Surgical instruments, implantable articles and surgical procedures disclosed for treating medical disorders, particularly incontinence. Improved surgical sling procedures are disclosed. Novel surgical instruments and kits for use in sling procedures are also disclosed. The present invention affords options for surgeons with concomitant advantages to the patient and the healthcare provider.

An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

A suture passer includes a shaft having an axis, a first jaw mounted to the shaft in alignment with the axis, the first jaw being configured to releasably support a length of suture thereon; a second jaw movably mounted to the shaft, and a needle movably mounted to the shaft, the needle having a hook and being configured to reciprocate in alignment with the axis so that the hook can selectively pass by the second jaw and engage suture releasably supported on the first jaw, wherein the first jaw comprises a spring for selectively binding the suture to the first jaw, and further wherein the spring comprises a recess for receiving the suture therein.

A method for retaining a suture includes: extending a distal end of a suture manipulator of a suture passer from a hollow tube of the suture passer, the suture manipulator including a distal portion having a catching surface for catching a portion of a suture; locating a portion of a suture adjacent to the catching surface; and retracting the distal portion of the suture manipulator into a distal portion of the hollow tube and pulling the portion of the suture into the hollow tube so that a loop of the suture is located in a lumen of the hollow tube. A width of a gap between an inner surface of the distal portion of the hollow tube and a side surface of the distal portion of the suture manipulator is less than a width of the distal portion of the suture manipulator.

A method for retaining a suture includes extending a distal end of a suture manipulator of a suture passer from a distal portion of a hollow tube of the suture passer, the distal portion of the suture manipulator forming a single arm so that only the single arm extends out of the distal end of the hollow tube when the suture manipulator is fully extended, locating a portion of a suture adjacent to a catching portion of the suture manipulator, and retracting the distal end of the suture manipulator into the hollow tube and pulling the portion of the suture into the hollow tube so that a loop of the suture is located in a lumen of the hollow tube and the portion of the suture is compressed by an inner surface of the hollow tube and a side surface of the catching portion.