Aiming device for surgical instrument and method for use for treating female urinary incontinence

• US 6,596,001 B2
• Filed: 04/23/2001
• Issued: 07/22/2003
• Est. Priority Date: 05/01/2000
• Status: Expired due to Fees

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Lehe, Jorn, Hoepffner, Jochen, Stormby, Johan, Landgrebe, Susanne
• Primary Examiner(s): Woo, Julian W.
• Application Number:
  US09/840,614
• Publication Number:
  US 20020068948A1
• Time in Patent Office: 820 Days
• Field of Search: 606/144, 606/145, 606/223, 606/224, 606/225, 606/102, 600/29, 600/30, 600/135, 600/138, 600/141, 600/142
• US Class Current: 606/144
• 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 2017/0472 Multiple-needled, e.g. double-needled, instruments
• 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

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 tape may be made from synthetic and natural materials. The needle and tape may also be modified to allow the surgeon to attach and detach the tape during the surgical operation. The needle attaches to a handle on which attaches a mechanical arm to track the position of the needle point as it passes through the body and exits the abdominal wall.

Claims

1. A surgical instrument for implanting a device within a patients body to treat female urinary stress incontinence comprising:

a) a handle;

b) a surgical element dimensioned for introducing the device into the body, the surgical element defining in part a curved shaft and having a distal end and a proximal end, the proximal end being coupled to the handle so as to fix the surgical element in position relative to the handle; and

c) an articulating mechanical arm having a distal end and a proximal end, the articulating mechanical arm being coupled to the handle and movable relative to both the handle and surgical element to at least a position in which the distal end of the arm aligns in a predetermined manner with the distal end of the surgical element, the arm further being movable relative to the surgical element and handle and being dimensioned to enable it to remain outside of the body to provide a visual indicator as to the position of the surgical element when it is used to introduce the support device into the body.

2. The surgical instrument of claim 1, wherein the device is a tape that provides support to the urethra.

3. The surgical instrument of claim 1, wherein the mechanical arm comprises a stationary element and a rotating element pivotably coupled to the stationary element so that a distal end of the rotating element travels along an arc that intersects with the distal end of the surgical element.

4. The surgical instrument of claim 3, wherein the stationary element is substantially Z-shaped.

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

a) providing a surgical element defining in part a curved shaft and having a distal end and a proximal end and a tape attached thereto;

b) coupling the proximal end of the surgical instrument to a handle;

c) providing an articulating mechanical arm connected to the handle and movable relative to the handle to at least a position in which the distal end of the arm aligns in a predetermined manner with the distal end of the surgical element; and

d) passing the surgical element and tape into the body to form a sling around the urethra while the articulating mechanical arm remains outside of the body to provide a visual indicator as to the position of the surgical element as it is passed through the body.

6. A method for implanting a device within a patients body to treat female urinary incontinence comprising the steps of:

a) providing a curved element dimensioned for introducing the device into the body, the curved element defining in part a curved shaft and having a proximal and distal end;

b) coupling the proximal end of the curved element to a handle;

b) providing an articulating mechanical arm connected to the handle, and positioned relative to the handle to track the location of the distal end of the curved element from an exterior of the body;

c) attaching a tape to the curved element; and

d) passing the curved element and tape into the body to form a sling around the urethra while the articulating mechanical arm remains outside the body to provide a visual indicator of the position of the curved element within the body.

7. A surgical kit for implanting a device in a patient'"'"'s body to treat female urinary stress incontinence comprising:

a) a surgical element defining in part a curved shaft and having a distal end and a proximal end, the proximal end for connection to a handle; and

b) an articulating mechanical arm having a distal end and a proximal end, wherein the proximal end is coupled to the handle and the distal end is movable relative to the handle and dimensioned so that it remains outside the patient'"'"'s body to provide a visual indicator of the position of the surgical element as it used to implant the device.

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

providing first and second surgical elements, each defining in part a curved shaft, and each having a distal end and a proximal end;

providing a tape having a first end coupled to the first surgical element and a second end coupled to the second surgical element;

coupling the proximal end of the first surgical element to a handle;

providing an articulating mechanical arm connected to the handle and movable relative to the handle to at least a position in which the distal end of the arm is aligned in a predetermined manner with the distal end of the first or second surgical element when coupled thereto;

passing the first surgical element into the body on one side of the urethra and through the abdomen wall while the articulating mechanical arm remains outside of the body to provide a visual indicator as to the position of the surgical element as it is passed through the body;

uncoupling the first surgical element from the handle;

coupling the proximal end of the second surgical element to the handle; and

passing the second surgical element into the body on the opposite side of the urethra than the first surgical element and through the abdomen wall to thereby create a supporting sling below the urethra while the articulating mechanical arm remains outside of the body to provide a visual indicator as to the position of the second surgical element as it is passed through the body.