Surgical instrument
First Claim
1. A surgical instrument for use in placing an elongate filamentary element into a patient to treat female incontinence said instrument comprising:
- an elongate shaft defining an internal passage, said shaft having a cutting tip formed on one end thereof and a handle formed on the other end thereof;
the shaft including the handle being sized and shaped such that the shaft may be passed into and through a patient, the internal passage being provided to introduce a said elongate element into the patient whilst the instrument is located in a patient in use;
wherein the shaft has one of a longitudinally extending slot, a groove and a channel formed therein which extends at least part way along the length thereof and defines at least in part said internal passage.
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Accused Products
Abstract
The invention provides a surgical instrument for inserting an elongate element into a human patient. In the preferred form of the invention the instrument has a curved hollow shaft defining an arc corresponding to the general curvature of a passage between the anterior vaginal wall and the abdomen of a female patient and having a cutting tip at one end and a handle at the other end. An elongate threading element is used draw a filamentary element through the shaft. Once the filamentary element is in position the shaft is removed from the patient, leaving the element in position. The instrument is preferably used to insert a U-shaped loop of filamentary material into the patient which passes around the patient'"'"'s urethra and helps the patient improve her urinary control.
172 Citations
33 Claims
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1. A surgical instrument for use in placing an elongate filamentary element into a patient to treat female incontinence said instrument comprising:
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an elongate shaft defining an internal passage, said shaft having a cutting tip formed on one end thereof and a handle formed on the other end thereof;
the shaft including the handle being sized and shaped such that the shaft may be passed into and through a patient, the internal passage being provided to introduce a said elongate element into the patient whilst the instrument is located in a patient in use;
wherein the shaft has one of a longitudinally extending slot, a groove and a channel formed therein which extends at least part way along the length thereof and defines at least in part said internal passage. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A surgical instrument for use in placing an elongate filamentary element into a patient to treat female incontinence said instrument comprising:
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an elongate shaft defining an internal passage, said shaft having a cutting tip formed on one end thereof and a handle formed on the other end thereof, the shaft including the handle being sized and shaped such that the shaft may be passed into and through a patient, the internal passage being provided to introduce a said elongate element into the patient whilst the instrument is located in a patient in use;
wherein the shaft has a series of apertures spaced apart along the length of at least part of the shaft, said apertures passing through a wall of the shaft into said internal passage.
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12. A surgical instrument for use in placing a filamentary element into a female patient so as to form a sling or loop around the urethra extending over the back of the pubic bone to the abdominal wall, said instrument comprising:
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a generally arcuately curved tubular shaft defining an internal passage, said shaft having a cutting tip formed on one end thereof and a handle attachment formed on the other end thereof;
a handle, non-rotatably and removably connected to the handle attachment of the shaft and being selectively disconnectable from the shaft during surgical procedures; and
a flexible threading element a adapted to be inserted into and through said internal passage and adapted to be used to draw one end of a said filamentary element through said internal passage;
wherein the shaft has a series of apertures spaced apart along the length of at least part of the shaft, said apertures passing through a wall of the shaft into said internal passage.
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13. A surgical instrument for use in placing a filamentary element into a female patient so as to form a sling or loop around the urethra over the back of the pubic bone, to the abdominal wall, said instrument comprising:
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a generally arcuately curved shaft defining a longitudinally extending internal passage, said shaft having a cutting tip formed on one end thereof and a handle attachment formed on the other end thereof;
a handle, non-rotatably connectable to the handle attachment of the shaft; and
a flexible threading element insertable into and through said internal passage from either end of said shaft and adapted to be used to draw one end of a said filamentary element through said internal passage;
said tubular shaft being curved so that the shaft lies substantially in a single plane;
wherein the shaft has one of a longitudinally extending slot, a groove and a channel formed therein which extends at least part way along the length thereof and defines at least in part said internal passage;
the cutting tip at least in part being of planar bevel shape so as to lie in a plane perpendicular to said single plane and at an acute angle to the shaft axis. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A surgical instrument comprising:
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a. a hollow curved tubular shaft defining an interior passage and having an acutely cut first end forming a sharp point and a handle that is non-rotatable and is further detachably connectable to the other end;
b. a flexible threading element which is at least as long as the shaft, the threading element and the shaft being adapted to be used, when the handle is detached, to draw a filamentary element through the internal passage through the shaft; and
c. the shaft is shaped and configured to be used to pass a filamentary element through a female patient through an anterior wall of the vagina to an anterior wall of the abdomen through the wall thereof into the interior passage wherein the filamentary element forms a sub urethral sling, in part extending over the back of the pubic bone to the abdominal wall.
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28. A surgical instrument for use in placing a filamentary element into a female patient so as to form a sling or loop around the urethra extending over the back of the pubic bone to the abdominal wall, said instrument comprising:
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a generally arcuately curved tubular shaft defining an internal passage, said shaft having a cutting tip formed on one end thereof and a handle attachment formed on the other end thereof;
a handle, non-rotatably and removably connected to the handle attachment of the shaft and being selectively disconnectable from the shaft during surgical procedures; and
a flexible threading element a adapted to be inserted into and through said internal passage and adapted to be used to draw one end of a said filamentary element through said internal passage;
wherein the shaft has one of a longitudinally extending slot, a groove and a channel formed therein which extends at least part way along the length thereof and defines at least in part said internal passage.
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29. A surgical instrument for use in placing a filamentary element into a female patient so as to form a sling or loop around the urethra over the back of the pubic bone, to the abdominal wall, said instrument comprising:
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a generally arcuately curved shaft defining a longitudinally extending internal passage, said shaft having a cutting tip formed on one end thereof and a handle attachment formed on the other end thereof;
a handle, non-rotatably connectable to the handle attachment means of the shaft; and
a flexible threading element insertable into and through said internal passage from either end of said shaft and adapted to be used to draw one end of a said filamentary element through said internal passage;
said tubular shaft being curved so that the shaft lies substantially in a single plane;
wherein the shaft has a series of apertures spaced apart along the length of at least part of the shaft, said apertures passing through a wall of the shaft into said internal passage; and
the cutting tip at least in part being of planar bevel shape so as to lie in a plane perpendicular to said single plane and at an acute angle to the shaft axis.
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30. A method of introducing a filamentary element into a female patient so as to form a sling or loop extending around the urethra to the abdominal wall, said method including the steps of:
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a) inserting a generally arcuately curved shaft having a longitudinally extending internal passage into the patient through a first incision in the anterior surface of the vaginal wall, so as to pass on one side of the urethra between the pubis and the bladder and out of the patient through the abdominal wall;
b) passing a threading element through the internal passage from one or other end thereof so that the distal end of the threading element passes out of the remote end of the internal passage;
c) attaching a filamentary element to the distal end of the threading element and drawing the filamentary element through the internal passage with the threading element;
d) withdrawing the hollow shaft from the patient whilst leaving the filamentary element in position in the patient;
e) inserting the shaft into the patient through the anterior surface of the vaginal wall, so as to pass on the other side of the urethra between the pubis and the bladder;
f) drawing the filamentary element into position through the internal passage using the threading element; and
g) withdrawing the shaft from the patient whilst leaving the filamentary element in position thereby forming a loop which extends around the urethra to the abdominal wall. - View Dependent Claims (31, 32, 33)
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Specification