Needle design for male transobturator sling
First Claim
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1. A surgical instrument for implanting an implantable material to a pelvic region, the instrument comprising:
- a handle having a longitudinal axis and an elongate width dimension normal to the longitudinal axis, the elongate width dimension defining a midplane,a needle portion extending from the handle along the longitudinal axis, the needle portion comprisinga spacer portion connected to the handle,a three-dimensional region connected to the spacer portion distal from the handle, and having structure in three dimensions, anda needle distal end at the distal end of the three-dimensional region,wherein the needle portion is sized and shaped to extend between an incision substantially adjacent to a patient'"'"'s obturator foramen, through the obturator foramen, and to a medial incision; and
wherein the needle distal end is located at an angle between 20 to 70 degrees from the midplane when viewed along the longitudinal axis, andwherein an angle between an axis of the needle end portion and the midplane, the angle being an acute angle defined by the needle tip, an intersection of the axis and midplane, and the longitudinal axis when viewed along the longitudinal axis, is in the range from 30 degrees to 60 degrees.
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Abstract
Described are surgical instruments for use in surgical procedures, related methods, systems, and kits, the instruments including features that optionally include one or more specific dimensions, and features that may result in an ergonomic advantage during use.
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Citations
26 Claims
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1. A surgical instrument for implanting an implantable material to a pelvic region, the instrument comprising:
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a handle having a longitudinal axis and an elongate width dimension normal to the longitudinal axis, the elongate width dimension defining a midplane, a needle portion extending from the handle along the longitudinal axis, the needle portion comprising a spacer portion connected to the handle, a three-dimensional region connected to the spacer portion distal from the handle, and having structure in three dimensions, and a needle distal end at the distal end of the three-dimensional region, wherein the needle portion is sized and shaped to extend between an incision substantially adjacent to a patient'"'"'s obturator foramen, through the obturator foramen, and to a medial incision; and wherein the needle distal end is located at an angle between 20 to 70 degrees from the midplane when viewed along the longitudinal axis, and wherein an angle between an axis of the needle end portion and the midplane, the angle being an acute angle defined by the needle tip, an intersection of the axis and midplane, and the longitudinal axis when viewed along the longitudinal axis, is in the range from 30 degrees to 60 degrees. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A surgical instrument for implanting an implantable material to treat incontinence, the instrument comprising:
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a handle comprising a longitudinal axis, needle extending from the handle, the needle comprising a spacer portion connected to the handle, and a three-dimensional region connected to the spacer portion distal from the handle, and having structure in three dimensions including a needle distal end at the distal end of the three-dimensional region, wherein the needle portion is sized and shaped to extend between an incision substantially adjacent to a patient'"'"'s obturator foramen, through the obturator foramen, and to a perineal incision; the three-dimensional region has a length in the range from 2.3 to 5 inches and a diameter in the range from 2.3 to 5 inches, and an axis of the needle end portion lies within a plane that is orthogonal to the longitudinal axis of the tools, wherein an angle between an axis of the needle end portion and a tangent of a circle having an origin at the longitudinal axis and a radius extending to the needle distal end, when viewed along the longitudinal axis, is less than 15 degrees. - View Dependent Claims (21)
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22. A method of treating urinary incontinence in a male, the method comprising
creating a pair of lateral incisions substantially adjacent a patient'"'"'s obturator foramen, creating a medial incision at the perineum, medial to the pair of lateral incisions, providing a surgical instrument comprising, a handle having a longitudinal axis and an elongate width dimension normal to the longitudinal axis, the elongate width dimension defining a midplane, a needle portion extending from the handle along the longitudinal axis, the needle portion comprising a spacer portion connected to the handle, a three-dimensional region connected to the spacer portion distal from the handle, and having structure in three dimensions, and a needle distal end at the distal end of the three-dimensional region, the needle distal end comprising a functional section that engages a surgical implant, providing an implantable assembly adapted for treating the incontinence, the assembly having a surface complementary to the functional section, engaging the functional section of the needle distal end with the surface of the implantable assembly, passing the three-dimensional region having the functional section between a lateral incision and the medial incision and through an obturator foramen by grasping the handle with the midplane approximately parallel to the palm and rotating the handle using the hand such that during the rotation the handle rotates at least ninety degrees, and during ninety degrees of the rotation the hand traverses ninety degrees between a forty-five degree open palm and a forty-five degree closed palm, wherein the needle distal end is located at an angle between 20 to 70 degrees from the midplane, when viewed along the longitudinal axis, and an angle between an axis of the needle end portion, and the midplane, the angle being an acute angle defined by the needle tip, an intersection of the axis and midplane, and the longitudinal axis, when viewed along the longitudinal axis, is in the range from 30 degrees to 60 degrees.
Specification