Apparatus and method for repairing and preventing para-stomal hernias

• US 4,854,316 A
• Filed: 10/03/1986
• Issued: 08/08/1989
• Est. Priority Date: 10/03/1986
• Status: Expired due to Fees

• Current Assignee: Emsley A. Davis
• Original Assignee: Emsley A. Davis
• Inventors: Davis, Emsley A.
• Primary Examiner(s): Coven, Edward M.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US06/915,041
• Time in Patent Office: 1,040 Days
• Field of Search: 128/1 R, 128/334 R, 128/334 C, 623/11, 623/12, 623/14, 623/66, 604/8, 604/29, 604/329, 604/175
• US Class Current: 606/153
• CPC Class Codes: A61F 2/0063 Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0068 having a special mesh pattern
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2230/0069 cylindrical

Abstract

A sheet-like inner member formed of prosthetic mesh has an opening formed therethrough. A tubular member formed of prosthetic mesh has two opposite ends with an opening extending therethrough between its two ends. The inner member is connected to the tubular member at or near one end thereof such that a passage extends through the openings of the two members. The tubular member is adapted to be located in the opening of an abdominal wall of a human inward of the outer skin thereof with the inner member being adapted to be attached to an inner portion of the abdominal wall around the opening thereof inward of the other end of the tubular member. The passage of the device has a size sufficient to receive and support a portion of the gastrointestinal tract. In another embodiment a sheet-like outer member formed of prosthetic mesh and having an opening formed therethrough is connected to the tubular member at or near its other end such that the passage of the device extends through the opening of the outer member. The outer member is adapted to be attached to an outer portion of the abdominal wall around the opening thereof inward of the outer skin. For use in repairing a stomal hernia, the device has a slit or a gap formed through one side thereof whereby it may be located around the gastrointestinal tract and sutured in place without disturbing the stomal bud.

Claims

1. A device for use in repairing and preventing a para-stomal hernia in a human, the stoma resulting from the rerouting of a portion of the gastrointestinal tract of the human through an opening in the abdominal wall, said device comprising:

a sheet-like inner member having an opening formed therethrough,

a tubular member having two opposite ends with an opening extending therethrough between said two ends,

said inner member being connected to said tubular member at or near one end thereof such that a passage extends through said openings of said inner member and of said tubular member, said tubular member being adapted to be located in the opening of the abdominal wall inward of the outer skin of the abdominal wall with said inner member being adapted to be attached to an inner portion of the abdominal wall near the opening thereof inward of the other end of said tubular member,

said passage of said device having a size sufficient to receive and support a portion of the gastrointestinal tract located in the opening of the abdominal wall inward of the outer skin and when said inner member is attached to an inner portion of the abdominal wall near the opening thereof inward of the other end of said tubular member,

a sheet-like outer member having an opening formed therethrough, said outer member being connected to said tubular member at or near its other end such that said passage extends through said opening of said outer member,

said outer member being adapted to be attached to an outer portion of the abdominal wall near the opening thereof inward of the outer skin,

said inner member, said tubular member, and said outer member being formed of prothetic mesh comprising a material that is relatively flexible;

is suitable for surgical application;

is suturable to abdominal wall tissue; and

is acceptable to a human biological system.

2. The device of claim 1, wherein:

said inner member has a gap extending between its outer edge and its opening,

said outer member has a gap extending between its outer edge and its opening,

the wall of said tubular member has a gap extending between its two opposite ends,

said inner and outer members being connected to said tubular member such that their gaps are aligned to allow said device to be located around the gastrointestinal tract with a portion of the gastrointestinal tract located within said passage of said device whereby said device may be employed for repairing a para-stomal hernia without disturbing the stomal bud.

3. The device of claim 2, wherein:

said tubular member has two edges defining said gap of said tubular member,

when said two edges of said tubular member are located next to each other, the wall of said tubular member between said two ends thereof, when viewed from either of said two ends, is continuous between said two edges for substantially 360°

.

