Abdominal closure reinforcement methods and tissue anchoring devices for reducing the rate of abdominal wall closure dehiscence are described. The tissue anchors avoid a permanent footprint of foreign material and precluding materials spanning the interior layer of the abdominal closure where risk to visceral structures exists.

A system for piercing through biological tissue and providing access to internal structures; particularly, intra-abdominal structures, and closing an opening in the tissue. The system includes a suture guide sub-system having a tissue positioning sub-system for engaging segments of tissue disposed proximate the tissue opening and a suture passer sub-system that slideably engages the suture guide sub-system. The suture passer sub-system includes suture deployment and capture means that is configured to removably secure a suture thereto and deliver the suture to the segments of tissue disposed proximate the tissue opening.

A gastrocutaneous closure device allows gastrocutaneous fistula closure from external abdominal access through the fistula site. Access through the fistula ensures accurate closure placement on the interior lumen wall of the stomach. A closure or clip has a plurality of prongs defined by a deformable material, such that the prongs extend radially from a central hub in an arcuate or curved, semicircular shape. The arcuate shape converges towards a central point or axis at a distal end, and the proximate end of the prongs attaches to the central hub such that the prongs radiate from the hub and the distal end curves back toward the axis through the hub. The deformable prongs may therefore radially compress or retract to define a larger or smaller diameter. The fistula lies on the axis such that the biased, inserted prongs pull the inner stomach wall closed around the healing fistula.

An access assembly includes an instrument valve housing defining a cavity, and a valve assembly. The valve assembly includes a flange seal member, a seal assembly, a centering mechanism, and a retainer frame assembly. The flange seal member includes an arcuate portion configured to adjustably engage first and second surfaces of the instrument valve housing in a sealing relation. The centering mechanism is configured to bias the valve assembly towards a generally centered position within the cavity. The centering mechanism includes a plurality of coils including inner coil portions operatively secured with the seal assembly, and outer coil portions configured to engage the first surface of the instrument valve housing. The retainer frame assembly includes first and second members. The inner coil portion of the centering mechanism is disposed between seal assembly and the second member of the retainer frame assembly.

Devices for approximating multiple tissue edges internal to a body are disclosed.

Devices for approximating multiple tissue edges internal to a body are disclosed.

Devices for approximating multiple tissue edges internal to a body are disclosed.

Surgical access devices having wound closure features incorporated as part of the device are provided. The devices allow suture to be inserted directly into the device and operated to close an opening through which the device is disposed as or shortly after the device is removed from the surgical site. Further, the wound closure features allow for various orientations of wound closure to be achieved by adjusting an angle at which the suture enters tissue surrounding the opening to be closed. Some of the wound closure features provided for include openings formed in both the housing and cannula of the surgical access device, multiple openings formed in one or both the housing and cannula, locations of the openings being adjustable or otherwise movable, and various flexible seals. Other features, as well as methods of closing an opening through which the surgical access device was disposed, are also provided.

A method of suturing a trocar path incision in a tissue of a patient with an obturator includes inserting the obturator through the tissue such that a shaft of the obturator extends through a tissue opening about the trocar path incision and a distal tip of the obturator is positioned within a cavity of the patient. The method also includes directing the suture via a suturing feature with the obturator inserted through the tissue in order to direct the suture relative to the tissue. Furthermore, the method includes closing the tissue opening about the trocar path incision with the suture.

A hernia repair device including a main body, a plurality of suture needle ports, a plurality of suture needles and a central shaft. The central shaft includes a retractable distal flange disposed at a distal end portion of the central shaft and defines a central channel extending through the main body. The suture needle ports are adjustable between a first configuration in which the suture needle ports are housed entirely within the main body and a second configuration in which the suture needle ports partially extend from the distal end portion of the main body. The suture needles are adjustable between a first configuration in which the suture needles are housed entirely within the suture needle ports and a plurality of second configurations in which the suture needles partially extend from distal end portions of the suture needle ports. A hernia repair mesh is attached to the plurality of suture needles.