Abstract: The present disclosure provides medical devices possessing reactants thereon, which further promote adherence of the device to tissue in vivo and/or release of bioactive agents from the device.

Abstract: Tissue anchoring and deployment systems are described herein. Generally, an anchor housing may define a receiving channel within or along its periphery. A securement member which is adjustably slidable relative to the receiving channel and further defining a suture receiving channel along a portion of the member may also be used such that the suture receiving channel is aligned with an opening defined along a first surface. The securement member and a compression surface along the receiving channel are spaced apart from one another and form a suture compression interface. Additionally, a length of suture may also be used where the suture has a first portion positioned along the suture compression interface and a second portion passed through the suture receiving channel and opening along the first surface. The compression interface has a height which is sized to be relatively smaller than a diameter of the first portion of suture.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the cinch applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and cutter defined in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture, and displaces the cutter to sever the suture.

Abstract: A surgical construct having a flexible strand with a middle region and at least two opposing tail regions that are spliced to form a single tail. The middle region has a first diameter and the opposing tail regions have a second diameter, which is smaller than the first diameter. The tail regions may have similar or different diameters. Because of the thin spliced tail regions, the suturing construct of the present invention can be easily inserted into suture/tape passing and retrieving instruments and passed through soft tissue (such as a rotator cuff). Once the suturing construct has been passed through tissue, the splice may be cut to allow the suture/tape to have again individual tails.

Abstract: Described herein are a group of degradable, thermoplastic polymers, which are able to change their shape after an increase temperature. Their shape memory capability enables bulky implants to be placed in the body through small incisions or to perform complex mechanical deformations automatically. The shape memory polymers are preferably biocompatible and can be biodegradable or non-degradable polymers. Preferably, the biodegradable polymer has a linear degradation rate. In a specifically preferred embodiment, the suture is formed of biodegradable polymer capable of forming a self-tightening knot. In a most preferred embodiment, the suture is used to close a wound or body scission.

Abstract: A device including a self-locking suture including both a braided section and a monofilament section is provided. The monofilament includes a single strand. The braided section includes three or more strands that are intertwined or woven together. The terminal end of the braid is compressible to take on a radially expanded configuration. The braided structure is temporarily fixable in the open configuration providing a wide berth opening. A needle at the terminal end of the monofilament is insertable through the wide berth opening and pushed out through the back wall of the expanded braid, after which the braid can be pulled on to collapse it down onto the barbed monofilament. The construct may then be tightened onto the tissues to be joined, and the one-way locking mechanism between the braided trap and the directionally biased suture automatically engages. Another aspect includes a method of fastening tissue using the device.

Abstract: A flexible suture for coupling tissue includes a first suture portion extending to a first end and a second suture portion extending to a second end. A plurality of braided strands form the first and second suture portions. An identifier characteristic is formed into the plurality of braided strands. The identifier characteristic extends from the first end of the first suture portion to the second end of the second suture portion, and the identifier characteristic distinguishes the first suture portion from the second suture portion.

Abstract: An improved method of connecting body tissue to a bone in a body. The method includes utilizing an anchor with a conical leading end, a trailing end, a central longitudinal axis passing through the leading and trailing ends, at least two suture passages extending through the anchor transverse to the central longitudinal axis, and a length. The leading end of the anchor has a maximum dimension transverse to the central longitudinal axis that is less than a maximum dimension of the trailing end transverse to the central longitudinal axis. The anchor includes at least one of the suture passages having a portion of a suture positioned therein. The method includes advancing the anchor to insert the leading end of the anchor first through an aperture in a cortical layer of the bone to place the entire anchor within cancellous tissue of the bone, wherein the length of the anchor is greater than a width of the aperture.

Abstract: Methods and devices are provided for anchoring suture to tissue, incorporating anchoring devices constructed substantially from suture. The anchoring devices are constructed as longitudinally extended, preformed knot configurations that upon deployment are reconfigured to form anchoring knots having an increased cross-section relative to the preformed knot configuration, for secure lodging in tissue. The anchoring devices are suitable for single and multi-anchor surgical procedures in soft tissue or bone, and multiple anchors can be delivered using a single delivery device.

