Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: A wound closure system includes a device having a first main body and a second main body. Each of the first main body and the second main body has an adhesive backing. The first main body is coupled to the second main body by an adjustable connector. The adjustable connector is permitted to move in a single direction. In the event of an injury, the first and second main bodies are placed on opposite sides of a wound and are then pulled together, thereby sealing the wound.

Abstract: Devices, tools, systems, kits and methods for closing a tissue opening non-invasively are presented. The devices include a tissue closure device that reliably induces eversion of tissue edges that define a tissue opening.

Abstract: Systems and methods for soft tissue to bone repairs employing tensionable knotless anchors, without knot tying. The tensionable knotless anchors may be used by themselves or in combination with additional constructs (which may have a similar or different configuration, i.e., modified according to the specific repair) to achieve novel remplissage and soft tissue repairs.

Abstract: A patch having expansion and supporting effects, comprising a body (10, 10A, 10B), at least one first support member (20, 20A, 20B), and at least one second support member (30, 30A, 0B).

Abstract: A top locking rotatable suture anchor device secures one or more sutures with the suture anchor device, installed within a bone at a surgical treatment site, providing rotation of the suture while secured within the suture anchor device and providing adjustment to the tension of the suture during the surgical procedure, the suture anchor device including a delivery tool cooperating with the suture device to conduct the installation of the suture anchor device and tensioning of the suture within suture anchor device.

Abstract: An instrument for stretching the skin comprising an elongate, dimensionally stable guide with at last two modules that are disposed on said guide and comprise anchoring means for securing to the skin, wherein at least one of said modules can be moved on the guide in the longitudinal direction thereof, and a non-return device allows movement thereof in a movement direction and blocks movement thereof in the opposite, reverse direction, said non-return device being able to be inverted in terms of the movement direction and the reverse direction.

Abstract: A closure device 100 that closes a wound on a skin includes a pair of sheet members 41a, 41b that have an axial direction da and a width direction db orthogonal to the axial direction da and face each other with a space 41s provided in the width direction db, and a plurality of closure elements 2a, 2b that are attached to the pair of sheet members 41a, 41b across the space 41s and arranged in the axial direction da. The closure element 2a, 2b respectively include bases 10a, 10b and adjusters 30a, 30b that are arranged on the pair of sheet members 41a, 41b to face each other across the space 41s, and drawstrings 20a, 20b that extend from the bases 10a, 10b and engage with the adjusters 30a, 30b. The pair of sheet members 41a, 41b include a plurality of slits 51, 52 provided in a plurality of areas, each of the plurality of areas being provided between pairs of the closure elements 2a, 2b adjacent to each other.

Abstract: An apparatus including a first leg; a second leg distant from the first leg; and a bridge extending between and connecting the first leg to the second leg; wherein the bridge is configured such that a length of the bridge between the first leg and the second leg can be incrementally adjusted.

Abstract: The present invention relates generally to wound closure devices comprising one or more microstructures. The devices are designed such that the microstructures are able to grip the skin or tissue surrounding a wound, optionally closing the wound, or securing the tissue or skin in place. Also provided are wound closure systems that comprise one or more microstructure wound closure devices along with other components, such as protective covers and wound healing therapeutics. A variety of packaging specifications are disclosed, as is a dispenser apparatus configured to enable simple one-handed application of the wound closure devices. Methods described herein provide for the closure of various wounds with the wound closure devices and systems.

Abstract: An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

Abstract: A sutureless device and methods for closing a tissue opening that minimizes the labor, cost, and skill typically required is disclosed. The apparatus comprises two anchors that attach to either side of an open tissue wound. The two anchors are connected together by a tie strip; the tie strip has a plurality of teeth and a rack. As the wound edges and anchors are brought together the ratchet system on the tie strip prevents the anchors and tissue wound from reopening. To control the distance between the two anchors, a rack and pinion system and a key or a lever system is utilized. The rack is located on the tie strip and the pinion is located on the key.

Abstract: A strap tie includes a body including a receiving channel and a strap engagement member. The receiving channel extends through the body. The receiving channel is configured to receive a remote strap. The engagement member is configured to engage a movement restriction member of the remote strap to prevent translation of the remote strap away from the body. The strap extends from the body. The strap includes a proximal end attached to the body, a distal end opposite the proximal end, and a plurality of movement restriction members. The rotational element of the body is configured to removably couple to a base to allow the strap tie to rotate relative to the base.

