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 kit for placing a bypass between two body vessels (R, L) of a patient comprises two catheters (10, 11), two guide wires (30, 31) moveable within one of the catheters (10, 11) each and a bypass element delivery system (52, 53, 8) for holding a bypass element (6, 7). The bypass element delivery system (52, 53, 8) is moveable along the first guide wire (30) and the bypass element delivery system (52, 53, 8) is capable of releasing and setting free the bypass element (6, 7). The kit further comprises an expansible element (40) being capable of connecting with the bypass element delivery system (52, 53, 8), of moving the bypass element delivery system (52, 53, 8) towards the opposite end of the first guide wire (30) and of setting the bypass element delivery system (52, 53, 8) free. The inventive kit enables an atraumatic placement of a bypass.

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.

An apparatus for reversely deactivating a port seal in a laparoscopic port and providing a continuous passage between the laparoscopic port and a remote location in a body cavity.

An apparatus configured to lock an intrabody implant over a thread passing through the implant includes a lock body configured to advance to the implant over the thread and including at least one rotatable element, the lock body being configured to grip the thread proximally to the implant upon rotation of the rotatable element, and a rotation-maintaining element, configured to inhibit a reversal of the rotation of the rotatable element by engaging with the lock body. Other embodiments are also described.

A device is disclosed that can pierce and hold tissue and then pass suture through tissue. The device can have a shuttle that can removably attach to a suture and jaws that can be rotatably opened and closed with respect to each other. A method for using the device to repeatedly pass the suture through the tissue without removing the suture or device from the target site is also disclosed.

An arthroscopic bone tunneling and suturing device including a bone-engaging needle driving assembly including a bone-engaging needle and being adapted for arthroscopic insertion into engagement with a patient's bone at a first bone location through an arthroscopic incision and for driving the needle forwardly along a generally arcuate tunneling path through the bone at least to a second bone location and a bone-engaging pin driving assembly arranged for operative engagement with the bone-engaging needle driving assembly and being adapted for arthroscopic insertion into engagement with a patient's bone at a third bone location through the arthroscopic incision.

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 device for closing an opening in tissue includes a shaft having a proximal end, a distal end, and a channel disposed between the proximal and distal ends. A pair of pins are disposed within the channel and cooperate with a slidable and axially movable foot. The foot extends distally from the channel with a flexible guidebody extending from a distal foot end of the foot.