Surgical constructs that at least one fixation device, at least one flexible strand the forms at least one adjustable loop, and a self-locking mechanism, and methods of tissue repair using the same.

The present teachings provide methods for resizing, reducing, and/or closing an atrial appendage. A delivery catheter is percutaneously advanced to the atrial appendage. At least two tissue anchors are implanted in tissue of the heart. Both tissue anchors are pulled together so that the atrial appendage is resized, reduced, and/or closed. This closure method and system could be used alone in closing the atrial appendage. This closure method and system could also be used in addition to other treatment mechanisms.

A clip unit includes: an arm portion including arms extending from a proximal end portion to a distal end portion so as to be openable and closeable; a holder than can hold the arms in a closed state by accommodating the proximal end portion of the arm portion; and a thread grip attached to at least one of the arms and positioned between the arms. In a state where the arms are spread open, a dimension of the thread grip in the opening/closing direction of the arms is equal to or larger than a distance between the arms in the closed state. The thread can be elastically deformed in the closed state.

A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

A method for coupling tissue with a flexible member including a tail and a self-locking construct coupled to the tail. The self-locking construct includes an adjustable first loop and an adjustable second loop coupled thereto. The method includes implanting an anchor in bone, the anchor slidably mounted to the tail. The tail is positioned relative to the tissue. An end of the tail is inserted through the first loop. The tail is passed through the first loop, the second loop is pulled into the anchor, and the self-locking construct is positioned relative to the tissue. The self-locking construct is tightened against the tissue by pulling on an end of the self-locking construct. The first loop is tightened onto the second loop.

A method of attaching a surgical suture inside of a pelvis includes moving an anchor deployment component relative to the anchor delivery component, pushing an anchor out of the anchor delivery component and into tissue inside of the pelvis, and engaging anchor with the tissue inside of the pelvis.

An orthopedic button assembly providing the ability to perform a soft tissue repair or bone repair using a method for securing sutures or fixation members in a knotless manner is described. The orthopedic button assembly of the present disclosure is designed in a manner to as to not rely on an additional component to perform the locking. The orthopedic button assembly of the present disclosure includes the ability to optimally tension the repair by pulling the tensionable fixation members (e.g. sutures) in the tensioning direction and prevent slippage of the tensionable fixation members in the opposite direction by capturing the tensionable fixation members in a manner such that pulling on the tensionable fixation members in the direction opposite of the tensioning direction (e.g., if connected tissue or bone were to attempt to “pull away” from the button assembly under tension) actually increases the tension, resulting in a tighter locking interface to increase the security of the repair.

An apparatus includes an end effector including an anvil and lower jaw. The anvil is pivotable toward the lower jaw to capture tissue. The apparatus further includes a stapling and severing assembly configured to sever and staple tissue clamped between the anvil and the lower jaw. A staple cartridge is coupled with the lower jaw. The staple cartridge includes a deck facing the anvil, a plurality of staples positioned in a plurality of staple openings formed through the deck, and a cinching feature positioned on the deck. At least a portion of the cinching feature is configured to be captured by the staples as the staples are driven out of the staple openings in response to activation of the stapling and severing mechanism. The cinching feature is configured to cinch severed and stapled tissue.

A locking suture construct having suture material with a first end and a second end, each attached to a first body in a slidable manner, a constricting member formed in the second end of the suture material, and a bight in the suture material between the first end and the second end. The bight can be pulled through the constricting member around a second body to create a locking loop. The first end and the second end are passed through the locking loop. Pulling the first end increases a perimeter of the locking loop and moves the constricting member toward the second body. When the constricting member reaches the second body, pulling the first end reduces the perimeter of the locking loop and moves/rotates the constricting member around the second body toward the first body to hold the first body in relative position to the second body.

A medical device for approximating and securing tissue without requiring knots includes a lock-head, a strap section, distal protuberance, and a leader section. The device also includes a transition section between the leader and the strap section and a stiffening section proximal to the protuberance. The leader section is used to draw the strap section into the body through small apertures in tissue and the transition section provides a gradual transition in stiffness and size between the leader and the strap section. Tensioner and cutter and a threading tool configured to be slidably removed from a lumen of the tensioner and cutter is provided. A blade within the lumen of the tensioner and cutter is provided to cut excess leader and/or strap when the procedure is completed.