Abstract: A flexible portal cannula for use in arthroscopic surgery. Distally positioned flaps extend radially outwardly from the outer surface of the cannula and are resiliently foldable to lie against the outer surface of the cannula during insertion into a surgical portal, and resiliently biased to return to the radially outwardly extending position when unconstrained. A clip disposed on the cannula outer surface outside of an arthroscopic workspace acts to clamp tissue disposed between the clip and the flaps. The clip has an extension to receive pairs of slots to sort and engage the sutures.

Abstract: Suture delivered patches adapted for interposition, augmentation or repair devices for use in tendon and ligament repair, including rotator cuff repair, have been developed as well as methods for their delivery using suture guided arthroscopic methods. The repair patches may be provided from suitable biocompatible materials. The patches may be delivered using anchored sutures already in use during a surgical repair including, open, minimally invasive, endoscopic, and arthroscopic repair procedures. Additionally, fixation of the suture delivered repair patch is secured along with the normal suture securing workflow of the one or more sutures used to deliver the patch.

Abstract: A wound closure system and a method of closing a wound are disclosed. The disclosure is directed to a wound closure system comprising a skin anchor mechanically attached to external skin tissue on a first side of a generally linear wound, an anchorable tensioning apparatus mechanically attached to external skin tissue on an opposite side of the wound, and a line extending between the skin anchor and the tensioning apparatus to movably connect the anchor to the tensioning apparatus. The line is fixedly engaged with an anchor on one side of the wound while the tensioning apparatus provides tension on the line to draw the skin anchor and the tensioning apparatus toward each other and toward the wound.

Abstract: A wound dressing for use in the application of negative pressure to a wound, comprising a support member and a cover member positionable over the wound in use. The support member can have a first support element having a first portion aligned with a first axis and a body portion coupled with and extending away from the first portion, and a second support element having a first portion aligned with the first axis and a body portion coupled with and extending away from the first portion of the second support element. At least the body portion of each of the first support element and the second support element can be independently rotatable about the first axis. The support member can support at least a middle portion of the cover member above a surface of the wound so as to define a space between the wound cover and the wound.

Abstract: A suture securing device includes a body connected to an arm by a hinge and is useable to secure a suture without requiring the tying of a knot. The body includes a bottom surface that contacts a patient's skin when in use, an eversion recess formed in the bottom surface, and a first gripping surface. The arm is connected to the body by the hinge and includes a second gripping surface that contacts at least a portion of the first gripping surface when the hinge is in the closed configuration. The device may also include an engagement structure configured to secure the arm to the body in the closed configuration.

Abstract: A suture securing device includes a body connected to an arm by a hinge and is useable to secure a suture without requiring the tying of a knot. The body includes a bottom surface that contacts a patient's skin when in use, an eversion recess formed in the bottom surface, and a first gripping surface. The arm is connected to the body by the hinge and includes a second gripping surface that contacts at least a portion of the first gripping surface when the hinge is in the closed configuration. The device may also include an engagement structure configured to secure the arm to the body in the closed configuration.

Abstract: An apparatus can include a tensioning member having a body defining a first bone engaging surface, a second opposite suture receiving surface, and an outer perimeter. First and second suture attachment members can be positioned relative to the second surface and spaced apart from each other, and can be configured to be coupled to a suture. First and second suture engaging members can extend from the second surface and can be positioned in spaced relation to the first and second suture attachment members. Rotation of the tensioning member in a first direction can selectively engage the first and second suture receiving members with the suture, thereby forming a non-linear path of travel of the suture relative to the first and second suture attachment members and suture engaging members and increasing the tension in the suture.

Abstract: A suture fixation system that is configured to secure a suture includes a pad and a suture fixation device configured to clamp and retain at least one end of a suture. The pad includes a suture surface opposite a tissue surface and defines an opening formed through the suture and tissue surfaces that is sized to provide a margin around a tissue lesion to be sutured. The suture is employed to stitch the tissue lesion closed, the suture having at least one free end that is held in place by the suture fixation device, and the pad configured to elevate a portion of the suture away from the tissue.

Abstract: A sternal clamp having a first sliding body member and a second sliding body member telescopically mated, and a suture-receiving channel disposed on the exterior of the first sliding body member and the second sliding body member, wherein the first sliding body member and the second sliding body member are securable about a severed sternum by encircling and securing a suture about the first sliding body member and the second sliding body member, the suture being received and retained within the suture-receiving channel.