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

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably, to the filament engagement feature. The first and second noose limbs emerge from the anchor as first and second free filament limbs that are capable of being passed through tissue to be repaired and then passable through the noose. The noose is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after anchor fixation. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs as a single unit.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose with first and second noose limbs connected, preferably slidably, to the filament engagement feature. The first and second noose limbs emerge from the anchor as first and second free filament limbs that are capable of being passed through tissue to be repaired and then passable through the noose. The noose is capable of receiving the free filament limbs and strangulating them when tension is applied to at least one of the free filament limbs and the noose to enable incremental tensioning of the tissue after anchor fixation. Preferably, the snare assembly further includes a flexible sleeve joining at least some portion of the first and second free filament limbs to facilitate passing of the free filament limbs as a single unit.

Abstract: A barbed suture includes a flexible thread having a core with a leading end, a trailing end, and a central axis. The barbed suture includes a first flexible flap connected to the core, the first flap extending between the leading and trailing ends of the core, and a second flexible flap connected to the core, the second flap extending between the leading and trailing ends of the core. The flexible flaps and the core have an S-shaped profile when viewed in cross-section. The barbed suture includes first and second slots formed in the respective first and second flaps for dividing the flaps into first and second barbs projecting from the core, whereby each slot extends outwardly from the core and rearwardly toward the trailing end of the core.

Abstract: A barbed suture with a first end and a second end and a body with a plurality of barbs extending from the body. Each barb causes the suture to resist movement in an opposite direction from which the barb faces. Projections extend from said suture. The projections can also engage tissue. The barbs cover the projections when the first end of the suture is moved in tissue and exposes the projections in order to engage tissue when the suture is moved in the direction of the second end through tissue.

Abstract: Fixation of soft tissue to bone (or of soft tissue to soft tissue) is performed using a flexible material (for example, a suture strand, a braid, a suture tape, a stuffed suture, or a combination thereof) with a portion having an expanded footprint to provide a cushion or tissue protector between the flexible strand (suture) and the tissue to be attached. The suture and cushion may be manufactured from materials that have properties to amplify the body's healing response. The cushion may have any shape and geometry that provides cushioning action between the suture and the tissue to be fixated. The cushion may be provided along the length of the flexible strand (i.e., the flexible strand may be provided with a cushion) or the flexible strand may extend from the cushion.

Abstract: Methods and devices are provided for repairing a tear in a meniscus. A pair of fixation member each entailing a preformed knot configuration coupled together by a suture length. The fixation members are placed on the meniscal tissue with the suture length spanning the tear, the knot configurations are expanded to form anchoring knots and the suture length is shortened to close the tear.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Abstract: A suture thread having: a thread-shaped main body with spikes and a stopper cylinder having a diameter enlarged with respect to the main body is described.

Abstract: A medical fastening device is provided. The fastening device may include a first arcuate needle adapted to rotate about a first axis in a first direction, entering through a first section of one of a tissue and a prosthetic material, and exiting through a second section of one of the tissue and the prosthetic material; a second arcuate needle adapted to rotate about a second axis in a second direction, entering through the second section of one of the tissue and the prosthetic material, and exiting through the first section of one of the tissue and the prosthetic material; and a drive mechanism operatively coupled to each of the first and second arcuate needles and configured to engage each of the first and second arcuate needles between a retracted position and an extended position.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: A wound closure device includes a flexible filament having a first end, a second end, and a longitudinal axis extending between the first and second ends. A plurality of barbs project outwardly from the flexible filament. Each barb has a base connected with the flexible filament, a blunt tip spaced from the base, a leading edge extending between the base and the blunt tip and facing toward the first end of the flexible filament, and a trailing edge extending between the base and the tip and facing toward the second end of the flexible filament. The trailing edge of the barb and the longitudinal axis of the flexible filament define an angle of at least 68° that opens toward the second end of the flexible filament.

