Method and Apparatus for Securing a Urethral Sling to Pubic Bone
First Claim
Patent Images
1. A surgical kit comprising:
- a urethral sling having opposed sling sides and extending between a first sling end adapted to be coupled to a first pubic bone and a second sling end adapted to be coupled to a second pubic bone (26) to fix the urethral sling in a sub-urethral location to support the urethra and alleviate incontinence, the urethral sling having or capable of having a sling opening formed through the sling adjacent the first and second sling ends;
at least one bone anchor having a bone fixation mechanism adapted to be affixed to pubic bone and an elongated anchor suture adapted to be passed through a urethral sling opening to enable advancement of the urethral sling over the suture body and toward a pubic bone after the bone anchor is affixed to the pubic bone; and
at least one suture retainer having a retainer body (102;
162;
204, 214;
272;
304;
312;
342) and a retainer bore through the retainer body, the retainer bore sized and shaped to receive and engage the suture adjacent the urethral sling to apply retentive force through the retainer body against the urethral sling to retain a portion of the urethral sling proximate the pubic bone.
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Abstract
Surgical procedures, kits and implants for alleviating human incontinence, and particularly providing improved methods and apparatus to secure a urethral sling to pubic bone to support the urethra and alleviate incontinence are disclosed. Bone anchors are driven into pubic bones with elongated bone anchor sutures configured to be passed through openings of a urethral sling. Suture retainers are applied to the sutures to apply retentive force to the urethral sling to maintain the fixation of the urethral sling proximate to the pubic bone.
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Citations
29 Claims
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1. A surgical kit comprising:
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a urethral sling having opposed sling sides and extending between a first sling end adapted to be coupled to a first pubic bone and a second sling end adapted to be coupled to a second pubic bone (26) to fix the urethral sling in a sub-urethral location to support the urethra and alleviate incontinence, the urethral sling having or capable of having a sling opening formed through the sling adjacent the first and second sling ends; at least one bone anchor having a bone fixation mechanism adapted to be affixed to pubic bone and an elongated anchor suture adapted to be passed through a urethral sling opening to enable advancement of the urethral sling over the suture body and toward a pubic bone after the bone anchor is affixed to the pubic bone; and at least one suture retainer having a retainer body (102;
162;
204, 214;
272;
304;
312;
342) and a retainer bore through the retainer body, the retainer bore sized and shaped to receive and engage the suture adjacent the urethral sling to apply retentive force through the retainer body against the urethral sling to retain a portion of the urethral sling proximate the pubic bone. - View Dependent Claims (2, 3, 4, 6, 8, 9, 10, 11, 12, 13, 14, 15)
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5. (canceled)
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7. (canceled)
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16. A method of securing a urethral sling to pubic bone in a sub-urethral location to support the urethra and alleviate incontinence comprising:
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affixing a plurality of bone screws having exposed elongated bone screw sutures into pubic bones on either side of the urethra; passing the bone screw sutures through urethral sling openings; and applying suture retainers to the bone screw sutures to apply retentive forces against the urethral sling to retain portions of the urethral sling proximate the pubic bone.
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17. A method of securing a urethral sling to pubic bone in a sub-urethral location to support the urethra and alleviate incontinence comprising:
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providing a urethral sling having opposed sling sides and extending between a first sling end adapted to be coupled to a first pubic bone and a second sling end adapted to be coupled to a second pubic bone to fix the urethral sling in a sub-urethral location to support the urethra and alleviate incontinence, the urethral sling having or capable of having a sling opening formed through the sling adjacent the first and second sling ends; affixing a plurality of bone anchors having exposed elongated anchor sutures into the first and second pubic bones on either side of the urethra; passing the anchor sutures extending from the first pubic bone through urethral sling openings proximate the first sling end; engaging each anchor suture extending from the first pubic bone with a retainer bore of a suture retainer having a retainer body to dispose the retainer body in contact with a portion of the urethral sling; passing the anchor sutures extending from the second pubic bone through urethral sling openings proximate the second sling end; engaging each anchor suture extending from the second pubic bone with a retainer bore of a suture retainer having a retainer body to dispose the retainer body in contact with a portion of the urethral sling; tensioning the urethral sling between the first and second one or more suture retainers. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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Specification