US20030036676A1 - Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape - Google Patents
Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape Download PDFInfo
- Publication number
- US20030036676A1 US20030036676A1 US10/268,960 US26896002A US2003036676A1 US 20030036676 A1 US20030036676 A1 US 20030036676A1 US 26896002 A US26896002 A US 26896002A US 2003036676 A1 US2003036676 A1 US 2003036676A1
- Authority
- US
- United States
- Prior art keywords
- tape
- sheath
- needle
- urethra
- traction element
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
- A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
- A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
- A61F2/0045—Support slings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00805—Treatment of female stress urinary incontinence
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06004—Means for attaching suture to needle
- A61B2017/06009—Means for attaching suture to needle having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
Definitions
- the present invention relates to the problems of urinary incontinence in women and more specifically to the problems of urinary stress incontinence.
- the invention relates more particularly to a percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape.
- a flexible and elongate urethra support means comprising a tape and a protective sheath lying flat and enveloping the tape
- a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate urethra support means.
- U.S. Pat. No. 5,899,909 discloses a treatment method and a treatment device for incontinence.
- the device described which allows a tape to be placed under the urethra, comprises two special needles. These are mounted in turn, by screw fastening, on a reusable steel insertion tool made of a handle and of a threaded manipulator rod which allows each of the needles to be manipulated in turn. Each needle is fixed to one of the ends of the tape-sheath assembly.
- Each end of the tape-sheath assembly is fixed to a frustoconical part of one end of the corresponding needle, using a shrunk or bonded polymer ring.
- the tape is therefore implanted by introducing each of the needles through a short incision in the anterior vaginal wall, these incisions being one on each side of the central position of the urethra.
- the needles implanted in turn using the manipulator rod then travel up around the bladder and the pubic bone and reemerge from the body through incisions made in the abdominal wall in the suprapubic region.
- a device such as this requires the use of ancillaries of the insertion handle and rigid intravesical catheter guide types especially designed for this type of surgical intervention.
- the known surgical intervention also has a disadvantage insofar as the needles are introduced into the anterior wall of the vagina to reemerge in the suprapubic region. This bottom-upward path cannot be controlled precisely for going around the base of the bladder. Vesical perforations are far from uncommon. They need to be recognized preoperatively through the use of two cystoscopies and entail repeating the maneuvers under more difficult conditions.
- the sheath-tape assembly has therefore to be cut and the device can no longer be used to take a different path. It also carries the risk of no longer being sterile as it may have been contaminated during these additional maneuvers.
- the present invention provides a device for treating urinary stress incontinence in women comprising a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free.
- a method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence comprising (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (
- the object of the present invention is to overcome the drawbacks of the prior art so as to obtain a different operative technique which is easier, quicker and safer (as far as the bladder and vessels are concerned).
- the risk of vascular lesion is minimised because of the orientation and the given direction of the needle from the start of the procedure.
- the risk of vesical puncture is small even in the case of previous interventions in this regard, as is particularly frequent in this type of pathology.
- the percutaneous route is used to form top-to-bottom tracks using the needle, i.e., penetrating via abdominal cutaneous mini-incisions to exit via a previously formed vaginal opening. Detachment of the vagina allows the index finger of the surgeon to be insinuated up to the lower rim of the pubis and thus enables the track of the needle to be precisely directed.
- the device of the invention enables tracks to be made from top to bottom on both sides of the abdomen and enables the absence of vesical puncturing to be confirmed by cystoscopy before engaging the sheath-tape system.
- the present device makes it possible to employ the techniques that will be described in detail later on in this description.
- Another object of the present invention is to produce a device for treating urinary incontinence which can be reused easily if it is introduced into the body in a non-optimum path, an eventuality which, according to the present invention, can occur only under exceptional circumstances if there is very strong adhesion between the bladder and the pubis, generally as the result of earlier interventions.
- the proximal end of the puncturing needle is connected to the first end of the flexible means by virtue of an intermediate traction element, the second end of the flexible means being free or extended by an additional intermediate traction element.
- the protective sheath completely envelopes the tape, including its first and second ends.
- the sheath can be split into two parts that can be separated by sliding them in two opposite directions relative to the tape, the device comprising a splinable means between the two central and adjacent ends of the sheath.
- the device comprises a filament arranged roughly at right angles to the longitudinal axis of the sheath, configured to cut the sheath when traction is exerted on the filament.
- the sheath is made of a fluoropolymer-based heat-shrinkable material.
- the tape is formed from a macroporous knitted material.
- the tape in its central region has resorbable hydrophilic film reducing the risk of adhesion to or the risk of erosion of the urethra.
- the puncturing needle has a curved part continuously adjacent to a roughly straight part ending in its proximal end.
- the intermediate traction element is a traction lace.
- the device according to the invention comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches.
- the traction lace has a length roughly equal to the length of the flexible means.
- the intermediate traction element is tubular.
- the intermediate traction element and the puncturing needle are assembled by screwing.
- the traction element consists of two parts of roughly the same length, placed end to end and joined together removably, for example by screwing, using a coupling.
- the puncturing needle with an active distal end and a proximal end attached to a flexible and elongate means is the only puncturing needle.
- FIG. 1 depicts a view in section of the flexible means of the device according to the invention
- FIG. 2 depicts a view from above, with partial cutaway, of the flexible means shown in FIG. 1;
- FIG. 3 depicts, in part, another exemplary embodiment of the flexible means of FIG. 2;
- FIG. 4 depicts a partial view of a device according to the invention
- FIGS. 5 and 6 depict details of FIG. 4;
- FIGS. 7 and 8 depict another embodiment of the flexible means of the device according to the invention.
- FIG. 9 depicts a partial view of another embodiment of the device according to the invention.
- FIGS. 10, 11 a , 11 b and 11 c depict details of the device depicted in FIG. 9;
- FIGS. 12 to 19 diagrammatically depict the surgical method employed using the device according to the invention.
- FIGS. 20 and 21 diagrammatically depict the position of the device according to the invention in the body of a patient.
- the device depicted in FIGS. 1, 2, 3 and 4 comprises an elongate flexible means 1 generally comprising a composite band.
- the flexible means 1 is shown only in part and not in its entire length. It generally has a flattened and elongate shape.
- the first end 1 a of the flexible means 1 can be connected to an intermediate traction element 2 (cf. FIG. 4) and the second end 1 b is free or extended by an additional intermediate traction element (not depicted).
- the device according to the invention also comprises a puncturing needle 3 , for example made of stainless steel, connected to the intermediate traction element.
- the flexible means 1 comprises a protective sheath 5 lying flat and enveloping a tape 6 .
- the single puncturing needle 3 has an active distal end 3 a and a proximal end 3 b connected to the first end 1 a of the flexible means 1 .
- the proximal end 3 b of the puncturing needle 3 is connected to the first end 1 a by virtue of an intermediate traction element 2 .
- the proximal end 3 b is thus a non-puncturing end.
- the proximal end 3 b of the puncturing needle may have a substantially rectangular cross-section and may be flattened and/or ribbed. These features allow the surgeon to grip the needle and allows the needle to be oriented correctly.
- the distal end 3 a is at the end of a curved part continuously adjacent to a roughly straight part, approximately between points 3 b and 3 d, ending in the proximal end 3 b.
- the distal end 3 a may be partially curved and preferably has a round cross-section.
- Distal end 3 a may have a diameter of, for example, 0.5 mm.
- the roughly straight part may be, for example, 20 to 25 cm in length and may, in embodiments, be ribbed over at least a portion thereof.
- the puncturing needle has, for example, a diameter of 3.5 mm in its curved part.
- the proximal end 3 b is also equipped with an attachment means allowing it to make a connection with the intermediate traction element.
- the intermediate traction element is constituted by a hollow PVC tube with a diameter that is identical to, or closely similar in diameter to, that of the needle.
- the intermediate traction element or tubing may be approximately 40 to 50 cm long. Its distal end 19 and proximal end 20 comprise a male screw connecting piece. This screw connecting piece is integrally fixed to the traction element by adhesion and/or screwing.
- the intermediate traction element may be colored, for example blue, so that it can readily be located during cystoscopy in the event of a vesical puncture.
- the protective sheath 5 completely envelopes the tape 6 , including its first end 6 a and its second end 6 b.
- the sheath 5 is made, for example, of a fluoropolymer-based heat-shrinkable material.
- the material of which the sheath 5 is made is chosen so that it is impervious, for example hermetically sealed, to isolate the tape 6 intended to be implanted in the body of the patient from contact with the skin and mucosa when following the implantation paths through the body.
