fits around the cannulated rod, which is used to push the knot off of the cannulated rod after the stitching of the tissue is accomplished. The defect is approximated by tensioning the free end. Various suturing methods or patterns are disclosed for defect approximation.

Abstract: An organism tissue suturing apparatus for suturing a penetrated hole formed subcutaneously in a tissue membrane of an organism includes a body part having a predetermined length. The body part includes a rotary portion, disposed at a front end thereof, that can be inserted into the tissue of the organism from the hole, a needle member accommodated in a portion, inside the body part, rearward from the rotary position, and a pressing mechanism for advancing the needle member from a side surface of the body part and pressing the needle member into the rotary portion. The rotary portion has a needle member receiving portion for receiving essentially a front end of the needle member pressed into the rotary portion by the pressing mechanism, with the rotary portion disposed in the tissue of the organism. The needle member has a suturing thread of a duct for the suturing thread.

Abstract: A method and apparatus for sizing a member. The apparatus may include a first member and a second member movable relative to one another to impinge the member. The apparatus may be used in a small area to achieve a selected sizing of the member.

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, suture thread disposed along a portion of the first puncture element, wherein the suture thread is arranged to be grabbed at the distal end of the first puncture element, and a suture grabber positioned at the distal end of the second puncture element.

Abstract: Provided is an anastomotic device including a first holder and a second holder for holding a first anastomotic ring and a second anastomotic ring, respectively, a first slave body which is connected to the first holder, and which has a first slave surface, a second slave body which is connected to the second holder, and which has a second slave surface, a first driving body which has a first driving surface sliding along the first slave surface, and which moves along a predetermined direction, and a second driving body which has a second driving surface sliding along the second slave surface, and which moves along the predetermined direction. The first slave body moves toward the second slave body and the second slave body moves toward the first slave body by the movements of the first driving body and the second driving body.

Abstract: An anastomosis normally closed clip comprising a first side including at least one first suture guide, the first suture guide being disposed on a top of the clip, the first end portion and the first suture guide defining a first suture space open toward the top of the clip, the first side further including a first carrier slot on the bottom of the clip; and a second side which is the mirror image of the first side. An introducer device is used to open the clip and introduce it into a patient over two organ segments to be sutured together and allow the clip to close. The suture spaces allow for continuous suturing of the organ segments. The introducer device is used to remove the clip from the patient after the suture procedure.

Abstract: An anastomosis clip comprising a first side including a first end portion and at least one first suture guide, the first suture guide being disposed on a top of the clip, the first end portion and the first suture guide defining a first suture space open toward the top of the clip, the first side further including a first carrier slot on the bottom of the clip. The clip further includes a second-side, including a second end portion and at least one second suture guide, the second suture guide being disposed on the top of the clip, the second end portion and the second suture guide defining a second suture space open toward the top of the clip, the second side further including a second carrier slot on the bottom of the clip. The clip further includes a hinge connecting the first and second side, the hinge being disposed on the top of the clip. The first side is biased toward the second side. An introducer device including handles and posts may be used to introduce the anastomosis clip into a patient.

Abstract: A suture passer including a tubular member having a proximal end and a distal end and a central axis defined therethrough, in which the tubular member includes at least one lumen formed therein, an eyelet configured to receive a suture, a movable jaw formed on the distal end of the tubular member configured to move between an open position and a closed position, in which the movable jaw includes a plurality of portions, and an actuator configured to be received within the at least one lumen of the tubular member, in which the actuator is configured to move along the central axis of the tubular member between a first position and a second position, in which, in the first position, the movable jaw is in the closed position, and in which, in the second position, the movable jaw is in the open position.

Abstract: This disclosure relates to suture passer guides and related kits and methods. In certain aspects, a suture passer guide includes an elongate member and a suture positioning member that can be radially extended from a distal end region of the elongate member and rotated relative to the elongate member such that the suture positioning member can reposition a suture from a first side area of the elongate member to a second side area of the elongate member.

Abstract: The present invention provides an instrument for anorectal surgery, comprising a hollow main body, a suture junction disposed at a rear end of the main body and an inserting guider disposed at a front end of the main body. At an operating position, all or part of mucosa and tissues can get through the main body. At least one opening is made in the wall of the main body, and all or part of the mucosa and tissues can get into a hollow interior of the main body through the opening. Because of the openings on the wall of the main body, the present invention can be operated to perform the anorectal surgery of local and non-annular cutting, which facilitates a quick surgical operation, further allays the pain of the patients, and a better operation effect is obtained.