A system, including a needle guide defining a path of travel of a needle inserted through the guide, and a tissue manipulator configured to approximate tissue and said needle guide and to position at least a portion of the tissue in the path of travel of the needle, and wherein the tissue manipulator and the needle guide are alignable such that the path of travel crosses a same surface of the tissue a plurality of times.

A soft tissue repair device. The device includes an inserter having a distal portion, a first anchor carried externally onto the distal portion, a second anchor carried externally onto the distal portion, and a flexible strand coupling the first and second anchors and forming an adjustable knotless loop.

An end effector for use with a surgical device is provided. The end effector includes a drive assembly, a driver, a needle assembly and a biasing element. The driver is disposed in mechanical cooperation with the drive assembly. Rotation of the drive assembly in a first direction causes distal translation of the driver with respect to the drive assembly. The needle assembly is disposed in mechanical cooperation with the driver. Distal translation of the driver causes a corresponding distal translation of the needle assembly. The biasing element is disposed in mechanical cooperation with the needle assembly and is configured to bias the needle assembly proximally.

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

A tissue closure device to assist in retrieving a suture during a suturing procedure, the device including an elongated body having a proximal end, a distal end, and a lumen extending axially through the elongated body. The device further including an actuator rod at least partially extending through the lumen of the elongated body to actuate a plurality of wings and a plurality of shields attached to a distal end of the elongated body. The elongated body including at least one needle guide lumen with an opening an exit, the at least one needle guide lumen traversing the elongated body at an angle with respect to a central axis of the elongated body to guide a suture grasper to an enclosed suture retrieval cavity.

An assembly for use in repairing a severed tendon comprises an elongate threading element adapted to transit along a lumen of a tendon sheath, for covering a curved needle and carrying the needle within the lumen. The assembly can also comprise a liner for lining an internal surface of the tendon sheath, defining an internal passage along which a tendon stump coupled to the curved needle can pass. The liner can have a collapsed, rest configuration in which it is adapted to be inserted into the lumen of the tendon sheath, and an expanded, operating configuration, the liner being movable to the expanded configuration by contact with the tendon stump. Once released from the liner, the threading element receives the curved needle, for covering and carrying the curved needle through the liner and along the lumen of the tendon sheath trailing the connected tendon stump.

Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

A protective assembly for use during laparoscopic surgery, the assembly comprising: a thin membrane formed from non-toxic material, the membrane being sufficiently thin and maneuverable to be passed through a cannula of a trocar; a flexible connector extending from the thin membrane; and an insertable shaft dimensioned to be passed through the cannula wherein a distal portion of the shaft is anchored to the flexible connector.

A device for suturing tissue includes a handle including a housing and a suturing needle for advancing a suture through the tissue. The device also includes a first needle gripper that is configured to both grasp and release the suturing needle. A second needle gripper is also configured to both grasp and release the suturing needle. An actuator is coupled to the housing and is operatively coupled to: (a) a first linkage that pivots the second gripping gripper between a fully extended position and a retracted position relative to the housing; and (b) a second linkage that is operatively coupled to the first and second needle grippers and configured to alter a state of each of the first and second needle grippers. The second linkage can include a one-way clutch.

Some suturing devices include a pair of flexible arms configured to force two pieces of tissue together and form a protrusion defined by the two pieces of tissue. Some suturing devices include a third flexible arm including a movable needle configured to apply a suture through both pieces of tissue of the protrusion. Some suturing devices include an actuator configured to move each flexible arm of the pair of flexible arms independently relative to the tissue and move the third flexible arm relative to the tissue. Some suturing devices include a pump configured to generate a suction force through the pair of flexible arms to force the tissue towards the pair of flexible arms.