- the sheath 5 may also exhibit properties of low coefficient of friction. These properties are therefore found both on the inside and on the outside of the sheath 5 , so as, on the one hand, to ensure good separation from the tape 6 and, on the other hand, to reduce the friction inside the body of the patient when the flexible means 1 is being pulled.
- the tape 6 advantageously has a width of between 6 and 14 mm, preferably between 10 and 12 mm and a length of between 30 and 50 cm, preferably around 40 cm.
- the tape 6 is preferably formed from a macroporous knitted material.
- the macroporous knitted material comprises, for example, an open knit made of single stranded polypropylene of between 0.12 and 0.16 millimeter thick and made up of two layers formed by two threaded guide bars each—one full guide and one empty guide—these two guides being moved symmetrically for open mesh according to the following chart:
- bar II 32-21-01.
- the tape 6 is cut to length in the warp direction of the knit.
- the tape 6 with a width of for example 12 mm, has the following properties:
- curling is intended to mean the property whereby the tape 6 rolls up on itself spontaneously about its longitudinal axis under longitudinal tensile stress.
- the tape 6 has attractive advantages and, in particular, low emission of particles as it is stretched, and curling which occurs only under high stress (6N). None of these aforementioned properties in any way detracts from the porosity of the tape 6 .
- Tape 6 can have a resorbable hydrophilic film in its central portion that reduces the risk of erosion or sclerosis of the urethra to a minimum. This central zone may be indicated by a colored marker.
- the tape may comprise other biologically acceptable materials.
- the sheath 5 can preferably be split into two parts 51 , 52 that can be separated by sliding them in two opposite directions with respect to the tape 6 .
- the device according to the invention has a splittable means 15 , roughly at the middle of the sheath 5 and the two ends of which are secured to the corresponding and adjacent central ends 5 c, 5 d of the sheath 5 .
- the material of the splittable means 15 is chosen from materials of the thermoplastic type approved for surgical application.
- connection between, on the one hand, the central ends 5 c, 5 d of the two parts 51 and 52 respectively and, on the other hand, the splittable center 15 may be obtained by any means able to make the sheath 5 impervious.
- the same is true of the free end 5 b of the sheath 5 which may be plugged and/or sealed.
- the splittable means 15 comprises a flat slit 15 a passing through it from one longitudinal end to the other, for the free passage of the tape 6 .
- the splittable means 15 may be replaced in an embodiment depicted in figures 7 and 8 , by an adhesive sleeve 16 a joining the ends of the two splittable parts 51 and 52 of the sheath 5 .
- This sleeve may be weakened, for example by a partial broken cut or a line of weakness in the sheath 5 .
- the adhesive sleeve 16 a made of a flexible material which sticks firmly to the central ends 5 c, 5 d and has a precut tab 16 b to make the sleeve 16 a easier to tear and therefore make the sheath 5 easier to split into the two parts 51 and 52 .
- the one-piece sheath 5 incorporates a filament 16 c arranged roughly at right angles to the longitudinal axis of the sheath 5 , configured to cut the sheath 5 when traction is exerted on the filament 16 c.
- a filament 16 c may be advantageously in color so that it can easily be identified.
- the sheath 5 can thus be split in the central zone 1 c of the flexible means 1 so release the tape 6 inside the body of the patient.
- the intermediate traction element is, according to one embodiment of the invention, configured, for example, with a traction lace 2 depicted in FIG. 4.
- the device according to the invention may also comprise an end piece 4 to which the sheath 5 is attached by heat-shrinking.
- the sheath 5 more particularly its first end 5 a, may be heat shrunk in a sealed manner onto the end piece 4 .
- the end piece 4 comprises anchoring notches 4 a into which the heat-shrunk material of the sheath 5 engages.
- the end piece 4 is made, for example, of a piece of stainless steel or any other rigid material capable of contacting with intracorporal tissue.
- the flexible means 1 comprises a knotting eye 4 b (cf. FIG. 4) arranged on the outside of the sheath 5 .
- Knotting eye 4 b consists, for example, of a closed loop and may, as appropriate, have a point 4 c intended to pass through and catch on one end of the traction lace 2 or any other intermediate traction element.
- the knotting eye 4 b may, for example, be made integrally in the end piece 4 .
- the latter may also have a roughly flattened and partially frustoconical shape so as to achieve continuity between the various thicknesses of the traction lace 2 and the flexible means 1 .
- the latter has a greater width than the traction lace 2 .
- the traction lace may for example be made of a Teflon-coated material.
- FIG. 4 diagrammatically depicts one exemplary embodiment of the device according to the invention.
- the needle 3 comprises the proximal end 3 b onto which the first end 2 a of the traction lace 2 is attached.
- the latter has, for example, at each of its ends 2 a and 2 b, a loop 2 c (cf. FIGS. 5 and 6 respectively) obtained by ultrasonic welding, stitching or any other means.
- One of these loops, 2 c, is mounted on the proximal end 3 b of the needle 3 while the other is mounted in the eye 4 b.
- the device according to the invention therefore, for example, has a traction lace 2 , the length of which is, for example, roughly equal to the length of the flexible means 1 , namely a length of between 30 and 60 cm, for example 40 cm.
- a traction lace 2 the length of which is, for example, roughly equal to the length of the flexible means 1 , namely a length of between 30 and 60 cm, for example 40 cm.
- Such dimensions or lengths of the traction lace 2 make it possible, if reference is made to the operative procedure, to avoid engaging the flexible means 1 in the body before being sure that the path taken by the needle 3 and the traction lace 2 is optimum.
- the long available length of traction lace 2 for carrying out the operative actions described thus makes it possible for another path to be taken through the body if need be, without having to manipulate the flexible means 1 .
- An additional traction lace 2 secured to the free end 1 b which may also have an end piece 4 for this purpose, allows traction to be exerted in the opposite direction to its introduction on the flexible means 1 , and allows it to back-track along its path if it is penetrating incorrectly.
- the intermediate traction element is a tubular element 20 .
- the material of which the latter is made may be, for example, PVC.
- Tubular element 20 may be, for example, 2.5 mm in diameter.
- the tubular element 20 is preferably semirigid, so that it can be screwed onto a threaded end 3 c secured to the proximal end 3 b of the needle 3 .
- the other end of the tubular element 20 is connected, for example by screwing, to the flexible means 1 comprising an end piece 30 secured to the sheath 5 , for example by heat shrinking.
- the end piece 30 for this purpose has a complementary threaded part 30 a (see FIGS. 7 and 8).
- the flexible means 1 , the tubular element 20 and the two parts 3 a, 3 b of the puncturing needle 3 may thus be assembled removably by screw fastening.
- the tubular element consists for example of a number of parts of roughly the same length, for example 20 and 41 , placed end to end and joined together removably by screw fastening. This end-to-end joining is obtained using a coupling 40 depicted in FIGS. 10, 11 a, 11 b and 11 c.
- the coupling 40 is made up of two elements, namely an internal connecting mandrel 42 and an external clamping bush 43 .
- the mandrel 42 has a threaded nipple 42 b engaged in the tubular element part 41 and at the other end has a stud 42 a with teeth 42 c intended to be engaged in the tubular element part 20 as depicted in FIGS. 11 b and 11 c.
- the shape and dimensions of the teeth 42 c tend to oppose separation of the tubular element part 20 from the mandrel 42 .
- Each mandrel 42 is associated with a bush 43 engaged on the tubular element part 41 so as to clamp part of tubular element part 41 between the threaded nipple 42 b and bush 43 .
- Bush 43 may also be provided on the anterior end with a tapping 43 a which bites by screwing into the material of which the abutting end of part 20 is made.
- part 41 of the tubular element is screwed onto the nipple 42 b.
- Bush 43 is then attached to this end of the part 41 , with the constituent material trapped between the screw thread of the nipple 42 b and the sleeve 43 , the latter also clamping the rest of the mandrel 42 except for the projecting stud 42 a.
- the two tubular element parts 20 and 41 are assembled by engaging the stud 42 a in one end of part 20 (FIG. 11 b ) and then by screwing the end of bush 43 onto the exterior periphery of part 20 (FIG. 11 c ).
- the turning of bush 43 is depicted diagrammatically by the arrow R in FIG. 11 c.
- the mechanical connection between the tubular element part 20 and the coupling 40 is thus improved.
