A medical device configured to form one or more holes within a bone of a patient may include a handle assembly including a housing, a lever rotatably coupled to the housing, and a sheath extending distally from the housing, the handle assembly including a spring biasing the lever toward an initial or intermediate position; and a bone punch including an elongate shaft, a head at a proximal end of the elongate shaft, and a piercing tip at a distal end of the elongate shaft configured to be driven into the bone. The elongate shaft may be slidably disposed within the sheath in a first position when the lever is in the initial or intermediate position. Translation of the bone punch distally within the sheath from the first position to a second position may cause a distal end of the lever to rotate away from the housing to an extended position.

An instrument for performing thorascopic repair of heart valves includes a shaft for extending through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a capture valve leaflet and draw the suture therethrough. The suture is thus fastened to the valve leaflet and the instrument is withdrawn from the heart chamber transporting the suture outside the heart chamber. The suture is anchored to the heart wall with proper tension as determined by observing valve operation with an ultrasonic imaging system.

An instrument for performing thorascopic repair of heart valves includes a shaft for extending through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a capture valve leaflet and draw the suture therethrough. The suture is thus fastened to the valve leaflet and the instrument is withdrawn from the heart chamber transporting the suture outside the heart chamber. The suture is anchored to the heart wall with proper tension as determined by observing valve operation with an ultrasonic imaging system.

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 device having an implantable body associated with at least two filaments or sutures and configured for use in soft tissue reconstructions is provided. One exemplary embodiment includes an implantable body, an adjustable filament loop for holding ligament grafts that is coupled to the body, and a shuttle suture removably coupled to the implantable body and configured for shuttling the body through at least a portion of a bone tunnel. The loop can be defined by a self-locking knot, and one or more loop-adjusting limbs can extend from the knot, with a portion of the limb(s) also extending into a hollow portion of the shuttle suture. In some embodiments having two adjustable limbs, an intermediate portion of each limb can be the portions disposed in respective hollow portions of the shuttle suture. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

A wirelessly triggered device for implantation in vivo is disclosed herein. In a described embodiment, the wirelessly triggered device comprises an electrically conductive suture; and an electronic circuit coated with a biocompatible encapsulating material and communicatively coupled to the electrically conductive suture, the electronic circuit arranged to convert a received wireless triggering signal into an electrical signal for passing through the conductive suture. A reader for use with the device and an electrically conductive surgical thread is also disclosed, among other aspects.

A repaired tendon includes a proximal tendon section having a free end, and a distal tendon section having a free end that opposes the free end of the proximal tendon section. Four bidirectional barbed sutures are implanted in the repaired tendon for approximating the free end of the proximal tendon section with the free end of the distal tendon section. Each of the four bidirectional barbed sutures includes a proximal section having proximal barbs that engage the proximal tendon section, a distal section having distal barbs that engage the distal tendon section, and a stop located between the proximal and distal barbs that engages the approximated free ends of the proximal and distal tendon sections. The bidirectional barbed sutures have first suture bites and second suture bites that are shorter than the first suture bites.

A device is disclosed that can pierce and hold tissue and then pass suture through tissue. The device can have a shuttle that can removably attach to a suture and jaws that can be rotatably opened and closed with respect to each other. A method for using the device to repeatedly pass the suture through the tissue without removing the suture or device from the target site is also disclosed.

Suture passer devices and methods of using the devices having one or more protective interlocks preventing or limiting operation of the suture passer when deployment of the needle may damage the apparatus or harm the patient. For example, described herein are suture passer devices that include an interlock preventing deployment of the tissue penetrator (needle) when the jaws are not clamped onto a tissue. Also described herein are interlocks preventing retraction of a jaw axially until the needle is retracted.