The invention generally relates to devices and methods for suturing tissue. The invention provides methods and devices for suturing by pushing two ends of a suture through tissue from a proximal side of the tissue and fastening the two ends together on a distal side of the tissue through one operation of a trigger.

Apparatus, comprising: (i) a catheter (64); (ii) an implant (100), comprising a flexible longitudinal member (102), and a linking member (104) that extends from a first linking site (106a) of the longitudinal member to a second linking site (106b) of the longitudinal member, the implant having: (a) a delivery state in which the longitudinal member is coaxial with the catheter, and at least a portion of the linking member is disposed alongside the longitudinal member, and (b) an implanted state in which a first distance between the first linking site and the second linking site, measured along the longitudinal member, is greater than a second distance between the first linking site and the second linking site, measured along the linking member; and (iii) a plurality of tissue anchors (46), slidable through the catheter and with respect to the longitudinal member. Other embodiments are also described.

Devices, systems, and methods for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners to at least one prosthesis end. The fasteners are usually helical fasteners which are releasably restrained on the fastener driver, and are delivered by rotation of the fastener driver. The fasteners may be applied singly, typically in circumferentially spaced-apart patterns about the interior of at least one end of the prosthesis. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.

Methods related to delivery of various heart valve implants are described. The implant may be delivered using an ultrasound imaging delivery system. The ultrasound imaging delivery system may be used to deliver a variety of different devices, including mitral valve reshaping devices, mitral valve replacement valves, and others. A deployment catheter carrying an implant having a tissue anchor is advanced to a deployment site in a heart. An imaging element is positioned adjacent the implant and a relationship between the tissue anchor and an anatomical landmark in the heart is visualized. The implant is then attached by driving the tissue anchor into tissue in the heart.

Apparatus and methods are provided for use with a mitral valve of a heart of a subject. The apparatus includes a P1-anchor, a P2-anchor, and a P3-anchor, that are anchored to tissue in a vicinity of, respectively, P1, P2 and P3 segments of a posterior leaflet of the mitral valve, a tether being fixedly coupled to the P2-anchor, and slidably coupled to the P1 and P3 anchors. A cardiac-site anchor anchors the tether to an anchoring location that is at a cardiac site that is anterior and inferior to the posterior leaflet. Other embodiments are also described.

Medical devices, medical procedure trays, kits and related methods are provided for use to perform medical procedures that require access to the interior of a bone. The devices, trays and methods allow multiple use of non-sterile medical devices with sterile medical devices for performing medical procedures requiring sterile conditions.

A surgical fastener and a related deployment device as well as their methods of use are disclosed. In one embodiment, the deployment device includes one or more surgical fasteners including a head and a distally extending coil body attached to the head. The head includes a through hole with an internal thread. The deployment device also includes a mandrel including a threaded portion located at a distal end of the mandrel. The threaded portion is engaged with the internal thread of the one or more surgical fasteners. A rotator is associated with the one or more surgical fasteners such that the rotator can selectively rotate the one or more surgical fasteners relative to the mandrel to displace the one or more surgical fasteners in a distal direction.

Surgical instruments and their methods of use are described. In one embodiment, a surgical instrument includes a power transmission including a trigger and a fastener driver operatively coupled to the trigger. Actuation of the trigger from a first configuration to a second configuration moves the fastener driver between at least a first position and a second position. Additionally, an actuation lockout system operatively associated with the power transmission is moveable between a locked configuration and an unlocked configuration. The actuation lockout system prevents movement of the fastener driver from the first position to the second position when the actuation lockout system is in the locked configuration. Actuation of the trigger from the first configuration towards the second configuration moves the actuation lockout system from the locked configuration to the unlocked configuration.

The present disclosure provides a wound closure device that includes (a) a biocompatible material configured to be brought into abutment with a tissue surface, and (b) a plurality of fixation components connected to and extending through the biocompatible material, where at least one of the plurality of fixation components is configured to allow a suture to be connected to and extend through the at least one fixation component.

An endoscopic treatment tool includes a sheath having a lumen, an elongated shaft inserted into the lumen and having an insertion passage, a stylet disposed in the insertion passage, an implant connected to the stylet, and a manipulation part main body provided on the sheath, a slider advanceable and retractable in an axial direction relative to the manipulation part main body, and a cam tube retracting while rotating in accordance with manipulation of the slider and having a spiral guide passage. A proximal end portion of the stylet has a projection engaged with the guide passage such that a force retracting the stylet is applied to the stylet by the cam tube retracting while rotating. The projection is slidable on the guide passage such that the stylet is advanceable relative to the elongated shaft against the force.