- the device according to the present invention makes it possible to implement a method for treating women suffering from urinary stress incontinence. This method will be specified herein below and allows the tape 6 to be fitted in the patient's body.
- the treatment method comprises:
- the method comprises guiding the paths of the puncturing needle 3 along the posterior surface 105 a of the pubis, by contact with the finger 50 of the surgeon introduced through the opening 103 a, formed in the anterior vaginal wall 103 , as far as the lower edge 105 b of the same side of the pubis 105 .
- a one-piece needle may be used that can terminate in a male screw connecting piece. Passage of a track on the right and left side is made by screwing a portion of the traction element to the proximal end of the needle. Cystoscopy verifies the absence of punctures; then the two tubular halves are connected to each other using the small metal part to form a single traction element disposed in a loop beneath the urethra. The remainder of the intervention is identical.
- the flexible means 1 is attached to the intermediate element 2 or 20 after the check provided for in step (e) has been made.
- the opening 103 a made in the anterior vaginal wall 103 is vertical.
- a urethral probe 60 for example of the FOLEY balloon type, may be inserted into the patient beforehand.
- step (f) use is made of two intermediate traction elements 2 or 20 connected end to end during step (f).
- the puncturing needle 3 and the intermediate traction element 2 or 20 are separated once the check according to step (e) has been made and once the flexible means 1 has been introduced along the first path. This separation then makes it possible to create the second path using the puncturing needle 3 connected to the intermediate traction element 2 or 20 .
- the first step (a) is illustrated in FIG. 12.
- the patient is placed in a gynecological position and a sterile operating zone is formed.
- a urethral balloon probe 60 is positioned in the bladder 101 and is connected to a sterile collecting bag to empty and flatten the bladder 101 .
- a short vertical incision 103 a is made in the middle of the vaginal wall 103 , for example in a T or I shape, centered in the central third of the urethral canal 100 opening to the urinary meatus 100 a.
- Each lip 103 b of the vaginal incision 103 a is detached from the underlying tissues using scissors 71 and appropriate instruments 70 , as illustrated in FIG. 13.
- a very small cutaneous incision 106 , 107 less than 10 mm long is made in the abdominal skin immediately above the pubis 105 , on each side of the centerline and about 20 mm away from the latter, to allow the percutaneous passage of the needle 3 just off the posterior face 105 a of the pubis 30 in the direction of the vagina 104 .
- the surgeon's index finger 50 is introduced into the vaginal passage thus prepared by detachment, and the active distal end 3 a of the needle 3 follows a path to come into direct contact with index finger 50 .
- the path of the puncturing needle 3 is therefore controlled.
- the needle 3 can then reemerge through the vaginal opening 103 a and the bladder 101 has remained safe from any injury by the needle.
- the straight percutaneous path is made first.
- the end of the intermediate traction element for example the tubular element 20 , reemerges behind the needle 3 via the vaginal opening 103 a.
- This end of the traction element 20 is for example unscrewed from the proximal end 3 b of the needle 3 and is detached from the latter in the direction of the arrow S in FIG. 15.
- the needle 3 is then passed along the second path (on the left-hand side in FIG. 16) in the same way as for the first side (right-hand side).
- the distal part 3 a of the needle is well away from the vaginal opening 103 a, it can be detached by unscrewing its proximal portion 3 b. This separation is depicted diagrammatically by the arrow T in FIG. 16.
- proximal portion 3 b is long enough to project when the percutaneous incision 107 is made.
- the proximal portion 3 b may be extended by an additional tubular element 20 which projects out of the abdominal incision 107 .
- the next step consists in connecting the end of the tubular traction element 20 that follows the first path to the proximal portion 3 b or to the additional tubular element 20 that follows the second path.
- proximal portion 3 b is then led back out through the abdomen by pulling in the direction of the arrow V illustrated in FIG. 18.
- the tubular element 20 Before the flexible means 1 penetrates the patient's body, the tubular element 20 thus forms a loop around the urethra and its two ends reemerge respectively through the two abdominal cutaneous incisions 106 and 107 (FIG. 18).
- the urethral probe 60 may then be removed and cystoscopy is used to check for the absence of vesical perforation.
- the end of the tubular element 20 that emerges from the abdominal incision 106 is assembled by screw fastening on the threaded end 30 a of the flexible means 1 (sheath 5 plus tape 6 ) and the assembly is pulled (arrow V in FIG. 18) through the right and left paths to position the flexible means 1 under the urethra 100 .
- this positioning which corresponds to step (g) is complete, the ends 1 a , 1 b of the flexible means 1 reemerge from the abdominal incisions 106 , 107 as depicted in FIG. 21.
- the sheath 5 may then be separated from the tape 6 by cutting the sheath 5 in its central zone 1 c and withdrawing each of the halves 51 and 52 thus obtained through the corresponding abdominal incision 106 , 107 according to step (h) (arrows W in FIG. 19).
- the tape 6 may thus be released, positioned and adjusted under the underside of the urethra 100 , usually in a central position, without tension and without being squashed, as depicted in FIG. 20.
- the cutaneous incisions may be closed up using conventional methods.
- the tape 6 advantageously runs around the pubic bone 105 via its pelvic or deep face, and heads towards the contralateral abdominal wall.
- the resulting vaginal incision 103 a made in the vaginal wall 103 may then be closed once the definitive position of the tape 6 under the urethra 100 has been checked.
- the traction lace 2 can also be used for implementing the method.
- the operating procedure thus used is notable in that it is a percutaneous operating technique because the dimension of the abdominal cutaneous incisions is minimal, intended to be just enough to allow the needles to pass through and because the paths taken by the needle 3 are downwards, in other words entering through abdominal incisions 106 and 107 to emerge through the predetermined and prepared corresponding vaginal opening 103 a.
- the surgical technique described requires neither the use of an insertion tool for the needle, nor the use of an endovesical rod to move the bladder 101 and the urethra 100 away each time the needle 3 passes on a downward path.
- the device according to the invention is a percutaneous device, which is advantageous when compared with the known device which enters via the vaginal mucosa and emerges through the skin in the abdominal suprapubic region.
- the operator chooses the position of the tape 6 with respect to the urethral duct 100 according to the clinical case being studied.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- Surgery (AREA)
- Urology & Nephrology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Prostheses (AREA)
- Medicines Containing Plant Substances (AREA)
- Absorbent Articles And Supports Therefor (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicinal Preparation (AREA)
Abstract
A device for treating urinary stress incontinence in women includes a flexible and elongate mechanism including a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free. A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence is also provided including (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra.
Description
- 1. Field of Invention
- The present invention relates to the problems of urinary incontinence in women and more specifically to the problems of urinary stress incontinence. The invention relates more particularly to a percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape.
- 2. Description of Related Art
- These problems are currently treated during surgical interventions under local, regional or general anesthetic and consist in implanting a tape in such a way as to support the urethra without tension.
- Thanks to the regional or local anesthesia, the surgeon can immediately check that continence has been restored, with the participation of the patient.
- An intervention such as this is performed using an appropriate device including special instruments.
- In particular, it is a known practice in treating urinary incontinence to use a tape that can be implanted under the urethral canal, and a sheath surrounding the tape, where the sheath is withdrawn from the tape after the latter has been implanted.
- There is a known device for treating urinary stress incontinence in women, comprising:
- a flexible and elongate urethra support means comprising a tape and a protective sheath lying flat and enveloping the tape, and
- a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate urethra support means.
- Thus, U.S. Pat. No. 5,899,909 discloses a treatment method and a treatment device for incontinence. The device described, which allows a tape to be placed under the urethra, comprises two special needles. These are mounted in turn, by screw fastening, on a reusable steel insertion tool made of a handle and of a threaded manipulator rod which allows each of the needles to be manipulated in turn. Each needle is fixed to one of the ends of the tape-sheath assembly.
- Each end of the tape-sheath assembly is fixed to a frustoconical part of one end of the corresponding needle, using a shrunk or bonded polymer ring.
- The tape is therefore implanted by introducing each of the needles through a short incision in the anterior vaginal wall, these incisions being one on each side of the central position of the urethra.
- The needles implanted in turn using the manipulator rod, then travel up around the bladder and the pubic bone and reemerge from the body through incisions made in the abdominal wall in the suprapubic region.
- The two halves of the sheath which overlap at the middle of the tape are withdrawn by pulling on the ends that emerge from the suprapubic incisions.
- A device such as this requires the use of ancillaries of the insertion handle and rigid intravesical catheter guide types especially designed for this type of surgical intervention.
