A wound closure device includes a filamentary element having a proximal end and a distal end, and a plurality of barbs extending outwardly from the filamentary element. Each barb has a base connected with the filamentary element, a tip spaced from the base, and an outer edge that extends between the base and the tip. The outer edge includes a first section having a concave surface that extends between the base and a transition point of the barb and a second section having a convex surface that extends between the transition point of the barb and the tip of the barb. The outer edge transforms from the concave surface of the first section to the convex curve of the second section at the transition point of the barb. The tip of the barb has a convexly curved surface facing the distal end of the filamentary element. The unique dual radius shape of the outer edge of the barbs and the tips of the barbs minimizes resistance when the filamentary element is pulled in a first direction through tissue and maximizes resistance to movement when the filamentary element is pulled in an opposite, second direction through tissue for holding the wound closure device stationary.

A method comprises advancing an elongate tube to a target implantation site, the elongate tube having a needle disposed at least partially therein that has a coiled sutureform wrapped around at least a portion thereof, contacting a distal end of the elongate tube to a target tissue, projecting a tip of the needle from the distal end of the elongate tube to pierce through the target tissue such that the tip of the needle and at least a portion of the coiled sutureform project through the target tissue, advancing a pusher device within the elongate tube and over the needle to push the at least a portion of the coiled sutureform off of the tip of the needle, and proximally pulling one or more suture tails associated with the coiled sutureform to form the coiled sutureform into a knot on a distal side of the target tissue.

Meniscal repair devices, systems, and methods are provided.

A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

In one embodiment, the present invention is a system for repairing a meniscus including: a suture assembly including a first anchor, a second anchor, and a flexible suture connecting the first anchor and the second anchor, the flexible suture including a slide knot between the first anchor and the second anchor; and an inserter including a needle having a longitudinal extending bore and an open distal end, the bore being configured to receive the first anchor and the second anchor, a housing operatively connected to a proximal end of the needle, the housing having a lumen and a slot, the slot including a first portion, a second portion, a first shoulder and a second shoulder and a pusher configured to rotate and slide within the lumen of the housing and the longitudinal extending bore of the needle, the pusher having an extension extending through the slot and configured to be maneuverable through the first portion and second portion and engageable with the first shoulder and second shoulder.

The present disclosure provides embodiments of a method for improving coaptation of the anterior and posterior mitral valve leaflets by applying a remodeling force to the posterior leaflet. In particular embodiments, a tension member is secured at a location on or proximate to the posterior leaflet. Tension can be applied to the tension member in a direction superiorly and anteriorly toward the interatrial septum. The tension member can be secured at a location proximate the septum to maintain the tension. The tension provides the remodeling force, pulling the posterior leaflet superiorly and anteriorly to improve coaptation with the anterior leaflet.

The present teachings provide methods for resizing, reducing, and closing left atrial appendage. Specifically, a percutaneous trans-septal access is first established from outside the body to a patient's LAA. At least two tissue anchors are then implanted inside the LAA chamber and along the tissue wall. At least one anchor is implanted near the opening of the LAA camber. Both tissue anchors are pulled together so that the wall of the LAA chamber collapse. The LAA chamber is therefore resized, reduced, and/or closed off completely. This closure method and system could be used alone in closing LAA chamber. This closure method and system could also be used in addition to other treatment mechanisms, such as filling the LAA chamber with space-filling material, then closing off its opening.

A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures 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 constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

Systems and methods are provided and adapted to engage and pull (e.g., pull up) or reposition urethral support tissue, such as the portion of the perineal membrane above or below the urethra. The perineal membrane intersects the urethra and vagina at the midurethra or distal location and can thus be stabilized or controlled in a manner that helps restore continence.

A method of transfascial suturing may include delivering a suture assembly into an abdominal cavity of a patient, passing a suture anchor, from within the abdominal cavity, through a soft tissue repair prosthetic provided in the abdominal cavity and then through the abdominal wall to a location either above or below the skin, and tightening the suture assembly. An instrument for transfascial suturing may include a handle, a shaft extending from the handle, and a drive system for advancing a suture or suture assembly out of the instrument and across the fascia. The instrument may advance a suture anchor and a suture from within the abdominal cavity and across the abdominal wall to present the suture anchor on the opposite side of the fascia. The instrument may be adapted to present the suture anchor either above or below the skin surface for subsequent tightening of the suture assembly.