Abstract: In some embodiments, an apparatus includes a handle and an elongate member coupled to the handle. The elongate member has a first portion, a second portion and a third portion. The first portion of the elongate member extends from the handle and defines a first longitudinal axis. The second portion of the elongate member extends from the first portion and defines a second longitudinal axis. The first longitudinal axis and the second longitudinal axis define a first angle and a first plane. The third portion of the elongate member extends from the second portion of the elongate member and defines a third longitudinal axis. The third longitudinal axis and the second longitudinal axis define a second angle and a second plane. The second plane is non-parallel with the first plane.

Abstract: The present disclosure relates to compositions comprising a copolymer that includes a first monomer and a second monomer that is different from the first monomer, wherein both the first and second monomer are selected from the group consisting of 3-sulfopropyl acrylate potassium salt, sodium acrylate, N-(tris(hydroxyl methyl)methyl)acrylamide, and 2-acrylamideo-2-methyl-1-propane sulfonic acid. The present disclosure further relates to methods for preparing the copolymer compositions and shaped articles comprising the copolymers.

Abstract: Described are devices, methods and systems for securing sutures external to the body. In certain aspects, a suture securement device includes a housing member defining an internal cavity and a wedge member moveable within the cavity between a suture-release position to a suture-retention position. The wedge member defines a suture aperture extending therethrough. At the suture-retention position, the housing member is configured to compress the wedge member to clamp the suture, thereby substantially preventing the suture from moving within the aperture.

Abstract: The present disclosure relates to an anchor. The anchor includes a suture bridge having a proximal end and distal end. The distal end of the suture bridge has a thickness greater than a thickness of the proximal end of the suture bridge. At least two ribs extend from the proximal end of the suture bridge to a proximal end of the anchor. At least one open helical coil wraps around the at least two ribs and extends, substantially, from the proximal end of the suture bridge to the proximal end of the anchor. The at least one open helical coil defines an internal volume communicating with a region exterior to the anchor through apertures between turns of the at least one open helical coil. The at least two ribs are engagable with a grooved shaft of a driver.

Abstract: A surgical tack is provided that can have a single shaft formed of a bio-compatible material and a tip adapted for entering and engaging bone or tissue; and a head mounted on said shaft.

Abstract: A method and device comprising a plate with attached suture, the plate made at least partially of silicone, are provided for wound closure. The silicone in the plate inhibits scarring in the healing wound, and the device provides for improved wound closure.

Abstract: A surgical retractor includes a base defining an open area therein to correspond with a surgical incision in a body. The base has an inner wall facing the open area and an outer wall facing away from the open area. A plurality of channels extend through the base between the inner and outer walls, and at least one of the channels is at an angle offset from normal to the inner wall where the at least one channel intersects the inner wall. A respective retractor arm is carried within each of the channels for retracting the body to open the surgical incision. In a surgical method, such as a thyroidectomy, a base is positioned so that the open area corresponds with a surgical incision in a body. Respective retractor arms carried within each of the channels are moved to retract the body to open the surgical incision.

Abstract: The present disclosure relates to compositions comprising a copolymer that includes a first monomer and a second monomer that is different from the first monomer, wherein both the first and second monomer are selected from the group consisting of 3-sulfopropyl acrylate potassium salt, sodium acrylate, N-(tris(hydroxyl methyl)methyl)acrylamide, and 2-acrylamideo-2-methyl-1-propane sulfonic acid. The present disclosure further relates to methods for preparing the copolymer compositions and shaped articles comprising the copolymers.

Abstract: A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Abstract: An improved bone joint suture button including a body having a channel extending across at least a portion of the top surface of the body, a pair of suture passages extending from the channel inclined, inwardly to the bottom of the body, and a bridge portion recessed from the body top surface between the suture passages and having a curved upper surface for providing a smooth surface for bearing against the suture; and an improved bone joint suture grommet including a pair of grommets to be inserted into holes drilled in a bone, each grommet including a hollow shaft and a head portion having a top with a chamfered channel in communication with the interior of the hollow shaft, a pair of buttons each including a chamfered side wall, a top with a chamfered channel therein, and a pair of inwardly angled suture passages extending from the channel through the button and separated by a chamfered portion, and at least one suture strand looped through the pair of inwardly angled suture passages of one button over the

Abstract: A device for fixing and tensioning at least one pulling thread for applying a neovagina comprises a base body on which at least one fixing element is arranged for fixing the at least one pulling thread with tensioning. The fixing element is able to turn about an axis of rotation in order to tension the at least one pulling thread, and a blocking device is provided for the fixing element, by means of which blocking device the fixing element can be blocked at least in a direction of rotation opposite to the direction of rotation for tensioning the at least one pulling thread.

