Visually-directed surgical instrument and method for treating female urinary incontinence

• US 6,475,139 B1
• Filed: 05/18/2000
• Issued: 11/05/2002
• Est. Priority Date: 06/09/1999
• Status: Expired due to Fees

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Miller, Gary H.
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): RAM, JOCELYN D
• Application Number:
  US09/573,645
• Time in Patent Office: 901 Days
• Field of Search: 600/135, 600/114, 600/101, 600/138, 600/129, 600/29, 600/30, 600/37, 606/119, 606/139, 604/515
• US Class Current: 600/135
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/06028 by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/0608 J-shaped
• CPC Class Codes: A61B 2017/06085 having a blunt tip blunt dissectors A61B2017/320044
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

Described is a surgical instrument and method for treating female urinary stress incontinence. The instrument includes a curved needle-like element defining in part a curved shaft having a distal end and a proximal end. A tape attaches to the needle for implanting into the lower abdomen of a female to provide support to the urethra. The needle defines an inner lumen for passage of optical devices and/or fluids. A surgical optical system may interface directly with the needle, or alternatively, the needle hand piece or handle may be modified to accept the optical system. The tip of the needle is also modified to contain a window or viewing port that allows for the transmission of light from the ambient target tissue into the imaging lens of the optical system. The optical system allows the surgeon to maintain continuous anatomic visualization during introduction and navigation of the needle within the lower abdomen.

Claims

1. A surgical instrument for treating female urinary stress incontinence comprising:

a) a tape for implanting into a female patient'"'"'s lower abdomen to provide support to the patient'"'"'s urethra; and

b) a curved needle element having a proximal end and a distal end and defining in part a conical tip and a curved shaft, the conical tip and curved shaft each defining a lumen for accepting a light transmitting means for transmitting images at the distal end to a viewing means external of the needle element.

2. The surgical instrument of claim 1 wherein the conical tip comprises a viewing port.

3. The surgical instrument of claim 1 wherein the conical tip is transparent.

4. The surgical instrument of claim 1 wherein the lumen extends from the distal end to the proximal end.

5. A surgical instrument for treating female urinary stress incontinence comprising:

a) a curved needle element having a distal end and a proximal end and defining in part a curved shaft, the curved shaft defining a lumen for accepting a light transmitting means for transmitting images at the distal end to a viewing means external of the needle element.

6. The surgical instrument of claim 5 wherein the lumen extends from the distal end to the proximal end.

7. A surgical system for treating female urinary stress incontinence comprising:

a. a tape for implanting into a female patient'"'"'s lower abdomen to provide support to the patient'"'"'s urethra;

b. a curved needle element having a proximal end and a distal end and defining in part a curved shaft, the curved shaft defining a lumen for accepting an endoscope; and

c. an optical system for transmitting images from the endoscope to a viewing means external of the needle element.

8. The surgical system of claim 7 wherein the optical system comprises a camera, a light source and a means for viewing images from the endoscope.

9. The surgical system of claim 7, wherein the needle element defines, at a distal tip, a conical tip.

10. The surgical system of claim 9, wherein the conical tip defines a viewing port.

11. The surgical system of claim 9, wherein the conical tip is transparent.

12. The surgical system of claim 7 wherein the lumen extends from the distal end to the proximal end.

13. A method for treating female urinary incontinence comprising the steps of:

a) providing a first needle element and a second curved needle element and a tape attached at a first end to the first needle element and at a second end to the second needle element, each of the first and second needle elements defining in part a curved shaft and having a distal end and a proximal end, each of the first and second needle elements further defining a lumen for accepting a light transmitting means for transmitting images at the distal end to a viewing means external of the needle element;

b) passing the first needle and tape into a female patient'"'"'s body via the patient'"'"'s vagina and on one side of the patient'"'"'s urethra and extending the tape over the patient'"'"'s public bone and through the patient'"'"'s abdomen wall;

c) passing the second needle element and tape into the patient'"'"'s body via the patient'"'"'s vagina and on an opposite side of the patient'"'"'s urethra than the first needle element and extending the tape over the patient'"'"'s pubic bone and through the patient'"'"'s abdomen wall so that the tape thereby creates a supporting sling below the patient'"'"'s urethra; and

d) viewing images at the distal end of the first needle element during step (b) and the second needle element during step (c).

14. A method for treating female urinary incontinence comprising the steps of:

a) providing a curved needle element having a tape attached thereto, the needle element defining in part a curved shaft and having a distal end and a proximal end, the needle element further defining a lumen for accepting a light transmitting means for transmitting images at the distal end to a viewing means external of the needle element;

b) passing the needle element and tape into a patient'"'"'s body via the patient'"'"'s vagina to so that the tape thereby forms a sling around the patient'"'"'s urethra; and

c) viewing images at the distal end of the needle element.

15. A method for treating female urinary incontinence comprising the steps of:

a) providing a curved needle element defining in part a curved shaft, the needle element defining a lumen for accepting a light transmitting means for transmitting images at the distal end to a viewing means external of the needle element;

b) attaching a first end of a tape to the needle element;

c) passing the needle element and tape into a patient'"'"'s body;

d) detaching the first end of the tape from the needle element;

e) attaching a second end of the tape to the needle element and passing the needle element and tape into the patient'"'"'s body to thereby form a sling around the patient'"'"'s urethra; and

e) viewing images at the distal end of the needle element.

16. A method for treating female urinary incontinence comprising the steps of:

a. passing a tape into a patient'"'"'s body via the patient'"'"'s vagina to form a loop around the patient'"'"'s urethra, the loop formed between the patient'"'"'s vaginal wall and the patient'"'"'s urethra and extending the tape over the pubic bone; and

b. viewing images of the patient'"'"'s tissue while passing the tape into the patient'"'"'s body.