Abstract: Systems and methods for soft tissue to bone repairs employing tensionable knotless anchors, without knot tying. The tensionable knotless anchors may be used by themselves or in combination with additional constructs (which may have a similar or different configuration, i.e., modified according to the specific repair) to achieve novel remplissage and soft tissue repairs.

Abstract: Apparatus for closing a surgical incision comprise a base having left and right panels, a force distribution structure coupled to each panel, and a closure component which releasably attaches to the force distribution structure to draw the inner edges of the panels together in order to close adhered tissue edges. The force distribution structures allow the inner edges of the panels to expand while restraining expansion of the outer edges of the panels and limiting elongation of the lateral dimension of the panels. The incision closure appliance may be placed on skin or other tissue prior to forming the incision to be available to close said incision at the end of the surgical procedure.

Abstract: A sternal closure assembly for securing first and second lateral halves of a sternum. The assembly includes a first sliding body having a female portion and a second sliding body having a male portion, the male portion being telescopically mateable with the female portion. The male portion is capable of being fully introduced into the female portion only upon there being an elastic deformation of at least a part of at least one of the male and female portions, the male and female portions configured such that when the second body is mated with the first body the elastic deformation results in a forceful engagement between the male and female portions and also a forceful engagement between a first set of non-deforming teeth extending upward from an interconnecting bridge member of the first sliding body and a second set of non-deforming teeth extending upward from an interconnecting bridge member of the second sliding body.

Abstract: A device for causing hemostasis includes a sheet of mesh stretchable between an expanded and a retracted configuration, a size of the sheet in the retracted configuration being selected to cover a target tissue site; a spring mechanism coupled to the mesh, the spring mechanism moving between an expanded configuration and a retracted configuration when the mesh is moved between the expanded and retracted configurations; and a plurality of hooks coupled to the mesh and oriented to extend into tissue to lock the mesh in position when the mesh is placed in a desired position over the target tissue site in the expanded configuration. The hooks are lockingly engaging the target tissue so that, after the hooks have lockingly engaged the tissue, the spring mechanism reverts to the retracted configuration drawing the engaged portions of tissue radially inward.

Abstract: A strap tie assembly includes a first strap tie including a first base, a first body including a first receiving channel and a first engagement member, and a first strap extending from the first body. The assembly includes a second strap tie including a second base, a second body including a second receiving channel and a second engagement member, and a second strap extending from the second body. The first receiving channel can receive the second strap. The first engagement member can rotate about a first rotation axis to engage the second strap to prevent translation of the second strap away from the first body. The second receiving channel can receive the first strap. The second engagement member can rotate about a second rotational axis to engage the first strap to prevent translation of the first strap away from the second body.

Abstract: A system for wound closure has at least two closure elements. One closure element is detachably tethered to another closure element. Each closure element includes: a base member with an integral strap hingably connected to the base member, and a lock member slidably disposed on the strap and being lockable on the strap. Alternatively, the base member defines a plane and the strap being affixed to the base member at an angle to the plane. The system may further include a wound covering disposed between the straps and the wound. The wound covering may be a laminate having at least two layers; a first layer is a moisture impervious layer adapted to contain body heat, and a second hydrophilic layer is adapted to retain moisture.

Abstract: In a device for stretching the skin, particularly for closing a wound, anchoring elements are anchored in the skin. The anchoring elements are movable on a guide device. First anchoring elements are anchored in the skin of the edge of the wound. Second anchoring elements are adjustable on the guide device in the stretching direction behind the first anchoring elements in relation to and independently of said first anchoring elements.

Abstract: Instruments are provided, representative embodiments of which have a first and a second jaw, from each of which at least one engaging element, whose distal end is suitable for engaging the skin tissue to be stretched, protrudes; an elastic member connecting the jaws, stressing them against each other when subjected to a traction force; and elements for adjusting the distance separating the jaws in the absence of traction force on the elastic member.

Abstract: A strap tie assembly includes a first strap tie and a second strap tie. The first strap tie includes a first base, a first body including a first opening and a first engagement member disposed within the first opening, and a first strap extending from the first body. The first strap includes a plurality of movement restriction members disposed along a surface of the first strap. The second strap tie includes a second base, a second body including a second opening and a second engagement member disposed within the second opening, and a second strap extending from the second body. The first strap tie is configured to receive the second strap and prevent translation of the second strap away from the first body. The second strap tie is configured to receive the first strap and prevent translation of the first strap away from the second body.

