Laparoscopically implanting bladder control apparatus
First Claim
1. A method for implanting an artificial sphincter to control urinary incontinence in a human patient having a bladder and a urethra, the method comprising:
- implanting an inflatable compression balloon intrapelvically above the pelvic diaphragm adjacent one side of the urethra with a transcutaneous conduit;
selectively inflating and deflating said compression balloon via the transcutaneous conduit; and
externally controlling and monitoring a pressure within the compression balloon via the transcutaneous conduit to establish alternately a first pressure sufficient to occlude the urethra and a second pressure sufficient to permit voiding.
1 Assignment
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Accused Products
Abstract
A method for implanting an artificial sphincter to control urinary incontinence in a patient includes two implantation procedures and an intervening interval of testing and healing. The first procedure employs a trocar or laparoscope to insert and position an inflatable compression balloon 66 in the patient'"'"'s space of Retzuis between the patients'"'"'s posterior pubic symphysis and bladder neck/urethra 12,14 with a fluid conduit 26 extending transcutaneously through the abdominal wall. Using a trocar and Foley catheter, the patient'"'"'s anterior bladder is elevated and connected to the patient'"'"'s abdominal wall by a felt matrix or mesh patch 32 to effectively lengthen and stabilize the urethra. The conduit is used externally to determine respective first and second fluid pressures needed to occlude the urethra and to permit voiding. The second procedure is to implant a fluid reservoir 22 and manually-actuable valve 46 subcutaneously ofer the patient'"'"'s anterior pubis 16 or abdomen and to connect them to the compression balloon via the conduit in a closed system. The system is filled with a quantity of fluid just sufficient to inflate the balloon to the first pressure occlude the urethra when the reservoir is manually compressed by the patient and to equilibrate to the second pressure to permit voiding when the valve is actuated.
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Citations
19 Claims
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1. A method for implanting an artificial sphincter to control urinary incontinence in a human patient having a bladder and a urethra, the method comprising:
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implanting an inflatable compression balloon intrapelvically above the pelvic diaphragm adjacent one side of the urethra with a transcutaneous conduit; selectively inflating and deflating said compression balloon via the transcutaneous conduit; and externally controlling and monitoring a pressure within the compression balloon via the transcutaneous conduit to establish alternately a first pressure sufficient to occlude the urethra and a second pressure sufficient to permit voiding. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. In the patient having a pelvis including a pubis, a pelvic cavity, an abdominal wall connected inferiorly to the pubis, a urinary bladder located within the pelvic cavity posteriorly of the pubis and a urethra descending inferiorly from the bladder through the pelvic diaphragm, a method of implanting an artificial sphincter for controlling urinary incontinence in a patient, the method comprising:
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inserting a sheath-type device anteriorly-inferiorly through the patient'"'"'s abdominal wall and preperitoneal space and retropubic space into the space between the pubic bone and bladder; introducing an inflatable compression balloon through the sheath-type device, said compression balloon being arranged to compress, when inflated, against the urethra and/or bladder neck along an extended area of one side thereof; positioning the compression balloon interapelvically above the pelvic diaphragm within the space between the patient'"'"'s pubic bone and bladder between the patient'"'"'s posterior pubic symphysis and urethra for occluding the urethra; and coupling a conduit to the compression balloon and extending the conduit over the superior pubis and through the abdominal wall to provide external fluid communication with the compression balloon for inflating the compression balloon in response to externally-applied fluid pressure. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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Specification