Abstract: A method and apparatus for reattaching the opposed ends of a member, such as a tendon, ligament or bone, during preparing and healing of the member using a surgical repair device that can be securely attached to the member and then safely guided through tortuous anatomy for reattachment and repair. The repair device further includes structural means so as to secure opposed ends of the member against separation during healing. Devices for aiding in the positioning of the surgical repair device are provided.

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 barbed suture for connecting tissue, and a combination surgical needle with a barbed suture. The suture includes an elongated body and a plurality of barbs projecting from the body. Each barb causes the suture to resist movement in an opposite direction from which the barb faces. The disposition of the barbs on the body may be staggered, twist cut multiple spiral, overlapping, or random. Also, the configuration of the barbs may be a certain spirality angle ?, barb cut angle ?, barb cut depth, barb cut length, barb cut distance, corrugated barb underside, arcuate barb base, or varying barb size.

Abstract: A method of forming retainers on a suture includes providing a suture having a longitudinal axis and a circumference, a cutter, and a displacer that can longitudinally displace at least one of the suture and the cutter relative to the other, and can at least one of revolve the cutter about the suture and rotate the suture; and placing the cutter and suture into cutting engagement to form a first helical escarpment about the suture circumference. An apparatus for performing the method is also provided.

Abstract: A medical device includes an elongated body including an outer surface having a plurality of barbs extending therefrom and an inner surface defining a lumen therethrough. The elongated body includes at least one channel extending through the inner surface and the outer surface, the channel defined between an inner surface of one of the plurality of barbs and a cut outer surface of the elongated body. A wound treatment material is disposed within the lumen of the elongated body. The barb is configured to move between a first position to close the channel and retain the wound treatment material within the lumen and a second position to open the channel and permit the release of the wound treatment material therethrough.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions whereby a ligation or anchor is placed and secured into soft tissue. An objective of this invention is to provide a method to reduce gastroesophageal reflux by endosonography-guided intervention. Specifically, endosonography is used to insert a ligation element through the esophageal wall, through the diaphragmatic crus and into the fundus of the stomach. This ligation element placed from the esophagus and around the Angle of His to create a barrier to gastroesophageal reflux.

Abstract: Effective treatments of pain for extended periods of time are provided. Through the administration of an effective amount of clonidine in a fiber at or near a target site, one can relieve pain caused by diverse sources, including but not limited to spinal disc herniation (i.e. sciatica), spondilothesis, stenosis, discogenic back pain and joint pain, as well as pain that is incidental to surgery. When appropriate fiber formulations are provided within biodegradable polymers, this pain relief can be continued for at least three days.

Abstract: Subcutaneous sinusoidal wound-closure techniques use one-way sutures. The one-way sutures have tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is deployed along a curvilinear path which passes alternately through subcutaneous tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Abstract: An embodiment of a suture for use in a surgical procedure applied to tissue comprises an elongated body having a first end and a second end, and a plurality of retainers arranged along a portion of the elongated body. The retainers substantially yield to motion of the elongated body within the tissue when the elongated body is drawn at the first end and resist motion of the elongated within the tissue when the elongated body is drawn at the second end. The retainers include an upper surface and a lower surface, the upper surface extending from a periphery of the elongated body and the lower surface having at least two facets.

Abstract: The present invention relates to a tissue securement system, device and method for endoscopy or endosonography-guided transluminal interventions through which a ligation is placed and secured into tissue. An objective of this invention is to provide a stable securement platform for the coupling of secondary anchors to the gastrointestinal tract. Specifically, endoscopy is used to insert an anchoring element through the walls of adjacent body cavities. The ends of the anchoring element are coupled together to form a loop. This anchoring element can be used to secure other anchors or devices to the gastrointestinal tract.