Abstract: A cannula has a flange and a body with slots extending through the entire flange and into the body. The cannula may also have a longitudinal slot extending its entire length. An obturator used with the cannula may also have a longitudinal slot extending along its length. A surgical method using these instruments includes separating lengths of suture and managing the suture by placing lengths of suture in the slots in the cannula. The cannula and obturator may be used after suture is already in place by placing the suture in the longitudinal slots and then introducing the cannula and obturator to the tissue defect site. The cannula may also be used to deliver a therapeutic implant to the tissue defect site. The instruments and method may be used in mensical surgery.

Abstract: A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Abstract: A suture anchoring device comprising (1) a first retaining member having a first surface, a second surface and a first outer edge; where the second surface lies in a first plane; the first retaining member having an opening that extends from the first outer edge to at least partially through the second surface to an inner point of the first retaining member; (2) a second retaining member having a third surface, a fourth surface and a second outer edge; where the third surface lies in a second plane, the second retaining member having a holding means; and (3) a coupler having a third outer edge and a cross-sectional area taken in a plane parallel to the first plane that is smaller than the cross-sectional area of the first retaining member taken in a plane parallel to the first plane; where the coupler joins the first retaining member to the second retaining member at the second surface and third surface; wherein the second and third surfaces are parallel to each other and non-coterminous.

Abstract: The present invention provides methods and devices for treating the annulus of an intervertebral disc. The methods and devices can employ an expandable treatment device which is deployed at least partially in the subannular space. Fixation devices and methods are also disclosed, which help to secure the treatment device in place.

Abstract: A threading device that includes an elongated tube having first and second opposite ends and a fiberoptic core. The elongated tube includes an interior and an eyelet defined therein. The first end of the elongated tube includes a blunt tip affixed thereto and the second end includes a threaded connector. The blunt tip is translucent. The fiberoptic core includes at least one fiberoptic strand extending through the interior of the elongated tube that illuminates the translucent tip when the at least one fiberoptic strand is energized.

Abstract: A tendon attachment system may include two fasteners forming a fastener assembly. The first fastener may comprise a capture body with suture apertures and a threadable capture body hole, two sharpened legs attached to the capture surface, and a tendon channel. The suture may be secured to a tendon, and slid through the apertures guiding the first fastener to the fixation site. The two sharpened legs may be driven into the bone. The capture body may provide security of the tendon to the bone and the sutures may be secured to the first fastener. The second fastener may comprise a head portion, and a threadable portion which may pass through the capture body hole and threadably engage with the bone, further advancing the first fastener toward the bone. The suture may be further secured by the engagement of the second fastener to the first fastener.

Abstract: A meniscal repair system including a pair of elongate needles with a suture filament attached between respective proximal ends of the needles. Two implants are attached to the suture (e.g., molded thereon) between the needles so as to form a suture bridge between the implants. One implant may comprise a barbed shaft aligned with the suture, while the other may be in the form of a T-bar that can be deployed so as to be perpendicular to a portion of the suture filament. The system may further include one or more dilators (e.g., one or more suture knots or molded beads) disposed along the length of the suture filament to aid in passage of the implant after the associated needle.

Abstract: Methods and devices for repairing the TFCC of a patient's wrist are provided. In general, the device includes first and second anchor bodies that are connected to one another by a suture. The first anchor body is configured to be passed through a portion of the TFCC of a patient's wrist and an anchoring tissue, preferably using a delivery device, such that the first anchor body is positioned across a torn portion of the TFCC, the second anchor body is positioned across the anchoring tissue, and the suture extends therebetween. The suture can then be tensioned to anchor the TFCC to the anchoring tissue.

Abstract: A device for securing a surgical suture to a bone comprises a first element, which can be introduced into a bone, and a second, movable element, which can be introduced into said bone in such a way that it meets said first element. A channel being formed in said bone as a result of introducing said first and said second elements into that bone. One of said two elements carries a surgical suture. A suture catcher is arranged within that element of the two elements not carrying said suture, by means of which suture catcher said suture can be taken hold of and said suture can be withdrawn via said element not carrying said suture.

Abstract: A polymeric, surgical clip having first and second curved leg members joined at their proximal end by a hinge portion and movable from an open position to a closed position for securing and maintaining a desired amount of tension on a suture. A ridge protrudes from a portion of the inner surface of one leg and a groove is formed in a corresponding portion of the inner surface of the other leg. An eyelet extends through the ridge to engage a portion of a suture.