- The known surgical intervention also has a disadvantage insofar as the needles are introduced into the anterior wall of the vagina to reemerge in the suprapubic region. This bottom-upward path cannot be controlled precisely for going around the base of the bladder. Vesical perforations are far from uncommon. They need to be recognized preoperatively through the use of two cystoscopies and entail repeating the maneuvers under more difficult conditions.
- The two accessories (manipulator handle and rigid probe guide) must therefore be available to the surgical team during each intervention, having been previously washed, packaged and sterilized prior to each use. In addition, this lateral passage with respect to the bladder, with a vaginal point of entry runs the risk that the point of the needle will injure the iliac vessels in the retrocrural region. These vascular lesions have been observed and have led to fatalities.
- Another drawback of the known device lies in the difficulty of repeating the intervention, using the same device, when cystoscopy reveals that the sheath-tape assembly has taken the wrong course. Retreat may prove difficult and tricky for the sheath, and especially for the bulky needles.
- The sheath-tape assembly has therefore to be cut and the device can no longer be used to take a different path. It also carries the risk of no longer being sterile as it may have been contaminated during these additional maneuvers.
- Thus no percutaneous treatment exists for female urinary stress incontinence which uses a tape which can lead to the devices and technique of the present invention.
- The present invention provides a device for treating urinary stress incontinence in women comprising a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free.
- A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence is also provided by the present invention comprising (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra.
- The object of the present invention is to overcome the drawbacks of the prior art so as to obtain a different operative technique which is easier, quicker and safer (as far as the bladder and vessels are concerned). The risk of vascular lesion is minimised because of the orientation and the given direction of the needle from the start of the procedure. The risk of vesical puncture is small even in the case of previous interventions in this regard, as is particularly frequent in this type of pathology. Using the device and operating method of the invention, the percutaneous route is used to form top-to-bottom tracks using the needle, i.e., penetrating via abdominal cutaneous mini-incisions to exit via a previously formed vaginal opening. Detachment of the vagina allows the index finger of the surgeon to be insinuated up to the lower rim of the pubis and thus enables the track of the needle to be precisely directed.
- The device of the invention enables tracks to be made from top to bottom on both sides of the abdomen and enables the absence of vesical puncturing to be confirmed by cystoscopy before engaging the sheath-tape system. The present device makes it possible to employ the techniques that will be described in detail later on in this description.
- Another object of the present invention is to produce a device for treating urinary incontinence which can be reused easily if it is introduced into the body in a non-optimum path, an eventuality which, according to the present invention, can occur only under exceptional circumstances if there is very strong adhesion between the bladder and the pubis, generally as the result of earlier interventions.
- According to an embodiment of the invention, the proximal end of the puncturing needle is connected to the first end of the flexible means by virtue of an intermediate traction element, the second end of the flexible means being free or extended by an additional intermediate traction element.
- According to one embodiment of the device according to the invention, the protective sheath completely envelopes the tape, including its first and second ends.
- According to one embodiment of the invention, the sheath can be split into two parts that can be separated by sliding them in two opposite directions relative to the tape, the device comprising a splinable means between the two central and adjacent ends of the sheath.
- According to another embodiment of the device according to the invention, the device comprises a filament arranged roughly at right angles to the longitudinal axis of the sheath, configured to cut the sheath when traction is exerted on the filament.
- According to one embodiment of the device according to the invention, the sheath is made of a fluoropolymer-based heat-shrinkable material.
- According to one embodiment of the device according to the invention, the tape is formed from a macroporous knitted material.
- According to one embodiment of the invention, the tape in its central region has resorbable hydrophilic film reducing the risk of adhesion to or the risk of erosion of the urethra.
- According to one embodiment of the device according to the invention, the puncturing needle has a curved part continuously adjacent to a roughly straight part ending in its proximal end.
- According to one embodiment of the invention, the intermediate traction element is a traction lace.
- According to one embodiment, the device according to the invention comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches.
- According to one embodiment according to the invention, the traction lace has a length roughly equal to the length of the flexible means.
- According to a preferred embodiment of the device according to the invention, the intermediate traction element is tubular.
- According to one embodiment of the device according to the invention, the intermediate traction element and the puncturing needle are assembled by screwing.
- According to one embodiment of the device according to the invention, the traction element consists of two parts of roughly the same length, placed end to end and joined together removably, for example by screwing, using a coupling.
- According to one embodiment of the device according to the invention, the puncturing needle with an active distal end and a proximal end attached to a flexible and elongate means is the only puncturing needle.
- Other features and advantages of the invention will become apparent from the detailed non-limiting description given hereinafter with reference to the appended drawings, in which:
- FIG. 1 depicts a view in section of the flexible means of the device according to the invention;
- FIG. 2 depicts a view from above, with partial cutaway, of the flexible means shown in FIG. 1;
- FIG. 3 depicts, in part, another exemplary embodiment of the flexible means of FIG. 2;
- FIG. 4 depicts a partial view of a device according to the invention;
- FIGS. 5 and 6 depict details of FIG. 4;
- FIGS. 7 and 8 depict another embodiment of the flexible means of the device according to the invention;
- FIG. 9 depicts a partial view of another embodiment of the device according to the invention;
- FIGS. 10, 11a, 11 b and 11 c depict details of the device depicted in FIG. 9;
- FIGS.12 to 19 diagrammatically depict the surgical method employed using the device according to the invention; and
- FIGS. 20 and 21 diagrammatically depict the position of the device according to the invention in the body of a patient.
- The device depicted in FIGS. 1, 2,3 and 4 comprises an elongate
flexible means 1 generally comprising a composite band. - The flexible means1 is shown only in part and not in its entire length. It generally has a flattened and elongate shape.
- The
first end 1 a of theflexible means 1 can be connected to an intermediate traction element 2 (cf. FIG. 4) and thesecond end 1 b is free or extended by an additional intermediate traction element (not depicted). - The device according to the invention also comprises a puncturing
needle 3, for example made of stainless steel, connected to the intermediate traction element. - The flexible means1 comprises a
protective sheath 5 lying flat and enveloping atape 6. - The
single puncturing needle 3 has an activedistal end 3 a and aproximal end 3 b connected to thefirst end 1 a of theflexible means 1. - The
proximal end 3 b of the puncturingneedle 3 is connected to thefirst end 1 a by virtue of anintermediate traction element 2. Theproximal end 3 b is thus a non-puncturing end. Theproximal end 3 b of the puncturing needle may have a substantially rectangular cross-section and may be flattened and/or ribbed. These features allow the surgeon to grip the needle and allows the needle to be oriented correctly. - The
distal end 3 a is at the end of a curved part continuously adjacent to a roughly straight part, approximately betweenpoints proximal end 3 b. Thedistal end 3 a may be partially curved and preferably has a round cross-section.Distal end 3 a may have a diameter of, for example, 0.5 mm. The roughly straight part may be, for example, 20 to 25 cm in length and may, in embodiments, be ribbed over at least a portion thereof. - The puncturing needle has, for example, a diameter of 3.5 mm in its curved part.
- The
proximal end 3 b is also equipped with an attachment means allowing it to make a connection with the intermediate traction element. - The intermediate traction element is constituted by a hollow PVC tube with a diameter that is identical to, or closely similar in diameter to, that of the needle. The intermediate traction element or tubing may be approximately 40 to 50 cm long. Its distal end19 and
proximal end 20 comprise a male screw connecting piece. This screw connecting piece is integrally fixed to the traction element by adhesion and/or screwing. The intermediate traction element may be colored, for example blue, so that it can readily be located during cystoscopy in the event of a vesical puncture. - The
protective sheath 5 completely envelopes thetape 6, including itsfirst end 6 a and itssecond end 6 b. - The
sheath 5 is made, for example, of a fluoropolymer-based heat-shrinkable material. The material of which thesheath 5 is made is chosen so that it is impervious, for example hermetically sealed, to isolate thetape 6 intended to be implanted in the body of the patient from contact with the skin and mucosa when following the implantation paths through the body. - The
sheath 5 may also exhibit properties of low coefficient of friction. These properties are therefore found both on the inside and on the outside of thesheath 5, so as, on the one hand, to ensure good separation from thetape 6 and, on the other hand, to reduce the friction inside the body of the patient when theflexible means 1 is being pulled. - The
tape 6 advantageously has a width of between 6 and 14 mm, preferably between 10 and 12 mm and a length of between 30 and 50 cm, preferably around 40 cm. - The
tape 6 is preferably formed from a macroporous knitted material. - The macroporous knitted material comprises, for example, an open knit made of single stranded polypropylene of between 0.12 and 0.16 millimeter thick and made up of two layers formed by two threaded guide bars each—one full guide and one empty guide—these two guides being moved symmetrically for open mesh according to the following chart:
- bar I: 01-12-32
- bar II: 32-21-01.
