A surgical tensioner and methods for surgical repairs. A tensioner can tension a flexible strand (suture or wire) attached to tissue (for example, graft or bone segments). A tensioner can include an angled tip with a split hole to past-point on a knot and lock the construct during tensioning. A tensioner can include a securing mechanism that can capture a flexible strand and lock it into place.

A multi-barrel drill guide and anchor deployment assembly with an elongated body extending along a longitudinal axis having a proximal end and a distal end, an elongated distal guide tube attached to and extending from the distal end, a handle extending from the elongated body between the proximal end and the distal end, and a sliding inserter movably connected to the elongated body and configured to move between the proximal and distal ends of the elongated body. The elongated body has a first channel extending from the proximal end to the distal end and a second channel extending from the distal end to a position between the distal and proximal ends. The second channel extends at an angle relative to the first channel and intersects the first channel at a convergence area at the distal end.

A semi-automatic precision positioning robot apparatus and method for use of the same to hold, position, orient and/or move a workpiece are provided. The positioning apparatus utilizes an actuator system of a given configuration to manipulate a workpiece holding unit with multiple degrees of freedom to achieve various positions and orientations. An associated tool may further be provided to interact with the workpiece in various positions and orientations. The positioning apparatus enables an operator to obtain high degrees of maneuverability while maintaining precision and consistency in the manufacture and production of various products and components.

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.

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.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include tissue anchors such as for chordae tendineae repair.

A tissue anchor and an anchor delivery and deployment system. The tissue anchor is shiftable between a delivery configuration when housed in anchor garage of the anchor delivery and deployment system, and a deployment configuration when deployed outside the anchor garage. The anchor has a plurality of talons which may be formed from a laser cut tube. The talons may taper, such as widthwise.

An all-suture anchor for generating bone compression and increasing interference fixation. The all-suture anchor includes a fibrous construct which is movable between a pre-deployment configuration and a deployed configuration. The fibrous construct has a first density. The all-suture anchor also includes a monofilament woven through the fibrous construct. The monofilament has a second density, which is different than the first density. The contrasting densities (i.e., irregularities) aids in the “locking” ability of the all-suture anchor by greater purchase in hard and soft bone. The all-suture anchor can have a variety of textures, barbs, and rigidities that aid in creating irregularities within the bone surface for more secure fixation.

A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a plurality of independently cinchable working suture loops with one working suture loop connecting each pair of anchors in series to form a chain. Each of the suture anchors as connected by working suture loops allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the cinchable working suture loop subsequent to tensioning so that the loop remains fixed in size during cyclic loading during joint use. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a high density, continuous array of anchor-to-anchor stitches for robust securement of soft tissue to bone.

Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.