Devices, systems, and methods are provided for managing suture filament during a tissue repair procedure. One exemplary embodiment of an anchor insertion tool includes a handle, an elongate shaft extending distally from the handle, and a ring disposed around the elongate shaft. The ring can be configured to slide along a length of the shaft, and can be configured to engage a filament extending from an anchor removably coupled to the shaft's distal end during a suture anchor insertion procedure. In some embodiments, the ring can include one or more slots for receiving a filament and maintaining a tension applied to the filament. The ring can also include features that prevent it from rotating with respect to the shaft, such as a boss formed on a ring's central opening that engages a slot formed in the shaft. Other devices, systems, and methods for suture anchor insertion are also provided.

A method and apparatus for positioning a locator. The method includes inserting a tissue locator through an opening in a tissue wall, and distally advancing a proximal member, positioned proximal a proximal end of a first arm of the tissue locator, to move a portion of the first arm from a first position to a second position that is separated from a longitudinal axis of the tissue locator by a greater distance than the first position.

Various exemplary methods and devices are provided for passing sutures around anatomical structures. In an exemplary embodiment, a suture delivery device is provided that includes a body portion having a suture delivery member disposed therein and configured to pass a suture around an anatomical structure. The suture delivery member can be movable between a retracted configuration in which the suture delivery member is disposed within the body portion and an advanced configuration in which the suture delivery member extends distally beyond the body portion and assumes an arcuate shape. The arcuate shape can correspond to a shape of the anatomical structure and can extend almost all of the way around the anatomical structure, for example at least around 270° of a circle, thus assisting a user in passing the suture around the anatomical structure without having to manually manipulate the suture delivery device at awkward angles around adjacent tissue.

Meniscal repair devices, systems, and methods are provided.

A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

A device for use in the treatment of hemorrhoids. The device includes an elongated tube-shaped element that includes a forward end and an aft end. The aft end provides access to the interior of the tube-shaped element. The tube-shaped element extends along a longitudinal axis L and includes at least one opening formed between the forward and aft end. The device includes an anal mucosa support device removably arranged within the tube shape element. The support device includes at least two cavities to receive anal mucosa. At least one needle guide structure is formed in the elongated tube-shaped element and the anal mucosa support device such that at least one needle is capable of being guided during movement within the tube-shaped element across the at least two cavities in the anal mucosa support device to a position where the needle extends across the opening in the tube-shaped element.

A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

Medical devices for applying a cinch to a suture and methods for making and using such devices are disclosed. An example medical device may include an elongated shaft including a proximal region and a distal region. The distal region may define a lumen having a lumen dimeter, and a distally facing end surface. The medical device may also include an outer cinch member defining a bore and having an outer surface defining a shoulder. An elongated inner shaft may extend through and be longitudinally movable within the lumen and the bore and including a distal end section. An inner cinch member may be engaged with the distal end section of the elongated inner shaft.

A delivery device for tissue anchor delivery is provided. The delivery device includes a first flexible tube having a rigid distal portion attachable to a tissue anchor, a second flexible tube coaxially disposed around the first tube and a tubular sheath covering the second flexible tube. Also provided is a system which includes an imaging device coupler reversibly attached to the delivery device through guides.

Embodiments of the bone anchor assembly (36, 50) described herein have adjustable lengths and therefore accommodate many needs. Therefore, the physician does not need to maintain a multitude of bone anchors having a variety of lengths in order to be prepared for many situations. The bone anchor assembly (36, 50) has an elongated hollow shaft portion (38, 52) formed of multiple shaft segments (46, 58) joined together. The length of the shaft portion (38, 52) is adjusted after the implanting of the bone anchor assembly into the bone by removing shaft segments (46, 58).