Knotless surgical constructs and methods of tissue repairs. A surgical construct can offer both repair and shuttling capabilities to allow for a single pass to load multiple sutures at once. A surgical construct can pass or shuttle multiple repair sutures while making a single pass through or around soft tissue.

A button inserter and system are disclosed that enable easily and effectively deploying a near bone suture button from the button inserter when implementing the suture button technique. To deploy the near bone button, with a far bone button deployed from the button inserter and against the far bone, the button inserter's handle may be translated away from the deployed far bone button. Translating the handle changes a position of a carriage body within a channel of the handle thereby compressing a spring. Protrusions on the carriage body may be forced through notches in the handle, which thereby alters an orientation of the carriage and releases the compressed spring, which applies force to the carriage body. The combination of force induces the carriage to rotate, which thereby releases the near bone button from the carriage. A free end of suture also releases from the carriage.

A new and innovative method of routing a strand of material for creating a self-locking construct that joins two objects is provided. More specifically, the provided routing method includes a crossover point at which the routed strand of material crosses over itself thereby enabling the strand portions routed through one of the objects to travel in a same direction when the self-locking construct is cinched. The strand portions traveling in the same direction generates less friction between the portions than if the portions traveled in opposite directions. Accordingly, the provided routing method helps enable a self-locking construct that generates less friction than typical self-locking constructs, which thereby helps reduce the occurrences of weaknesses in the final self-locking construct. The reduced friction generation also helps increase an ease of use for a user when cinching the self-locking construct.

Exemplary methods and systems can be provided for resurfacing of skin that include formation of a plurality of small holes, e.g., having widths greater than about 0.2 mm and less than about 0.7 mm or 0.5 mm, using a mechanical apparatus. Compressive and/or tensile forces can then be applied to the treated region of skin as the damage heals to facilitate hole closure, and provide enhanced and/or directional shrinkage of the treated skin area.

Surgical constructs and methods include the use of a one-way adjustable fixation loop that is formed by tying two knots in a surgical filament, each knot defining an individual adjustable loop and the individual adjustable loops being interconnected to form the one-way adjustable fixation loop. The knots enable a non-spliceable suture to be used in the creation of the one-way adjustable fixable loop. Embodiments can include a fixation device, such as a cortical button or plate for use in a bone tunnel, and enable the knots to work independent of and suspended below the fixation device. Embodiments can increase the compatibility of the adjustable fixation loop with existing fixation devices and can isolate and protect the knots from damage during use and after implantation.

Meniscal repair devices, systems, and methods are provided.

A system is for use at a heart valve having an annulus and leaflets coupled to the annulus. The system comprises a tensile member, and first and second anchors, each anchor comprising multiple flat, flexible anchor elements. The system further comprises one or more catheters, configured to (i) transluminally anchor the first anchor and the second anchor to the annulus across the valve from each other such that the tensile member extends from the first anchor, over at least one of the leaflets, to the second anchor, and (ii) subsequently, apply tension to the tensile member by sliding the tensile member through the first anchor in a manner that (a) for each of the first and second anchors, draws the anchor elements together and against the annulus, and (b) draws the first anchor and the second anchor toward each other. Other embodiments are also described.

The disclosure provides a dynamic vascular access and closure device for radial cinching of an access site. The device includes a tensioning tube, a resilient member disposed within the tensioning tube, and a plurality of sutures extending axially between a distal end of the tensioning tube and a proximal end of the tensioning tube. A proximal end of each of the plurality of sutures can be configured to attach to the resilient member such that movement of that suture causes compression or extension of the resilient member within the tensioning tube to provide cinching to the sutures.

The present invention provides a tissue anchor and a system and method employing same, the anchors including a body having a first section and a second section reversibly engagable with one another, each section including a plurality of barbs in the form of microneedles projecting from the underside therefore, the barbs on one section being inclined towards barbs on the other section, such that tissue may be captured and deformed between the barbs through displacement of the first section relative to the second section in order to achieve robust retention of the tissue anchor at a deployment site.

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.