Transvaginal bone anchor implantation device
First Claim
1. A surgical method of correcting urethral hyper-mobility and recurrent female urinary incontinence comprising:
- incising a vagina to create a triangular-shaped opening;
determining an anchor site via palpation of a pubic bone, said anchor site being approximately 0.5 cm posteriorly and superiorly from an inferior edge of an ischial ramus;
providing a device having a handle and a shaft extending from said handle, said shaft having a straight portion and a curved portion extending from said straight portion such that said straight portion and said handle lie along a same longitudinal plane and said curved portion lies above said longitudinal plane, wherein said curved portion releasably engages a bone anchor;
attaching a first self-tapping bone anchor to a distal end of said device;
affixing said bone anchor to said pubic bone by;
inserting said curved portion of said device through said incision;
locating said self-tapping bone anchor at said anchor site on said pubic bone;
pulling said device rearwardly to cause said self-tapping bone anchor to penetrate and attach to said pubic bone;
pushing said device in a forward direction until said bone anchor detaches from said device; and
removing said device through said incision;
affixing a second self-tapping bone anchor contralaterally and in a manner similar to said first self-tapping bone anchor;
providing a rectangular-shaped mesh sling having one of more holes at each end of said mesh sling, each of said holes being sized to receive a shank of a head of said bone anchor;
inserting a first end of said mesh sling through said vaginal incision;
attaching a first hole of a first end of said mesh sling to said first bone anchor;
locating said mesh sling about said urethra;
attaching a first hole of a second end of said mesh sling to said second bone anchor;
tensioning said sling so as to support and stabilize said urethra in its normal anatomic position; and
suturing said incision to close said triangular-shaped opening.
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Accused Products
Abstract
The bone anchor implantation device of the present invention comprises a shaft or body having a grip at a first end of the shaft, an anchor mount at a distal end of the shaft, and a bone anchor removably mounted in the anchor mount. The shaft is preferably bent so that the anchor mount generally faces the grip such that the bone anchor can be implanted at an anchoring site in a bone by pulling rearwardly on the device. The body is adapted to be separable from the anchor after the anchor has been implanted in bone. A suture thread is attached to the bone anchor such that the suture thread is accessible to a surgeon using the device after the bone anchor has been implanted in bone and after the body has been separated from the bone anchor. The shaft is at least partially hollow, and the suture thread is housed in the shaft. The anchor mount comprises a cannula at the distal end of the shaft. The cannula is sized to removably receive an end of the anchor.
241 Citations
9 Claims
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1. A surgical method of correcting urethral hyper-mobility and recurrent female urinary incontinence comprising:
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incising a vagina to create a triangular-shaped opening;
determining an anchor site via palpation of a pubic bone, said anchor site being approximately 0.5 cm posteriorly and superiorly from an inferior edge of an ischial ramus;
providing a device having a handle and a shaft extending from said handle, said shaft having a straight portion and a curved portion extending from said straight portion such that said straight portion and said handle lie along a same longitudinal plane and said curved portion lies above said longitudinal plane, wherein said curved portion releasably engages a bone anchor;
attaching a first self-tapping bone anchor to a distal end of said device;
affixing said bone anchor to said pubic bone by;
inserting said curved portion of said device through said incision;
locating said self-tapping bone anchor at said anchor site on said pubic bone;
pulling said device rearwardly to cause said self-tapping bone anchor to penetrate and attach to said pubic bone;
pushing said device in a forward direction until said bone anchor detaches from said device; and
removing said device through said incision;
affixing a second self-tapping bone anchor contralaterally and in a manner similar to said first self-tapping bone anchor;
providing a rectangular-shaped mesh sling having one of more holes at each end of said mesh sling, each of said holes being sized to receive a shank of a head of said bone anchor;
inserting a first end of said mesh sling through said vaginal incision;
attaching a first hole of a first end of said mesh sling to said first bone anchor;
locating said mesh sling about said urethra;
attaching a first hole of a second end of said mesh sling to said second bone anchor;
tensioning said sling so as to support and stabilize said urethra in its normal anatomic position; and
suturing said incision to close said triangular-shaped opening. - View Dependent Claims (2, 3, 4, 5)
detaching a first hole of said second end of said mesh sling from said second bone anchor; and
attaching a second hole of said second end of said mesh sling to said second bone anchor.
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3. The surgical procedure of claim 2 further comprising:
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detaching a first hole of said first end of said mesh sling from said first bone anchor; and
attaching a second hole of said first end of said mesh sling to said first bone anchor.
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4. The surgical procedure of claim 1 further comprising:
performing a cystopic examination of said urethra.
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5. The surgical procedure of claim 1 further comprising:
repairing additional defects about said urethra or vagina.
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6. A surgical method of correcting urethral hyper-mobility and recurrent female urinary incontinence comprising:
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incising a vagina to create a triangular-shaped opening;
determining an anchor site via palpation of a pubic bone, said anchor site being approximately 0.5 cm posteriorly and superiorly from an inferior edge of an ischial ramus;
providing a device having a handle and a shaft extending from said handle, said shaft having a straight portion and a curved portion extending from said straight portion such that said straight portion and said handle lie along a same longitudinal plane and said curved portion lies above said longitudinal plane, wherein said curved portion releasably engages a bone anchor;
providing a first bone anchor having a self-tapping first end and sutures attached to a second end;
attaching said second end of said first bone anchor to a distal end of said device;
inserting said curved portion of said device through said incision;
locating said self-tapping first end of said first bone anchor at said anchor site on said pubic bone;
pulling said device rearwardly to cause said self self-tapping first end of said first bone anchor to penetrate and attach to said pubic bone;
pushing said device in a forward direction until said bone anchor detaches from said device; and
removing said device through said incision;
affixing a second bone anchor having a self-tapping first end and sutures attached to a second end contralaterally and in a manner similar to said first bone anchor;
providing a rectangular-shaped mesh sling;
inserting a first end of said mesh sling through said vaginal incision;
attaching said mesh sling to said first bone anchor using said sutures;
locating said mesh sling adjacent an intermediate portion of said urethra;
attaching a second end of said mesh sling to said second bone anchor using said sutures;
tensioning said sling so as to support and stabilize said urethra in its normal anatomic position; and
suturing said incision to close said triangular-shaped opening.
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7. A sling for use in treating a patient'"'"'s incontinence comprising:
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a substantially rectangular mesh material having longitudinal edges and transverse edges, the mesh materal being sized and shaped to stabilize functional urethral continence;
at least one suture interwoven in said mesh material, said at least one suture being adjustable so as to adjust tension in said sling during placement of said sling at an intermediate portion of the patient'"'"'s urethra, wherein said at least one suture is woven transversely between the longitudinal edges of said mesh, and wherein the weave of said at last one suture exits said mesh substantially adjacent a longitudinal edge of said mesh. - View Dependent Claims (8, 9)
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Specification