A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

A multiple-firing clip device comprises a shaft comprising an exterior surface, an interior receiving therein suture fixation clips, and a distal end opening shaped to eject a suture fixation clip therefrom. The shaft defines a lateral opening and a distal shaft portion between the lateral opening and the distal end opening. A shuttle moves on the shaft and comprises a shuttle body, a snare having a distal snare portion, and a snare extension slide movable from the shuttle body along a given extent defining a slide distance and a distal end. The shuttle extends at least the distal snare portion distally through the lateral opening from the environment into the interior, through the distal shaft portion, and through the distal end opening along a length that is at least equal to the slide distance when the snare extension slide moves to the distal end of the given extent.

A knotting assembly for surgical suture line has an outer tube and an inner tube being slidably mounted in the outer tube. The inner tube protrudes from the outer tube and forms a loop section between a distal end thereof and a distal end of the outer tube. A suture line is looped surround the loop section to form a pre-knot and a loop. The suture has an inner section being moveably inserted in the inner tube. The loop is inserted by at least one second suture line. While the inner section is pulled, the second loop is closed to hold the at least one second suture line and folds the second suture line and pulls the folded second suture into the inner tube to finish the knot.

Various embodiments of a cartridge are disclosed, for loading a suture onto a suturing instrument and, in some embodiments, 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. The cartridge may be operable to load the suture and/or the knot onto the suturing instrument at a point of use. In some embodiments, the cartridge defines a path for insertion thereto and withdrawal therefrom of the suturing instrument. The cartridge further comprises a seat for releasably holding a portion of a suture and a mechanism for transferring the suture from seat to the suturing instrument, various features of which are described herein.

A surgical device for suturing a body lumen is described, as well as methods for suturing tissue employing the surgical device. The device can include a body having a shaft and a foot for insertion into an opening in the body lumen. The device can include tissue ports between the shaft and the foot configured to receive tissue surrounding the opening in the body lumen. The foot can include a suture secured to needle capture devices. The device can include needles that can be advanced through tissue and into the needle capture devices. The needle capture devices can then be withdrawn, thereby harvesting the suture, which can then be used to close the opening in the body lumen.

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.

Apparatus and methods for performing a non-invasive procedure to repair a cardiac valve are described herein. In some embodiments, apparatus and methods are described herein for repairing a mitral valve using an edge-to-edge repair to secure the mitral valve leaflets. Implant securing devices are also described that can be used during a procedure to repair a mitral valve. In some embodiments, an implant securing device includes an outer member and an inner member movably disposed within the outer member. The inner member can be used to hold or secure a suture extending from an implant deployed on an atrial side of a leaflet of a mitral valve, and the outer member can be used to push or move a half hitch knot toward a ventricular side of the leaflet, which can be used to secure the implant in the desired position.

A knot tying device including a sheath configured for placement over a surgical instrument. The sheath includes a proximal end portion and a distal end portion. The distal end portion is elastically reconfigurable between a straightened configuration and a hook shaped configuration. Position of the sheath on the surgical instrument is adjustable between an extended position in which the sheath extends beyond a distal tip of the surgical instrument and a retracted position in which the sheath is pulled back from the distal tip of the surgical instrument. The distal end portion is in the hook shaped configuration when the sheath is in the extended position and the distal end portion is in the straightened configuration when the sheath is in the retracted position.

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.

Knots and methods of forming knots made of flexible material for use in a surgical environment are described. The knots include one or more ways to unlock at least a portion of the knot.