A knot pusher device for surgical port closure includes a head portion having at least one suture guide inlet and at least one suture retainer, the head portion being configured to contact a suture knot inside an incision to close a portion of a surgical port made by the incision, and a coupling member operatively connected to the head portion, the coupling member enabling releasable connection of the knot pusher device to a suturing device.

The present disclosure discloses a knot-tying device and a knot-tying system with the knot-tying device. The knot-tying device comprises a shear knife provided at a front end of a driving rod. Hilts of the shear knife (18) are opened by an elastic member, and the hilts are pressed by the driving rod to close and cut a suture. The shear knife is used as a substitute for a cutter in the related art, and is driven to close by the driving rod so as to realize a shearing function. When the suture is cut off by the shear knife, a requirement for sharpness of blades are greatly reduced, and the blades are able to be realized by a common processing method, thereby greatly reducing cost while ensuring reliability. In addition, abrasion on the blades from the suture is reduced, thereby greatly prolonging the service life of the product.

Apparatus, systems, and methods are provided for repairing heart valves through percutaneous transcatheter delivery and fixation of annuloplasty rings to heart valves via a trans-apical approach to accessing the heart. A guiding sheath may be introduced into a ventricle of the heart through an access site at an apex of the heart. A distal end of the guiding sheath can be positioned retrograde through the target valve. An annuloplasty ring arranged in a compressed delivery geometry is advanced through the guiding sheath and into a distal portion of the guiding sheath positioned within the atrium of the heart. The distal end of the guiding sheath is retracted, thereby exposing the annuloplasty ring. The annuloplasty ring may be expanded from the delivery geometry to an operable geometry. Anchors on the annuloplasty ring may be deployed to press into and engage tissue of the annulus of the target valve.

An apparatus includes a handle, a cartridge configured to removably couple to the handle, an actuator movably coupled to the handle, and a lock operably coupled to the actuator. A first needle assembly and a second needle assembly of the cartridge are operably coupled to a first coupling portion and a second coupling portion, respectively, of the actuator when the cartridge is coupled to the handle. The first coupling portion is configured to transition the first needle assembly from a first configuration to a second configuration such that a first capture portion engages a first needle. The second coupling portion is configured to transition the second needle assembly from a first configuration to a second configuration such that a second capture portion engages the second needle. The lock is configured to selectively limit movement of the first coupling portion and the second coupling portion.

Various embodiments of a cartridge for loading a suture onto a suturing instrument are disclosed. In some embodiments, the cartridge is operable for loading a pre-tied knot formed from the suture onto the suturing instrument. The suturing instrument is typically of the type having a suture passing member defining a suture receiving passage therein. In some embodiments, the cartridge comprises a housing defining a chamber, and a partially pre-tied knot mounted about the housing or the chamber. The cartridge additionally provides a base coupled to the housing, the base defining a seat for releasably holding a portion of a suture to be aligned with, and. transferred to, the suturing instrument. The portion of the suture may be held independently, or it may be coupled to a component such as a ferrule or shuttle.

A closure device system for sealing a percutaneous puncture in a vessel wall can comprise a toggle configured to engage an interior surface of the vessel wall, a plug configured to engage an exterior sur-face of the vessel wall, and a suture that extends through the plug and through the toggle along at least a first direction so as to couple the toggle to the plug. The system can further comprise a tube that extends through the plug and through the toggle along the first direction such that a distal end of the tube is disposed distally to the toggle. The tube can define a guidewire lumen that extends therethrough along the first direction. And the guidewire lumen can be configured to receive a guidewire that protrudes from the vessel wall such that the plug, toggle, and tube are slidable along the guidewire toward the vessel wall.

Knot placement devices and methods can improve the ease for a user and/or success of ejecting a knot having a knot body and a plug, cutting suture and/or releasing the cut suture. The knot placement device can have an incremental rotational feature to cut the suture. The knot placement device can include first and second actuators configured for forming and ejecting a knot. The second actuator can be reversed in its position to release suture(s) caught within the device.

A suture management member including a body being elongate in a first direction and having a suture-receiving recess in a second direction transverse to the first direction. The suture-receiving recess extends partially through the body and separates the body into a first portion and a second portion. The first portion is being biased towards the second portion to securely retaining a suture within the suture-receiving recess.

Pharmaceutical compositions and dosage forms for administration of hydrophobic drugs, particularly steroids, are provided. The pharmaceutical compositions include a therapeutically effective amount of a hydrophobic drug, preferably a steroid; a solubilizer, preferably a vitamin E substance; and a surfactant. The synergistic effect between the hydrophobic drug and the vitamin E substance results in a pharmaceutical formulation with improved dispersion of both the active agent and the solubilizer. As a result of the improved dispersion, the pharmaceutical composition has improved bioavailability upon administration. Methods of improving the bioavailability of hydrophobic drugs administered to a patient are also provided.

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.