4. A method of repairing and preventing a para-stomal hernia in a human, the stoma resulting from the rerouting of a portion of the gastrointestinal tract of the human through an opening in the abdominal wall, said method comprising the steps of:

entering the human through an incision in the abdominal wall to gain access to the gastrointestinal tract located in the abdominal cavity,

locating a section of the gastrointestinal tract within the passage of a device comprising a sheet-like inner member having an opening formed therethrough, a tubular member having two opposite ends with an opening extending therethrough between said two ends and a sheet-like outer member having an opening formed therethrough with said inner member being connected to said tubular member at or near one ned thereof and said outer member being connected to said tubular member at or near the other end thereof such that said passage extends through said openings of said inner member, of said outer member, and of said tubular member, with most of the length of said passage extending through said opening of said tubular member, said device having a gap formed through one side thereof such that said device is spread apart at its gap to locate the gastrointestinal tract within said passage of said device without disturbing the stomal bud, said inner member, said tubular member, and said outer member being formed of a prosthetic mesh comprising a material that is relatively flexible;

is suitable for surgical application;

is suturable to abdominal wall tissue; and

is acceptable to a human biological system,

with said section of the gastrointestinal tract located within said passage of said device, and with said tubular member being located in the opening of the abdominal wall inward of the outer skin thereof, attaching said outer member to an outer position of the abdominal wall around near the opening thereof inward of the outer skin of the abdominal wall and said inner member to an inner portion of the abdominal wall around near the opening thereof inward of said outer member,

when said section of the gastrointestinal tract is located within said passage of said device and said outer member is attached to said outer portion of the abdominal wall and said inner member is attached to said inner portion of the abdominal wall, said tubular member between said two ends thereof, extends substantially continuously around said section of the gastrointestinal tract providing, between said two ends thereof, substantially continuous support and confinement for said section of the gastrointestinal tract around the periphery thereof.

5. A device for use in repairing and preventing a para-stomal hernia in a human, the stoma resulting from the rerouting of a portion of the gastrointestinal tract of the human through an opening in the abdominal wall, said device comprising:

a sheet-like member having an opening formed therethrough,

a tubular member having two opposite ends with an opening extending therethrough between said two ends,

said sheet-like member being connected to said tubular member at or near one end thereof such that a passage extends through said openings of said sheet-like member and of said tubular member,

said tubular member being adapted to be located in the opening of the abdominal wall inward of the outer skin of the abdominal wall with said sheet-like member being adapted to be attached to a portion of the abdominal wall near the opening thereof inward of the outer skin of the abdominal wall,

said passage of said device having a size sufficient to receive and support a portion of the gastrointestinal tract of a human when said tubular member is located in the opening of the abdominal wall inward of the outer skin and when said inner member is attached to a portion of the abdominal wall near the opening thereof inward of the outer skin,

a second sheet-like outer member having an opening formed therethrough,

said second sheet-like member having connected to said tubular member at or near its other end such that said pressure extends through said opening of said sheet-like member,

said second sheet-like member being adapted to be attached to a portion of the abdominal wall near the opening thereof inward of the outer skin,

said sheet-like member, said tubular member, and said second sheet-like member being formed of a prosthetic mesh comprising a material that is relatively flexible;

is suitable for surgical application;

is suturable to abdominal wall tissue; and

is acceptable to a human biological system.

6. The device of claim 5, wherein:

the wall of said tubular member between said two ends thereof, when viewed from either of said two ends, is continuous for substantially 360°

.

7. A device for use in repairing and preventing a para-stomal hernia in a human, the stoma resulting from the rerouting of a portion of the gastrointestinal tract of the human through an opening in the abdominal wall, said device comprising:

a sheet-like inner member having an opening formed therethrough,

a tubular member having two opposite ends with an opening extending therethrough between said two ends,

said inner member being connected to said tubular member at or near one end thereof such that a passage extends through said openings of said inner member and of said tubular member,

said tubular member being adapted to be located in the opening of the abdominal wall inward of the outer skin of the abdominal wall with said inner member being adapted to be attached to an inner portion of the abdominal wall near the opening thereof inward of the other end of said tubular member,

said passage of said device having a size sufficient to receive and support a portion of the gastrointestinal tract of a human when said tubular member is located in the opening of the abdominal wall inward of the outer skin and when said inner member is attached to an inner portion of the abdominal wall near the opening thereof inward of the other end of said tubular member,

a sheet-like outer member having an opening formed therethrough, said outer member being connected to said tubular member at or near its other end such that said passage extends through said opening of said outer member,

said outer member being adapted to be attached to an outer portion of the abdominal wall near the opening thereof inward of the outer skin,

said inner member has a gap extending between its outer edge and its opening,

said outer member has a gap extending between its outer edge and its opening,

the wall of said tubular member has a gap extending its two opposite ends,

said inner and outer members being connected to said tubular member such that their gaps are aligned to allow said device to be located around the gastrointestinal tract located within said passage of said device whereby said device may be employed for repairing a para-stomal hernia without disturbing the stoaml bud,

said inner member, said tubular member, and said outer member being formed of a material that is relatively flexible;

is suitable for surgical application;

is suturable to abdominal wall tissue; and

is acceptable to a human biological system.