Systems and methods of placing one or more suture loops into tissue, such as the base of the tongue, are described. A system can include a variable-thickness suspension line for suspending tissue, including a suture having a first thickness dimension; an elastomer surrounding a portion of the suture and defining a central segment of the suspension line having a second thickness dimension greater than the first thickness dimension, and at least one transition zone extending from the central segment of the suspension line to a lateral end of the suspension line, the transition zones having a thickness dimension that tapers from the second thickness dimension to the first thickness dimension.

There is provided a suture passer device used in procedures of robotic assisted minimally invasive suspension of the hyoid and tongue base in treatment of sleep apnea. The suture passer device is a dual use suture passer, having both suture insertor and extractor functionality on a single unitary instrument section of the device by means of insertion and extraction hooks positioned on an elongated needlelike body which is connected to a handle grip. The insertion and extraction hooks receive a suture via an opening in the body of the instrument, with the suture capable of removal and fastening to the extraction hook by robotic forceps. Procedures for using the device are disclosed which include a single point of entry on a patient and the device moved to first and second positions above and below the hyoid bone during robotic assisted surgery.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include a cord that is flexible and elongated defining a length. The cord may include a core having a porous surface and a porosity-reducing element on at least a portion of the core.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include a cord that is flexible and elongated defining a length. The cord may include a core having a porous surface and a porosity-reducing element on at least a portion of the core.

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.

Devices and methods for ultrasound image-guided percutaneous, cardiac valve implantation and repair comprise, in combination, a plurality of devices including but not limited to an ultrasound-image guided catheter, a pericardial sheath, a cardiac-valve delivery system and an ascending aortic filter. An image-guided catheter is utilized to introduce via an introducer needle and a guide wire a pericardium portal for permitting entry from the chest wall to inside the pericardial space between the pericardial outer lining and inner lining. The pericardium portal permits the use of ultrasound vision to locate a site proximate the left ventricular apex, for introduction of a sheath via a .myocardium needle into the left ventricular space at an angle and avoiding any coronaries or vessels. A first delivery system permits placement of at least one aortic filter which collects any emboli, particulate matter, plaque and prevents such matter travelling via the ascending aorta to the brain, causing a stroke. A second delivery system permits placement of an aortic and/or mitral valve replacement or repair using several types of repair tools.

A method of suturing includes: (1) wrapping a first segment of a suture through a traction loop; (2) pulling the traction loop and the first segment through an opening in a suture lock; (3) continuing to pull the traction loop such that a second segment of the suture extends through the opening, wherein the second segment has a greater denier than the first segment such that the second segment more nearly fills an entire dimension of the opening than the first segment; and (4) locking the suture in place with the second segment in the opening.

A barbed suture including a body with barbs on the periphery, a pointed end, and an anchor at one end to resist movement of the suture in the direction of the pointed end is provided. One or more limbs on the anchor may be provided, which may be arcuate, of varying lengths, and of varying distribution about the periphery of the suture body. Other anchor designs are provided. Methods of placing single-directional and bi-directional barbed sutures to approximate the tissue on each side of a wound and to position and support tissue in the absence of a wound, as in cosmetic surgery, are provided, and may include terminal J-stitches or S-stitches. Methods of placement may be made with sharp, pointed ends, which may be needles, or Insertion devices. Sinusoidal patterns of sutures that have amplitudes generally perpendicular to the resultant holding force of the suture are provided.

A suturing apparatus and method thereof using autotransfer are provided. The suturing apparatus includes a tube that has a rod movable there within and a needle that has an insertion portion. A suture engages with a tip of the needle or the tube. The insertion portion of the needle is inserted through a material prior to engagement with the suture and is withdrawn with the suture back through the material. The suturing system allows for single hand operation, thus simplifying a suturing process.

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.