- The
tape 6 is cut to length in the warp direction of the knit. - The
tape 6, with a width of for example 12 mm, has the following properties: - a breaking strength in the warp direction of 105N±20%,
- an elongation at break in the warp direction of 92%±20%
- an elongation of 36% under a force of 20N
- an onset of curling with a force of 6N and an elongation of
- 15%.
- The expression “curling” is intended to mean the property whereby the
tape 6 rolls up on itself spontaneously about its longitudinal axis under longitudinal tensile stress. - The
tape 6 has attractive advantages and, in particular, low emission of particles as it is stretched, and curling which occurs only under high stress (6N). None of these aforementioned properties in any way detracts from the porosity of thetape 6. -
Tape 6 can have a resorbable hydrophilic film in its central portion that reduces the risk of erosion or sclerosis of the urethra to a minimum. This central zone may be indicated by a colored marker. - In a variation, the tape may comprise other biologically acceptable materials.
- The
sheath 5 can preferably be split into twoparts tape 6. - For this purpose, the device according to the invention has a splittable means15, roughly at the middle of the
sheath 5 and the two ends of which are secured to the corresponding and adjacentcentral ends sheath 5. - The material of the splittable means15 is chosen from materials of the thermoplastic type approved for surgical application.
- The connection between, on the one hand, the central ends5 c, 5 d of the two
parts splittable center 15, may be obtained by any means able to make thesheath 5 impervious. The same is true of thefree end 5 b of thesheath 5, which may be plugged and/or sealed. - The splittable means15 comprises a flat slit 15 a passing through it from one longitudinal end to the other, for the free passage of the
tape 6. - The splittable means15 may be replaced in an embodiment depicted in figures 7 and 8, by an
adhesive sleeve 16a joining the ends of the twosplittable parts sheath 5. This sleeve may be weakened, for example by a partial broken cut or a line of weakness in thesheath 5. Theadhesive sleeve 16 a made of a flexible material which sticks firmly to the central ends 5 c, 5 d and has aprecut tab 16 b to make thesleeve 16 a easier to tear and therefore make thesheath 5 easier to split into the twoparts - According to another embodiment of the device according to the invention, the one-
piece sheath 5 incorporates afilament 16 c arranged roughly at right angles to the longitudinal axis of thesheath 5, configured to cut thesheath 5 when traction is exerted on thefilament 16 c. An example such as this is depicted, for example, in figure 3. Thefilament 16 c may be advantageously in color so that it can easily be identified. - The
sheath 5 can thus be split in thecentral zone 1 c of theflexible means 1 so release thetape 6 inside the body of the patient. - The intermediate traction element is, according to one embodiment of the invention, configured, for example, with a
traction lace 2 depicted in FIG. 4. - The device according to the invention may also comprise an
end piece 4 to which thesheath 5 is attached by heat-shrinking. Thesheath 5, more particularly itsfirst end 5 a, may be heat shrunk in a sealed manner onto theend piece 4. - As depicted in FIG. 2. the
end piece 4 comprises anchoringnotches 4 a into which the heat-shrunk material of thesheath 5 engages. Theend piece 4 is made, for example, of a piece of stainless steel or any other rigid material capable of contacting with intracorporal tissue. - Advantageously, the
flexible means 1 comprises aknotting eye 4 b (cf. FIG. 4) arranged on the outside of thesheath 5. Knottingeye 4 b consists, for example, of a closed loop and may, as appropriate, have apoint 4 c intended to pass through and catch on one end of thetraction lace 2 or any other intermediate traction element. - The
knotting eye 4 b may, for example, be made integrally in theend piece 4. The latter may also have a roughly flattened and partially frustoconical shape so as to achieve continuity between the various thicknesses of thetraction lace 2 and theflexible means 1. The latter has a greater width than thetraction lace 2. Thus a certain continuity between the dimensions of thetraction lace 2 and of theflexible means 1 is obtained. The traction lace may for example be made of a Teflon-coated material. - FIG. 4 diagrammatically depicts one exemplary embodiment of the device according to the invention.
- The
needle 3 comprises theproximal end 3 b onto which thefirst end 2 a of thetraction lace 2 is attached. The latter has, for example, at each of itsends loop 2 c (cf. FIGS. 5 and 6 respectively) obtained by ultrasonic welding, stitching or any other means. - One of these loops,2 c, is mounted on the
proximal end 3 b of theneedle 3 while the other is mounted in theeye 4 b. - During the procedure, it is thus possible to attach the
end 2 a of thetraction lace 2 to theeye 4 b either using thepoint 4 c secured to theeye 4 b or simply by running it through the closed loop that forms theeye 4 b. - The device according to the invention therefore, for example, has a
traction lace 2, the length of which is, for example, roughly equal to the length of theflexible means 1, namely a length of between 30 and 60 cm, for example 40 cm. Such dimensions or lengths of thetraction lace 2 make it possible, if reference is made to the operative procedure, to avoid engaging theflexible means 1 in the body before being sure that the path taken by theneedle 3 and thetraction lace 2 is optimum. The long available length oftraction lace 2 for carrying out the operative actions described thus makes it possible for another path to be taken through the body if need be, without having to manipulate theflexible means 1. - By way of variation, it is possible to provide the
second end 1 b of theflexible means 1 with an additional intermediate traction element, such as an additional lace like the one previously described underreference 2. - An
additional traction lace 2 secured to thefree end 1 b, which may also have anend piece 4 for this purpose, allows traction to be exerted in the opposite direction to its introduction on theflexible means 1, and allows it to back-track along its path if it is penetrating incorrectly. - According to another embodiment of the device according to the invention, depicted for example in FIG. 9, the intermediate traction element is a
tubular element 20. The material of which the latter is made may be, for example, PVC.Tubular element 20 may be, for example, 2.5 mm in diameter. - The
tubular element 20 is preferably semirigid, so that it can be screwed onto a threaded end 3 c secured to theproximal end 3 b of theneedle 3. The other end of thetubular element 20 is connected, for example by screwing, to theflexible means 1 comprising anend piece 30 secured to thesheath 5, for example by heat shrinking. Theend piece 30 for this purpose has a complementary threadedpart 30 a (see FIGS. 7 and 8). - The flexible means1, the
tubular element 20 and the twoparts needle 3 may thus be assembled removably by screw fastening. - Other known removable means of connection or attachment may also be suitable in the context of the present invention.
- The tubular element consists for example of a number of parts of roughly the same length, for example20 and 41, placed end to end and joined together removably by screw fastening. This end-to-end joining is obtained using a
coupling 40 depicted in FIGS. 10, 11a, 11 b and 11 c. - The
coupling 40 is made up of two elements, namely an internal connectingmandrel 42 and anexternal clamping bush 43. - At one end, the
mandrel 42 has a threadednipple 42 b engaged in thetubular element part 41 and at the other end has astud 42 a withteeth 42 c intended to be engaged in thetubular element part 20 as depicted in FIGS. 11b and 11 c. The shape and dimensions of theteeth 42 c tend to oppose separation of thetubular element part 20 from themandrel 42. - Each
mandrel 42 is associated with abush 43 engaged on thetubular element part 41 so as to clamp part oftubular element part 41 between the threadednipple 42 b andbush 43. -
Bush 43 may also be provided on the anterior end with a tapping 43 a which bites by screwing into the material of which the abutting end ofpart 20 is made. - To begin with, one end of
part 41 of the tubular element is screwed onto thenipple 42 b.Bush 43 is then attached to this end of thepart 41, with the constituent material trapped between the screw thread of thenipple 42 b and thesleeve 43, the latter also clamping the rest of themandrel 42 except for the projectingstud 42 a. - The two
tubular element parts stud 42 a in one end of part 20 (FIG. 11b) and then by screwing the end ofbush 43 onto the exterior periphery of part 20 (FIG. 11c). The turning ofbush 43 is depicted diagrammatically by the arrow R in FIG. 11c. The mechanical connection between thetubular element part 20 and thecoupling 40 is thus improved. - The device according to the present invention makes it possible to implement a method for treating women suffering from urinary stress incontinence. This method will be specified herein below and allows the
tape 6 to be fitted in the patient's body. - The treatment method comprises:
- a) forming an
opening 103 a in the anteriorvaginal wall 103; - b) making two small
suprapubic incisions - c) using the puncturing
needle 3 connected to an intermediate traction means 2 or 20 to create a first path traveling around thepubic bone 105 and emerging in theopening 103 a formed in the anteriorvaginal wall 103; - d) using the puncturing
needle 3 connected to an intermediate traction means to create a second path around thepubic bone 105 and emerging in theopening 103 a formed in the anteriorvaginal wall 103; - e) using cystoscopy to check that the making of these paths has not punctured the
bladder 101 or theurethra 100; - f) connecting the parts of the device emerging from the opening103 a formed in the anterior
vaginal wall 103; - g) pulling on the
intermediate traction element flexible means 1 on the underside of theurethra 100; - h) separating and withdrawing the two halves of the
sheath 5; and - i) leaving the
tape 6 between the firstsuprapubic incision 106 and the secondsuprapubic incision 107 passing under the underside of theurethra 100. - According to one embodiment of the invention, the method comprises guiding the paths of the puncturing
needle 3 along theposterior surface 105 a of the pubis, by contact with thefinger 50 of the surgeon introduced through the opening 103 a, formed in the anteriorvaginal wall 103, as far as thelower edge 105 b of the same side of thepubis 105. - In a variation, a one-piece needle may be used that can terminate in a male screw connecting piece. Passage of a track on the right and left side is made by screwing a portion of the traction element to the proximal end of the needle. Cystoscopy verifies the absence of punctures; then the two tubular halves are connected to each other using the small metal part to form a single traction element disposed in a loop beneath the urethra. The remainder of the intervention is identical.
