Devices for minimally invasive pelvic surgery

• US 7,691,050 B2
• Filed: 02/09/2004
• Issued: 04/06/2010
• Est. Priority Date: 02/13/1997
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Gellman, Barry N., Brenneman, Rodney, Appell, Rodney, Morin, Armand A., Sauvageau, David, Pintauro, William
• Primary Examiner(s): Lacyk; John P
• Application Number:
  US10/774,826
• Publication Number:
  US 20040230206A1
• Time in Patent Office: 2,248 Days
• Field of Search: 600/29, 600/30, 600/37, 604/19, 604/73, 604/93.01, 604/104, 604/134, 604/136, 604156-164, 604/164.01, 604/164.03, 604/164.08, 604/166.01, 604/170.01, 604/170.02, 604/170.03, 604/171, 604/242, 604/264, 604/272, 604/506, 604/523, 606/118, 606/119, 606/144, 606/148, 606/151, 606/190, 606222-281, 623/11.11, 623/13.11, 623 1313- 132
• US Class Current: 600/29
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/061 hollow or tubular
• CPC Class Codes: A61B 2017/06104 interconnected at their distal ends, e.g. two hollow needles forming a loop for passing a suture
• CPC Class Codes: A61B 2017/22035 for retrieving or repositioning foreign objects
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• 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: Y10S 128/25 Artificial sphincters and devices for controlling urinary incontinence

Abstract

Devices and methods relating to percutaneous and hiatal approaches for treating urinary incontinence are provided herein. In particular, guide member placement devices, sling application catheters, tissue dissectors/dilators, sling application devices and a sling application system, tissue expanders, grasping devices, and balloon catheters are disclosed herein. Methods for using the preceding devices to stabilize the bladder neck or the urethral floor in order to maintain or improve urinary incontinence are also disclosed.

Claims

1. A system for treating urinary incontinence comprising,

a shaft having a curved portion;

and

a sling assembly including

a urethral support sling having a substantially flat shape,

a pouch for covering only partially the sling, and

an end for associating with an end of the shaft.

2. The system of claim 1, wherein the shaft comprises first and second ends, the first end of the shaft attaches to a handle, and the second end of the shaft associates with the sling assembly.

3. The system of claim 1, wherein the shaft comprises an engaging member located at a distal end.

4. The system of claim 3, wherein the engaging member is capable of engaging the end of the sling assembly.

5. The system of claim 4, wherein the engaging member is capable of releasably engaging the end of the sling assembly.

6. The system of claim 1, wherein the sling assembly comprises an elongated extension located at the end of the sling assembly.

7. The system of claim 1, wherein the sling assembly comprises an aperture located at the end of the sling assembly.

8. The system of claim 1, wherein the pouch comprises an opening intermediate to first and second ends of the sling assembly.

9. The system of claim 1, wherein the pouch is substantially flat.

34. The system of claim 1, wherein the pouch covers an end of the sling.

38. The system of claim 1, wherein the sling is releasably withdrawable from said pouch.

10. A system for treating urinary incontinence comprising,

a shaft having a solid cross-section for a substantial length of the shaft and having a curved portion and an engaging member on a distal end of the shaft;

and

a sling assembly comprising a urethral support sling having a substantially flat shape, and an engaging surface complementary to the engaging member;

wherein, the engaging member is capable of securely engaging the engaging surface.

11. The system of claim 10, wherein the engaging member of the shaft is inserted into the engaging surface of the sling assembly.

12. The system of claim 10, wherein the shaft is capable of receiving the sling assembly.

13. The system of claim 10, wherein the shaft is capable of releasably receiving the sling assembly.

14. The system of claim 10, wherein the sling assembly is indirectly connected to the shaft.

15. The system of claim 10, wherein the engaging surface is indirectly connected to the sling assembly.

16. The system of claim 10, wherein the sling assembly further comprises a pouch for covering only partially the sling.

17. The system of claim 16, wherein the pouch comprises an opening intermediate to first and second end of the sling assembly.

18. The system of claim 16, wherein the pouch is substantially flat.

35. The system of claim 16, wherein the pouch covers an end of the sling.

39. The system of claim 16, wherein the sling is releasably withdrawable from said pouch.

19. A system for treating urinary incontinence comprising,

a shaft having a solid cross-section for a substantial length of the shaft and having a curved portion and a distal end;

and

a sling assembly comprising a urethral support sling having a substantially flat shape, and an end capable of fitting over the distal end of the shaft.

20. The system of claim 19, wherein the shaft is capable of engaging the sling assembly.

21. The system of claim 19, wherein the shaft is capable of releasably engaging the sling assembly.

22. The system of claim 19, wherein the sling assembly is indirectly connected to the shaft.

23. The system of claim 19, wherein the sling assembly further comprises a pouch for covering only partially the sling.

24. The system of claim 23, wherein the pouch comprises an opening intermediate to first and second ends of the sling assembly.

25. The system of claim 23, wherein the pouch is substantially flat.

36. The system of claim 23, wherein the pouch covers an end of the sling.

40. The system of claim 23, wherein the sling is releasably withdrawable from said pouch.

26. A system for treating urinary incontinence comprising, a handle;

a shaft having a solid cross-section for a substantial length of the shaft and attached to the handle and having an engaging member located at an end and a curved portion; and

a sling assembly comprising a urethral support sling having a substantially flat shape, and an end capable of securely engaging the engaging member of the shaft.

27. The system of claim 26, wherein the engaging member is capable of receiving the end of the sling assembly.

28. The system of claim 26, wherein the engaging member is capable of releasably receiving the end of the sling assembly.

29. The system of claim 26, wherein the sling assembly comprises an elongated extension located at the end of the sling assembly.

30. The system of claim 26, wherein the sling assembly comprises an aperture located at the end of the sling assembly.

31. The system of claim 26, wherein the sling assembly further comprises a pouch for covering only partially the sling.

32. The system of claim 31, wherein the pouch comprises an opening intermediate to first and second ends of the sling assembly.

33. The system of claim 31, wherein the pouch is substantially flat.

37. The system of claim 31, wherein the pouch covers an end of the sling.

41. The system of claim 31, wherein the sling is releasably withdrawable from said pouch.