TRANSOBTURATOR METHODS FOR INSTALLING SLING TO TREAT INCONTINENCE, AND RELATED DEVICES

• US 20110105833A1
• Filed: 01/12/2011
• Published: 05/05/2011
• Est. Priority Date: 02/04/2005
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: AMS Research LLC (Boston Scientific Corporation)
• Inventors: Gozzi, Christian, Rehder, Peter
• Granted Patent: US 8,771,168 B2
• Time in Patent Office: Days
• US Class Current: 600/30
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• 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
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled
• CPC Class Codes: A61B 2017/06085 having a blunt tip
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

Described are methods of treating urinary incontinence using a urinary sling and a tissue path that passes through the obturator foramen, along with related surgical implants, devices, systems, and kits.

Claims

1-20. -20. (canceled)

21. A method of treating incontinence in a male patient, the method comprising providing an elongate implantable sling comprising a central support portion and elongate end portions,

creating an incision at the perineum of the male patient,

inserting the implant through the perineal incision,

installing the central support portion below the bulbous urethra, and

attaching an end portion to an obturator membrane without making a lateral incision substantially adjacent the patient'"'"'s obturator foramen.

22. The method of claim 21, comprising placing tension on the sling to approximate pelvic tissue including the urethra, to improve sphincter function and coaptation of the urethra.

23. The method of claim 21, wherein the sling is placed in contact with corpus spongiosum.

24. The method of claim 21, wherein the implant comprises a widened central support portion.

25. The method of claim 21 comprising approximating the urethra without placing compressive forces on the urethra.

26. The method of claim 21 comprising placing the central support portion at a location below a membranous urethra.

27. The method of claim 21 comprising approximating pelvic tissue to improve coaptation of the urethra without requiring a compressive effect on the urethra.

28. The method of claim 21 comprising

approximating pelvic tissue without requiring a compressive effect on the urethra, and

placing the central support portion at a location below a membranous urethra.

29. The method of claim 21 wherein the implant comprises an anchor and the anchor attaches to the obturator membrane.

30. The method of claim 21 wherein the implant comprises a central support portion located between two opposing elongate end portions, the central support portion is integral with the end portions, and a width of the central support portion is the same as a width of the elongate end portions.

31. The method of claim 24 wherein the width of the central support portion is in a range from 1 to 2 centimeters, and the width of the elongate end portions is in a range from 1 to 2 centimeters.

32. The method of claim 21 wherein the implant comprises a central support portion located between two opposing elongate end portions, and a dilator at an end of each elongate end portion.

33. The method of claim 32 wherein the method comprises providing an implantation tool comprising a curved needle having an end configured to engage a dilator.

34. The method of claim 21 comprising placing tension on the end portions of the sling to approximate the urethra in a proximal direction.

35. The method of claim 21 comprising placing tension on the end portions of the sling to approximate the urethra in a proximal direction by a distance in a range from 1 to 5 centimeters.