Embodiments of a knot pusher and methods of use thereof are disclosed, that are usable for pushing various types of knots including sliding knots and overhand knots formed from a suture, two limbs of the suture extending from the knots, for example using a single device. The knot pusher comprises a distal head defining top and bottom walls terminating in a distal knot pushing surface. The distal head includes side grooves that are defined between the top and bottom walls. Each of these side grooves are operable to receive one of the two limbs of suture during advancement of the distal head to aid in pushing the overhand knot. The distal head additionally comprises a suture receiving element associated with the top wall for receiving one of the two suture limbs during advancement of the distal head to facilitate advancement of the sliding knot.

A one-way knot pusher and/or locking device is provided and can be used for the adjustment of soft tissue anchoring components that create or improve continence. The device can be generally button- or disc-shaped and can include a carrier and a pin. When the device is pushed in the free sliding direction it acts as a knot pusher. However, when reversed the suture (e.g., the knot) jams or wedges inside of the cavity of the carrier, restricting or preventing motion in the opposite direction.

A suturing device includes an elongate body, an actuator, a needle holder and a knot pusher. The elongate body includes a proximal end portion and a distal end portion. The actuator interacts with the elongate body and is operable between a first operating position and a second operating position. The needle holder extends away from the distal end portion or is provided as part of the distal end portion of the elongate body, and includes a distal end section having a distal-most tip. The needle holder defines a needle passage and a distal opening adjacent the distal-most tip. The knot pusher connects with and extends away from at least one of the elongate body and the needle holder.

The invention comprises a surgical instrument assembly for minimally invasive surgery. The surgical instrument assembly comprises a light emitting arrangement and a surgical instrument. The surgical instrument has a distal end and a proximal end and comprises a handle portion at its proximal end and a grasper at its distal end, the grasper comprising at least two jaws and having a closed grasper position and an open position where a grasping space is formed between the jaws. The light emitting arrangement comprises a light source for generating light and a projector for projecting at least a beam of light comprising a string shape perpendicular to the optical axis of the beam of light. At least the projector of the light emitting arrangement is at least temporally fixed to the surgical instrument proximally to the jaws and is arranged to project the string shaped beam of light such that it will be broken upon a lateral movement of an object into the grasping space.

Multiple endoscopic devices and methods for closing perforations and/or creating anastomoses in tissue are described. For example, this document provides devices and methods for performing esophagogastric anastomoses and for closing esophageal perforations in a minimally invasive fashion. The devices and methods provided herein can also be used for, without limitation, colorectal anastomoses, any bowel anastomosis, gastric bypass anastomoses, and broader vessel anastomoses.

A suturing kit includes a suture and a suture holder for holding the suture. The suture has a first end and a second, opposite, end. The suture holder includes an elongated wall defining a suture receiving passage that is elongated along a longitudinal axis and terminates at a suture exit opening. The suture receiving passage has a width at least twice the diameter of the suture and receives the suture such that the suture is folded over forming a half loop section spaced from the suture exit opening. A first second of the suture extends from the half loop section toward the first end and a second section of the suture extends from the half loop section towards the second end. The first section and the second section of the suture within the suture receiving passage are aligned parallel to the longitudinal axis.

An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween, a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle, and an actuator extending from the proximal end of the proximal section to actuate a reciprocating needle drive having a needle driver for engaging and rotating the suturing needle.

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.

Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

First and second arms have first and second retaining members, respectively. A switching mechanism switches a retained state of a first position of a tying medium between first and second states. In the first and second states, the first position is retained by the first and second retaining members at first and second retaining positions, respectively. A loop retaining member retains a loop around the second arm in a path extending from the first retaining position through second and third positions to a fourth position of the tying medium. The second position intersects the third position as a result of the loop such that the third position is closer to the first retaining position than the second position in the path. A moving portion moves the loop relative to the second arm to change a relative positional relationship between the loop and the first position on the path.