Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

Methods for tissue repairs with direct pass cinch are disclosed. A direct pass cinch is created with a suturing construct using only one portal and without shuttling steps. The suturing construct may be a loop terminating in a single tail.

An apparatus includes a thread (58) and a tissue anchor (60) coupled to the thread. The anchor includes a proximal portion (60p), shaped to define one or more appendages (82), a distal portion (60d), and a plurality of strips (84) joining the proximal portion to the distal portion. The anchor is configured to anchor the thread at tissue (42) of a subject by virtue of the appendages expanding radially, and the strips expanding radially to form respective loops at a distal side of the tissue, upon removal of a radially-constraining force from the anchor. Other embodiments are also described.

Suture/needle constructs are disclosed in which either a first round or flat section of suture can be crimped on a needle. If the first section is round, then a transition to flat second section is formed by a braiding machine. After a short space of flat, the braiding machine weaves a bifurcation into the second section, forming third and fourth suture sections. The third and fourth suture sections transition back together again into a woven fifth section at a distance from the needle, which forms a suture loop. This looped section of the suture can then be used for whipstitching a tendon or a ligament graft.

This disclosure enables various threading devices (e.g., suturing devices) that can sequentially send a plurality of carriers (e.g., needle caps, sleeves) to an object (e.g., animate, inanimate, human tissue, organ tissue, heart tissue) or sequentially receive a plurality of carriers (e.g., needle caps, sleeves) from an object (e.g., animate, inanimate, human tissue, organ tissue, heart tissue). For example, some threading devices can sequentially send some carriers in a relatively rapid succession or some threading devices can sequentially receive some carriers in a relatively rapid succession.

An apparatus includes a thread (58) and a tissue anchor (60) coupled to the thread. The anchor includes a proximal portion (60p), shaped to define one or more appendages (82), a distal portion (60d), and a plurality of strips (84) joining the proximal portion to the distal portion. The anchor is configured to anchor the thread at tissue (42) of a subject by virtue of the appendages expanding radially, and the strips expanding radially to form respective loops at a distal side of the tissue, upon removal of a radially-constraining force from the anchor. Other embodiments are also described.

A method of performing a tendon replacement, of a tendon connecting a first bone and a second bone, in an animal body utilizing a suture assembly that includes the following construction. A button has two apertures and a suture, engaged to the button, defines a lumen and forms a double loop, formed by a double trap that is opposed to the button. The suture assembly further defines a first single trap, and a third trap. In the method, a drill hole is drilled sequentially through the two bones. Also, a length of tendon tissue is draped over the loop and the button is passed through the drill hole through the first bone and the second bone and the button is oriented to sit on a surface of the second bone and the suture ends extend outwardly through the drill hole.

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.

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.

A knot delivery device for securing a suture comprises an elongated body having a proximal end and a distal end, a pre-configured knot disposed at the distal end of the elongated body, a suture snare having a snare configured to capture suture material, wherein the snare extends through the pre-configured knot and a suture locker secured to one end of material forming the pre-configured knot, wherein tension applied to the suture locker tightens the pre-configured knot.