According to an aspect of the present disclosure, an end effector for use with a surgical device is provided. The end effector includes a drive assembly, a driver, a needle assembly and a biasing element. The driver is disposed in mechanical cooperation with the drive assembly. Rotation of the drive assembly in a first direction causes distal translation of the driver with respect to the drive assembly. The needle assembly is disposed in mechanical cooperation with the driver. Distal translation of the driver causes a corresponding distal translation of the needle assembly. The biasing element is disposed in mechanical cooperation with the needle assembly and is configured to bias the needle assembly proximally.

The present invention is directed to suturing systems having a needle, an elongated flexible suture having a connecting end attached to a said needle and an opposing free end and at least one elongated external beneficial filament that is attached to said needle or attached to said suture at the connecting end. The beneficial filament has a smaller cross-sectional area and lower mechanical strength than the suture and contains a medicant.

Disclosed are a system and method to implement a novel treatment to restore bilateral longitudinal parallel paraurethral support, the system comprising a trocar, and introducer, and one or more barbed suture-type devices, the components used cooperatively to implant the one or more barbed suture-type devices in the patient to provide sufficient paraurethral support to restore continence in the patient.

A suturing apparatus comprises an invaginating device secured to a distal end of an endoscope for invaginating two parts of the interior of a wall of a vessel, for example, a stomach to be sutured together to form a gastric sleeve. The invaginating device includes a suction chamber for forming invaginated parts of the interior of the wall of the vessel. A suturing instrument extending through an instrument channel of the endoscope extends into the invaginating device, and is urged into or adjacent the suction chamber for inserting a suture into the invaginated part in the suction chamber. The next invaginated part is then formed, and the suture is inserted into it. The suture is then tightened to draw the two invaginated parts together.

A toggle-type suture anchor that incorporates individual suture tensioning and locking without knot tying. The anchor includes several exemplary designs of toggle bodies having a working suture pre-threaded through one or more passages therethrough. A locking suture loop is pre-threaded relative to the working suture and includes a collapsible loop that encircles a portion of the length of suture running longitudinally adjacent the side of the anchor. With the loop open, the working suture can slide through the anchor, however, when the loop is closed the working suture is locked in position to retain tension on the working suture. Alternatively, the locking suture loop can be replaced with a mechanical locking member that moves from a first unlocked to a second locked position. The exemplary anchors can be utilized in a pre-strung connected array of anchors.

A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a plurality of independently cinchable working suture loops with one working suture loop connecting each pair of anchors in series to form a chain. Each of the suture anchors as connected by working suture loops allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the cinchable working suture loop subsequent to tensioning so that the loop remains fixed in size during cyclic loading during joint use. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a high density, continuous array of anchor-to-anchor stitches for robust securement of soft tissue to bone.

A suture instrument comprising an elongated outer sleeve (3) and a cannula (9) terminating in a distal piercing tip (12) is slideable within a cannula bore (7) extending through the outer sleeve (3). A plurality of sutures (15), are located in a suture bore (14) extending longitudinally through the cannula (9). Each suture (15) comprises a suture thread extending between a pair of anchor bars (20), and a cinch clip (24), which is located on a loop (22) of the suture thread (7) formed between the anchor bars (20), and is slideable along the loop (22) for reducing the effective length of the suture thread (17) between the anchor bars (20). The anchor bars (20) and the cinch clips (24) of the sutures (15) are aligned end-to-end sequentially along the suture bore (14) of the cannula (9) with the cinch clip (24) of each suture (15) located between the anchor bars (20) thereof. A pusher rod (35) slideable in the suture bore (14) is operable by a linear actuator for sequentially urging the anchor bars (20) and the cinch clip (24) of each suture (15) from the suture bore (14) through the distal piercing tip (12) of the cannula (9).

A device is disclosed that can pierce and hold tissue and then pass suture through tissue. The device can have a shuttle that can removably attach to a suture and jaws that can be opened and closed. A method for using the device to repeatedly pass the suture through the tissue with or without removing the suture or device from the target site is disclosed.

The fastener assemblies, systems, and methods of the present disclosure are generally directed to a first T-fastener and a second T-fastener securable to one another through the use of a suture extending therebetween and deliverable to an anatomical location using a minimally invasive technique. For example, a cannula of a needle assembly may be percutaneously deliverable to a treatment site and, through actuation of a hub of the needle assembly, the first T-fastener and the second T-fastener may be deliverable relative to biological tissue to be fastened at the treatment site. The suture may intracorporeally fasten the first T-fastener and the second T-fastener relative to one another for robust securement biological tissue therebetween. As compared to securement using external fixation, the fastener assemblies, systems, and methods of the present disclosure may facilitate intracorporeally fastening tissue while reducing or eliminating certain requirements associated with postoperative care.

A suturing device (1) for suturing parts (5,6) together of a lumen (8) with one or more sutures (3) comprises an actuator (34) having a handle (33) and first and second operating elements (60,68) slideable longitudinally on the handle (33). A tubular shield (35) extends from the handle (33), and a cannula (40) slideable in the tubular shield (35) is connected to the first operating element (60) for urging the cannula (40) between a withdrawn state within the tubular shield (35) to an extended state extending from the tubular shield (35). An elongated push rod (52) slideable in the cannula (40) terminating in a distal hook (55) is coupled to and operated by the second operating element (68). Anchor elements (22) of the suture (3) are located in the cannula (40), and are sequentially urged therefrom by the push rod (52), as the cannula (40) sequentially pierces through the parts (5,6). A loop (26) of the suture (3) is engaged by the hook (55), which is then withdrawn into the tubular shield (35) for engaging the adjustment element (25) of the suture (3) against an abutment face (38) of the tubular shield (35) for in turn drawing the anchor elements (22), and in turn the parts (5,6) of the colon (8) together. The adjustment element retains the parts (5,6) together.