A kit for plantar plate repair may include implants and instruments specific to the procedure, such as an implant assembly, a needle assembly, a distractor, a needle driver, and k-wires. Methods of assembling the items of the kit and methods of plantar plate repair are disclosed.

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 kit for plantar plate repair may include implants and instruments specific to the procedure, such as an implant assembly, a needle assembly, a distractor, a needle driver, and k-wires. Methods of assembling the items of the kit and methods of plantar plate repair are disclosed.

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.

In one general aspect, a medical device can include an implant having a medial portion and a distal portion. The medical device can include a delivery member including a dilator having a distal portion, and a tube coupled to the dilator. The tube can define a lumen in fluid communication with an opening in the tube. The opening can be disposed between the distal portion of the implant and the distal portion of the dilator of the delivery member. The medical device can include a sleeve having a lumen. The distal portion of the implant and at least a portion of the delivery member can be disposed within the lumen portion of the sleeve.

One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising: a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein the proximal end of the suture member extends proximally beyond the deployed suture pattern into a local suture length storage reservoir coupled to the delivery member, the reservoir containing an additional length of suture and being configured such that upon rotation of the delivery member in the first direction, the anchor member pulls along the distal portion of the suture member causing at least a portion of the additional length of suture to be extended out from the local suture length storage reservoir, and causing the distal portion of the suture member to form a deployed suture pattern which remains coupled to the anchor member.

One embodiment is directed to a method for providing surgical access across a wall of a tissue structure, comprising: installing a guiding member into the wall of the tissue structure to a desired guiding depth; using the installed guiding member as a positional guide, advancing a helical member into the wall of the tissue to a desired helical member depth, the helical member comprising a helical member distal end removably coupled to an anchor member which is coupled to a distal end of a suture member, such that advancing the helical member into the wall causes the anchor member to be advanced into the wall and to pull a distal portion of the suture member along with the anchor member into the wall to substantially encapsulate a number of helical loops of suture member that is greater than about 1 loop and less than about 3 loops; withdrawing the helical member from the wall of the tissue structure, leaving the anchor member in a deployed configuration decoupled from the helical member and coupled to at least a portion of the wall of the tissue structure; and tensioning the suture member to apply a load to the deployed anchor member.

One embodiment is directed to a system for providing surgical access across a wall of a tissue structure, comprising a delivery member having proximal and distal ends; a first helical member having proximal and distal ends and a helical shape, the proximal end coupled to the delivery member distal end, the distal end extending distally of the delivery member distal end; an anchor member removably coupled to the helical member distal end; and a suture member coupled distally to a portion of the anchor member and extending proximally to a position wherein at least a portion of it may be freely manipulated by an operator; wherein upon rotation of the delivery member in a first direction, the first helical member and coupled anchor member are advanced across at least a portion of the wall of the tissue structure, pulling along the distal portion of the suture member in a deployed suture pattern which remains coupled to the anchor member, the deployed suture pattern being characterized in that it is substantially helical and represents a number of helical loops encapsulated by the wall of the tissue structure that is greater than about one helical loop, and is less than about three helical loops.

One embodiment is directed to a method for tensioning a suture member that crosses a portion of a wall of a tissue structure, comprising: advancing a distal portion of the suture member across at least a portion of a wall of the tissue structure; advancing a tensioning assembly, through which the suture member is threaded, toward the wall of the tissue structure, the tensioning assembly comprising: a tensioning member base having a tissue interface surface configured to engage a portion of the tissue structure when coupled to a suture member that may be threaded through the tensioning member base and into the tissue structure; a suture clamping member configured to be switched from a first mode, wherein a suture may be tensioned back and forth through a space defined at least in part by the clamping member, to a second mode, wherein a suture may only be tensioned in one direction relative to the suture clamping member; and a mode switching member movably coupled to the suture clamping member and configured to be operable to switch the suture clamping member from the first mode to the second mode; adjusting the physical relationship between the tensioning assembly, suture member, and tissue structure wall by modulating the position of the tensioning member base relative to the suture member and tissue structure wall with the tensioning mode switching member in the first mode; and controllably switching the tensioning mode switching member to the second mode.

Methods and devices provide constriction of a heart valve annulus to treat cardiac valve regurgitation and other conditions. Embodiments typically include a device for attaching a cinching or tightening apparatus to a heart valve annulus to reduce the circumference of the annulus, thus reducing valve regurgitation. Tightening devices may include multiple tethered clips, multiple untethered crimping clips, stabilizing devices, visualization devices, and the like. In one embodiment, a plurality of tethered clips is secured circumferentially to a valve annulus, and the tether coupling the clips is cinched to reduce the circumference of at least a portion of the annulus. Methods and devices may be used in open heart surgical procedures, minimally invasive procedures, catheter-based procedures, and/or procedures on beating hearts or stopped hearts.