Abstract: The present invention relates to a shot applicator device and, more particularly, to an automatic shot applicator device including a housing with a shot storage/delivery chamber, a tip structured to deliver the shot into tubing attached to various fishing tackle/equipment including fishing rigs, line, hooks, leaders, fly fishing tippet, and/or inserting directly into lures and baits, thereby changing the density (add or decrease weight) of the fishing tackle/equipment, and a mechanism structured to apply a force to the shot thrusting it through the tip and into such material.

Abstract: Instrument for stretching the skin for closing wounds, having a skin expander, having at least two jaws mechanically adjustable relative to each other in a tension direction on the skin expander, having barbs associated with the jaws the barbs being anchorable in the skin in the area of the edges of the wound, wherein a tensile force is exerted on the skin by means of the barbs by adjusting the jaws, the force stretching the skin and drawing the edges of the wound toward each other, wherein one or more barbs are each disposed on a carrier extending transverse to the tension direction, wherein the carriers are releasably mounted on the jaws, and wherein the carriers can be fixed in position relative to each other by attachable fixing elements.

Abstract: The present invention provides a surgical system for securing a suture against relative movement with respect to a body tissue. The surgical system includes a fastener and medical device for positioning and securing a fastener onto a suture. The fastener includes inner and outer members that can slide together and rotate. The suture extends through the inner and outer members so that rotation of the inner member causes it to wrap the suture around it. As the suture is wound around the inner member, the fastener is drawn toward a position against the body tissue. Further rotation of the inner member allows tension to be applied to the suture. The fastener may be bonded to the suture in order to further secure the suture against relative movement with respect to the body tissue.

Abstract: A surgical instrument adapted and configured for use in minimally invasive surgical procedures includes a shaft, an end effector and a proximal handle. The longitudinal shaft has proximal and distal end portions, and defines a longitudinal axis of the surgical instrument. The distal end effector is connected to the distal end portion of the shaft, and is adapted and configured for performing a surgical task. The proximal handle portion is operably connected to the proximal end portion of the longitudinal shaft and has an actuatable portion operably connected to the end effector to result in movement of the end effector. The distal end portion of the shaft can be laterally offset from the longitudinal axis of the shaft and/or have one or more bends or curves formed therein. The proximal portion of the shaft can include at least one bend to allow for comfortable positioning of a surgeon's hands.

Abstract: The present disclosure provides a wound closure device including: (a) a first opposing member and a second opposing member disposed on opposing sides of a central axis, each resiliently moveable between a closed position and open position relative to each other, each of the opposing members having a distal edge; (b) skin penetrating means for anchoring the device; (c) a pressure bar along each distal edge; (d) releasable locking means for biasing or maintaining the device in the closed position; and optionally (e) an accessory component.

Abstract: There is disclosed a threaded tissue tack for use in approximating and securing a pair of tissue sections together. The threaded tissue tack has a central body portion and first and second screws extending from opposite ends of the central body portion. The first screw includes a left-hand thread and the second includes a right-hand thread. Engagement structure is provided on the central body portion to rotate the threaded tissue tack about its longitudinal axis and into the pair of tissue sections. There is also disclosed a tack driver for rotating the threaded tissue tack into the tissue. Guards are provided intermediate first and second ends of the central body portion and the first and second screws to protect surrounding tissue from the tack driver.

Abstract: A biodegradable device for maintaining the alignment of the edges of a trocar defect, consisting of two bases joined by a connector, a first base to be positioned below the defect and a second base above. The first base has a threaded hole from its upper surface but not through the lower surface. The connector attached to the bases such that there is a hole aligned with the threaded hole in the first base allowing a device to mate with the threads in the first base. The second base has a hole aligned with the hole in the connector and wide enough to allow a device to mate with the threads in the first base. The device is arranged so the distance between the lower surface of the second base and upper surface of the first base holds but does not compress the fascia around the trocar defect.

Abstract: Instruments are provided, representative embodiments of which have a first and a second jaw, from each of which at least one engaging element, whose distal end is suitable for engaging the skin tissue to be stretched, protrudes; an elastic member connecting the jaws, stressing them against each other when subjected to a traction force; and elements for adjusting the distance separating the jaws in the absence of traction force on the elastic member.

Abstract: Instrument for stretching the skin for closing wounds, having a skin expander, having at least two jaws mechanically adjustable relative to each other in a tension direction on the skin expander, having barbs associated with the jaws the barbs being anchorable in the skin in the area of the edges of the wound, wherein a tensile force is exerted on the skin by means of the barbs by adjusting the jaws, said force stretching the skin and drawing the edges of the wound toward each other, wherein one or more barbs are each disposed on a carrier extending transverse to the tension direction, wherein the carriers are releasably mounted on the jaws, and wherein the carriers can be fixed in position relative to each other by attachable fixing elements.

