Transvaginal bone anchor implantation device

• US 20010000533A1
• Filed: 12/20/2000
• Published: 04/26/2001
• Est. Priority Date: 03/18/1997
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Ams Research Corporation (Endo International PLC)
• Inventors: Kovac, S. Robert
• Granted Patent: US 6,599,235 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• 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 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

The bone anchor implantation device of the present invention comprises a shaft or body having a grip at a first end of the shaft, an anchor mount at a distal end of the shaft, and a bone anchor removably mounted in the anchor mount. The shaft is preferably bent so that the anchor mount generally faces the grip such that the bone anchor can be implanted at an anchoring site in a bone by pulling rearwardly on the device. The body is adapted to be separable from the anchor after the anchor has been implanted in bone. A suture thread is attached to the bone anchor such that the suture thread is accessible to a surgeon using the device after the bone anchor has been implanted in bone and after the body has been separated from the bone anchor. The shaft is at least partially hollow, and the suture thread is housed in the shaft. The anchor mount comprises a cannula at the distal end of the shaft. The cannula is sized to removably receive an end of the anchor.

Claims

1. A transvaginal bone anchor implantation device comprising a body including a first portion having a gripping end and a second portion having an anchor mount, and a bone anchor removably mounted in the anchor mount;

the body second portion being angled relative to the body first portion when the device is in use such that the bone anchor can be implanted at an anchoring site in a bone by pulling rearwardly on the body first portion, the body being adapted to be separable from the anchor after the anchor has been implanted in bone.

2. The transvaginal bone anchor implantation device of

claim 1

wherein the body is bent, such that the body second portion mounting end generally faces toward the first portion gripping end.

3. The transvaginal bone anchor implantation device of

claim 1

wherein the body comprises a shaft.

4. The transvaginal bone anchor implantation device of

claim 3

including a suture thread attached to the bone anchor such that the suture thread is accessible to a surgeon using the device after the bone anchor has been implanted in bone and after the body has been separated from the bone anchor.

5. The transvaginal bone anchor implantation device of

claim 4

wherein the shaft is at least partially hollow, the suture thread being housed in the shaft.

6. The transvaginal bone anchor implantation device of

claim 1

wherein the bone anchor is a harpoon-type anchor.

7. The transvaginal bone anchor implantation device of

claim 1

wherein the anchor mount comprises a cannula at the distal end of the body second portion defines a hollow portion;

the cannula being sized to removably receive an end of the anchor.

8. A method of implanting a bone anchor in the pubic bone of a female patient comprising:

creating an incision in the vaginal wall;

locating an anchor site on the pubic bone;

introducing an anchoring device into the patient transvaginally through the vaginal wall incision;

the anchoring device comprising a body having a forward end and a gripping end and a bone anchor removably mounted to the forward end of the anchoring device;

the forward end of the anchoring device facing generally toward the gripping end;

placing the anchor at the anchor site on the pubic bone;

pulling on the anchoring device to drive the anchor into the pubic bone; and

separating the anchoring device body from the anchor and removing the anchoring device from the patient.

9. The method of

claim 8

wherein the anchoring device includes suture threads pre-attached to the anchor;

the method including a step of making the suture threads available to the surgeon after the body has been separated from the anchor.

10. The method of

claim 9

wherein the anchoring device is at least partially hollow and the suture threads are housed in the anchoring device body;

said step of making the suture threads available comprising the step of separating the anchoring device body from the anchor.

11. The method of

claim 10

wherein the step of locating the anchoring point on the pubic bone comprises locating the anchoring point on a posterior surface of the pubic bone.

12. The method of

claim 11

wherein the step of locating the anchoring point on the pubic bone comprises locating the anchoring point on an inferior, posterior surface of the pubic bone.

13. The method of

claim 12

wherein the step of locating the anchoring point on the pubic bone comprises locating the point of connection of the arcus tendineus to the pubic bone.

14. A method of implanting a bone anchor in the pubic bone of a female patient comprising:

locating an anchor site on the pubic bone;

transvaginally introducing a bone anchor implanting device into the patient;

the bone anchor implanting device comprising a body having a forward end and a gripping end and a bone anchor removably mounted to the forward end of the bone anchor implanting device;

the forward end of the bone anchor implanting device facing generally toward the gripping end;

placing the bone anchor at the anchor site on the pubic bone;

pulling on the bone anchor implanting device to drive the bone anchor into the pubic bone; and

separating the bone anchor implanting device body from the bone anchor.

15. A bone anchor implantation device, comprising:

an elongated member having a first end and a second end; and

a bone anchor releasably engaged to said elongated member in the vicinity of said first end.

16. A device for inserting a bone anchor into a bone comprising:

a handle having a proximal end and a distal end;

a shaft having a first end and a second end, said first end being connected to said distal end of said handle; and

a bone anchor mount for releasably engaging said bone anchor, said bone anchor mount connected to said second end of said shaft and oriented toward said handle so that said bone anchor may be inserted into the bone by applying a retrograde force to said bone anchor.

17. The device of

claim 16

wherein said shaft is hook shaped.

18. A method for inserting a bone anchor releasably engaged to a bone anchor implantation device into a bone comprising the steps of:

locating a bone anchor implantation site on the bone; and

applying a retrograde force to said bone anchor to implant said bone anchor into said bone.

19. A method for inserting a bone anchor releasably engaged to a bone anchor implantation device into a bone comprising the steps of:

locating a bone anchor implantation site on the bone; and

pulling said bone anchor implantation device to implant said bone anchor into said bone.

20. The method of

claim 19

wherein said pulling step comprises applying a retrograde force to said bone anchor implantation device.

21. The method of

claim 20

wherein the locating and implanting steps are accomplished vaginally.

22. The method of

claim 19

wherein the bone anchor is implanted transvaginally into the pubic bone.

23. The method of

claim 22

wherein the bone anchor is implanted in posterior pubic bone.

24. The method of

claim 23

wherein the bone anchor is implanted lateral to the symphysis pubis and cephalad to the inferior edge of the pubic bone.

25. The method of

claim 24

wherein at least one bone anchor is implanted on either side of the urethra.

26. The method of

claim 19

further comprising stabilizing the bladder neck with a suture attached to the bone anchor.

27. The method of

claim 19

further comprising:

creating an opening in the tissue between the vaginal wall and the urethra;

positioning a sling in the opening; and

stabilizing the bladder neck with the sling using sutures connected between the sling and the bone anchors.

28. The method of

claim 27

wherein the two bone anchors are implanted on each side of the urethra.

29. The method of

claim 28

wherein one bone anchor on each side of the urethra is located lateral to the symphysis pubis and cephalad to the inferior edge of the pubic bone.

30. The method of

claim 29

wherein the second bone anchor is located on the cephalad aspect of the ramus.