A fixation assembly for securing parts of a sternum has a first section having a first attachment structure for securing the first section to a first sternum part. The fixation assembly includes a second section having a second attachment structure for securing the second section to a second sternum part. A mating arrangement is provided defining a mating direction and a predetermined relative position between the first and second sections in a plane perpendicular to the mating direction. At least one holding member is provided for detachably holding the first and second sections in an abutting relationship in the predetermined relative position. This may be achieved in one variant by simultaneous engagement of the first and second sections substantially along the mating direction.

In accordance with the disclosure, devices are provided for closing an opening in tissue. The devices include a proximal portion configured and arranged to occlude the tissue opening, and a distal anchor portion configured and arranged to anchor the device in the tissue opening. If desired, the distal anchor portion can be moved proximally or distally with respect to the proximal portion during implantation. The proximal portion can be configured and arranged to fit into a left atrial appendage of a patient, and further wherein the distal anchor portion is configured and arranged to extend into the left atrial appendage.

Disclosed herein is a needle for being connected to a suture, including: a body having a tip portion disposed at one end portion thereof and a rear end portion disposed at the other end portion thereof; and a suture connection part formed in a side surface portion of the body, wherein the suture connection part includes a reception path extended toward a lengthwise axial portion of the body and receiving a portion of the suture therein, and a closure member constituting a portion of the body and deformed by external force after a portion of the suture is received in the reception path, thereby closing a portion of the reception path.

Devices and methods of endolumenal formation of gastric sleeves are described. Some embodiments allow templating of a gastric sleeve by a gastric bougie, exposing a selected amount of tissue for suturing access, while maintaining sufficient internal working space for suturing within the template lumen.

This application describes a braided cord containing a braided sheath and optionally a core surrounded by the braided sheath. The braided cord has changing cross-sectional area ranging from 0.0004 mm.sup.2 to 30 mm.sup.2 and contains one or more sections having a tapering angle ranging from 1° to 60° when observed in one direction along the cord axis. The change in the cross-sectional area of the cord can be achieved by changing the thickness of the braided sheath and/or changing the cross-sectional area of the core when the core is present. The thickness of the braided sheath can be adjusted by changing the size and/or twist level of one or more sheath strands, changing the pick count of the braided sheath, and/or using one or more shaped sheath strands. This application also describes a process of producing the braided cord with changing cross-sectional area.

Self-retaining sutures having a first end for penetrating tissue and an elongated suture body comprising a plurality of intermittent apertures structured to enable formation of knotless suture loop closures that securely hold opposing tissue faces together due to the presence of the intermittent apertures through the suture that permit one-way passage of the suture body thus forming a self-retaining or self-engaging loop in the suture that does not slip backwards. Once a desired loop size is formed between tissue faces by pulling the suture through one of the intermittent apertures in the suture thread, the suture thread is clipped and a further loop is begun using the remainder of the suture thread affixed to the suture needle.

Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical repair construct includes an anchor, a filament having a snare formed on one end and a collapsible loop on another end, and a suture having a plurality of stationary protrusions formed therein. The suture is configured to be coupled to detached tissue and have its ends passed through an opening in the snare. The snare can be collapsed around the suture such that at least one of the suture protrusions is proximal of the collapsed snare. The anchor can be disposed in bone and the filament coupled thereto. Accordingly, collapsing the snare around the suture couples the tissue to bone, and applying tension to a tensioning limb of the filament can collapse the collapsible loop to incrementally tighten and secure the tissue to bone. Other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

A method for approximating a wound using a uni-directional, barbed wound closure device having a needle and a stop element. The method includes taking a first pass by entering intact tissue at a location in proximity to the first apex and exiting in intact tissue at a location away from and above said first apex, pulling the wound closure device until the stop element is seated above the tissue plane, moving back toward the first apex and taking at least a second pass in a direction substantially perpendicular to the first pass at a location above or adjacent to the first apex, moving in a direction toward the second apex, approximating the wound using a continuous suturing pattern, moving toward the first apex, taking at least two passes across the wound, and cutting off a free end of the wound closure device in proximity to a surface of the tissue.

Barbed medical devices include a crown interconnecting a pair of legs and at least one barb extending from each of the legs. The at least one barb may define an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the leg, a second portion disposed at a second orientation relative to the longitudinal axis, and optionally, a third portion disposed at a third orientation relative to the longitudinal axis of the leg.

A suture-less pelvic implant system and method is provided for treating pelvic conditions, such as incontinence or vaginal prolapse. The implant can include a fixation portion, which may be rectangular or suture line, having a plurality of fixation elements, e.g., barbs, extending therefrom to fixate within target pelvic tissue, such as the vaginal apex. In a sacralcolpopexy, an opposing end or anchor of the implant is fixated within the sacrum or like structure to stabilize, raise, support or reposition the vaginal apex.