Method of tensioning a suspended tissue mass
First Claim
1. A method of suspending a first tissue mass from a second tissue mass with a preselected tension, comprising the steps of:
- providing a suture, said suture having at least a first portion, a second portion, and a third portion, the first portion of said suture being between the second and third portions of said suture;
positioning the first portion of said suture around the first tissue mass;
securing at least one of the second and third portions of said suture to the second tissue mass;
positioning a suture tensioner having a preselected cross-sectional area between said suture and either of the first or second tissue masses;
tying the second and third portions of said suture; and
thereafterremoving the suture tensioner to produce an amount of slack in said suture corresponding to the cross-sectional area of the suture tensioner.
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Accused Products
Abstract
The surgical treatment of stress urinary incontinence is described. The methods include: 1) a technique of probe passage to avoid injuring the bladder and to provide a more accurate and reproducible capture of the pubocervical fascia lateral to the bladder neck and urethra, 2) anchor fixation of the suspending sutures to the pubic bone to decrease the risk of suture pull through from above and to decrease post-operative pain and 3) a simple and reproducible technique to set a limited tension of the suspending sutures. A description of these methods and results of procedures with some of these methods are included. Novel drill guides, suture passers, suture tensioners, and various related tools and devices for use in the surgical method are also discussed.
420 Citations
22 Claims
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1. A method of suspending a first tissue mass from a second tissue mass with a preselected tension, comprising the steps of:
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providing a suture, said suture having at least a first portion, a second portion, and a third portion, the first portion of said suture being between the second and third portions of said suture; positioning the first portion of said suture around the first tissue mass; securing at least one of the second and third portions of said suture to the second tissue mass; positioning a suture tensioner having a preselected cross-sectional area between said suture and either of the first or second tissue masses; tying the second and third portions of said suture; and
thereafterremoving the suture tensioner to produce an amount of slack in said suture corresponding to the cross-sectional area of the suture tensioner. - View Dependent Claims (2, 3, 4)
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5. A method of suspending a tissue mass with a preselected tension, comprising the steps of:
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securing at least one suture to a bone such that a first and second suture ends extend therefrom; advancing at least one of said first and second ends of the suture around the tissue mass; positioning a suture tensioner having a preselected cross-sectional area between the suture and the bone; tying said first and second suture ends; and
thereafterremoving the suture tensioner to produce an amount of slack in the suture corresponding to the cross-sectional area of the suture tensioner. - View Dependent Claims (6, 7, 8)
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9. A method of suspending a bladder neck with a preselected tension, comprising the steps of:
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providing a first suture, said suture having at least a first portion, a second portion, and a third portion, the first portion of said suture being between the second and third portions of said suture; securing the first portion of said suture to tissue generally adjacent the bladder neck; securing at least one of the second and third portions of said suture to a first anchor; positioning the anchor in a bone; positioning a suture tensioner having a preselected cross-sectional area between the suture and either the bone or the tissue generally adjacent the bladder neck; tying the second and third portions of said suture; and
thereafterremoving the suture tensioner to produce an amount of slack in said suture corresponding to the cross-sectional area of the suture tensioner. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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Specification