Abstract: Apparatus and methods for repairing damaged tendons or ligaments. Various repair apparatus include an elongate tensile member and a pair of anchor structures connected for movement along the tensile member on either side of a repair site, such as a tear or laceration. The anchor structures may take many forms, and may include barbed, helical, and crimp-type anchors. In the preferred embodiments, at least one anchor structure is movable along the elongate tensile member to assist with adjusting a tendon segment to an appropriate repair position and the anchor structure or structures are then lockable onto the elongate tensile member to assist with affixing the tendon at the repair position. The invention further provides tendon-to-bone repair apparatus and methods employing similar concepts. Tendon retrieval devices of the invention include helical members for rotating into a tendon end and subsequently moving the tendon to an appropriate operating position.

Abstract: A suture buttress comprises a hollow tube having an outer surface and opposed ends. The suture buttress may further include an external securing element, such as a securing tab suitable to retain the suture buttress within a bone tunnel. The suture buttress may also include a resilient flange disposed on one end of the suture buttress.

Abstract: This invention is a cinch suture having first and second segments and a locking device joining these segments which responds to teeth on the first segment to lock a ligature in place and prevent loosening. The locking device has teeth positioned to interact with engaging elements carried by the first segment as it is passed through the locking device to prevent removal. The locking device teeth are flexible and movable and arranged in two rows in a face to face offset relationship. The first segment engaging elements have a spherical configuration. The first segment passing through the locking device forms an endless loop for encircling and closing an opening formed by surgical excision of an organ or vessel. The locking mechanism has a receiving entrance and a removal exit. The two rows of offset teeth alternately engage spherical engaging elements to provide minute adjustment in the tightness of the suture and place pressure on the suture to hold it firmly in place.

Abstract: The present invention relates in general to implantable, resorbable copolymers containing L-lactide and glycolide repeat units, and in particular to terpolymers containing L-lactide, glycolide, and one other type of repeat unit selected from the group consisting of D-lactide, D,L-lactide, and &egr;-caprolactone. Medical devices for in vivo implantation applications containing such implantable, resorbable copolymers are also described, as well as methods for making such copolymers and devices.

Abstract: A tape for use in closing a tissue opening including a substrate and a plurality of sutures sewn directly into the substrate. The tape may have serrated edges in order to facilitate closure of a nonlinear tissue opening. Moreover, the tape may include windows in order to facilitate viewing of the tissue opening during closure and wound healing thereof. The sutures may be sewn laterally across the tape or not, and they may be imbedded individually into each side of the substrate, or they may be disposed under bridges between the windows in the substrate. The tape may have an adhesive affixed to one side thereof. Also disclosed is a method for closing a tissue opening by first cleaning the tissue; applying a layer of adhesive to the tissue adjacent to the opening; applying the tape over the opening; and, then tying each of the sutures together in order to pull the opening in the tissue closed.

Abstract: A frame (1) and a method for suturing a wound (22). The frame (1) is placed on each side of the wound (22) and reaches across it. The frame (1) has a first and second foundation part (2, 3) for placing on the skin (20) on each side and along the wound/wound edges respectively. A joining device extends (10) between the first and second foundation parts (2, 3). The first and second foundation parts (2, 3) are arranged with an adhesive (4, 5) for securing to the skin (20), and the joining device (10) is a flexible, jointed device of mainly constant length.

Abstract: An apparatus and method for manipulating and anchoring tissue is provided. The invention is directed to solving the problem of manipulating and anchoring tissue within a joint when access to that tissue is limited, for example, during arthroscopic surgery.

Abstract: A suture buttress system has a suture retriever and a suture buttress. The suture retriever includes a handle portion with an elongate member extending therefrom and having an outer surface and a distal end that includes a suture retaining element. The suture buttress comprises a resilient hollow tube having an outer surface and opposed ends. The suture buttress is removably and replaceably disposed on the elongate member. The suture buttress may further include an external fastening element suitable to retain the suture buttress within a bone tunnel. A suture buttress deployment tool may also be provided.

Abstract: Methods and assemblies for reducing the volume of a lung. A plurality of anchors are anchored at different positions in the lung. A cord is attached to each of the anchors. The anchors are drawn towards one another via the cords to cause the lung to collapse, thus compressing the tissue in the lung and establishing a reduction in lung volume.

