A knot may be formed in suture material using a device having an elongated body with a longitudinal axis and a holder. A rail portion of the suture material is secured with a first grasper on the elongated body and a non-rail portion of the suture material is secured with a second grasper on the holder. A plurality of helical windings may be created with the non-rail portion. Detaching the holder from the elongated body in a motion away from the longitudinal axis of the elongated body completes the knot. The holder may be wrapped around the elongated body in a knot-forming pattern.

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.

A suturing device includes a needle, a suture, an elongate body, an actuator and a needle holder. The suture connects with the needle. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder includes a distal end section having a distal-most tip, and defines a needle passage for holding the needle and a distal opening. At least a portion of the suture extends through the distal opening when the needle is received in the needle passage and the actuator is in a first operating position. At least a portion of the suture extends along the needle passage toward the distal opening between the needle and an inner surface of the needle holder when the needle is received in the needle passage and the actuator is in the first operating position.

A suturing kit includes a double-armed suture, at least one suturing device and a suture holding structure. The double-armed suture has a first needle at a first end and a second needle at a second, opposite, end. The at least one suturing device includes a first needle holder configured to receive the first needle in a retracted position, a second needle holder configured to receive the second needle in a retracted position and at least one actuator configured to drive the first needle or the second needle in an advance direction toward a released condition. The suture holding structure holds at least a portion of the suture between the first end and the second end, and the suture holding structure is separate from the at least one suturing device so as not to be inserted into the patient during the surgical procedure.

Systems, devices, and methods for endoscopically retracting a target tissue. The device includes a first shaft and a second shaft slidably coupled thereto. An internal member extends in a transverse direction from the first shaft and is configured for advancement through a penetration in the target tissue to atraumatically engage a distal surface of the target tissue after being advanced therethrough. A pair of external members extend from the second shaft generally parallel to the transverse direction. The external members are spaced apart and are configured to atraumatically engage a proximal surface of the target tissue when the internal member is moved longitudinally relative to the external members. The internal member applies traction to the target tissue when retracted past the pair of external members, which apply counter-traction to the target tissue on opposing lateral sides of the internal member, to re-shape the target tissue and enable subsequent suture placement.

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.

A method and apparatus are disclosed for loading a closing device onto a delivery device at the point of use and for using the apparatus for treating the intervertebral disc. The apparatus includes a cartridge for loading a closing device onto a delivery device at the point of use, the cartridge comprising a tab holding feature for holding one or more tabs of the closing device and a tab loading feature for loading tabs onto the delivery device. A method of treating an intervertebral disc includes the steps of loading a closing device into a delivery device at the point of use, the closing device comprising at least two tabs coupled to a connecting element, and substantially approximating a defect in the intervertebral disc using the closing device delivered by the delivery device.

A suturing device includes first and second holding members, a plurality of needles, a needle moving mechanism, and a suture hook. The first and second holding members are configured to move toward and away from each other to sandwich therebetween edges of a cut. The needles are disposed at the first holding member and aligned in a needle arrangement direction with their points pointing to the second holding member. The needles are configured to hold a suture at tips thereof. The needle moving mechanism is configured to move the plurality of needles toward the second holding member. The suture hook is disposed at the second holding member and configured to move along the needle arrangement direction to catch the suture that has reached the second holding member via the edges of the cut by movement of the needles toward the second holding member by the needle moving mechanism.

The present disclosure relates generally to systems, devices, and methods for endoscopic suture termination. In some embodiments, a suture device may include an elongate member having a working channel and a suture channel, the elongate member having a proximal end and a distal end. The suture device may further include a suture extending through the suture channel, and a plurality of anchor components coupled to the suture, wherein the suture and the plurality of anchor components are deployable from the elongate member for engagement with a target tissue.

An improvement to devices and methods for suturing tissue in various applications, such as percutaneous closure of arterial and venous puncture sites and the like, providing a self-locking or self-securing suture that does not require manual knot-tying to hold in apposition the tissue of the vessel wall on opposite sides of the puncture.