Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device and a plurality of anchor assemblies. The delivery system is configured to deliver a first anchor using loaded energy and reload the energy required to deliver an addition anchor.

Catheter-based devices and methods for endoluminally accessing and occluding hollow anatomical structures are disclosed. Occlusion clips are contained in one or more needles that pierce opposing walls of the anatomical structure to deploy the clips externally of the structure. The clips then are drawn together to press the opposing anatomical walls together.

Articulating surgical instruments are disclosed. In one embodiment, a surgical instrument may include an elongated shaft assembly including an articulable portion moveable between a non-articulated configuration and an articulated configuration. First and second articulating shafts of the elongated shaft assembly may be coaxially arranged and axially fixed at an attachment point located distally from the articulable portion. Proximal portions of the first and second articulating shafts may be displaceable in opposing directions to articulate the articulable portion from the non-articulated configuration to the articulated configuration. In another embodiment, an articulation control may be movable from a first position to a second position to move an articulation lock from a locked configuration to an unlocked configuration to selectively permit articulation of a surgical instrument. The articulation lock also may be movable from the second position to a third position to articulate the surgical instrument.

A suturing device for being inserted into and used in a body is disclosed. The suturing device includes a front arm that has string support portions supporting both ends of a surgical string, and a front guide portion attached to the string support portions and a back arm that has a needle-shaped member, a needle support portion supporting the needle-shaped member in a state of pointing to a predetermined first direction, and a back guide portion attached to the front guide portion such that the back guide portion is capable of sliding in a direction substantially parallel to the first direction, and rotating around an axis substantially parallel to the first direction. The front guide portion has a first guide groove guiding the needle-shaped member to one end of the surgical string supported by the string support portion and a second guide groove guiding the needle-shaped member.

An instrument for crimping one or more suture fasteners to one or more corresponding surgical sutures is disclosed. The instrument also includes at least one shaft having one or more receiving faces, one or more anvils, one or more hammers, one or more pushers moveable in a direction substantially parallel to a longitudinal axis of the at least one shaft and configured to engage at least one of the hammer and the anvil for urging the hammer and the anvil together; and a loading tool. The loading tool may also include a target cover defining one or more snare guides, a target tray coupled to the target cover, one or more suture fasteners, one or more snare loops, and at least one handle.

A method for use with a heart of a subject includes advancing a tool distally along a flexible elongate contracting member, toward an anchor implanted at the heart. Tension is applied to the contracting member such that the contracting member slides proximally through a fastener disposed at the heart while a stop coupled to the fastener maintains the fastener in an open state. Using the tool, the stop is pulled proximally (i) away from the fastener, such that the fastener responsively clamps to the contracting member, thereby locking the tension in the contracting member, and (ii) against a cutting element of the tool such that the cutting element moves in a manner that severs the contracting member. Other embodiments are also described.

A surgical snare assembly is disclosed. The surgical snare assembly has a suture fastener having an entrance and an exit. The surgical snare assembly also has first and second suture engaging loops. The surgical snare assembly further has first and second handles configured such that: a) movement of the first handle a first distance away from the suture fastener causes the first suture engaging loop to move through the suture fastener from the exit to the entrance; and b) movement of the second handle a second distance away from the suture fastener causes the second suture engaging loop to move through the suture fastener from the entrance to the exit.

The disclosure provides a dynamic vascular access and closure device for radial cinching of an access site. The device includes a tensioning tube, a resilient member disposed within the tensioning tube, and a plurality of sutures extending axially between a distal end of the tensioning tube and a proximal end of the tensioning tube. A proximal end of each of the plurality of sutures can be configured to attach to the resilient member such that movement of that suture causes compression or extension of the resilient member within the tensioning tube to provide cinching to the sutures.

A surgical device for closing a vaginal cuff includes a handle having an elongated shaft and a plurality of needles disposed therein. Each needle includes a suture anchor at a distal end thereof having a suture engaged therewith. An anvil is disposed at a distal end of the elongated shaft. A cutting mechanism is operably associated with the handle and is configured to cut tissue upon actuation thereof. A firing mechanism is operably associated with the handle and is movable between an unactuated position wherein the plurality of needles and suture anchors remain retained within the elongated shaft, an actuated position wherein the plurality of needles and suture anchors deploy from the elongated shaft through the cervical tissue, and a reverted position wherein the plurality of needles retract leaving the plurality of suture anchors and sutures engaged with the cervical tissue for tying off the vaginal cuff.