A suspensory fixation device includes a standing block at one end thereof and a set of at least two adjustable loops at the second end thereof. The standing block includes a rigid fixation member having a plurality of apertures forming at least one sheave and a becket. A single reeved fall, rigid fixation member, adjustable loops, and sliding knot form a block and tackle system. A suspensory fixation button includes a rigid body having a top side and a bottom side, a plurality of lobes extending radially from the center of the body, and at least one aperture through the body near the root of a lobe. A method of coupling a suspensory fixation button to a set of adjustable flexible loops includes passing each adjustable loop over an edge of an extension of the button from the top side to the bottom side.

Devices, systems and methods for passing a suture. In general, described herein are suturing devices, such as suture passers, as well as methods of suturing tissue. These suture passing devices may include dual deployment suture passers in which a first distal jaw member is moveable at an angle with respect to the longitudinal axis of the elongate body of the device and the second distal jaw member is retractable proximally to the distal end region of the elongate body and/or the first jaw member.

An adjustable, knotless button/loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.

A suture including a loop having a tapered surface is provided. The suture includes an elongate body including a proximal portion and a distal portion, wherein the distal portion includes first and second overlapping sections and a loop. A proximal end of the first overlapping section may be tapered with respect to a longitudinal axis of the elongate body. The first overlapping section may be secured to the second overlapping section proximal of the loop. The overlapping sections may be secured together by at least one method selected from the group consisting of glues, adhesives, epoxies, solvents, heat and ultrasonic energy.

The problem of positioning one or more nerve ends inside a sheathing implant is solved by the use of a pulley and cinching systems that pull a nerve end into an implant and that can adjust the diameter of an implant to conform the implant to the diameter of the nerve, respectively. The pulley system utilizes a suture that traverses the wall of an implant leaving one end outside the implant wall and another end that can be attached to a nerve. Pulling the suture end outside the wall pulls the nerve attached to the other end of the suture into the bore of the implant. A cinching system utilizes specially arranged sutures within the wall of an implant to tighten or cinch up the wall after a nerve is placed therein, so as to conform at least part of the implant to the diameter of the nerve. Methods are also disclosed by which such pulley systems can be formed during an intraoperative procedure.

The present disclosure relates generally to devices and methods for treating a tissue defect, for example, by suturing. In some embodiments, a suturing device may include an elongate member having a working channel, a suture channel, and a suture arm extending from the elongate member. The suturing device may further include a needle passer located within the working channel, the needle passer operable to deliver a needle between the elongate member and a distal end of the suture arm for suturing a target tissue, and a suture extending through the suture channel, wherein the suture is coupled to the needle. The suturing device may further include a plurality of imaging devices, wherein a first imaging device is positioned along a distal face of the elongate member, and wherein a second imaging device is positioned along the suture arm.

A system for forming and closing an aperture in tissue for atrial transseptal access includes an elongate shaft with a tip at the distal end and a fastener platform coupled to the elongate shaft. The system also carries one or more fasteners with an anchor, and one or more penetrating shafts disposed alongside the elongate shaft. The fastener platform is deployable to an expanded configuration that engages and supports tissue surrounding the aperture. The one or more penetrating shafts may be extended through the tissue to engage a free end of the one or more fasteners so the fastener may be pulled through the tissue, or the penetrating shafts may pierce the tissue to deliver the fastener to a left side of the patient's heart for anchoring.

An improvement to devices and methods for suturing tissue in various applications, such as percutaneous closure of arterial and venous puncture sites and the like, providing a self-locking or self-securing suture that does not require manual knot-tying to hold in apposition the tissue of the vessel wall on opposite sides of the puncture.

A surgical instrument is provided, including: at least one articulatable arm having a distal end, a proximal end, and at least one joint region disposed between the distal and proximal ends; an optical fiber bend sensor provided in the at least one joint region of the at least one articulatable arm; a detection system coupled to the optical fiber bend sensor, said detection system comprising a light source and a light detector for detecting light reflected by or transmitted through the optical fiber bend sensor to determine a position of at least one joint region of the at least one articulatable arm based on the detected light reflected by or transmitted through the optical fiber bend sensor; and a control system comprising a servo controller for effectuating movement of the arm.

A releasable elongated assembly includes a release member having a length and an opening that extends along the length. The releasable elongated assembly includes a first elongated element having a first coupling member disposed in the opening and a second elongated element having a second coupling member disposed in the opening opposite the first coupling member along the length. The first and second elongated elements are interlaced with each other in the opening at a location between the first coupling member and the second coupling member such that the first and second elongated elements are attached to each other. The release member is moveable from a first position where the first and second coupling members are captured in the opening to a second position where the first and second coupling members are released from the opening so as to detach the first and second elongated elements from each other.