Tissue aperture repair device

• US 5,258,000 A
• Filed: 11/25/1991
• Issued: 11/02/1993
• Est. Priority Date: 11/25/1991
• Status: Expired due to Term

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Gianturco, Cesare
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US07/797,321
• Time in Patent Office: 708 Days
• Field of Search: 606/213, 606/215, 606/151, 606/232
• US Class Current: 606/151
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• 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 2002/0072 Delivery tools therefor
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2210/0019 operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Abstract

A tissue aperture repair device which is inserted using either an openly or minimally invasive surgical procedure for at least partially covering a tissue aperture or hernial ring. The repair device includes a foldable sheet of material that is maintained with support means in an unfolded shape. The support means includes a second sheet of material attached to the circumference of the foldable sheet for forming a cavity therebetween. An elastic stiffener wire is inserted into the cavity for maintaining the device in its unfolded shape. Percutaneous insertion of the device is accomplished with the inclusion of an introducer in which the device is folded about the distal end thereof and contained within a containment sheath. The device is percutaneously inserted into the abdominal cavity of a patient, unfolded, and extended to the unfolded shape with an elastic stiffener wire also percutaneously inserted through the introducer. The device is attached to tissue surrounding the hernial ring using suture material or helical coil fasteners. Alternatively, the device is fastened using an affixation suture extending from the foldable sheet of material.

Claims

1. A tissue aperture repair device comprising:

a foldable sheet of material having an unfolded shape and an unfolded circumference for at least partially covering a tissue aperture; and

support means extending and attached circumferentially about said unfolded circumference of said foldable sheet of material for maintaining said foldable sheet of material in said unfolded shape.

2. The tissue aperture repair device of claim 1 wherein said support means comprises stiffener means for applying force to said foldable sheet of material for maintaining said foldable sheet of material in said unfolded shape.

3. The tissue aperture repair device of claim 2 wherein said support means further comprises attachment means for attaching said stiffener means to said foldable sheet of material.

4. The tissue aperture repair device of claim 1 wherein said support means comprises attachment means for attaching said support means to said foldable sheet of material.

5. The tissue aperture repair device of claim 4 wherein said attachment means comprises a second sheet of material attached about said unfolded circumference of said foldable sheet of material and forming a cavity between said foldable and second sheet of material.

6. The tissue aperture repair device of claim 5 wherein said support means further comprises stiffener means for applying force about said unfolded circumference of said foldable sheet of material for maintaining said foldable sheet of material in said unfolded shape and wherein said cavity includes an opening thereto for insertion of said stiffenere means into said cavity.

7. The tissue aperture repair device of claim 6 wherein said stiffener means comprises an elastic wire.

8. The tissue aperture repair device of claim 5 wherein said support means further comprises an elastic wire.

9. The tissue aperture repair device of claim 1 further comprising affixation means for affixing said foldable sheet of material to tissue positioned about said tissue aperture.

10. The tissue aperture repair device of claim 9 wherein said affixation means comprises a length of suture material extending from said foldable sheet of material.

11. The tissue aperture repair device of claim 9 wherein said affixation means comprises a helical fastener insertable through said foldable sheet of material and into said tissue about said tissue aperture.

12. A percutaneously insertable tissue aperture repair device comprising:

a first foldable sheet of material having a first unfolded shape and a first circumference when in said first unfolded shape for at least partially covering a tissue aperture;

a second foldable sheet of material having a second unfolded shape and a second circumference substantially equivalent to said first unfolded shape and said first circumference, respectively, attached about said first circumference of said first foldable sheet of material, and forming a cavity between said first and second foldable sheets of material, at least one of said first and second foldable sheets of material also including an opening positioned therein; and

an introducer attached to at least one of said first and second foldable sheets of material foldable thereabout for percutaneous insertion to a tissue aperture and having a hollow passageway extending therein communicating with said cavity through said opening positioned in at least one of said first and second foldable sheets of material.

13. The percutaneously insertable device of claim 12 further comprising a stiffener which when inserted in said cavity maintains at least one of said first and second foldable sheets of material in at least one of said first and second unfolded shapes.

14. The percutaneously insertable device of claim 13 wherein said stiffener comprises an elastic wire.

15. The percutaneously insertable device of claim 14 wherein said elastic wire comprises a nickel-titanium alloy.

16. The percutaneously insertable device of claim 13 further comprising a guide insertable through said passageway of said introducer and having a distal end attached about a proximal end of said stiffener.

17. The percutaneously insertable device of claim 13 further comprising a length of suture material extending from at least one of said first and second foldable sheets of material for percutaneous affixation to tissue about said tissue aperture.

18. The percutaneously insertable device of claim 13 wherein said stiffener has a predetermined length approximately five times at least one of said first and second circumferences of said first and second foldable sheets of material.

19. The percutaneously insertable device of claim 13 wherein an other of said first and second foldable sheets of material comprises a porous material.

20. The percutaneously insertable device of claim 12 further comprising a sheath having a hollow longitudinal passageway therein for containment of at least one of said first and second foldable sheets of material when folded about said introducer.

21. The percutaneously insertable device of claim 12 wherein at least one of said first and second unfolded shapes is elliptical.

22. The percutaneously insertable device of claim 12 wherein at least one of said first and second unfolded shapes is circular.

23. The percutaneously insertable device of claim 12 further comprising a suture material attaching said first and second foldable sheets of material together about said first and second circumferences thereof.

24. The percutaneously insertable device of claim 12 wherein at least one of said first and second foldable sheets of material comprises a prosthetic mesh material

25. A percutaneously insertable hernial ring repair of device comprising:

a first foldable sheet of material comprising a porous prosthetic mesh positionable against said hernial ring and having an unfolded circular shape and a circumference when in said unfolded circular shape for at least partially covering a hernial ring, said foldable sheet also including an opening centrally positioned therein;

a second foldable sheet of material comprising a nonporous material positionable facing away from said henial ring and attached about said circumference of said first foldable sheet of material and forming a cavity therebetween;

a suture positioned about said circumference of said first foldable sheet of material attaching said first and second foldable sheets of material together;

an introducer positioned through said opening in said first foldable sheet of material and having a hollow passageway extending longitudinally therein and communicating with said cavity, said first and second foldable sheets of material being folded about a distal end of said introducer when positioned in a sheath for percutaneous insertion of said hernial ring;

a sheath having a hollow passageway extending longitudinally therein and containing said distal end of said introducer with said first and second foldable sheets of material being folded thereabout for percutaneous insertion to said hernial ring;

an elastic stiffener wire having a predetermined length approximately five times the circumference of said first foldable sheet of material and insertable through said hollow passageway of said introducer and into said cavity for maintenance of said first and second foldable sheets of material in said unfolded circular shape;

a wire guide having a distal end detachably connected to a proximal end of said elastic stiffener wire for insertion thereof in said cavity; and

a suture extending from at least one of said first and second foldable sheets of material for attachment thereof to tissue about said hernial ring.