Meniscal repair devices, systems, and methods are provided.

The instant disclosure is directed to methods and devices for passing suture bi-directionally using a hybrid approach. Embodiments of a method described herein include steps of advancing a suture at least partially through tissue; and retrieving the suture; wherein one of the steps of advancing and retrieving comprises manipulating the suture directly, and wherein the other step of advancing and retrieving comprises manipulating a suture trap to which the suture is coupled. Embodiments of a device that may be used to practice the method embodiments include a bi-directional suture passer having a proximal portion for holding a portion of a suture therein; a distal tip coupled to the proximal portion and defining a tissue receiving gap there-between; a reciprocally moveable suture passing member housed within the proximal portion for translating the suture portion between the proximal portion and the distal tip; and a suture trap operable to be detachably coupled to the distal tip for capturing the suture passed by the suture passing member.

Closure devices and methods are provided for ligating tissue, such as the left atrial appendage. Generally, the closure devices include an elongate body, a snare loop assembly comprising a snare and a suture loop, and a shuttle connected to the snare and releasably coupled to the elongate body and retractable therein. In some variations, the shuttle may be configured to fit into the lumen. In other variations, a handle may be attached to the elongate body, and the handle may comprise a track and a snare control coupled to the track. The handle may be configured to release the shuttle from the elongate body and allow movement of the snare control along the track to retract the snare loop and the shuttle into a lumen of the elongate body.

A tissue repair assembly is disclosed, including a soft anchor body and at 5 least a first suture operably coupled to the anchor body. Tensioning on first and/or second ends of first suture may deploy the anchor body to a second configuration, in which the anchor body is axially compressed and radially extended. The tissue repair assembly may also include a means to cinch around a portion of a first and/or second suture and knotlessly lock the tissue repair assembly. Some embodiments 10 may include a pre-formed knot. In some embodiments, the preformed knot may be a nail knot, provided wrapped around an insertion instrument and configured to receive and cinch around a suture extending therethrough.

A wound closure assembly includes an insertion tool having a proximal end and a distal section, such as a curved distal section, having a penetrating tip and first and second notches that are formed on opposite sides of the distal section. The assembly includes a tissue anchor having a hollow body and an insertion tool channel extending through the hollow body. First and second spaced tips project distally from the distal end of the hollow body and oppose one another on opposite sides of the insertion tool channel. The distal section of the insertion tool is inserted into the insertion tool channel of the tissue anchor so that the penetrating tip is distal to the first and second spaced tips, with the first and second spaced tips nested within the first and second notches for generating a releasable interference fit between the tissue anchor and the insertion tool.

An aortic closure device for trans-caval procedures having a deployment assembly having a housing, a release tube, and a delivery tube disposed within the release tube, a tamper disposed within the delivery tube, a sealing element, a suture assembly, and an actuator.

Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical soft tissue repair device includes a snare assembly coupled to a soft anchor in which the soft anchor has a first, unstressed configuration that can be used to insert the anchor into bone and a second, anchoring configuration that can be used to fixate the anchor in the bone. The snare assembly can be configured to actuate the anchor from the first configuration to the second configuration, and it can also be used to engage and approximate tissue by drawing the tissue closer to the anchor fixated in the bone. The snare assembly can be used in conjunction with a number of different anchor configurations, and other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Embodiments of a knot pusher and methods of use thereof are disclosed, that are usable for pushing a knot formed from a suture, two limbs of the suture extending from the knot. The knot pusher comprises a distal head defining top and bottom walls terminating in a distal knot pushing surface. The distal head includes at least two side grooves defined between the top and bottom walls that extend proximally from the knot pushing surface. Each of these side grooves is operable to receive one of the limbs of suture. The distal head additionally comprises a top wall suture receiving element for receiving one of the two limbs of the suture during advancement of the distal head to facilitate advancement of a sliding knot

A bone or tissue repair device can deploy first and second anchors from a distal end of a bore of a needle. A cylindrical first anchor can be disposed in the bore proximal to a distal end of the bore. A cylindrical second anchor can be disposed in the bore proximal to the first anchor. A pusher wire can include teeth positioned at a distal end of the pusher wire. The pusher wire and teeth can be configured to engage an interior of the first anchor; advance distally, with respect to the needle, to force the first anchor distally out of the bore; retract proximally, with respect to the needle and the second anchor, to position the teeth inside an interior of the second anchor; engage the interior of the second anchor; and advance distally, with respect to the needle, to force the second anchor distally out of the bore.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.