Abstract: An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A suture. A grommet for a bone. A method for securing a suture through a bone.

Abstract: The present invention relates to a suture tightening wound closure device for use on mammals including humans. This device is comprising a smooth suture (to be sewn across an open wound through the skin and underlying tissue) and a suture loop tension means (for closing the wound). This tension means is by grasping one end of the suture, and pulling back its second end, forming a tensioned suture loop, enclosing the wound. Specifically, the device of the present invention is characterized by the tension means having a manual control mechanism (for pulling or releasing said second end). The smooth suture according to the preferred embodiment of the present invention is a suture band, which is flexible for bending along it's length and is resistant to bending along it's width. The device of the present invention also relates to embodiments having in addition a pair of suture supporting skin reinforcing means.

Abstract: The present invention is directed to a suture support assembly for use during a surgical procedure. The suture support assembly in accordance with the present invention includes an elongated main body portion, and a proximal end portion having a passageway formed therein for receiving at least one suture therein. The proximal end portion and at least a portion of the elongated main body portion are adapted to be located within a vessel during the surgical procedure. The suture support assembly may be inserted into the vessel via an axillary incision, a brachial incision, or a femoral or a common iliac arteriotomy, and may be used in connection with the repair of an abdominal aortic aneurysm.

Abstract: A suture buttress includes a hollow tube having an outer surface and opposed ends. The suture buttress may further include an external securing element, such as a securing tab suitable to retain the suture buttress within a bone tunnel. The suture buttress may also include a resilient flange disposed on one end of the suture buttress.

Abstract: A tension-adjusting device for sutures comprising a body through which sutures tend to be knotted at the top of the body with a plurality of flexible legs extending outwardly and downwardly from the body to rest on the body of a patient. In one embodiment, the body of the top half and the bottom half can be rotated with respect to each other to tighten the sutures passing therethrough.

Abstract: A method and assembly for reducing the volume of a lung. A plurality of anchors are anchored at different positions in the lung. A cord is attached to each of the anchors. The anchors are drawn towards one another via the cords to cause the lung to collapse, thus compressing the tissue in the lung and establishing a reduction in lung volume.

Abstract: Medical devices or components for medical devices formed from bioabsorbable elastomers comprising a segmented copolymer are disclosed. The segmented copolymer is a copolymer of from about 30 to about 40 mole percent of lactide and the balance being substantially p-dioxanone. The segmented copolymers surprisingly exhibit elastomeric properties, and the copolymers are bioabsorbable. The combination of physical and biological properties of these elastomeric copolymers are particularly well suited for numerous medical and surgical applications.

Abstract: A device and method for repairing a torn tendon or ligament wherein three incisions are made. A suture is passed from one side of the tear to the other. The suture is tightened to achieve an abutting relationship between the two sides and is secured. A similar product is also shown for use with a flexible suture for repairing bones.

Abstract: A system for closing together a first side of a sternum and a second side of the sternum of a patient. The system includes a first grommet to be disposed in the first side. The system includes a second grommet adapted to be disposed in the second side. The system includes a mechanism for placing a grommet into the sternum. The placing mechanism is adapted to hold the grommet for placement in the sternum. The system includes a first wire suture for insertion through the first and second grommets. The system includes a stop mechanism for allowing the placing mechanism to place a grommet into the sternum only in a desired location of the patient and any other portion of the patient is protected from damage by the placing mechanism during operation. A grommet. An approximator. A drill stop mechanism. A placement tool. A method of threading a wire suture through a hole in a sternum. A method of bringing together a first side of a sternum and a second side of the sternum.

Abstract: A device for sealing a hole in an anatomical structure comprises an elongated member formed with a proximal portion extending along a first axis and a distal portion extending along a second axis, wherein the second axis is different from the first axis and wherein a needle retention channel extends within the distal portion to a distal opening formed in the proximal end of the distal portion. A central portion connects the proximal and distal portions. In use, the device is guided into the hole in the anatomical wall and positioned in a first orientation so that the distal opening faces a first desired location on the inner wall. Thereafter, a first needle is withdrawn from the needle retention channel by drawing proximally a suture coupled to the first needle so that the first needle passes through the first desired location out of the body. The elongated member is then rotated within the hole to a second orientation so that the distal opening faces a second desired location on the inner wall.

Abstract: An apparatus and method for manipulating and anchoring tissue is provided. The invention is directed to solving the problem of manipulating and anchoring tissue within a joint when access to that tissue is limited, for example, during arthroscopic surgery.