- According to one embodiment of the method according to the invention, the
flexible means 1 is attached to theintermediate element - According to one embodiment of the method according to the invention, the opening103 a made in the anterior
vaginal wall 103 is vertical. - According to a method of the invention, a
urethral probe 60, for example of the FOLEY balloon type, may be inserted into the patient beforehand. - According to one embodiment of the treatment method according to the invention, use is made of two
intermediate traction elements - According to another embodiment of the treatment method according to the invention, the puncturing
needle 3 and theintermediate traction element flexible means 1 has been introduced along the first path. This separation then makes it possible to create the second path using the puncturingneedle 3 connected to theintermediate traction element - All of the above defined steps are now described with a device according to FIGS.7 to 11 and the description relating thereto.
- The first step (a) is illustrated in FIG. 12. The patient is placed in a gynecological position and a sterile operating zone is formed. A
urethral balloon probe 60 is positioned in thebladder 101 and is connected to a sterile collecting bag to empty and flatten thebladder 101. A shortvertical incision 103 a, at most 30 mm long, is made in the middle of thevaginal wall 103, for example in a T or I shape, centered in the central third of theurethral canal 100 opening to theurinary meatus 100 a. Eachlip 103 b of thevaginal incision 103 a is detached from the underlyingtissues using scissors 71 andappropriate instruments 70, as illustrated in FIG. 13. - Detachment is performed until the surgeon's
index finger 50, introduced through the resultingopening 103 a, can reach thelower edge 105 b of thepubis 105, away from theurethra 100 and the periurethral tissue (FIG. 14). - Next, a very small
cutaneous incision pubis 105, on each side of the centerline and about 20 mm away from the latter, to allow the percutaneous passage of theneedle 3 just off theposterior face 105 a of thepubis 30 in the direction of thevagina 104. - The surgeon's
index finger 50 is introduced into the vaginal passage thus prepared by detachment, and the activedistal end 3 a of theneedle 3 follows a path to come into direct contact withindex finger 50. The path of the puncturingneedle 3 is therefore controlled. Theneedle 3 can then reemerge through thevaginal opening 103 a and thebladder 101 has remained safe from any injury by the needle. - In general, the straight percutaneous path is made first. The end of the intermediate traction element, for example the
tubular element 20, reemerges behind theneedle 3 via thevaginal opening 103 a. This end of thetraction element 20 is for example unscrewed from theproximal end 3 b of theneedle 3 and is detached from the latter in the direction of the arrow S in FIG. 15. - The
needle 3 is then passed along the second path (on the left-hand side in FIG. 16) in the same way as for the first side (right-hand side). Once thedistal part 3 a of the needle is well away from thevaginal opening 103 a, it can be detached by unscrewing itsproximal portion 3 b. This separation is depicted diagrammatically by the arrow T in FIG. 16. - The so-called
proximal portion 3 b is long enough to project when thepercutaneous incision 107 is made. - By way of an alternative form according to the invention, the
proximal portion 3 b may be extended by an additionaltubular element 20 which projects out of theabdominal incision 107. - The next step consists in connecting the end of the
tubular traction element 20 that follows the first path to theproximal portion 3 b or to the additionaltubular element 20 that follows the second path. - Connection is made using the
coupling 40 depicted in FIG. 17. - The
proximal portion 3 b is then led back out through the abdomen by pulling in the direction of the arrow V illustrated in FIG. 18. - Before the
flexible means 1 penetrates the patient's body, thetubular element 20 thus forms a loop around the urethra and its two ends reemerge respectively through the two abdominalcutaneous incisions 106 and 107 (FIG. 18). - The
urethral probe 60 may then be removed and cystoscopy is used to check for the absence of vesical perforation. - Once the check has been made, the end of the
tubular element 20 that emerges from theabdominal incision 106 is assembled by screw fastening on the threadedend 30 a of the flexible means 1 (sheath 5 plus tape 6) and the assembly is pulled (arrow V in FIG. 18) through the right and left paths to position theflexible means 1 under theurethra 100. When this positioning which corresponds to step (g) is complete, theends flexible means 1 reemerge from theabdominal incisions - The
sheath 5 may then be separated from thetape 6 by cutting thesheath 5 in itscentral zone 1 c and withdrawing each of thehalves abdominal incision - The
tape 6 may thus be released, positioned and adjusted under the underside of theurethra 100, usually in a central position, without tension and without being squashed, as depicted in FIG. 20. - Once the
sheath 5 has been withdrawn through eachabdominal incision tape 6 which project out of theincisions - The cutaneous incisions may be closed up using conventional methods.
- The
tape 6 advantageously runs around thepubic bone 105 via its pelvic or deep face, and heads towards the contralateral abdominal wall. - The resulting
vaginal incision 103 a made in thevaginal wall 103 may then be closed once the definitive position of thetape 6 under theurethra 100 has been checked. - By way of a variation, the
traction lace 2 can also be used for implementing the method. - The operating procedure thus used is notable in that it is a percutaneous operating technique because the dimension of the abdominal cutaneous incisions is minimal, intended to be just enough to allow the needles to pass through and because the paths taken by the
needle 3 are downwards, in other words entering throughabdominal incisions vaginal opening 103 a. - This presents an enormous advantage from the safety point of view with respect to the risks of puncturing the
bladder 101 on the one hand, and the iliac vessels on the other hand. - This is a considerable advantage over the known operating technique. The path can be checked by cystoscopy.
- When it becomes apparent that the path is not appropriate, it is possible to withdraw the
intermediate traction element cutaneous incision 106, and to do so without introducing theflexible means 1 into the body. - All of the elements of the device according to the invention can thus be reused if the manipulation is incorrect, or if the path inside the patient's body needs to be improved or optimized. This represents a considerable advantage over the state of the prior art.
- Furthermore, the surgical technique described requires neither the use of an insertion tool for the needle, nor the use of an endovesical rod to move the
bladder 101 and theurethra 100 away each time theneedle 3 passes on a downward path. This constitutes an advantageous simplification insofar as the surgical technique put forward in the state of the art entails the use of an endovesical rod twice, namely after each passage of each of the two needles which are making an upward path. - It is to be noted that the device according to the invention is a percutaneous device, which is advantageous when compared with the known device which enters via the vaginal mucosa and emerges through the skin in the abdominal suprapubic region.
- It is notable that the extreme simplicity of the device according to the invention contributes not only to reducing its cost price and the number of its constituent parts but also to increasing the safety for the patient and the quality of the result when the operating technique described in the present invention is implemented.
