A drive-enhanceable handheld advancer is provided for advancing an elongate device through a pathway defined in an advancer body that includes a rotatable manual thumbwheel partially embedded in the body for receiving a user-exerted manual control movement from a thumb, and a manual drive having a nip, a transmission, and a reverse clutch. The transmission operatively connects the thumbwheel to the nip for driving advancement, and the reverse clutch maintains a first interference grip connection between the nip and the elongate device. The manual control thumbwheel can move inward responsive to user-applied grip movements to increase grip with the elongate device. The reverse clutch applies augmented force from grip movements to the nip for increasing the grip drive connection, which can be applied at a different angle from the inward movements. The reverse clutch can include slotted pivot supports for the thumbwheel and drive rollers on the advancer body.

The present disclosure relates to a system for radial cinching of an opening in an internal biological structure. The system includes, a tensioning tube, a plurality of sutures disposed within the tensioning tube, a plurality of delivery tubes. Each delivery tube is configured to receive a distal end of one of the plurality of sutures. The plurality of delivery tubes are further configured to deploy the distal ends of the plurality of sutures proximate a periphery of the opening. Upon deployment of the sutures proximate the periphery of the opening, one or more of the plurality of sutures are cinched while movement of portions of the plurality of sutures are constrained by the tensioning tube causes radial cinching of the periphery to close the opening.

A surgical device for suturing a body lumen is described, as well as methods for suturing tissue employing the surgical device. The device can include a body having a shaft and a foot for insertion into an opening in the body lumen. The device can include tissue ports between the shaft and the foot configured to receive tissue surrounding the opening in the body lumen. The foot can include a suture secured to needle capture devices. The device can include needles that can be advanced through tissue and into the needle capture devices. The needle capture devices can then be withdrawn, thereby harvesting the suture, which can then be used to close the opening in the body lumen.

The present application provides an occluder, for use in occluding a defect in a vascular system. The occluder comprises a first occlusion disc, a second occlusion disc, and a tightening wire; the first occlusion disc and the second occlusion disc are used for covering different openings of a defect, respectively; a connector is provided on the first occlusion disc; the connector is provided with a wire passing hole; the tightening wire passes through the wire passing hole of the connector; two ends of the tightening wire pass through the second occlusion disc, and form an adjustment wire knot on the side of the second occlusion disc facing away from the first occlusion disc; the distance between the first occlusion disc and the second occlusion disc can be adjusted by the ends of the tightening wire. The present application also provides an occlusion system having the occluder.

A method of suturing an abdominal cavity includes inserting a spool of suture in the abdominal cavity. The method also includes capturing a first portion of the suture and removing the first portion from the abdominal cavity. The method also includes capturing a second portion of the suture and removing the second portion from the abdominal cavity. The method also includes tying the first portion to the second portion outside of the abdominal cavity.

A surgical closure apparatus includes an outer member dimensioned for positioning within a wound opening, a needle assembly at least partially positioned within the outer member and a suture configured for at least partially closing the wound opening within the tissue. The needle assembly includes an elongate member defining a longitudinal opening, a suture needle coupled to the elongate member and extending to a needlepoint and being configured for movement between an unarmed condition where the needlepoint is in a relative radial inward position and an armed condition where the needlepoint is in a relative radial outward position and a deployment member extending at least partially through the longitudinal opening of the elongate member and coupled to the suture needle. The deployment member is movable within the longitudinal opening to permit the suture needle to move between the unarmed condition and the armed condition.

Techniques are described for closure of a defect in material, such as closure of a laparoscopic surgical defect. A defect closure device can be inserted into the defect to capture first material adjacent to the defect. The device houses at least first and second suture pins coupled together by a suture. A first interaction with a trigger structure can force the first suture pin through the captured first material and into a containment sub-assembly. After rotating the device to capture second material adjacent to the defect, a second interaction with the trigger structure can force the second suture pin through the captured second material and into the containment sub-assembly. As such, the suture is passed through the first and second portions of the material, and the ends of the suture can be cinched, and cut to form a stitch.

The double “J” laparoscopic fascial closure device has a fixed jaw and a movable jaw pivotally attached to the fixed jaw. An elongated hollow tube or cannula extends from the fixed jaw. The end of the elongated cannula distal from the jaws has two needles mounted thereon defining a double “J” configuration. A spring mechanism or cable guide is attached to the hollow tube, and a cable extends between the fixed jaw and the movable jaw. The other end of the cable extends through the elongated hollow tube, through the spacer arms, and back towards the needles at the ends of the needle mount arms. A suture thread is attached to both needles so that the thread bridges the gap between fascia on opposite sides of the laparoscopic port incision when the needles are draw back through the fascia towards the incision.

A method for closing a puncture in tissue that includes advancing a guide member into proximity with the tissue, the guide member having a needle guide, positioning a distal end of the guide member with the needle guide toward the tissue to present an opening of the needle guide toward the tissue the needle guide cooperating with a suture securing device that is slidably coupled to the guide member and a suture attached to the suture securing device, deploying the suture securing device, the suture securing device comprising a body with an anchor point for the suture and features that allow the suture securing device to pierce the tissue and resist retraction through the tissue, and establishing tension in the suture to move the suture securing device toward another suture securing device to thereby close the puncture in the tissue.

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.