Embodiments of the invention include a tissue repair system and related components and associated methods that provide for suturing of tissue using three or more suture anchoring implants, including multiple pairs of connected implants in some embodiments, all of which may be deployed from a single device. Some embodiments achieve this by employing a push mechanism capable of being activated to advance the push mechanism incrementally to discrete positions within the device and deploy implants one at a time from the device.

Methods and systems are provided for securing tissue to bone. A suture anchor system can include an inserter tool having a lumen and an inserter shaft with an anchor receiving portion that is proximal to a distal extension. The anchor receiving portion can have a drive feature and the distal extension can have a diameter less than the anchor receiving portion. An anchor can be disposed on the anchor receiving portion of the inserter tool, and can have a driven feature disposed in a lumen configured to engage the drive member of the anchor receiving portion and a bone-engaging feature disposed on an external surface. A suture seating member can be removably disposed on the distal extension, can be rotatable independent of the anchor, and can have a lumen with an opening on a distal end, where the distal end of the suture seating member has a suture seating surface.

Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

A method of altering facial tissue comprises inserting an anchor element into an area of a scalp attached to the facial tissue; attaching a connective element to the anchor element; and using a length of the connective element to alter a position of an area of the facial tissue.

Described herein is a simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a hole in a boney tissue, apply a precise amount of tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the bone, preferably while maintaining the requisite pre-determined suture tension and without introducing spin to the suture. Particularly preferred embodiments allow for the one-handed operation, namely embodiments in which relative axial movement between the inner tensioning device and outer driver device is optionally physically constrained, for example by means of cooperating and/or compressive elements disposed in the respective hub and handle portions, are described herein. Other preferred embodiments of the present invention relate to multi-anchor constructs that may employ threaded implants exclusively, push-in implants exclusively, or a combination of threaded and push-in implants.

Apparatus is provided, including an implant including a tissue-adjusting member including a longitudinal member, and a tissue anchor coupled to the tissue-adjusting member and configured to be anchored into the tissue of the patient. A tissue-coupling element is coupled to the longitudinal member. A delivery tool is reversibly couplable to the implant and is configured to deliver the implant to the tissue of the patient. The delivery tool includes an elongate shaft, a tissue-coupling-element holder coupled to a portion of the elongate shaft, the tissue-coupling-element holder being configured to hold the tissue-coupling element during delivery of the implant to the tissue of the patient, and an actuating element configured to rotate the tissue anchor so as to facilitate anchoring of the tissue anchor into the tissue of the patient while not rotating the tissue-coupling-element holder with respect to the shaft.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

According to some embodiments, an implant for correcting a deformity in or near a joint of a subject includes an implant body having an internal lumen, a suture side hole or window extending through a wall of the implant body and providing access to the internal lumen through an exterior of the implant body, a tension assembly comprising a first bone anchor and a second bone anchor, wherein the first and second bone anchors are configured to be placed on opposite sides of the implant body, and an adjustable suture loop coupling the first bone anchor to the second bone anchor, wherein at least a portion of the at least one adjustable suture loop is positioned within the internal lumen of the implant body.

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 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.