A wound closure system and a method of closing a wound are disclosed. The wound closure system includes a plurality of skin anchors mechanically attached to external skin tissue around a periphery of a wound, a line extending between the skin anchors, the line slidably engaged with each skin anchor, and a biasing member that provides tension on the line to draw all of the skin anchors toward the wound. The method of closing a wound includes the steps of attaching a plurality of skin anchors to external skin around a periphery of a wound, extending a line between the skin anchors around substantially the entire periphery of the wound, and providing tension to the line to draw the skin anchors toward the wound.

In one embodiment, a hook fastener has a plurality of hooks and a loop fastener has a plurality of loops to secure tissues sections to one another. At least one of these fasteners has a porous surface to allow tissue ingrowth to secure the fastener to the tissue. In another embodiment, only a single fastener is used, with a section of tissue being treated to engage and mate with the fastener. The disclosed tissue fastening systems can be used for a number of applications. One such example includes fastening tissue sections by wrapping a tissue fastener around the tissue and securing the fastener on itself. A suture may also be secured with the tissue fastener.

A sutureless device and methods for closing a tissue opening that minimizes the labor, cost, and skill typically required is disclosed. The apparatus comprises two anchors that attach to either side of an open tissue wound. The two anchors are connected together by a tie strip; the tie strip has a plurality of teeth and a rack. As the wound edges and anchors are brought together the ratchet system on the tie strip prevents the anchors and tissue wound from reopening. To control the distance between the two anchors, a rack and pinion system and a key or a lever system is utilized. The rack is located on the tie strip and the pinion is located on the key.

A bidirectional reversible medical skin tension reducing closer is provided. The closer comprises a left substrate and a right substrate, both of which are configured to be horizontally and symmetrically arranged, a left pawl and a right pawl fixedly arranged on adjacent ends of the left and right substrates respectively, and a left rack and a right rack, one end of each of which is fixedly connected to the left and right pawls respectively in an up-down side-by-side arrangement. Ratchets on the left and right pawls tilt towards the left and right substrates respectively, and the other ends of the left and right racks pass through the space beneath the right and left pawls respectively and are engaged with ratchets provided on the bottom of the right and left pawls respectively. Adhesive layers for fixing the left and right substrates onto the surface of the skin are arranged on the bottom surfaces of the left and right substrates. According to the invention, forces can be uniformly applied from two sides, and the closure degree of the closer can also be freely adjusted.

A surgical or wound closure device utilizes a slide fastener for rapidly closing a surgical incision or wound with precise apposition of the sides of the incision. The surgical closure devices are configured for linear incisions, shaped incisions, such as used for wedge biopsy or excisional biopsy, and long incisions, such as used for laparotomy or surgical removal of redundant skin. The surgical closure device may be adhered to the patient's skin prior to making an incision and is subsequently used for closing the incision.

A device for treating a tissue opening includes a capsule extending longitudinally from a proximal end to a distal end and including a lumen extending therethrough; a pair of arms movably housed within the lumen of the capsule such that the pair of arms are movable between an open configuration and a closed configuration, the pair of arms being biased toward the open configuration such that when the pair of arms are moved distally with respect to the capsule, distal ends of the pair of arms are separated from one another to receive target tissue therebetween; a needle releasably connected to a first one of the pair of aims, the needle extending laterally inward toward a second one of the pair of arms and including a connecting structure extending along a portion thereof, the second one of the pair of arms including an opening located so that, when the pair of arms are moved to the closed configuration, the connecting structure of the needle engages the opening; and a suture extending from a portion of the needle proximally through the capsule.

In one embodiment, a hook fastener has a plurality of hooks and a loop fastener has a plurality of loops to secure tissues sections to one another. At least one of these fasteners has a porous surface to allow tissue ingrowth to secure the fastener to the tissue. In another embodiment, only a single fastener is used, with a section of tissue being treated to engage and mate with the fastener. The disclosed tissue fastening systems can be used for a number of applications. One such example includes fastening tissue sections by wrapping a tissue fastener around the tissue and securing the fastener on itself. A suture may also be secured with the tissue fastener.

A device for treating a tissue opening includes a proximal portion including an elongated flexible member, a capsule releasably coupled to a distal end of the flexible member and including a lumen extending therethrough and a clip including a pair of arms movably housed within the capsule. A suture extending along a first one of the pair of arms and including a loop at a distal end thereof extending across an opening extending through the first one of the pair of arms. A suture grabbing element extending laterally from a second one of the pair of arms and including a hook so that, when the pair of arms are moved toward a closed configuration, the hook extends through the opening to grab the loop and draw the distal end of the suture from the first one of the pair of arms toward the second one of the pair of arms.

Abdominal approximation devices and methods are described where one variation of the tissue securement assembly may generally include a fixation member having a length, a thickness control securement member which is adjustably securable along the length, and a frame which is adjustably securable to the thickness control securement member. The frame may have a relaxed configuration and a biasing configuration which imparts a biasing force against the thickness control securement member when in the biasing configuration such that the biasing force is applied at a distance from tissue to be approximated via the fixation member.

Systems, devices and methods are provided that facilitate the formation of incisions in tissue while reducing, minimizing or avoiding the generation of scar tissue. Devices are provided that facilitate the generation of an incision during multiple passes of a laser beam, such as a picosecond infrared laser (PIRL) beam. Some implementations employ the use of guidelines or guide structures to facilitate alignment of a laser beam delivery tool during the formation of an incision, optionally based on feedback provided by one or more sensors. Optical waveguide structures are disclosed for the efficient and controlled generation of laser incisions. Devices and methods are disclosed for applying tension, via manual or autonomous means, during and/or after the formation of an incision. The tension may be applied, optionally based on feedback from one or more sensors, to avoid the deformation of tissue within the incision beyond the elastic deformation limit.