Systems and methods are provided for performing tensionable knotless surgical procedures. A suture locking device that includes a one-way locking mechanism may be utilized for tensioning and locking one or more strands of suture during the surgical procedure. The one-way locking mechanism may be established by one or more locking barbs of the suture locking device.

A deployment instrument for deploying a closure device for sealing a percutaneous puncture in a wall of a body passageway, the deployment instrument including a carrier assembly, wherein the carrier assembly is configured to hold the closure device in a pre-deployment state, and a tensioner assembly, wherein the filament is fixedly attached to the tensioner assembly, wherein the deployment instrument is configured to increase the tension in the filament upon linear movement of the deployment instrument away from the wall of the body passageway when the closure device is anchored to the wall via the anchor such that the tension is gradually increased as the deployment instrument is moved between a first linear distance and a second linear distance greater than the first linear distance from the wall of the body passageway.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Systems, assemblies, and methods are provided herein for fastening of one bone to another bone using one or more sutures. The features herein enable such fastening with a more accurate strength, and which can be more easily fastened in-situ.

A glossoplasty implant tension relief system for treating an airway of a patient has a first portion configured to engage a mandible of the subject. The system also has a second portion configured to engage a tongue of the subject to retain at least a portion of the tongue. The system includes a connecting portion configured to connect the first portion and the second portion. The connecting portion is constructed and arranged to provide tension between the first portion and the second portion. The connecting portion includes an i) inelastic portion and ii) an elastic portion configured to provide elasticity between the first portion and the second portion.

A percutaneous device for closing blood vessels has a main body in which a distal clip and a proximal clip connected to each other by a tie rod are accommodated, an abutment element, and a handle for maneuvering the distal and proximal clips, the abutment element and the tie rod. The distal clip has a proximal housing, and the proximal clip has a distal housing and a proximal housing. The tie rod is positioned inside the housings when the distal and proximal clips are inserted inside the main body, so as to not interfere with correct sliding thereof.

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. The needle body is tubular and has first and second ends and flexible tab retainers adjacent the second end for retaining the needle body relative to the needle holder arm. The tab retainers elastically deform to allow the needle body to be released from the needle holder arm upon application of force therebetween. The needle body has a suture opening located between the first end and the retainers. A suture extends into the suture opening of the needle body and is fixed therein.

Devices and methods for occluding or promoting fluid flow through openings are disclosed. In one exemplary embodiment an occlusion device is provided having an expandable outer elongate tubular body, a guide member extending from a distal end of the outer body, and a slide tube disposed within the outer body, the proximal portions of the outer body and the slide tube being fixedly mated. The slide tube is configured to slide distally within the outer tubular body when the tubular body is expanded to form wings. A tether can be included as part of the device and it can be used to assist in positioning and locking a location of the device in an opening. Exemplary methods for delivering devices disclosed herein 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.

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.