A medical device includes a surgical needle, an elongated suture, and an intervening segment. The elongated suture has a first end proximate to the needle and a second end located away from the needle. The elongated suture also includes a plurality of fibers defining a mesh wall between the first and second ends. A plurality of pores extend through the mesh wall, at least some which are in the macroporous size range of greater than 200 microns for facilitating tissue integration when introduced into a body. The intervening segment is disposed between and connected to either or both ends of the elongated suture and the needle. The intervening segment includes one or more fibers of the plurality of fibers and has a cross-sectional dimension smaller than a cross-sectional dimension of the mesh wall such that the intervening segment facilitates indirect attachment of the elongated macroporous mesh suture to the needle.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone. The method includes the following: implanting in bone a first anchor including a first suture construct connected to the first anchor; passing a first adjustable loop of the first suture construct at least one of over or through the soft tissue; coupling the first adjustable loop to one of a first locking feature of the first anchor or a second locking feature of a second anchor; adjusting the first adjustable loop by pulling a first end of the first suture construct; and securing the soft tissue against bone by pulling the first end of the first suture construct.

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.

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

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.

An intervertebral disc repair system comprises an implant and a delivery tool configured to deploy the implant at least partially in a vertebral body of a patient. The implant includes an anchor member and an adjustable suture assembly coupled thereto. The delivery tool includes a proximal handle, an outer tubular member extending distally from the handle, a needle cannula slidably received within the outer tubular member having a sharpened tip for penetrating tissue (e.g., the vertebral body), an inner pusher member slidably received within the needle cannula, and an actuating mechanism coupled to the handle for selectively retracting the needle cannula relative to the outer tubular member and the inner pusher member. At least the anchor member of the implant is releasably received within the needle cannula.

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 and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Assemblies for securing fractured bone are provided. The assembly includes a first fixation element, a second fixation element, and an adjustable flexible member construct. The first fixation element having a male or a female sleeve is secured within a first portion of the fractured bone. The second fixation element having the other of the male or female sleeve telescopically received within the one of the male or female sleeve is secured within a second portion of the fractured bone. The adjustable flexible member construct extends between the first and second fixation elements and has at least one adjustable loop coupled to the first fixation element and the second fixation element and a pair of adjusting ends extending through an opening in the first fixation element. The pair of adjusting ends can be pulled to reduce a diameter of the adjustable loop and to compress fragments of the fractured bone.

An endoscopic treatment tool set includes: an endoscopic treatment tool that includes a sheath having a lumen, an elongated shaft inserted into the lumen and the elongated shaft having an insertion passage, a stylet disposed in the insertion passage, an implant connected to the stylet, and a manipulation part provided at the sheath; and a jig. The endoscopic treatment tool is packed together with the jig. The jig is coupled to a proximal end portion of the stylet disposed in the manipulation part and the jig is configured to be movable relative to the manipulation part. The implant is connected to the jig via the stylet, and the implant is configured such that the jig is pulled toward a proximal end side of the manipulation part so that the stylet is moved to a proximal end side in the insertion passage and the implant is loaded in the insertion passage.