Surgical procedure for the treatment of female urinary incontinence: tension-free inside-out transobturator urethral suspension

• US 20040097974A1
• Filed: 07/29/2003
• Published: 05/20/2004
• Est. Priority Date: 08/29/2002
• Status: Active Grant

• Current Assignee: Centre Hospitalier Universitaire de Liège, University De Geneva
• Original Assignee: Centre Hospitalier Universitaire de Liège, University De Geneva
• Inventors: De Leval, Jean
• Granted Patent: US 7,204,802 B2
• Time in Patent Office: Days
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/06071 with an abrupt angle formed between two adjacent sections
• CPC Class Codes: A61B 2017/06076 helically or spirally coiled for sutures A61B2017/06171
• CPC Class Codes: A61F 2/0045 Support slings

Abstract

A new, quick, simple, efficient, safe, and reproducible surgical technique for the treatment of female urinary incontinence, in which the posterior urethra is suspended using a tape passed through the obturator orifices from inside (underneath the urethra) to outside (thigh folds). A variety of specifically designed surgical instruments are utilized to perform this operative procedure.

Claims

1. A surgical method for treating female urinary incontinence, said method comprising:

identifying a surgical exit point on a horizontal line above the urethral plane where a surgical needle will exit at a thigh of a patient,

making an incision of the vaginal wall,

performing a para-urethral dissection towards the ischio pubic ramus while avoiding a perforation of the vaginal wall,

rotating the surgical needle around the ischio pubic ramus, and

penetrating the previously identified surgical exit point from inside the patient with a tip of the surgical needle.

2. The surgical method as claimed in claim 1, wherein a tape is attached to the surgical needle prior to the surgical needle being passed through the exit point.

3. The surgical method as claimed in claim 1, wherein one of a string and a tube is attached to the surgical needle after the tip of the surgical needle passes through the exit point.

4. The surgical method as claimed in claim 3, wherein the surgical needle is rotated back towards the sub-urethral vaginal opening after the one of the string and the tube are attached to the surgical needle.

5. The surgical method as claimed in claim 4, where a tape is attached to the one of the string and the tube and the tape is pulled internally of the patient by removal of the one of the string and the tube from the exit point.

6. The surgical method as claimed in claim 1, wherein the surgical needle is removed from a handle after the surgical needle passes through the obturator foramen.

7. A surgical needle for use in treating female urinary incontinence, said surgical needle comprising:

a handle,

a straight section having two ends, one end of said straight section being connected to said handle, and

a spiral section having two ends, one end of said spiral section being connected at a junction to the other end of said straight section,

the other end of said spiral section being a free end terminating in a tip.

8. The surgical needle as claimed in claim 7, wherein the spiral section has a length defining one-half to three-quarters of a circle.

9. The surgical needle as claimed in claim 7, wherein the tip of the spiral section is located in a vertical plane located at a horizontal distance of 4 to 8 cm from the junction.

10. The surgical needle as claimed in claim 7, wherein the tip of the spiral section is spaced above the junction by, at the most, 3.5 cm.

11. The surgical needle as claimed in claim 7, wherein the spiral section has a diameter of 2 to 5 mm and a length of 6 to 18 cm.

12. The surgical needle as claimed in claim 11, wherein the tip of the spiral section includes an eyelet.

13. The surgical needle as claimed in claim 11, wherein the tip of the spiral section includes curled segments.

14. The surgical needle as claimed in claim 7, wherein the spiral section further comprises one linear segment.

15. The surgical needle as claimed in claim 7, wherein the spiral section has a diameter of 2 to 5 mm and a length of 4.5 to 17.6 cm.

16. The surgical needle as claimed in claim 7, wherein said junction releasably holds the spiral section.

17. The surgical needle as claimed in claim 16, wherein the spiral section has a diameter of 2 to 5 mm and a length of 6 to 18 cm.

18. A tube supporting needle comprising the spiral section of the needle as claimed in claim 7 and having a closed pointed end.

19. An arrow-like tube comprising a lateral opening for introduction of the tube supporting needle according to claim 18.

20. An arrow-like tube according to claim 19 made of high density polyethylene.

21. An arrow-like tube according to claim 19 having its proximal end bound to a tape.

22. An introducer comprising an open tubular segment for receiving the linear segment of the surgical needle as claimed in claim 14.