A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

Devices used to capture sutures are described. More particularly, suture capture devices described herein include an elongate cannulated tool having a first end with a sharpened point configured to pierce tissue, and an elongate hook member positioned within a hollowed center region of the elongate cannulated tool that has a hook on a first end of the elongate hook member proximate the sharpened point of the elongate cannulated tool. The elongate hook member is capable of advancing and retracting within the elongate cannulated tool. The devices further include a handle positioned on a second end of the elongate cannulated tool that includes a trigger that advances the hook into or out of the first end of the elongate cannulated tool when pushed in a first or second direction. Methods of capturing a suture using such a device are also described.

A trocar wound closure system includes a suture passing needle and a guide for directing the needle through the wound site. A distal portion of the needle includes a capture rod with a slot. An obturator tube with a cutout section can be axially actuated to align the cutout section with the slot, and then moved out of alignment so as to capture the suture. The guide includes at least two tracks for directing the needle through the tissue track. A suture catcher is located adjacent to the exit of each track and configured to be actuated from a radially extended configuration to a retracted configuration so as to capture the suture section inserted through each loop. Radially expandable arms at distal section are movable between an expanded configuration and a slender configuration.

A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

Devices, systems, and methods to improve both the reliability of soft tissue repair procedures and the speed at which the procedures are completed are provided. The devices and systems include one or more tissue augmentation constructs, which include constructs that are configured to increase a footprint across which suture applied force to tissue when the suture is tied down onto the tissue. The tissue augmentation constructs can be quickly and easily associated with the repair suture, and can be useful in many different tissue repair procedures that are disclosed in the application. Tissue augmentation constructs can include various blocks and scaffolds, among other formations. The present disclosure includes, among other disclosures, methods for using tissue augmentation scaffolds, including folding scaffolds, and descriptions and methods associated with extra-wide tissue augmentation blocks.

A tensioning device includes an elongate plunger, a plunger track housing configured to receive the plunger therein at least in part, an elongate tube configured to be coupled to the plunger track housing, and an actuator configured to cause axial translation of at least a portion of the plunger within the plunger track housing.

A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

A device for cardiac surgery is disclosed, having a) a plurality of pairs of suture guides spaced about the frame; b) a plurality of suture tubes, with one suture tube corresponding to each pair of suture guides; c) a plurality of snares, each corresponding to and passed through one of the plurality of suture tubes so that a handle at one end of the snare protrudes from a proximal end of the corresponding suture tube and a snare loop at another end of the snare protrudes through a distal end of the corresponding suture tube, and wherein the snare loop further protrudes through one of the suture guides in the corresponding pair of suture guides; and d) a plurality of sutures, each corresponding to one of the pairs of suture guides and coupled to the suture guide in the corresponding pair of suture guides which does not have the snare loop passing through it.

A suture instrument comprising an elongated outer sleeve (3) and a cannula (9) terminating in a distal piercing tip (12) is slideable within a cannula bore (7) extending through the outer sleeve (3). A plurality of sutures (15), are located in a suture bore (14) extending longitudinally through the cannula (9). Each suture (15) comprises a suture thread extending between a pair of anchor bars (20), and a cinch clip (24), which is located on a loop (22) of the suture thread (7) formed between the anchor bars (20), and is slideable along the loop (22) for reducing the effective length of the suture thread (17) between the anchor bars (20). The anchor bars (20) and the cinch clips (24) of the sutures (15) are aligned end-to-end sequentially along the suture bore (14) of the cannula (9) with the cinch clip (24) of each suture (15) located between the anchor bars (20) thereof. A pusher rod (35) slideable in the suture bore (14) is operable by a linear actuator for sequentially urging the anchor bars (20) and the cinch clip (24) of each suture (15) from the suture bore (14) through the distal piercing tip (12) of the cannula (9).

An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.