Articulating suturing device

A method for closing an opening extending through a tissue wall, the method comprising:

• inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a first arm and a second arm each extending between a proximal end and a distal end, the first and second arms each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the first and second arms are positioned distal of the tissue wall, first and second ends of a flexible filament respectively being removably coupled with the first and second arms;
• pivoting the proximal end of each of the first and second arms of the tissue locator about the distal end of the respective arm to move the proximal ends of the first and second arms from the retracted configuration to a deployed configuration in which the proximal ends of the first and second arms extend laterally away from the shaft;
• advancing a first penetrator and a second penetrator distally through the vessel wall such that the first and second penetrators respectively couple with the first and second ends of the flexible filament;
• and
• withdrawing the first and second penetrators proximally through the vessel wall, thereby causing the first and second ends of the filament to uncouple from the first and second arms, the first end of the flexible filament remaining coupled with the first penetrator such that the first end of the filament withdraws proximally through the vessel wall with the first penetrator.

An apparatus for closing an opening in a body tissue, the apparatus comprising:

• a shaft extending along an axis between a proximal end and a spaced apart distal end, the shaft having a size and configuration suitable for insertion through an opening in body tissue;
• a plurality of arms attached to or integrally formed with the shaft, the arms being movable between:
• a retracted configuration in which the arms are each aligned along the shaft, and
• a deployed configuration in which the arms extend laterally away from the shaft;
• a filament net or a plurality of flexible filaments having multiple ends, each of the ends of the filament net or flexible filaments being removably coupled with a separate one of the plurality of arms;
• and
• a penetrator associated with each arm, each penetrator being positioned proximal of the respective arm, the penetrator being advanceable distally through a vessel wall to the respective arm to couple with the end of the filament or filament net associated with the arm and to withdraw the filament or filament net through the vessel wall;
• and
• a plurality of penetrator actuators, each associated with a different penetrator, the penetrators being movable independent of each other by the penetrator actuators.

A method for closing an opening extending through a tissue wall, the method comprising:

• inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a plurality of arms, each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the plurality of arms are positioned distal of the tissue wall, at least one flexible filament or web being removably coupled with the plurality of arms;
• moving the plurality of arms from the retracted configuration to a deployed configuration in which the plurality of arms extend laterally away from the shaft;
• for each arm, advancing a penetrator distally through the vessel wall to couple with the at least one flexible filament or web associated with the arm, the penetrators being movable independent of each other;
• and
• withdrawing the penetrators proximally through the vessel wall, thereby causing the at least one flexible filament or web to uncouple from the plurality of arms and withdraw proximally through the vessel wall with the penetrators.

A method for closing an opening extending through a tissue wall, the method comprising:

• inserting a distal end of a tissue locator distally through the opening, the tissue locator comprising a plurality of arms, each being aligned along a shaft of the tissue locator in a retracted configuration, the tissue locator being inserted far enough through the opening that the plurality of arms are positioned distal of the tissue wall;
• advancing a plurality of penetrators distally to attempt to penetrate through the vessel wall, each penetrator being associated with a different one of the arms, one or more penetrators not penetrating through the vessel wall;
• removably coupling separate ends of a filament net with the plurality of arms, the one or more arms associated with the nonpenetrating penetrators not being coupled with the filament net;
• moving the plurality of arms from the retracted configuration to a deployed configuration in which the plurality of arms extend laterally away from the shaft;
• for each arm associated with penetrating penetrators, advancing a penetrator distally to penetrate through the vessel wall, the penetrators penetrating through the wall to couple with the end of the filament net associated with the corresponding arm;
• and
• withdrawing the penetrators proximally, thereby causing the ends of the filament net to uncouple from the plurality of arms and withdraw proximally through the vessel wall with the penetrators.