Abstract: A wound closure device includes first and second opposing members which open and close in a clam-shell configuration, skin penetrating needles and a pressure bar for applying pressure to close the wound when the device is closed, and releasable locking means for biasing or maintaining the device in a closed position.

Abstract: Embodiments of invention are directed to tissue approximation instruments that may be delivered to the body of a patient during minimally invasive or other surgical procedures. In one group of embodiments, the instruments have an elongated configuration with two sets of expandable wings that each have spreadable wings that can be made to expand when located on opposite sides of a distal tissue region and a proximal tissue region and can then be made to move toward one another to bring the two tissue regions into a more proximate position. The instrument is delivered through a needle or catheter and is controlled by relative movement of a push tube and control wire wherein the control wire can be released from the instrument via rotation in a first direction and can cause release of the approximation device from tissue that it is holding by rotation in the opposite direction.

Abstract: An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.

Abstract: The present invention relates to surgical clamps and clamp devices that provide a handle-free surgical field. The clamp jaws may be opened or closed by a rotationally or translationally moveable drive element that may be actuated from a position proximal or distal to the jaws. The surgical clamps may also be deployed using a clamp applier which slidably engages the clamp along a wire to releasably attach itself to the clamp.

Abstract: A wound closure system comprises a forceps including first and second legs adapted to close into a proximate position in response to a squeezing force applied to the forceps. The forceps also includes a ratchet strip connected to the second leg and passing through an opening in the first leg. The lower edge of the opening is formed as a ratchet pawl for engaging the ratchet strip, thereby providing a ratchet mechanism. Engaging the ratchet mechanism maintains the proximate position of the forceps; rotation of the ratchet strip about the hinge causes it to move upward, thereby disengaging the ratchet mechanism. The forceps may also include a safety latch connected to the first leg by a hinge. Rotation of the safety latch about the hinge inserts a portion of the safety latch into the opening to contact the ratchet strip and thereby prevent disengaging of the ratchet mechanism.

Abstract: A device (1) for closing an opening (2) in a septum (4) of a heart (3) comprises: at least two closure elements (12) with threads (8) for closing the opening (2), a feed catheter (5) for insertion of the closure element (12) into the heart (3), a puncture cannula (6), a stylet (7) for pushing the closure element (12) out of the puncture cannula (6), and a screw catheter (10) having a coil (11) for penetration the edge of the opening (2). The puncture cannula (6) and the elements (12) can be moved through the screw catheter (10) and the coil (11). If the edges of the opening (2) overlap, a lobe (15) away from the feed catheter (5) can be kept in place with a second coil (111), or a suction tube (16) during placement of the anchor (12).

Abstract: An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.

Abstract: An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.

Abstract: A suture anchor for securing soft tissue to bone may include a threaded body, a head extending along a longitudinal axis, and a plurality of eyelets that extend though the anchor head and that are each configured to receive a suture. The eyelets are offset from one another along an axis that is transverse to the longitudinal axis of the suture anchor. Each eyelet may have a desired shape and cross section. Surgical kits including one or more suture anchors and one or more surgical tools are also described.

Abstract: Provided herein are methods, devices and compositions to conductively or to inductively fix substrates, including tissues, using electromagnetic energy. Also provided is a method of controlling the fixing process via feedback monitoring of a property of the composition and/or of the electromagnetic energy used.

Abstract: Provided is a wound closure assisting and maintaining apparatus that can be attached to a wide open wound of a patient and can stretch skin around the wound gradually to achieve the wound closure and maintain the wound closure during most critical postoperative period. The apparatus includes: a loop suture being threaded through skin; a tightening member for gathering both ends of the threaded loop suture at one point and for exerting a pressure of wound tightening force evenly on skin; a pulling member for pulling the loop suture in order to tighten the threaded loop suture; a housing member for housing the pulling member and making the loop suture tightened by transformation of a pulling force to a wound tightening force when pulling member pulls the loop suture out of skin; and a locking member for fixing a position of the pulling member to maintain the tightened status.

Abstract: Devices and methods are disclosed for achieving hemostasis in solid visceral wounds. Such devices and methods are especially useful in the emergency, trauma surgery or military setting. In such cases, the patient may have received trauma to the abdominal viscera. The devices utilize flexible, variable depth transfixing bolts that penetrate the viscera. These bolts are pulled tight to bring the tissue into apposition and hold said tissue in apposition while the wound heals. These bolts overcome the limitations of sutures that are currently used for the same purposes. The bolts come in a variety of lengths and diameters. Since the bolts are flexible, the curvature may be adjusted by the surgeon. The devices are flexible, bendable, and conformable in their wet or dry state. They can be used either straight or through a broad range of curvatures to suit the needs of various pathologies.

