A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

A method for coupling tissue with a flexible member including a tail and a self-locking construct coupled to the tail. The self-locking construct includes an adjustable first loop and an adjustable second loop coupled thereto. The method includes implanting an anchor in bone, the anchor slidably mounted to the tail. The tail is positioned relative to the tissue. An end of the tail is inserted through the first loop. The tail is passed through the first loop, the second loop is pulled into the anchor, and the self-locking construct is positioned relative to the tissue. The self-locking construct is tightened against the tissue by pulling on an end of the self-locking construct. The first loop is tightened onto the second loop.

A tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

A kit for assembling an incision closing trocar comprising a cannula having a lumen, a proximal side, and a distal side is provided, the kit comprises an obturator comprising: a shaft having a distal end and a proximal end; at least two anchor recesses are provided near the distal end of the shaft, wherein each anchor recess retains a corresponding anchor; a handle provided at the proximal end of the obturator, is configured to actuate at least two pushers so as to push the corresponding anchors from the anchor recesses; and at least two holders, removably attached to the distal end of the obturator wherein each of the at least two holders holds a coiled or folded suture having a length and one end, wherein the one end of the suture is attached to the corresponding anchor, wherein the length of the suture can be pulled from the holders by removing and pulling away the holder from the obturator, wherein the obturator is sized to be inserted into the lumen of the cannula from the proximal side, together with the at least two holders so that the holders are exposed beyond the distal side when the obturator is fully inserted in the cannula, and then the holders can be removed from the obturator such that the sutures are outside the cannula.

Described herein are devices and methods for applying a tension force to various tissues. The devices may be delivered in minimally invasive fashion and used to manipulate tissues in the nose, ear, and throat. Force may be maintained by the devices for a time period that allows shaping, compression, or approximation of tissues.

A bone fusion device includes: a shaft including a porous section and a threaded proximal section configured for facilitating a compression.

A prosthetic heart valve system may include a prosthetic heart valve, a tether having a first end configured to connect to the prosthetic heart valve and a second end, and a collapsible and expandable anchor. The anchor includes a center rim configured to couple to the second end of the tether. The anchor further includes a plurality of struts extending radially outward from the center rim forming an inner dome that is concave toward a heart when the anchor is in a resting configuration implanted on an apex of the heart. The anchor further includes a plurality of wings extending radially outward from the struts.

Described herein are devices for approximating targeted tissue by intertwining two or more sutures together. The sutures are attached to the targeted tissue and routed to a twister device. The twister device secures end portions of the sutures and twists them to intertwine the sutures. Controlling the number of twists provides control over the forces applied to the targeted tissue. In conjunction with visualization feedback, real-time adjustments can be made to achieved targeted results, such as elimination of mitral regurgitation when the disclosed methods and apparatus are applied to mitral valve repair.

A prosthetic cardiac valve assembly and method of implanting the same is disclosed. In certain disclosed embodiments, the prosthetic valve assembly is an annuloplasty ring with an attached artificial valve. The prosthetic valve assembly can be secured to native heart tissue by suturing or other suitable method of the annuloplasty ring to the native heart tissue. The prosthetic valve leaflets of the prosthetic valve can also be anchored to the native heart tissue to prevent prolapse. In certain embodiments, the prosthetic valve leaflets are anchored to the native papillary muscles. In still other embodiments, the prosthetic valve assembly contains exactly the number of prosthetic valve leaflets as are in the native valve that the prosthetic valve assembly is configured to replace. With the prosthetic valve assembly properly positioned, it will replace the function of the native valve.

A medical device for joining materials is provided. The device comprises a piercing element configured to penetrate materials to be joined. The piercing element is sufficiently sharp to penetrate materials to be joined and comprises a hollow interior along at least a portion of its length configured to distal advancement of a fastener therethrough; and an open tip through which the fastener can be pushed. The device can be used for fastening materials including tissue, synthetic mesh, and biologic mesh (e.g., ADM).