Abstract: Endoscopic methods utilize self-retaining sutures to approximate tissue in a cavity of a subject. An endoscopic instrument is provided containing the self-retaining suture. The endoscopic instrument may be provided in combination with an endoscope and/or an endoscopic manipulator. The endoscopic instrument is passed through a cavity wall into a cavity of a patient. The self-retaining suture is deployed, using the endoscopic instrument, into a first tissue portion and a second tissue portion within the cavity. The self-retaining suture may be deployed endoscopically in patterns which include, purse string stitch, alpha stitch, linear stitching, curvilinear stitching, continuous helical stitch, and continuous sinusoidal stitch.

Abstract: A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Abstract: Provided herein are sutures to be used in a procedure applied to tissue, and methods for forming such sutures. A suture can include an elongated suture body and a plurality of heat-contact mediated retainers extending from and along the elongated suture body. The heat-contact mediated retainers can be formed by temporarily contacting the elongated suture body with one or more heated element.

Abstract: Suture constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct includes a first limb, a second limb, a coaxial region, and a collapsible snare defined by the first and second limbs. The coaxial region can be formed by a portion of the second limb being disposed in a volume of the first limb, which allows for a low profile construct that is useful in various soft tissue repair procedures. The construct can be configured to be disposed in tissue to draw the tissue toward bone, and the coaxial region can be deconstructed so that the first and second limbs can be used to help secure the desired location of the tissue with respect to the bone. Various features of the construct and methods for using the same in a surgical procedure are also provided.

Abstract: Suture constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct includes a first limb, a second limb, a coaxial region, and a collapsible snare defined by the first and second limbs. The coaxial region can be formed by a portion of the second limb being disposed in a volume of the first limb, which allows for a low profile construct that is useful in various soft tissue repair procedures. The construct can be configured to be disposed in tissue to draw the tissue toward bone, and the coaxial region can be deconstructed so that the first and second limbs can be used to help secure the desired location of the tissue with respect to the bone. Various features of the construct and methods for using the same in a surgical procedure are also provided.

Abstract: An anastomosis procedure utilizes a self-retaining suture to secure one vessel to another vessel. One or more self-retaining sutures are deployed around the interface between the vessels. The self-retaining sutures have tissue-grasping surface features which allow passage of the sutures in one direction through tissue, but not in the opposite direction. The self-retaining sutures may be deployed using a needle attached to the end of the sutures. The anastomosis technique may be performed without using knots.

Abstract: A method for joining and holding closed a wound in bodily tissue, fastening junctions of wounds, tying off wounds, joining a foreign element to tissue, and altering the position of tissue using a barbed suture including sharp pointed ends. Each end of the suture includes barbs on that permit movement in an opposing direction to the barbs on the other end of the suture. This two-way barbed suture is used by the method of the present invention in applications including abdominal surgeries such as a Nissen fundoplication, laparoscopic uses such as stabilizing a bowel structure and performing a closure of a cystostomy, liver to bowel anastomosis, closure of an orifice of a Zenker's Diverticulum, endoscopic uses such as closure of ulcerative lesions or and post-procedural tissue defects, bladder wound closure, valve replacement surgery, device attachment, cosmetic surgery, and blood vessel wound closure.

Abstract: A tissue fixation apparatus can include a flexible construct and an elongated locking member. The flexible construct can include at least two adjustable loops and tensioning members. The two adjustable loops can be configured to pass through the first tissue, and to be spaced apart along an outer surface of the first tissue in a first direction. The tensioning members can extend from the two adjustable loops, and can be configured to reduce the two adjustable loops from a first size to a second size. The flexible construct can be attached to the second tissue by an anchor. The locking member can be configured to be received within the two adjustable loops at the first size, and to engage the two adjustable loops at the second size.

Abstract: A multi-filament surgical suture comprising cover and core layers is differentially coated or impregnated with a long-acting local anesthetic so as produce a differential distribution of the anesthetic within the suture. The differential distribution of the anesthetic within the suture can be adjusted so as to release a uniform or variable prescribed dosage of the anesthetic at a uniform or variable prescribed rate over one or more prescribed intervals. The time-release period and the rate of anesthetic release can be regulated to suit the needs of the specific patient and/or the nature of the surgical procedure.

