Devices, systems, and methods are provided for managing suture filaments when performing soft tissue repair. One exemplary embodiment of a surgical suture management device is in the form of a suture loop management card. The card can generally be configured to hold open a collapsible loop of suture until a force applied to the loop is greater than a threshold tension. The card can include a number of different features that help to keep the loop open until the threshold tension is achieved, including features designed to prevent the filament from being mistakenly offloaded. The card can be configured to be removably inserted into a handle of an inserter tool for use as a surgical tissue repair system. Other devices, systems, and methods for performing soft tissue repair are also provided.

An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. A tissue anchor is stored in the anchor-storage zone. The anchor-handing device is configured such that, while the tissue anchor is stored in the anchor-storage zone, the tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening by the element moving in response to the proximally-directed force. Other embodiments are also described.

Example implantable tissue anchors, kits that include an implantable tissue anchor, and associated methods are described. An example implantable tissue anchor is moveable between a first, expanded configuration and a second, compressed configuration. The implantable tissue anchor has a first end, a second end, and a main body. The main body defines a first arm, a second arm, a first plurality of recesses on the first arm, a first plurality of barbs on the first arm, a second plurality of recess on the second arm, and a second plurality of barbs on the second arm. The first arm and the second arm define a first closed loop and a first passageway that extends through the main body when the implantable tissue anchor is in the first, expanded configuration.

An anchor-handling device comprises a housing shaped to define a channel having an anchor-storage zone and a proximal opening. A tissue anchor is stored in the anchor-storage zone. The anchor-handing device is configured such that, while the tissue anchor is stored in the anchor-storage zone, the tissue anchor is movable out of the anchor-storage zone toward the proximal opening in response to a proximally-directed force being applied to the tissue anchor. The anchor-handling device comprises an element that serves as an indicator of movement of the tissue anchor out of the anchor-storage zone toward the proximal opening by the element moving in response to the proximally-directed force. Other embodiments are also described.

A medical system includes a suture device. The suture device includes: an arm; a first jaw and a second jaw that are attached to a distal end of the arm; and a needle configured to attach a thread. At least one of the first jaw and the second jaw configured to be opened and closed to deliver the needle therebetween.

A catheter device includes a flexible tube and an extracorporeal unit. The tube has a distal opening that is configured to be transluminally advanced into a subject, and a proximal end. The extracorporeal unit is coupled to the proximal end, and includes (i) a body, and (ii) a series of cartridges, distributed along a proximal-distal axis of the body, with a distalmost cartridge being closest to the proximal end of the tube. A series of anchors includes a leading anchor and other anchors, each anchor being (i) housed by a corresponding cartridge, with the leading anchor housed by the distalmost cartridge, and (ii) coupled to a tether such that the tether extends along the body, parallel with the proximal-distal axis. Other embodiments are also described.

A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors 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 working suture in place subsequent to tensioning. 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 continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.

A system comprises a series of anchors, an anchor-storage device, and an anchor driver that is slidably coupled to the anchor-storage device. The anchor-storage device comprises a spring, and a housing, shaped to define: (i) a loading site, and (ii) a spiral channel that spirals inward to the loading site, the series of anchors arranged along the spiral channel, and the spring configured to urge the series of anchors along the spiral channel toward the loading site. The anchor driver comprises a rod extendable through the loading site in a manner that obstructs access of the series of anchors to the loading site from the spiral channel. Other embodiments are also described.

A deployment system includes a sheath, a torque able shaft having a handle positioned at its proximal end, a detachable helical first suture anchor positioned at the shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The shaft is detached from the first suture anchor thereby deploying it at the first tissue location. Then, the deployment system is removed from the patient, and a second suture anchor is coupled to the distal end of the shaft. The deployment system is re-inserted into the patient and the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second suture anchor at the second tissue location. A suture extends between the first and second fasteners, and tension is applied to the suture to draw the first and second tissues toward each other to reconfigure the tissue.

A medical manipulator includes an outer sheath, a channel tube that passes through the outer sheath, a bendable bending portion disposed at the distal end of the outer sheath, and a bending wire that bends the bending portion, and the bending portion includes a plurality of ring members through which the bending wire passes, and the ring members are spaced apart along the longitudinal direction of the outer sheath.