METHODS AND APPARATUS FOR SECURING A URETHRAL SLING TO A 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 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 comprising an anchor body having an anchor body axis and extending between a distal bone fixation mechanism adapted to attached to pubic bone through an anchor neck having a neck dimension lateral to the anchor body axis to a proximal anchor head having a head dimension lateral to the anchor body axis exceeding the neck dimension, whereby the urethral sling is adapted to be applied against the anchor head to insert the anchor head through the sling opening and engage the sling with the anchor neck; and
at least one sling retainer having a retainer dimension exceeding the head dimension adapted to be engaged by one of the anchor head and the anchor neck and applied against the urethral sling, whereby the sling retainer is adapted to be interposed between the urethral sling and the anchor head to retain the sling attached to the bone anchor.
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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 in a sub-urethral location to support the urethra and alleviate incontinence are disclosed. Bone anchors, e.g., bone screws, are driven into pubic bones with exposed bone anchor heads and necks configured to receive and support a urethral sling applied to the bone anchors with and without retainers applied against the urethral sling to retain portions of the urethral sling between the bone anchor heads and the pubic bones.
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Citations
41 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 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 comprising an anchor body having an anchor body axis and extending between a distal bone fixation mechanism adapted to attached to pubic bone through an anchor neck having a neck dimension lateral to the anchor body axis to a proximal anchor head having a head dimension lateral to the anchor body axis exceeding the neck dimension, whereby the urethral sling is adapted to be applied against the anchor head to insert the anchor head through the sling opening and engage the sling with the anchor neck; and at least one sling retainer having a retainer dimension exceeding the head dimension adapted to be engaged by one of the anchor head and the anchor neck and applied against the urethral sling, whereby the sling retainer is adapted to be interposed between the urethral sling and the anchor head to retain the sling attached to the bone anchor. - View Dependent Claims (2, 3, 4, 8, 9, 10, 11, 12, 13, 14, 16, 18)
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5-7. -7. (canceled)
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15. (canceled)
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17. (canceled)
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19-32. -32. (canceled)
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33. Sling retention apparatus for securing a urethral sling at a plurality of locations to pubic bone to fix the urethral sling in a sub-urethral location to support the urethra and alleviate incontinence, the urethral sling having a sling opening, the apparatus comprising:
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at least one bone anchor adapted to attached to pubic bone having an anchor neck and an anchor head having a head dimension enabling passage through the sling opening, and at least one sling retainer having a retainer dimension exceeding the head dimension and a neck receiving port, wherein the urethral sling is adapted to be applied against the anchor head to insert the anchor head through the sling opening and apply the sling against the anchor neck, and the sling retainer is adapted to be interposed between the sling and the anchor head with the anchor neck extending through the neck receiving port to retain the sling against the anchor neck and to inhibit passage of the sling over the anchor head. - View Dependent Claims (34, 35, 36, 37, 38)
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39. A method of securing a urethral sling at a plurality of locations to pubic bone to fix the urethral sling in a sub-urethral location to support the urethra and alleviate incontinence, the urethral sling having a sling opening, the method comprising:
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providing a bone anchor having an anchor body with an anchor body axis and extending between a distal bone fixation mechanism adapted to attached to pubic bone through an anchor neck having a neck dimension lateral to the anchor body axis to a proximal anchor head having a head dimension lateral to the anchor body axis exceeding the neck dimension, and a driver engagement element adapted to be engaged to drive the bone fixation mechanism into bone, providing a driver having a drive shaft and a driving element at the drive shaft distal end; engaging the driver engagement element with the driving element; operating the driver to drive the bone anchor into pubic bone, applying the opening of the urethral sling around the anchor neck; providing a sling retainer having a retainer dimension exceeding the head dimension and a neck receiving bore; and interposing the sling retainer between the sling and the anchor head with the anchor neck extending through the neck receiving port to retain the sling against the anchor neck and to inhibit passage of the sling over the anchor head. - View Dependent Claims (40, 41)
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Specification