This disclosure includes soft-tissue fasteners for coupling an implant to soft tissue, bone fasteners for coupling an implant to bone, fastener-delivery apparatuses (e.g., tools) for delivering such soft-tissue fasteners and bone fasteners, fastener cartridges for use with certain of the fastener-delivery apparatuses. The present fasteners generally include at least one barbed shaft and an enlarged head spaced from a distal end of the shaft. Some of the present fasteners include two barbed shafts and an enlarged head spanning the two shafts. This disclosure also includes kits that comprise a plurality of fasteners (e.g., a plurality of soft-tissue fasteners, a plurality of bone fasteners, or both). Some of the present kits also include one or more of the present fastener-delivery apparatuses or tools; for example, a plurality of fasteners with a single, reloadable tool; a plurality of tools each pre-loaded with a fastener; and/or a plurality of cartridges each pre-loaded with a fastener and a common tool for use with the cartridges.

Systems, devices and methods related to various heart valve implants and for delivery of those heart valve implants are described. The implants may be used to re-size a native valve annulus or to replace a native heart valve. The implants include a re-sizable frame having angled struts. Anchors secure the implant to tissue and collars are used to decrease the angle between the struts and contract the frame. The implant thus expands from a first size inside of a delivery catheter, to a second and larger deployed size inside the heart to engage and anchor with the tissue, and then to a third and contracted size to re-size the annulus and/or provide a secure fit for a replacement heart valve. Various delivery systems including imaging capabilities for precise delivery, positioning and anchoring of the various implants are further described.

An internal intramedullary fixation device for the stabilization of bone in arthrodesis and fractures of the foot and hand is disclosed. During implantation in medullary canals of bones, the device grasps the edges of the canals, stabilizing the bones, internally, during a healing process. The intramedullary fixation device comprises arrow-shaped proximal and distal heads comprising tips and a pairs of wings, the heads being sized to fit within an intramedullary canal of a bone. The intramedullary fixation device also comprises a rigid body defining a longitudinal axis connecting the proximal and distal heads. The rigid body comprises an intermediate portion, a distal neck portion connecting the rigid body to the distal head, and a proximal neck portion connecting the rigid body to the proximal head, the neck portions having a cross-sectional area smaller than a cross-section area of the intermediate portion.

An anastomotic coupler is provided. A ring can include a receiving portion. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure. The fasteners are received by the receiving portions such that the tubular structure is coupled with the ring.

Devices and methods for gastrointestinal bypass are described. A gastrointestinal bypass device includes a gastrointestinal cuff and a gastrointestinal sleeve. The cuff may be configured to be attached in the esophagus, and may be sufficiently flexible to expand and collapse to conform with the inside of the esophagus to allow the esophagus to function substantially normally. The sleeve is configured to be coupled to the cuff, and may be made of a material that is floppy or flaccid but does not substantially expand radially.

Thoracic/lumbar and cervical spinous process staples which staple/fuse adjacent spinous processes are disclosed. Thoracic/lumbar transverse process staples which staple/fuse adjacent transverse processes are also disclosed. Each embodiment has upper and lower claws connected by a ratchet spring mechanism, along with a multiplicity of bone fastener prongs attached to the upper and lower claws. Two sets of prongs on each staple claw are spaced by a distance approximately equal to the distance separating adjacent spinous or transverse processes so as to facilitate stapling/fusion of two adjacent processes. Also disclosed are staple prongs with multiple perforations which enable incorporation of bone fusion material thereby facilitating stapling/fusion of spinal elements.

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 surgical fastener applier having a housing containing a compartment therein, an elongated member extending distally from the housing and first and second jaws. A firing mechanism is positioned within the housing movable to a second position to effect firing of fasteners. A power pack is removably loadable into the compartment, the power pack having one or both of a) a first motor and a first engagement member removably engageable with the firing mechanism when the power pack is loaded into the compartment to effect movement of the firing mechanism; and b) a second motor and a second engagement member removably engageable with an articulating mechanism in the housing of the surgical fastener applier to effect movement of an articulation mechanism to effect articulation. One or both of a firing position and an articulation position are tracked during the surgical procedure. Sensors are provided to detect select parameters and instrument functions.

Implantable devices for retracting prostatic tissue of a patient are provided. In some embodiments, an implantable device may include a main body and a suture extending through at least a portion of the main body. The main body may be configured to extend through prostatic tissue of the patient such that a distal end portion of the main body resides at least partially outside of a prostatic capsule of the patient, and the distal end portion may be configured to deform from an undeformed configuration to a deformed configuration. The suture may include a first end and a second end extending from a proximal end of the main body, and the suture may be configured to cause the distal end portion to deform from the undeformed configuration to the deformed configuration when the first end and the second end are pulled proximally relative to the main body.

A suturing device includes a hollow needle. The hollow needle has a length extending between a proximal end and a distal end and defining a lumen having an inner diameter. The suturing device further includes a length of surgical suture having a leading end and a trailing end and an outer diameter smaller than the inner diameter of the lumen. At least a portion of the surgical suture is located within the lumen of the hollow needle. A surgical kit including the suturing device and methods of using the suturing device of the present invention are also disclosed.