System and method for treatment of anal incontinence and pelvic organ prolapse

• US 7,794,385 B2
• Filed: 06/20/2007
• Issued: 09/14/2010
• Est. Priority Date: 12/20/2004
• Status: Active Grant

• Current Assignee: Rosenblatt Associates, LLC
• Original Assignee: Ams Research Corporation (Endo International PLC)
• Inventors: Rosenblatt, Peter L.
• Primary Examiner(s): Lacyk; John P
• Application Number:
  US11/765,761
• Publication Number:
  US 20070299299A1
• Time in Patent Office: 1,182 Days
• Field of Search: 600 29- 32, 600/37, 128897-898, 128/DIG.25, 606/119, 606/148, 606222-225
• US Class Current: 600/30
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• 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: A61F 2/004 inflatable
• 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 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/0039 H-shaped
• CPC Class Codes: A61F 2230/0078 hyperboloidal
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61F 2250/0003 having an inflatable pocket filled with fluid, e.g. liquid or gas

Abstract

Using a sling that includes a central portion and at least two arms extending from the central portion, a method of treating anal incontinence may include positioning the central portion posteriorly to the rectum and/or anus of a subject, and extending each arm of the sling to a respective obturator region. Using a sling having the same or similar structure, a method of treating pelvic organ prolapse may include positioning the central portion beneath the ano-rectum of a subject, and extending each arm of the sling to a respective thigh incision near the obturator region.

Claims

1. A method of treating anal incontinence comprising:

using a sling that includes a central portion and at least two arms extending from the central portion,

positioning the central portion posteriorly to the rectum and/or anus of a subject; and

extending each arm of the sling to a respective obturator region.

2. The method of claim 1, further comprising extending each arm of the sling through a respective obturator foramen.

3. The method of claim 1, further comprising extending each arm of the sling to a respective portion of bone surrounding the respective obturator foramen.

4. The method of claim 3, further comprising attaching each arm to the bone.

5. The method of claim 4, wherein the bone is an ischial tuberosity or an ischiopubic ramus.

6. The method of claim 1, further comprising extending each arm through a respective obturator membrane.

7. The method of claim 1, further comprising extending each arm of the sling to the subject'"'"'s skin.

8. The method of claim 1, further comprising creating an incision between the subject'"'"'s anus and coccyx and positioning the sling through the incision.

9. The method of claim 8, further comprising extending each arm through the incision and through a respective obturator foramen.

10. The method of claim 9, further comprising attaching an end of an arm to a driver, and extending the arm through the obturator foramen by pushing the driver.

11. The method of claim 9, wherein the arm end comprises a filament, and attaching comprises attaching the filament to the driver.

12. The method of claim 11, wherein the filament comprises a suture.

13. The method of claim 8, further comprising creating an incision in a medial portion of one of the subject'"'"'s thighs, advancing a stylet through the thigh incision and through a respective obturator foramen, into a respective ischiorectal fossa and out through the incision between the anus and the coccyx, attaching an arm of the sling to the stylet, and withdrawing the stylet back through the thigh incision, thereby extending the arm toward the patient'"'"'s skin.

14. The method of claim 1, further comprising creating an incision in a medial portion of one of the subject'"'"'s thighs, advancing a stylet through the thigh incision and through a respective obturator foramen, attaching an arm of the sling to the stylet, and withdrawing the stylet back through the thigh incision, thereby extending the arm toward the patient'"'"'s skin.

15. The method of claim 14, wherein the arm comprises a filament end, and attaching comprises attaching the filament end to the stylet.

16. The method of claim 15, wherein the filament end comprises a suture.

17. The method of claim 14, further comprising creating a second incision in a medial portion of the patient'"'"'s other thigh, advancing a stylet through the second incision and through the other obturator foramen, attaching a second arm of the sling to the stylet, and withdrawing the stylet back through the second incision, thereby extending the arm toward the patient'"'"'s skin.

18. The method of claim 1, further comprising measuring the patient'"'"'s ano-rectal angle.

19. The method of claim 18, wherein measuring comprises inserting a flexible measurement device into the patient'"'"'s rectum, flexing the device to conform to the patient'"'"'s ano-rectal angle, and determining how much the device has been flexed.

20. The method of any preceding claim, wherein the central portion of the sling has a curved shape, and the method further comprises fitting the curved shape of the central portion against the rectum and/or anus.

21. The method of claim 20, wherein the curved shape is a saddle shape.

22. The method of claim 20, wherein the central portion comprises an inflatable sac, and the method further comprises inflating and/or deflating the sac.

23. The method of claim 20, wherein the central portion is preformed with the curved shape.