Medical sling procedures and anchor insertion methods and devices

• US 6,575,998 B2
• Filed: 12/27/2001
• Issued: 06/10/2003
• Est. Priority Date: 11/13/1992
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Ams Research Corporation (Endo International PLC)
• Inventors: Beyar, Mordechay
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US10/034,960
• Publication Number:
  US 20020095064A1
• Time in Patent Office: 530 Days
• Field of Search: 606/139, 606/232, 128/898, 227/175.1
• US Class Current: 606/213
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0493 Protective devices for suturing, i.e. for protecting the patient's organs or the operator
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• 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 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/869 characterised by an open form, e.g. wire helix
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2017/2904 curved, but rigid
• CPC Class Codes: A61F 2/0045 : Support slings
• CPC Class Codes: Y10S 606/916 : Tool for installing or removing orthopedic fastener

Abstract

A procedure for treating urinary stress incontinence by using bone anchors, whether screw or staple type, with or without suture, inserted pervaginally for use with a sling material for supporting the bladder neck and/or proximal urethra.

Claims

1. A device for placing a bone anchor in a patient comprising:

a body;

an anchor mount disposed on said body,

a bone anchor positioned on said anchor mount;

said body and anchor mount being sized and arranged for placing the bone anchor on a pubic bone of a patient through a vaginal incision;

an anchor disengagement mechanism disposed on said anchor mount;

a delivery mechanism associated with said body;

said anchor disengagement mechanism configured to automatically disengage said bone anchor from said anchor mount upon achieving a predetermined degree of placement of said bone anchor into the pubic bone.

2. A device according to claim 1, wherein said predetermined degree of placement includes a prescribed depth within the pubic bone of the patient.

3. A device according to claim 2, wherein said bone anchor includes a rotating shaft.

4. A device according to claim 3, wherein said bone anchor is a bone screw.

5. A device according to claim 1 wherein the body and anchor mount are sized and shaped for placing the bone anchor on a posterior surface of the pubic bone.

6. A device according to claim 1 further including a battery powered motor.

7. A method of placing a bone anchor in a patient comprising:

identifying a bone anchor receiving site;

directing said bone anchor proximate to said receiving site with a delivery tool;

initiating delivery of said bone anchor into said receiving site; and

,

automatically releasing said bone anchor from said delivery tool upon said bone anchor achieving a predetermined degree of insertion.

8. A method according to claim 7, wherein achieving a predetermined degree of insertion includes achieving a prescribed depth within a pubic bone.

9. A method according to claim 8, wherein initiating delivery includes rotating said bone anchor into the receiving site.

10. A method according to claim 9, wherein initiating delivery includes screwing the bone anchor into the site.

11. A method according to claim 8, wherein a suture is attached to the anchor at some time prior to delivery of the anchor to the receiving site.

12. A method according to claim 11, wherein the step of automatically releasing the bone anchor reduces the capacity for inadvertent damage to the suture.

13. A method according to claim 11, wherein said suture is a monofilament.

14. A method according to claim 7, wherein the step of identifying a bone anchor receiving site includes the step of identifying a posterior portion of a patient'"'"'s pubic bone.

15. A surgical device for inserting a bone anchor in a female patient during an incontinence procedure, the device comprising:

a body and an anchor delivery portion,

a bone anchor receivable on the anchor delivery portion;

said body and anchor delivery portion being sized and arranged for placing the bone anchor on a posterior portion of a pubic bone of a patient through a vaginal incision;

an anchor disengagement mechanism associated with said anchor delivery portion;

a delivery mechanism;

said anchor disengagement mechanism automatically disengaging the bone anchor from the anchor delivery portion upon achieving a predetermined depth of insertion of the bone anchor into the pubic bone.

16. A device according to claim 15, wherein the bone anchor is a bone screw.

17. A device according to claim 15, wherein the delivery mechanism comprises a battery powered motor.

18. A device according to claim 15, wherein the bone anchor includes a suture attached thereto.

19. A device according to claim 18, wherein the suture is a monofilament suture.

20. A device according to claim 15 wherein the body and anchor delivery portion comprise a substantially C-shape.