A stiffening assembly comprises an outer tube including a longitudinal axis, an inner tube extending along the longitudinal axis, and a plurality of laminar elements between the outer tube and the inner tube and separate from the outer tube and the inner tube. The stiffening assembly is adjustable between a flexible state in which each laminar element of the plurality of laminar elements is movable and a stiffened state in which an applied vacuum clamps the plurality of laminar elements between the outer and inner tubes such that a transfer of forces between the plurality of laminar elements stiffens the stiffening assembly. At least one laminar element of the plurality of laminar elements has a different thickness than at least another laminar element of the plurality of laminar elements.

A loading fixture for use with an endoscopic stitching device includes a needle and a loading portion configured to receive jaws of the endoscopic stitching device. The loading portion includes a shuttle configured to detachably support the needle thereon. The shuttle is transversely slidable such that the needle supported on the shuttle engages at least one of the jaws of the endoscopic stitching device. The loading portion further includes guides to position the jaws of the endoscopic stitching device therebetween and a biasing member configured to bias the shuttle toward one of the guides.

A surgical closure apparatus includes an outer member dimensioned for positioning within a wound opening, a needle assembly at least partially positioned within the outer member and a suture configured for at least partially closing the wound opening within the tissue. The needle assembly includes an elongate member defining a longitudinal opening, a suture needle coupled to the elongate member and extending to a needlepoint and being configured for movement between an unarmed condition where the needlepoint is in a relative radial inward position and an armed condition where the needlepoint is in a relative radial outward position and a deployment member extending at least partially through the longitudinal opening of the elongate member and coupled to the suture needle. The deployment member is movable within the longitudinal opening to permit the suture needle to move between the unarmed condition and the armed condition.

A surgical needle includes a pair of ends, a mid-region extending between the ends, and at least one grasping feature configured for grasping by a suturing instrument. An end of a suture is secured to the mid-region of the needle in a manner such that the end of the suture defines an oblique angle with at least part of the centerline defined by the mid-region of the needle. The end of the suture may be disposed in a hollow portion of the needle. The grasping feature may include a notch such as a scallop. The suture may be pivotally coupled with the needle via a ball or pin. The needle may have one or more sharp points. The sharp point may include three converging cutting edges, at least two planar surfaces bounded by the three cutting edges, and a rounded surface bounded by two of the three cutting edges.

Techniques are described for closure of a defect in material, such as closure of a laparoscopic surgical defect. A defect closure device can be inserted into the defect to capture first material adjacent to the defect. The device houses at least first and second suture pins coupled together by a suture. A first interaction with a trigger structure can force the first suture pin through the captured first material and into a containment sub-assembly. After rotating the device to capture second material adjacent to the defect, a second interaction with the trigger structure can force the second suture pin through the captured second material and into the containment sub-assembly. As such, the suture is passed through the first and second portions of the material, and the ends of the suture can be cinched, and cut to form a stitch.

An apparatus includes a first shaft extending distally from a proximal end to a distal end. The first shaft is sized to fit within an esophagus of a patient. The first shaft includes a first shaft lumen extending distally to the distal end. The apparatus further includes a second shaft slidably positioned within the first shaft lumen. The second shaft is sized to fit within the shaft lumen and extend through the transverse bore. The second shaft is configured to receive a guide element and a sphincter augmentation device so that the sphincter augmentation device may be deployed through an interior of the esophagus to an exterior of the esophagus.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A heart valve anchor apparatus may include a body having a proximal portion and a distal portion. The body may include a first radially expandable portion at the proximal portion of the body, a second radially expandable portion at the distal portion of the body, and a root portion extending from the first radially expandable portion to the second radially expandable portion, the root portion having an outer extent. The first radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. The second radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. In an unstressed configuration, the body may define a longitudinal centerline that extends away from a plane tangent to the root portion.

A heart valve anchor apparatus may include a body having a proximal portion and a distal portion. The body may include a first radially expandable portion at the proximal portion of the body, a second radially expandable portion at the distal portion of the body, and a root portion extending from the first radially expandable portion to the second radially expandable portion, the root portion having an outer extent. The first radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. The second radially expandable portion may be configured to self-expand to an outer extent greater than the outer extent of the root portion when radially unconstrained. In an unstressed configuration, the body may define a longitudinal centerline that extends away from a plane tangent to the root portion.