A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Systems and methods are provided and adapted to engage and pull (e.g., pull up) or reposition urethral support tissue, such as the portion of the perineal membrane above or below the urethra. The perineal membrane intersects the urethra and vagina at the midurethra or distal location and can thus be stabilized or controlled in a manner that helps restore continence.

Methods and devices for transvascular prosthetic chordae tendineae implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet anchor having a leaflet suture is secured to the mitral valve leaflet. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae. The suture lock has a body with a suture path extending therethrough. A wall in the housing is movable to reduce the cross section of the suture path. A drive mechanism advances the movable wall to clamp sutures extending through the suture path, in response to rotation of a coupling on the housing.

Various methods and devices are provided for reducing the volume of the ventricles of the heart. In one embodiment, a method for reducing the ventricular volume of a heart chamber is provided including the steps of inserting an anchoring mechanism onto dysfunctional cardiac tissue, deploying one or more anchors into the dysfunctional cardiac tissue, raising the dysfunctional cardiac tissue using the anchors, and securing the anchors to hold the dysfunctional cardiac tissue in place. Further, a device for reducing the volume of the ventricles of a heart chamber is provided where the device has one or more clips for placement on dysfunctional cardiac tissue of a heart, one or more anchors for deployment and securement into the dysfunctional cardiac tissue, and a lifting mechanism for raising the one or more anchors and the dysfunctional cardiac tissue.

A bio paracentesis needle includes a tube-shaped body having a hollow portion through which a suture is inserted, an insertion portion formed at an end of the body to cut skin and insert the body, and at least one removal cut to an inside of the body to remove waste under the skin when the body is inserted. The insertion portion includes a first inclined edge having a diagonal surface inclined downward in a direction from a first end of the both to the hollow portion, a second inclined edge having a diagonal surface inclined upward from a second end of the body to the first inclined edge, the second end being positioned opposite the first end, and a third inclined edge has a diagonal surface inclined downward in a direction from an end of the first inclined edge to the second inclined edge.

An assembly for use in repairing a severed tendon comprises an elongate threading element adapted to transit along a lumen of a tendon sheath, for covering a curved needle and carrying the needle within the lumen. The assembly can also comprise a liner for lining an internal surface of the tendon sheath, defining an internal passage along which a tendon stump coupled to the curved needle can pass. The liner can have a collapsed, rest configuration in which it is adapted to be inserted into the lumen of the tendon sheath, and an expanded, operating configuration, the liner being movable to the expanded configuration by contact with the tendon stump. Once released from the liner, the threading element receives the curved needle, for covering and carrying the curved needle through the liner and along the lumen of the tendon sheath trailing the connected tendon stump.

A fistula treatment system comprises a guide such as a guide coil 1101 which is adapted to extend partially around a tissue tract and an implant element 1102. The implant element 1102 is activated to draw tissue surrounding the tract inwardly.

A surgical clip applier is disclosed which is configured to automatically feed a clip from a clip cartridge once the surgical clip applier is positioned in the patient.

Medical constructs with collagen fibers and gelatin and related collagen fibers. The collagen fibers can be derived from extruded soluble dermal collagen and can include a gelatin film attached to the at least one collagen fiber. The gelatin film can include one or more minerals and has a gelatin concentration of between about 0.1% to about 40% weight per volume.

An apparatus for implantation at an annulus (75) of an intracardiac valve includes an annuloplasty ring (110) comprising a plurality of rotatably adjoining segments (112). The ring is configured to pass over multiple threads (58), respective distal ends of which are distributed over the annulus, and, while passing over the threads, expand from a collapsed state to an expanded state by virtue of the segments rotating with respect to each other. The apparatus further comprises a lock (114), configured to lock the ring in the expanded state at the valve by inhibiting rotation of the segments with respect to each another. Other embodiments are also described.