Implants, tools, and methods for treatments of pelvic conditions

• US 9,192,458 B2
• Filed: 02/08/2013
• Issued: 11/24/2015
• Est. Priority Date: 02/09/2012
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Ams Research Corporation (Endo International PLC)
• Inventors: Alexander, James A., Arcand, Benjamin Y., Khamis, Chartie, Taut, Daniel, Viker, Thomas O.
• Primary Examiner(s): LACYK, JOHN P
• Application Number:
  US13/763,296
• Publication Number:
  US 20130211193A1
• Time in Patent Office: 1,019 Days
• Field of Search: 600 29- 31, 600/37, 606139-158, 606/232
• US Class Current: 1/1
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/06166 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: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/320056 Tunnelers
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• 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 2230/006 Y-shaped

Abstract

Described are various embodiments of surgical procedures, systems, implants, devices, tools, and methods, useful for treating pelvic conditions in a male or female, the pelvic conditions including incontinence (various forms such as fecal incontinence, stress urinary incontinence, urge incontinence, mixed incontinence, etc.), vaginal prolapse (including various forms such as enterocele, cystocele, rectocele, apical or vault prolapse, uterine descent, etc.), and other conditions caused by muscle and ligament weakness, the devices and tools including devices and tools for anchoring an implant to tissue.

Claims

1. A method of reperitonealizing a sacral mesh comprising the steps of:

creating a tunnel under a patient'"'"'s peritoneal membrane with a curved trocar that is advanced along the right pelvic sidewall of the patient and toward the sacral promontory;

introducing the trocar into the patient through a small pocket that is created at the open vaginal cuff between the vaginal mucosa and the peritoneal membrane;

providing an incision in the peritoneal membrane adjacent the sacral promontory through which the trocar is advanced;

loading a suture onto the trocar and pulling the trocar from the tunnel;

attaching a mesh member to the suture and pulling the mesh member through the tunnel; and

attaching the mesh member to the sacral promontory of the patient.

2. The method of claim 1, further comprising a step of monitoring advancement of the trocar using a retractor system to clear the patient'"'"'s small bowel off of the patient'"'"'s peritoneum.

3. The method of claim 1, further comprising the step of attaching at least one fixation element to the sacral promontory.

4. The method of claim 1, further comprising the steps of attaching at least one fixation element to the sacral promontory and then attaching at least one eyelet of the mesh member onto at least one of the fixation elements.