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.

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 tissue repair construct having first and second implants coupled via a flexible element is provided. The flexible element forms an adjustable loop closed with a sliding knot, and has first and second free ends extending from the knot formed by wrapping the second end around the first end. The second implant can have a changeable configuration. The construct can be placed within a surgical site in a patient's body such that the first implant is passed into a bone adjacent to soft tissue and the second implant is disposed on an opposed side of the soft tissue. The first free end of the flexible element is configured to be tensioned to decrease a size of the loop and thereby change the configuration of the second implant and to thereby cause at least the second implant to move towards the first implant.

Suture passer systems for tissue suspension and tissue compression are described. The system can include a shaft and a needle, wherein the needle is freely rotatable with respect to the shaft. The suture may include an overmolded segment. Methods of placing one or more implants, sutures, fastener, bone anchors and other devices are also described. The methods include moving tissue, including the superior pharyngeal constrictor muscle, palatopharyngeal arch, and palatoglossal arch. The methods include hyoid bone suspension.

A surgical system, method, and apparatus for suturing a first anatomical structure to a second anatomical structure of a subject includes an endoscope tube for being advanced through a lumen of the first anatomical structure to a surgical site near the second anatomical structure. A manipulator arm extends through the endoscope tube to the surgical site, and includes a first concentric tube manipulator with an end effector configured to grasp and manipulate a suture at the surgical site. A needle arm extends through the endoscope tube to the surgical site, and includes a second concentric tube manipulator with a needle tip configured to pierce the tissue of the first and second anatomical structures. The needle arm is also configured to grasp the suture and to retract and pull the suture through the pierced tissue so that the suture extends through and forms stitching that stitches together the first and second anatomical structures.

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.

A suture apparatus having a housing, actuator and capture rod, the actuator being engaged to the capture rod to form an actuator-capture rod assembly, an elongated cannula shaft having a lumen that extends through the shaft, and capture rod retraction means, the housing including an internal region that is configured to receive and support the capture rod retraction means, actuator proximal end and actuator rod distal end therein, wherein said capture rod retraction means is in communication with said actuator. The actuator-capture rod assembly and capture rod retraction means being positioned and configured to transition from a retracted position to an extended position when an actuation force is applied to the actuator and return the retracted position by the retraction means when the actuation force is released.

A suture passer comprising: a hollow tube, said hollow tube comprising a distal end, a proximal end, and a lumen extending from said distal end to said proximal end; and a suture manipulation rod slidably received in said lumen of said hollow tube and selectively projectable out said distal end of said hollow tube, said suture manipulation rod comprising a distal end and a proximal end, said distal end of said suture manipulation rod being bifurcated into a first arm and a second arm, wherein said first arm includes a hook comprising a proximally oriented hooking surface and a return extending proximally of said hooking surface; wherein said hollow tube and said suture manipulation rod are sized so that said suture manipulation rod may capture a suture disposed adjacent to said distal end of said hollow tube and draw the suture into said lumen of said hollow tube, and further wherein, after a suture has been drawn into said lumen of said hollow tube, distal movement of said suture manipulation rod causes the suture to be expelled from said hollow tube.

A suture assembly, including a button having two apertures and a suture defining a lumen and forming a double loop, formed by a double trap having a first end and a second end, opposed to the button. A first portion of the suture is threaded through the trap from the first end to the second end, and a second portion of the suture is threaded through the trap from the second end to the first end. The assembly further defines a first single trap, in which the first portion of the suture is threaded through the lumen between the second end and the button. Also defined by the assembly is a third trap, in which the second portion of the suture is threaded through the lumen between the first end and the button. Finally, the double loop is threaded through the two apertures of the button.

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.