- Checking the effect obtained on continence and adjusting the tension of the
tape 6 are not justified for two main reasons. Specifically, continence in a lying-down position is not comparable to the upright position, and the effectiveness of the tape is explained not by a gripping effect (which carries the risk of leading to stenosis) but by an effect of providing uplifting support. - Furthermore, the operator chooses the position of the
tape 6 with respect to theurethral duct 100 according to the clinical case being studied. - In the state of the art, this choice cannot be made, and continence tests are carried out after the bladder has been filled and coughing stress applied in order to adjust the tension in the tape, even though the technique is supposedly said to be “tension free”.
Claims (26)
1. A device for treating urinary stress incontinence in women, comprising:
a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping said tape; and
a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism,
wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free.
2. The device of claim 1 , wherein the free second end of the flexible and elongate mechanism is attached to an extended by an additional intermediate traction element.
3. The device of claim 1 , wherein the tape has a first end and a second end and wherein the protective sheath completely envelopes the tape, including said first and second ends of the tape.
4. The device of claim 1 , wherein the sheath is capable of being split into two parts that are separable by sliding them in opposite directions relative to the tape, and wherein said device comprises a splinable mechanism between central and adjacent ends of the sheath.
5. The device of claim 1 , wherein the sheath is capable of being split into two parts that are separable by sliding them in opposite directions relative to the tape, and wherein said device comprises a filament arranged roughly at right angles to a longitudinal axis of the sheath, wherein said filament is configured to cut said sheath when traction is exerted on said filament.
6. The device of claim 1 , wherein the sheath comprises a fluoropolymer-based heat-shrinkable material.
7. The device of claim 1 , wherein the tape comprises a macroporous knitted material.
8. The device of claim 1 , wherein a central region of the tape has a resorbable hydrophilic film that reduces the risk of adhesion to or the risk of erosion of the urethra.
9. The device of claim 1 , wherein the puncturing needle has a curved part adjacent to a roughly straight part that ends at the proximal end of the puncturing needle.
10. The device of claim 1 , wherein the intermediate traction element is a traction lace.
11. The device of claim 9 , wherein said device further comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches.
12. The device of claim 9 , wherein the traction lace has a length roughly equal to the length of the flexible and elongate mechanism.
13. The device of claim 1 , wherein the intermediate traction element is a tubular traction element.
14. The device of claim 12 , wherein the tubular traction element and the puncturing needle are attached by screwing them together.
15. The device of claim 12 , wherein the tubular traction element comprises two parts of roughly equal length, placed end to end and joined together removably.
16. The device of claim 15 , wherein said two parts of roughly equal length are joined together by screwing them together using a coupling.
17. The device of claim 1 , wherein the puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism is the only puncturing needle present in the device.
18. The device of claim 1 , wherein the tape comprises an open knit made up of two layers formed by two threaded guide bars each, one full guide and one empty guide, the two threaded guide bars being movable symmetrically for an open mesh.
19. A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence, said method comprising:
(a) forming an opening in an anterior vaginal wall;
(b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall;
(c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle;
(d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra;
(e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra;
(f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra;
(g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and
(h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra.
20. The method of claim 19 , wherein a needle and an intermediate traction element are used to follow one of the tracks, and a needle and a second intermediate traction element are used to follow the other track.
21. The method of claim 19 , wherein each track is produced using a needle inserted through a suprapubic incision and guided along a posterior surface of a pubis in contact with a finger of a surgeon and introduced through an opening to a lower rim of the pubis on the same side as the suprapubic incision through which the needle was inserted.
22. The method of claim 19 , wherein a distal end of the tape is connected to a proximal end of the intermediate traction element after verifying by cystoscopy.
23. The method of claim 19 , wherein the sheath is cut in a central region.
24. The method of claim 19 , wherein the incision in the anterior vaginal wall is T or I shaped.
25. The method of claim 19 , in which vaginal detachment is performed.
26. The method of claim 19 , in which a urethral probe is inserted prior to performing a first incision.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/268,960 US20030036676A1 (en) | 2000-01-21 | 2002-10-11 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/489,336 US6406423B1 (en) | 2000-01-21 | 2000-01-21 | Method for surgical treatment of urinary incontinence and device for carrying out said method |
FR0012753A FR2804010B1 (en) | 2000-01-21 | 2000-10-05 | PERCUTANEOUS DEVICE FOR THE TREATMENT OF URINARY INCONTINENCE OF WOMAN'S EFFORT BY URETRAL STRIP |
FR0012753 | 2000-10-05 | ||
US09/765,351 US6478727B2 (en) | 2000-01-21 | 2001-01-22 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
US10/268,960 US20030036676A1 (en) | 2000-01-21 | 2002-10-11 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/765,351 Continuation US6478727B2 (en) | 2000-01-21 | 2001-01-22 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Publications (1)
Publication Number | Publication Date |
---|---|
US20030036676A1 true US20030036676A1 (en) | 2003-02-20 |
Family
ID=26212669
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/765,351 Expired - Lifetime US6478727B2 (en) | 2000-01-21 | 2001-01-22 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
US10/268,960 Abandoned US20030036676A1 (en) | 2000-01-21 | 2002-10-11 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/765,351 Expired - Lifetime US6478727B2 (en) | 2000-01-21 | 2001-01-22 | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Country Status (15)
Country | Link |
---|---|
US (2) | US6478727B2 (en) |
EP (1) | EP1248567B1 (en) |
AT (1) | ATE262835T1 (en) |
AU (1) | AU777013B2 (en) |
CA (1) | CA2397753C (en) |
DE (2) | DE60102557T2 (en) |
DK (1) | DK1248567T3 (en) |
ES (2) | ES2217117T3 (en) |
GB (1) | GB2359256B (en) |
HK (1) | HK1051798A1 (en) |
IT (1) | ITMI20010067A1 (en) |
NZ (1) | NZ520883A (en) |
PT (1) | PT1248567E (en) |
TR (1) | TR200400694T4 (en) |
WO (1) | WO2001052750A1 (en) |
Cited By (93)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20030045774A1 (en) * | 2001-01-23 | 2003-03-06 | Staskin David R. | Sling delivery system and method of use |
US20030050530A1 (en) * | 2001-01-23 | 2003-03-13 | Neisz Johann J. | Surgical articles and methods |
US20030130670A1 (en) * | 2001-01-23 | 2003-07-10 | Anderson Kimberly A. | Pelvic floor implant system and method of assembly |
US20030176875A1 (en) * | 2002-03-07 | 2003-09-18 | Anderson Kimberly A. | Transobturator surgical articles and methods |
US20030199732A1 (en) * | 2000-07-05 | 2003-10-23 | Mentor Corporation, A Minnesota Corporation | Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence |
US6641525B2 (en) | 2001-01-23 | 2003-11-04 | Ams Research Corporation | Sling assembly with secure and convenient attachment |
US6648921B2 (en) | 2001-10-03 | 2003-11-18 | Ams Research Corporation | Implantable article |
US6652450B2 (en) | 2001-01-23 | 2003-11-25 | American Medical Systems, Inc. | Implantable article and method for treating urinary incontinence using means for repositioning the implantable article |
US20030220538A1 (en) * | 2002-03-01 | 2003-11-27 | Bernard Jacquetin | Method and apparatus for treating pelvic organ prolapses in female patients |