Abstract: For stretching tissue of the skin a pull force is introduced into the skin via hooks (22) stuck into the skin at points. The hooks (22) are arranged adjacent to each other in a row transverse to the pull direction. Via the hooks (22) a high pull force can be introduced into the skin for a long stretch time. The high pull force is respectively alternatingly introduced via a portion of the hooks (22) while the other portion of the hooks (22) is relaxed. Thereby tissue necrosis on the pressure side of the hooks (22) is prevented even in the case of high pull forces and longer stretch durations.

Abstract: The invention relates to a tissue anchor which is an open helix of biocompatible material having a slope of from 0.5 to 10 turns per centimeter, a length from 3 to 75 millimeters, a diameter of from 1.5 to 11 millimeters, and an aspect ratio of from about 3 to about 5 to 1. The anchor can have a head which is capable of securing or clamping tissue together, such as holding a suture to secure a ligament or tendon to bone. The anchor can also have a head which causes an inward, compressive loading for use in fastening bone to bone, orthopedic plates to bone, or cartilage to bone. The head may be an integral member and may include a self-reinforcing wedge which joins the helix to the head. Further, the elongate member, or filament that forms the helix may have a tapering diameter along its length.

Abstract: A sternal closure device including impermanently joined sliding and receiving attachment structures which are adapted for intercostal positioning between at least two corresponding rib pairs and substantially surrounding a patient's sternum with each structure having a cross member, a plurality of integrated legs and foot members, a plurality of sternum engagement surfaces, and an end portion. The receiving structure further incorporates a resiliently tensioned catch member with angularly disposed teeth like structures positioned to receive and position a plurality of receiving structure projection members when inserted therein. The catch member further serves as a stabilizing structure with stabilization facilitated via an easily removed single screw like structure markedly facilitates quick release.

Abstract: A suture anchor for securing soft tissue to bone, including a body having opposing first and second ends, a longitudinal axis extending between the ends, an external threaded portion extending from the first end, and a bore extending from the second end towards the first end. The body also has a first pair of slots extending laterally outwardly from the bore and extending longitudinally to a predetermined first distance from the second end, and a second pair of slots extending laterally outwardly from the bore and extending longitudinally to a predetermined second distance from the second end. The anchor additionally includes an eyelet receivable within the first and the second pairs of slots of the body and having an opening for receiving a suture, and a spring biasing the eyelet into the bore.

Abstract: Process and instrument for stretching tissue of the skin For stretching tissue of the skin a pull force is introduced into the skin via hooks (22) stuck into the skin at points. The hooks (22) are arranged adjacent to each other in a row transverse to the pull direction. Via the hooks (22) a high pull force can be introduced into the skin for a long stretch time. The high pull force is respectively alternatingly introduced via a portion of the hooks (22) while the other portion of the hooks (22) is relaxed. Thereby tissue necrosis on the pressure side of the hooks (22) is prevented even in the case of high pull forces and longer stretch durations.

Abstract: A suture anchor for securing soft tissue to bone including a body extending along a longitudinal axis between opposite ends, and at least one eyelet extending between lateral surfaces of the body for receiving a suture. The eyelet defines two entry/exit void regions and a central void region extending between the entry/exit void regions. Each entry/exit void region extends from one of the lateral surfaces of the body and has an axis forming an acute angle with the longitudinal axis of the body. Each entry/exit void region also has a surface comprising a segment of a conic surface extending about the axis of the entry/exit void region and tapering inward towards the longitudinal axis of the body. The central void region extends along an axis transverse to the longitudinal axis of the body.

Abstract: A method for delivering a plurality of individual surgical fasteners. The method includes the step of providing a surgical fastener delivery device having a drive mechanism with distal and proximal ends, the drive mechanism comprising moving and fixed opposing members, the moving member being moveable proximally and distally with respect to the delivery device, and the fixed member being fixed with respect to the delivery device, the device having the plurality of surgical fasteners located between the moving and the fixed members. The method further involves the step of penetrating tissue and placing a distal end one of the surgical fasteners within tissue, by moving the moving member distally. The method further involves the step of deploying a distal end of one of the surgical fasteners by moving the moving member proximally.