Device for transvaginally suspending the bladder neck

• US 6,077,216 A
• Filed: 08/19/1998
• Issued: 06/20/2000
• Est. Priority Date: 12/03/1991
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Technology Incorporated (Boston Scientific Corporation)
• Inventors: Benderev, Theodore V., Legome, Mark J., Naves, Neil H.
• Primary Examiner(s): Gilbert, Samuel G.
• Application Number:
  US09/136,854
• Time in Patent Office: 671 Days
• Field of Search: 227/175.1-175.4, 606/138, 606/139-150, 600/29
• US Class Current: 600/29
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0461 with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 46/30 : for surgery through the lower body openings, e.g. urology, gynaecology

Abstract

The surgical treatment of stress urinary incontinence is disclosed. The disclosed 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 disclosed. Novel drill guides, suture passers, suture tensioners, and various related tools and devices for use in the surgical method are also disclosed.

Claims

1. An apparatus for transvaginally inserting a tissue support into a patient comprising:

an elongate central section including a proximal end, a distal end, and a longitudinal axis;

a handle section for gripping the apparatus, said handle section located at said proximal end of said elongate central section;

an engagement section located at said distal end of said elongate central section, said engagement section releasably engaging a tissue support, wherein at least a portion of said engagement section is generally curved with respect to the longitudinal axis of said elongate central section such that when said elongate central section is inserted into a vaginal canal said tissue support can pass through a vaginal mucosa generally adjacent to a urethra, said tissue support comprising a support body including a first tissue contacting side for contacting a tissue to be supported, said support body including a plurality of openings therein for allowing tissue ingrowth, a first securing section extending from a first end of said support body, said first securing section being adapted for securing said support body relative to the tissue to be supported when said first securing section is placed in a first securing tissue, and a second securing section located on a second end of said support body, said second securing section being adapted for securing said support body relative to the tissue to be supported when said second securing section is placed in a second securing tissue.

2. The apparatus of claim 1, wherein said first tissue contacting side is adapted to have a concave configuration upon introduction into a patient.

3. The apparatus of claim 1, wherein at least a portion of said engagement section is adapted for being pressed into tissue.