A method for syndesmotic repair includes forming a bone tunnel through a first bone and a second bone. A partial anchoring construct is inserted through the bone tunnel. The partial anchoring construct includes a first flexible strand defining a first adjustable loop and a first anchor coupled to a first end of the first adjustable loop. A second end of the first adjustable loop is coupled to a first pull-through strand. A second anchor is coupled to the second end of the first adjustable loop after the first adjustable loop is inserted through the bone tunnel by the first pull-through strand. The length of the first adjustable loop is adjusted to position the first bone and the second bone in a predetermined spacing.

A detachable motor pack, for use with multiple electrical surgical instruments, includes a housing; a plurality of motors retained within the housing; a controller configured to control one or more operations of the plurality of motors; a first interface portion, wherein the first interface portion is configured to releasably attach to a hand-held surgical instrument and to a robotic surgical instrument; and a second interface portion, wherein the second interface portion is configured to releasably attach to a first surgical tool of the hand-held surgical instrument and to a second surgical tool of the robotic surgical instrument.

Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.

A method and apparatus for surgically repairing a tear in soft tissue is disclosed. A plurality of collapsible tubes are positioned about the suture. The collapsible tubes are pushed through soft tissue and orthopedic mesh on opposite sides of a tear in soft tissue. When tension is applied to the suture, the tubes are compressed to fix the suture to the soft tissue and draw the soft tissue portions together.

A method of anchoring soft tissue to a suitable bone site, using a soft suture anchor, includes steps of disposing the soft suture anchor on a shaft of an inserter, and securing a proximal end of a tensioning suture limb, extending proximally from the soft suture anchor, to structure in a handle of the inserter, so that it is maintained in place at a first level of holding tension (T.sub.hold). The inserter shaft is inserted into a bone hole at a desired procedural site, so that the soft suture anchor is positioned at a location where it is to be anchored. A further step involves actuating a control mechanism in the inserter handle to move the structure proximally to apply a second level of deployment tension (T.sub.load) to the tensioning suture limb.

A suture assembly, including a button having two apertures and a suture defining a lumen and forming a double loop, formed by a double trap formed in the suture, opposed to the button, and in which a first portion of the suture is threaded through the lumen of the double trap and a second portion of the suture is also threaded through the lumen of the double trap, so that two portions of suture are positioned together in the double trap. The first portion of the suture, after emerging from the double trap, is threaded through the lumen again, thereby forming a second trap, increasing resistance of the double loop to expansion, the double loop being threaded through the apertures of the button, the suture having two suture ends that are threaded through the button apertures and accessible on a side of the button opposed to the double loop.

A method of anchoring soft tissue to a suitable bone site, using a soft suture anchor, includes steps of disposing the soft suture anchor on a shaft of an inserter, and securing a proximal end of a tensioning suture limb, extending proximally from the soft suture anchor, to structure in a handle of the inserter, so that it is maintained in place at a first level of holding tension (T.sub.hold). The inserter shaft is inserted into a hone hole at a desired procedural site, so that the soft suture anchor is positioned at a location where it is to be anchored. A further step involves actuating a control mechanism in the inserter handle to move the structure proximally to apply a second level of deployment tension (T.sub.load) to the tensioning suture limb.

An adjustable fixation device includes a cleat portion and a suture portion, where the suture portion has a loop portion and a suture tail. Pulling on the suture tail places in tension a graft coupled to the loop portion. The suture is arranged to convey a mechanical advantage so that substantial force can be readily and controllably applied to the graft.

An orthopedic attachment system includes a first bone anchor, a second bone anchor, and a flexible connector. The flexible connector is connected between the first bone anchor and the second bone anchor. The flexible connector includes a sliding loop, a tensioning end and a fixed end. The sliding loop is connected to a sling loop bone anchor, and the fixed end is connected to the fixed end bone anchor. The tensioning end is slidably connected and lockable to the fixed end. A flexible connector, a method for attaching a flexible connector between at least two bone anchors in a patient's body, and a method of making a flexible connector are also disclosed.

The present invention is a surgical suturing device that assists in applying an open-looped, pre-knotted suture around a targeted area of application. The surgical suturing device contains a handle, a grasping mechanism, a first jaw, a second jaw, a first coupler, and a second coupler. The first jaw and the second jaw each contains a jaw body and a coupler receiver. The first coupler and the second coupler each contains a strand receiver. The handle is operatively connected to the first jaw and the second jaw through the grasping mechanism. The coupler receiver is positioned adjacent to the jaw body, opposite to the grasping mechanism along the jaw body. The first coupler is removably positioned within the coupler receiver of the first jaw. The strand receiver traverses into the first coupler and the second coupler. The second coupler is removably positioned within the coupler receiver of the second jaw.