Surgical articles and methods

• US 7,291,104 B2
• Filed: 09/30/2003
• Issued: 11/06/2007
• Est. Priority Date: 01/23/2001
• Status: Expired due to Term

• Current Assignee: David Staskin
• Original Assignee: American Medical Systems Incorporated (Endo International PLC)
• Inventors: Neisz, Johann J., Bouchier, Mark S., Anderson, Kimberly A., Rocheleau, Gary A., Morningstar, Randy L., Lund, Robert E., Vandersloot, Vicki R., Moore, Terence M.
• Primary Examiner(s): GILBERT, SAMUEL G
• Application Number:
  US10/675,816
• Publication Number:
  US 20040068159A1
• Time in Patent Office: 1,498 Days
• Field of Search: 600 29- 31, 128/DIG.25, 128897-898
• US Class Current: 600/30
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• 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 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/00946 malleable
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/06009 having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
• CPC Class Codes: A61B 2017/06014 spring-loaded
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/06085 : having a blunt tip blunt dissectors A61B2017/320044
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 50/3001 : for sharps
• CPC Class Codes: A61B 90/02 : Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61F 2/0045 : Support slings
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2002/0068 : having a special mesh pattern
• CPC Class Codes: A61F 2002/0072 : Delivery tools therefor
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2250/0007 : for adjusting length

Abstract

Surgical instruments, implantable articles and surgical procedures disclosed for treating medical disorders, particularly incontinence. Improved surgical sling procedures are disclosed. Novel surgical instruments and kits for use in sling procedures are also disclosed. The present invention affords options for surgeons with concomitant advantages to the patient and the healthcare provider.

Claims

1. A surgical kit for treating incontinence comprising:

an implantable material suitable for a sling procedure,

at least one of a first type of needle suitable for a sling procedure, and

at least one of a second type of needle suitable for a sling procedure, and

a dilator for associating said implantable material suitable for a sling procedure with at least one of said first or second types of needles,

wherein the first type of needle comprises a substantially straight needle and the second type of needle comprises a needle with a curved portion.

2. A surgical kit according to claim 1 further including a synthetic insertion sheath associated with the implantable material to form a sling assembly.

3. A surgical kit according to claim 2 wherein said dilator is adapted for associating the sling assembly with a surgical needle.

4. A surgical kit according to claim 1 wherein the first type of needle comprises a needle with at least two handles.

5. A surgical kit according to claim 1 wherein the first type of needle includes an end portion with a passageway for receiving a suture.

6. A surgical kit according to claim 5 wherein the passageway for receiving a suture comprises a hole.

7. A surgical kit according to claim 1 wherein the first type of needle includes at least two straight portions situated at a predetermined angle.

8. A surgical kit according to claim 1 further comprising a first type of handle and a second type of handle wherein the first type of handle is different than the second type of handle.

9. A surgical kit according to claim 1 wherein the first type of needle is larger than the second type of needle.

10. A surgical kit according to claim 1 wherein the first type of needle includes a bladder perforation detector.

11. A surgical kit for treating incontinence comprising:

an implantable material suitable for a sling procedure,

at least one of a first type of needle suitable for a sling procedure, and

at least one of a second type of needle suitable for a sling procedure, wherein the first type of needle is different than the second type of needle, and

a dilator adapted to associate said implantable material suitable for a sling procedure with at least one of said first or second types of needles,

wherein the first type of needle comprises a movable inner member with a blunt end portion having a suture passageway and an outer sheath member with a sheath end, and

means for moving the blunt end portion between i) an extended position with the suture passageway extending beyond the outer sheath member, and ii) a retracted position with the blunt end portion spaced closer to the end of the outer sheath member than in the extended position.

12. A surgical kit according to claim 11 wherein the sheath end comprises a substantially sharp surface for cutting tissue, and the first type of needle includes a means for locking the blunt end portion in the extended position.

13. A method of implanting a sling to treat urinary incontinence in a patient comprising the steps of:

providing a surgical kit comprising at least one guide needle, and at least one sling transport needle with a tip, a sling attached to the sling transport needle, and an adapter having two ends with a gentle taper near one end, said adaptor further having tip receiving surfaces for receiving the tip of the sling transport needle, wherein said adapter comprises a snap mechanism configured to securely attach said guide needle and said adapter,

creating at least one vaginal incision,

creating at least one suprapubic incision,

initially passing the guide needle through the suprapubic incision and then through the vaginal incision,

attaching the adapter to the guide needle,

placing the tip of the sling transport needle in the tip receiving surfaces of the adapter, and

guiding the sling transport needle from the vaginal incision to the suprapubic incision with the guide needle to implant the sling.

14. A surgical kit for treating incontinence comprising:

at least one guide needle,

at least one sling transport needle with a tip, and a sling attached to the sling transport needle, and

an adapter having;

two ends with a gentle taper near one end,

tip receiving surfaces for receiving the tip of the sling transport needle, and

a snap mechanism configured to securely attach said guide needle and said adapter.

15. A surgical kit according to claim 14 wherein the adapter is integral with the guide needle.

16. A surgical kit for treating incontinence comprising:

an implantable material suitable for a sling procedure,

a needle that is sized and shaped for inserting a sling, the needle having surfaces for engaging a handle,

a dilator for associating said implantable material suitable for a sling procedure with said needle,

at least one of a first type of handle having surfaces for attaching the handle to the needle, and

at least one of a second type of handle having surfaces for attaching the handle to the needle, wherein the first type of handle is different than the second type of handle.

17. A surgical kit for treating incontinence comprising:

an implantable material suitable for a sling procedure,

at least one of a first type of needle suitable for a sling procedure, and

at least one of a second type of needle suitable for a sling procedure, wherein the first type of needle is different than the second type of needle,

a dilator for associating said implantable material suitable for a sling procedure with at least one of the first and second type of needle,

wherein at least one of said first and second type of needle comprises means for transporting said implantable sling material and dilator in a body of a patient.