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Endoscopic suture cinch system

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TLDR
A two-part suture cinch includes a collar and a plug as discussed by the authors, and the plug is coupled to the distal end of the flexible shaft of the tubular member.
Abstract
A two-part suture cinch includes a collar and a plug. A cinch applicator is also provided, and includes an elongate tubular member, a plunger engaged within the distal end of the tubular member, a flexible shaft extending through the tubular member and plunger, and a proximal handle for moving the shaft longitudinally relative to the tubular member. The plunger includes a distal housing for the collar of the cinch, and the plug is coupled to the distal end of the flexible shaft. The suture is thread through the collar and a portion of the applicator. Operation of the applicator draws the plug into the collar and clamps the suture between the plug and collar. In addition, once the plug is coupled in to the collar, the plunger is displaced proximally to release the two-part cinch form the applicator. A method for applying the cinch is also provided.

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References
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Patent

Flexible endoscopic surgical instrument for invagination and fundoplication

TL;DR: An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to proximal end of tube as mentioned in this paper.
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