Systems and methods for sling delivery and placement

• US 20060089524A1
• Filed: 10/25/2004
• Published: 04/27/2006
• Est. Priority Date: 10/25/2004
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Chu, Michael S. H.
• Granted Patent: US 8,500,624 B2
• Time in Patent Office: Days
• US Class Current: 600/37
• CPC Class Codes: A61B 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

The present invention provides devices and methods for delivering an implantable sling to an atomical location in a patient.

Claims

1. A delivery system for delivering a sling to an anatomical location in a patient comprising,

a handle having a proximal end and a distal end, and

a shaft extending distally from the distal end of the handle and including a distal portion sized and shaped for slidably associating with an end of a sling assembly and having a radially extending feature for impeding the sling assembly from sliding proximally along a substantial portion of the shaft.

2. The delivery system of claim 1, wherein the feature on the shaft includes a taper sufficient to impede the sling assembly from sliding proximally along the substantial portion of the shaft.

3. The delivery system of claim 1, wherein the feature on the shaft includes a radially outward extending protuberance sufficient to impede the sling assembly form sliding proximally along the substantial portion of the shaft.

4. The delivery system of claim 3, wherein the radially outward extending protuberance includes a shoulder extending around at least a portion of a circumference of the shaft.

5. The delivery system of claim 4, wherein the shoulder extends around an entirety of the circumference of the shaft.

6. The delivery system of claim 1, wherein the distal portion of the shaft is sized and shaped to interfit through a meshed opening in the sling assembly end.

7. The delivery system of claim 1, wherein the distal portion of the shaft is sized and shaped to interfit through an association loop in the sling assembly end.

8. The delivery system of claim 1, wherein the distal portion of the shaft is sized and shaped to interfit with an association tube attached to the sling assembly.

9. The delivery system of claim 1, wherein the shaft includes a covered portion.

10. The delivery system of claim 1, wherein the shaft includes a first portion substantially in a first plane and a first portion substantially in a second plane different from the first plane.

11. The delivery system of claim 1 including a pusher assembly slidably interfitted over the shaft and slidably actuatable in a distal direction by an operator to push the sling assembly end off the distal end of the shaft.

12. The delivery system of claim 11, wherein the pusher assembly includes a distal end, and the distal end of the pusher assembly forms the feature for impeding the sling assembly from sliding proximally along the substantial portion of the length of the shaft.

13. The delivery system of claim 1 including the sling assembly.

14. A sling assembly comprising,

an implantable sling having length indicating features for indicating length measurements on the sling and a center indicating feature for indicating a center location along a length of the sling, wherein the center indicating feature is differently colored than the length indicating features.

15. The sling assembly of claim 14 including a sleeve for enclosing, at least partially, the implantable sling.

16. A method for delivering a sling to an anatomical location in a patient including the steps of,

inserting a distal end of a delivery device into a sling assembly end,

inhibiting the sling assembly end from sliding proximally along a substantial length of the delivery device,

introducing the distal end of the delivery device and the sling assembly end into the body of the patient, and

removing the distal end of the delivery device from the sling assembly to deliver the sling to the anatomical location in the patient.

17. The method of claim 16, wherein the step of inserting includes inserting the distal end of the delivery device into the sling assembly at a length indicating feature.

18. The method of claim 16 including the step of folding an end of a sling included in the sling assembly lengthwise at a length indicating feature to adjust the length of the sling, and the step of inserting includes inserting the distal end of the delivery device through two layers of sling material near the length indicating feature.

19. A sling delivery assembly including,

a delivery device including a handle having an axially extending through lumen and hollow shaft extending distally from a distal end of the handle and having an axially extending through lumen in fluid communication with the through lumen of the handle,

a guide element for slidably interfitting within the hollow shaft, and

a dilator tube for slidably interfitting over the guide element subsequent to removal of the delivery device, and having a distal end sized and shaped for inserting into an opening in a sling end, and being tapered for inhibiting the sling end from sliding proximally along a substantial portion of the length of the dilator tube.

20. A method for delivering a sling to an anatomical location in a patient comprising the steps of,

inserting a delivery device into the body of the patient,

slidably interfitting a guide element into an axially extending through lumen in the delivery device,

removing the delivery device from the body of the patient, and

slidably interfitting over the guide element a dilator tube having a tapered distal portion associated with a first end of the sling assembly to deliver a sling included in the sling assembly to the anatomical location.

21. A sling delivery assembly comprising a trocar including a distal tip sufficiently sharp to pierce tissue during sling assembly delivery and an outer portion extending proximally from the distal tip and having a tapered distal end sized and shaped for interfitting with an opening in an end of a sling assembly and for inhibiting the sling and/or sling assembly from sliding proximally along a substantial portion of the length of the trocar.

22. A method for delivering a sling assembly to an anatomical location in a patient comprising the steps of,

interfitting a first end of the sling assembly over a tapered distal end of a trocar,

inhibiting a sling assembly end from sliding proximally along a substantial portion of the length of the trocar, and

inserting the distal tip of the trocar, with the first end of the sling assembly interfitted, into the body of the patient to deliver a sling included in the sling assembly to the anatomical location.

23. A sling assembly comprising,

an implantable sling,

a dilator tube, and

an association loop formed from a filament having first and second ends, the first end passing though an end of the implantable sling, the first and second ends of the filament then passing into a proximal end of the dilator tube, the first end of the filament extending through and passing out a distal end of the dilator tube, the second end of the filament exiting the dilator tube via an aperture in a sidewall, the first and second ends of the loop filament being affixed together near the proximal end of the dilator tube.

24. A method for delivering a sling to an anatomical location in a patient including the steps of,

inserting a dilator tube associated with an end of a sling assembly via an association loop into the body of a patient to deliver an end of the sling to the anatomical location,

making a single cut in the association loop at a proximal end of the dilator tube,

pulling on a cut end of the association loop at the proximal end of the dilator tube to remove the association loop from the body of the patient and to disassociate the dilator tube from the sling assembly, and

removing the dilator tube from the body of the patient.