Devices for minimally invasive pelvic surgery

• US 8,814,777 B2
• Filed: 10/31/2007
• Issued: 08/26/2014
• Est. Priority Date: 02/13/1997
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Gellman, Barry N., Brenneman, Rodney, Sauvageau, David, Pintauro, William, Appell, Rodney, Morin, Armand A.
• Primary Examiner(s): LACYK, JOHN P
• Application Number:
  US11/982,331
• Publication Number:
  US 20080125621A1
• Time in Patent Office: 2,491 Days
• Field of Search: 600 29- 32, 600/37, 128897-899, 128/DIG.25, 606/119, 606/148, 606151-156, 606222-225
• US Class Current: 600/30
• 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 hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/061 hollow or tubular suture extending inside a hollow needle A61B2017/06052; hollow sutures A61B2017/06185
• 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 blunt suture needles A61B2017/06085
• 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

The invention, in various embodiments, provides systems, devices, and methods for treating urinary incontinence.

Claims

1. An incontinence procedure comprising:

inserting a distal end of a first shaft through a first incision of a patient, the distal end of the first shaft including a detachable member associated with a sling;

extending the detachable member within the patient such that a portion of the detachable member penetrates a vaginal wall of the patient;

detaching the detachable member from the first shaft;

removing the distal end of the first shaft from the patient;

inserting a second shaft through a second incision of the patient;

connecting the second shaft to the detachable member;

removing the second shaft such that a position of the sling is adjusted under a urethra of the patient; and

anchoring the sling in fascia located in the patient'"'"'s pelvic area.

2. The method of claim 1, wherein a first end of the sling is positioned on a left side of the patient'"'"'s pelvic area and a second end of the sling is positioned on the right side of the patient'"'"'s pelvic area.

3. The method of claim 1, wherein the sling has a length of about 1.5 cm to about 6 cm in length.

5. The method of claim 1, wherein the second incision is an incision in an abdomen of the patient, and the second shaft is inserted through the abdomen to engage the detachable member.

6. The method of claim 1, wherein the second incision is a suprapubic incision in the patient, and the second shaft is inserted through the suprapubic incision.

7. The method of claim 1, wherein the vaginal wall comprises an upper vaginal wall.

4. The method of clam 1, wherein the first shaft and the second shaft are different shafts.

8. A method for treating incontinence, the method comprising:

advancing a first shaft into a body of a patient through a first incision, the first shaft being operatively coupled to a sling and a detachable member;

extending the detachable member within the body of the patient such that a portion of the detachable member extends to a position within the body of the patient;

decoupling the detachable member from the first shaft;

advancing a second shaft into the body of the patient through a second incision;

coupling the detachable member with the second shaft;

withdrawing the second shaft from the body of the patient to position the sling within the body of the patient; and

anchoring the sling in a pelvic area of the patient.

9. The method of claim 8, wherein the second incision is created in an abdomen of the patient, and the second shaft is inserted through the abdomen to engage the detachable member.

10. The method of claim 8, wherein the detachable member is coupled to the sling via a first suture, and the sling is coupled to the first shaft via a second suture.

11. The method of claim 10, wherein, when the sling is anchored, the first suture extends from the second incision to the sling, and the second suture extends from the first incision to the sling.

12. The method of claim 8, wherein the first shaft and the second shaft are different shafts.

13. The method of claim 8, wherein the portion of the detachable member includes a portion of a removable needle, and the method further includes:

securing the portion of the removable needle on a vaginal side of the patient; and

removing the removable needle after the detachable member is coupled with the second shaft.

14. The method of claim 8, further comprising:

distally moving a needle tip of a needle, disposed on the detachable member, to a position extending outside the detachable member.

15. The method of claim 8, wherein the first shaft includes an actuator and an inner shaft, and the decoupling the detachable member from the first shaft includes:

distally moving the inner shaft to contact the detachable member based on an operation of the actuator.

16. The method of claim 15, wherein the operation of the actuator includes pivoting the actuator.

17. A method for treating incontinence, the method comprising:

inserting a distal end of a shaft through an incision, the shaft being operatively coupled to a detachable member and a sling;

extending the detachable member within a body of the patient such that a portion of the detachable member extends to a position within the body of the patient;

decoupling the detachable member from the distal end of the shaft;

inserting a retrieval device through a secondary incision to engage the detachable member;

removing the shaft and the retrieval device from the patient; and

anchoring the sling on a pelvic area of the patient.

18. The method of claim 17, wherein the secondary incision is created in an abdomen of the patient, and the retrieval device is inserted through the abdomen to engage the detachable member.

19. The method of claim 17, wherein the sling has a length of about 1.5 cm to about 6 cm.

20. The method of claim 17, wherein the retrieval device and the shaft are different devices.