Abstract: A method for securing an anchor to tissue includes positioning the anchor in an area of the tissue. The anchor can include a flexible first tubular member, a flexible second tubular member, and a first suture member. The first tubular member can include a first wall defining a first passage between first and second ends. The second tubular member can include a second wall defining a second passage between first and second ends. The first suture member can couple the first tubular member and the second tubular member. The first suture member can pass through the first wall and the first passage and the second wall and the second passage. The first tubular member and the second tubular member can engage each other and deform to form an anchoring mass upon tensioning the first suture member.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: A suture thread having: a thread-shaped main body with spikes and a stopper cylinder having a diameter enlarged with respect to the main body is described.

Abstract: Surgical sutures having a core extending along a length thereof between a first end and a second end, and a plurality of sets of first and second projections, wherein the first projections extend in a direction of a first end of the suture and the second projections extend in a direction of a second end of the suture. The first projections may be sized and shaped, and positioned relative to the second projections so as to be capable of substantially shielding the second projections when the surgical suture is drawn through tissue by the second end thereof. The first projections may additionally or alternatively be capable of overlapping and substantially covering a distal end of the respective second projections when the suture is drawn through tissue by the second end.

Abstract: Continuous wound-closure techniques use one-way suture. The one-way suture has tissue-grasping surface features which allow passage of the suture in one direction through tissue, but not in the opposite direction. In closing a wound, the one-way suture is passed alternately through tissue on opposed sides of the wound. The wound-closure techniques allow approximation of the sides of the wound without knots, avoid loop stitching and reduce scarring.

Abstract: Described here are devices and methods for treating one or more conditions or symptoms associated with a tonsil procedure. In some variations, a drug-releasing device may be at least partially delivered to one or more tonsillar tissues before, during, or after a tonsil procedure. In some variations, the drug-releasing device may be configured to be biodegradable. In other variations, the drug-releasing device may comprise one or more hemostatic materials or one or more adhesives. The drug-releasing device may be configured to release one or more drugs or agents, such as, for example, one or more analgesics, local anesthetics, vasoconstrictors, antibiotics, combinations thereof and the like.

Abstract: An open abdomen wound as a result of injury or surgery is closed using hook and loop fastener sheets that are attached at opposing edges of the wound using bolsters through which surgical suture threat is passed to secure the abdominal wall between the fastener sheets and the bolsters. Tension forces are exerted on the fastener sheets and the sheets secured to one another in one or more steps drawing the wound edges toward one another. The tension forces are distributed by the bolsters to avoid loss of tissue at the wound edges. Successful closure of the wound is possible.

Abstract: A suture passer device is provided including a jaw configuration that grasps targeted tissue such as tendons or muscles in a similar manner as existing suture passer devices; however, the device introduces the needle and the attached suture along the axis of the shaft of the device. After grasping the targeted tissue, the needle is deployed by manipulating the handle of the device similar to conventional suture passers however, the needle is deployed in between the opposing jaws and the needle is advanced into tissue along the axis of the shaft as opposed to perpendicular to the shaft as in prior art devices. The invention further includes methods of deploying sutures and anchors. The invention also includes embodiments of jaw designs, and various embodiments of suture passing needles, sutures constructions, and anchor designs. Therefore, the invention also comprises the device in combination with the needles, sutures, and anchors, as well as the needles, sutures, and anchors in separate sub combinations.

Abstract: A barbed suture with a first end and a second end and a body with a plurality of barbs extending from the body. Each barb causes the suture to resist movement in an opposite direction from which the barb faces. Projections extend from said suture. The projections can also engage tissue. The barbs cover the projections when the first end of the suture is moved in tissue and exposes the projections in order to engage tissue when the suture is moved in the direction of the second end through tissue.

Abstract: The present disclosure relates to a method of forming fibers. First and second precursors, each possessing a core and at least one functional group known to have click reactivity, are mixed. The mixed precursors are then extruded under heat to cross-link during fiber production.