Methods and systems for treatment of prolapse
First Claim
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1. A method of supporting posterior vaginal tissue, the method comprising:
- providing an implant comprising a tissue support portion and an extension portion extending from the tissue support portion,creating an incision,contacting the support portion with posterior vaginal tissue,producing a tissue path that passes between a position of the tissue support portion and a region of an arcus tendineus, wherein the region of the arcus tendineus comprises a region from 2 centimeters above the arcus tendineus to 2 centimeters below the arcus tendineus and between an ischial spine and a distance 3 centimeters anterior to the ischial spine,wherein the tissue path passes below the arcus tendineus through an iliococcygeus muscle, wraps around the arcus tendineus to a location above the arcus tendineus, through an obturator internus muscle, and back to a region of the pelvic floor, andextending the extension portion through the tissue path.
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Abstract
Described are implants, tools, and related methods, for use in pelvic surgery to treat conditions such as prolapse, including embodiments of methods that involve a tissue path above the arcus tendineus.
319 Citations
19 Claims
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1. A method of supporting posterior vaginal tissue, the method comprising:
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providing an implant comprising a tissue support portion and an extension portion extending from the tissue support portion, creating an incision, contacting the support portion with posterior vaginal tissue, producing a tissue path that passes between a position of the tissue support portion and a region of an arcus tendineus, wherein the region of the arcus tendineus comprises a region from 2 centimeters above the arcus tendineus to 2 centimeters below the arcus tendineus and between an ischial spine and a distance 3 centimeters anterior to the ischial spine, wherein the tissue path passes below the arcus tendineus through an iliococcygeus muscle, wraps around the arcus tendineus to a location above the arcus tendineus, through an obturator internus muscle, and back to a region of the pelvic floor, and extending the extension portion through the tissue path. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A pelvic implant assembly comprising an implant and an insertion tool,
the implant comprising a tissue support portion, elongate extension portions extending from the tissue support portion, and a dilator located at a distal end of each elongate extension portion, the dilator comprising a curve having a radius of curvature in the range of from 0.5-1.5 centimeters, a sharp tip at a distal end, and an opening at a proximal end, the opening designed and adapted to fit and removably engage a distal end of the insertion tool.
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18. A pelvic implant assembly comprising an implant and a first and second insertion tools,
the implant comprising a tissue support portion, a first elongate extension portion extending from an end of the tissue support portion and a second elongate extension portion extending from an opposite end of the tissue support portion, and a first dilator located at a distal end of the first extension portion and a second dilator located at a distal end of the second extension portion, each dilator comprising a sharp tip at a distal end and an opening at a proximal end, the opening designed and adapted to engage a distal end of the first and second insertion tools; - and wherein
each insertion tool comprises a shaft, a handle, and a curved distal end, the curved distal end comprising a radius of curvature in the range of from 0.5-1.5 centimeters, and the curved distal end being capable of engaging one of the dilators and pushing the dilator through tissue. - View Dependent Claims (19)
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Specification