US20040039453A1 (en) * | 2001-07-27 | 2004-02-26 | Anderson Kimberly A. | Pelvic health implants and methods |
US20040054253A1 (en) * | 2000-09-07 | 2004-03-18 | Snitkin Eva S. | Coated sling material |
US20050004427A1 (en) * | 2003-04-30 | 2005-01-06 | Mauro Cervigni | Prosthesis for use in the surgical treatment of urogenital prolapse and female urinary incontinence |
US20050027220A1 (en) * | 2003-07-31 | 2005-02-03 | James Wagner | Bioabsorbable casing for surgical sling assembly |
US20050131391A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US20050131393A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US20050131392A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US20050245787A1 (en) * | 2004-04-30 | 2005-11-03 | Ams Research Corporation | Method and apparatus for treating pelvic organ prolapse |
US20050250977A1 (en) * | 2004-05-07 | 2005-11-10 | Ams Research Corporation | Method and apparatus for cystocele repair |
US20050278037A1 (en) * | 2004-06-11 | 2005-12-15 | Analytic Biosurgical Solutions-Abiss | Implant for the treatment of cystocele and rectocele |
US20050288708A1 (en) * | 2004-06-25 | 2005-12-29 | Kammerer Gene W | Soft tissue fastener having integral biasing section |
US20060058575A1 (en) * | 2004-09-15 | 2006-03-16 | Vincenza Zaddem | System and method for surgical implant placement |
US20060173468A1 (en) * | 2005-01-28 | 2006-08-03 | Marc Simmon | Obturator introducer with snare |
US20060196788A1 (en) * | 2005-02-02 | 2006-09-07 | Peter Komarnycky | Packaging assembly for surgical mesh implants |
US20060241622A1 (en) * | 2003-06-13 | 2006-10-26 | Zergiebel Earl M | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20070123746A1 (en) * | 2005-11-16 | 2007-05-31 | Boston Scientific Scimed, Inc. | Devices for minimally invasive pelvic surgery |
US7338432B2 (en) | 2003-11-17 | 2008-03-04 | Konstantin Valtchev | Urethral sling introducer and method of use |
US20080119863A1 (en) * | 2003-09-22 | 2008-05-22 | Ams Research Corporation | Prolapse Repair |
US20080200751A1 (en) * | 2000-10-12 | 2008-08-21 | James Browning | Urethral support system |
US20080196729A1 (en) * | 2004-05-21 | 2008-08-21 | Mpathy Medical Devices Limited | Implant for Treatment of Vaginal and/or Uterine Prolapse |
US20080207989A1 (en) * | 2005-08-29 | 2008-08-28 | Ams Research Corporation | System For Positioning Support Mesh in a Patient |
US20080281336A1 (en) * | 2003-06-13 | 2008-11-13 | Zergiebel Earl M | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20090082617A1 (en) * | 2007-08-14 | 2009-03-26 | Vecchiotti Richard G | Methods and devices for supporting, elevating, or compressing internal structures |
US20090192347A1 (en) * | 2005-07-26 | 2009-07-30 | Ams Research Corporation | Methods and Systems for Treatment of Prolapse |
US20090192540A1 (en) * | 2003-11-17 | 2009-07-30 | Boston Scientific Scimed, Inc. | Systems and methods relating to associating a medical implant with a delivery device |
US20090209994A1 (en) * | 2000-06-05 | 2009-08-20 | Boston Scientific Scimed, Inc. | Methods and devices for the treatment of urinary incontinence |
US20090240104A1 (en) * | 2007-10-26 | 2009-09-24 | Ams Research Corporation | Surgical Articles and Methods for Treating Pelvic Conditions |
US20090259092A1 (en) * | 2006-06-22 | 2009-10-15 | Ogdahl Jason W | Adjustable Sling and Method of Treating Pelvic Conditions |
US20090318752A1 (en) * | 2006-03-15 | 2009-12-24 | C. R. Bard, Inc. | Implants for the treatment of pelvic floor disorders |
US20100010631A1 (en) * | 2006-05-19 | 2010-01-14 | John Fritz Otte | Method and articles for treatment of stress urinary incontinence |
US20100030016A1 (en) * | 2008-07-31 | 2010-02-04 | Knoll L Dean | Methods and Implants for Treating Urinary Incontinence |
US20100094079A1 (en) * | 2005-06-21 | 2010-04-15 | Ams Research Corporation | Method and Apparatus for Securing a Urethral Sling to Pubic Bone |
US20100105979A1 (en) * | 2008-10-27 | 2010-04-29 | Ams Research Corporation | Surgical Needle and Anchor System with Retractable Features |
US20100168505A1 (en) * | 2005-06-21 | 2010-07-01 | Ams Research Corporation | Methods and apparatus for securing a urethral sling to a pubic bone |
US20100191039A1 (en) * | 2002-03-07 | 2010-07-29 | Anderson Kimberly A | Transobturator surgical articles and methods |
US20100241105A1 (en) * | 2005-08-04 | 2010-09-23 | C.R. Bard, Inc. | System for introducing implants |
US20100261950A1 (en) * | 2006-06-22 | 2010-10-14 | Ams Research Corporation | Adjustable Tension Incontinence Sling Assemblies |
US20110015479A1 (en) * | 2004-04-30 | 2011-01-20 | Anderson Kimberly A | Method and apparatus for treating pelvic organ prolapse |
US20110034759A1 (en) * | 2006-10-26 | 2011-02-10 | Ogdahl Jason W | Surgical articles and methods for treating pelvic conditions |
US7909753B1 (en) * | 2005-10-05 | 2011-03-22 | Ams Research Corporation | Connector for mesh support insertion |
US20110112357A1 (en) * | 2006-06-16 | 2011-05-12 | Ams Research Corporation | Surgical implants, tools, and methods for treating pelvic conditions |
US20110160527A1 (en) * | 2009-12-31 | 2011-06-30 | Ams Research Corporation | Suture-less Tissue Fixation for Implantable Device |
US8007430B2 (en) | 2000-10-12 | 2011-08-30 | Coloplast A/S | Apparatus and method for treating female urinary incontinence |
US20120046517A1 (en) * | 2010-08-18 | 2012-02-23 | Konstantin Lazarov Valtchev | Second generation tape |
US8123671B2 (en) | 2005-08-04 | 2012-02-28 | C.R. Bard, Inc. | Pelvic implant systems and methods |
US8128554B2 (en) | 2000-10-12 | 2012-03-06 | Coloplast A/S | System for introducing a pelvic implant |
US8469875B2 (en) | 2000-07-05 | 2013-06-25 | Coloplast A/S | Method and device for treating urinary incontinence |
US8480559B2 (en) | 2006-09-13 | 2013-07-09 | C. R. Bard, Inc. | Urethral support system |
US8574149B2 (en) | 2007-11-13 | 2013-11-05 | C. R. Bard, Inc. | Adjustable tissue support member |
US8602965B2 (en) | 2001-03-09 | 2013-12-10 | Boston Scientific Scimed, Inc. | System, methods and devices relating to delivery of medical implants |
US8708885B2 (en) | 2007-09-21 | 2014-04-29 | Ams Research Corporation | Pelvic floor treatments and related tools and implants |
US8709471B2 (en) | 2003-03-27 | 2014-04-29 | Coloplast A/S | Medicament delivery device and a method of medicament delivery |
US8808162B2 (en) | 2011-03-28 | 2014-08-19 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
US8845512B2 (en) | 2005-11-14 | 2014-09-30 | C. R. Bard, Inc. | Sling anchor system |
USD721175S1 (en) | 2011-09-08 | 2015-01-13 | Ams Research Corporation | Backers for surgical indicators |
USD721807S1 (en) | 2011-09-08 | 2015-01-27 | Ams Research Corporation | Surgical indicators |
US8986188B2 (en) | 2007-04-28 | 2015-03-24 | The Board Of Trustees Of The Leland Stanford Junior University | Dynamic and adjustable support devices |
US9005222B2 (en) | 2002-08-02 | 2015-04-14 | Coloplast A/S | Self-anchoring sling and introducer system |
US9017243B2 (en) | 2008-08-25 | 2015-04-28 | Ams Research Corporation | Minimally invasive implant and method |
US9089393B2 (en) | 2011-03-28 | 2015-07-28 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
USD736382S1 (en) | 2011-09-08 | 2015-08-11 | Ams Research Corporation | Surgical indicator with backers |
US9125717B2 (en) | 2011-02-23 | 2015-09-08 | Ams Research Corporation | Implant tension adjustment system and method |
US9226809B2 (en) | 2009-02-10 | 2016-01-05 | Ams Research Corporation | Surgical articles and methods for treating urinary incontinence |
US9345473B2 (en) | 2009-12-30 | 2016-05-24 | Astora Women's Health, Llc | Implantable sling systems and methods |
US9351723B2 (en) | 2011-06-30 | 2016-05-31 | Astora Women's Health, Llc | Implants, tools, and methods for treatments of pelvic conditions |
US9364308B2 (en) | 2009-12-30 | 2016-06-14 | Astora Women's Health, Llc | Implant systems with tensioning feedback |
US9381076B2 (en) | 2010-02-23 | 2016-07-05 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US9414903B2 (en) | 2011-07-22 | 2016-08-16 | Astora Women's Health, Llc | Pelvic implant system and method |
US9445881B2 (en) | 2010-02-23 | 2016-09-20 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US9468512B2 (en) | 2010-10-06 | 2016-10-18 | Astora Women's Health, Llc | Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions |
US9492259B2 (en) | 2011-03-30 | 2016-11-15 | Astora Women's Health, Llc | Expandable implant system |
US9492191B2 (en) | 2011-08-04 | 2016-11-15 | Astora Women's Health, Llc | Tools and methods for treatment of pelvic conditions |
US9572648B2 (en) | 2010-12-21 | 2017-02-21 | Justin M. Crank | Implantable slings and anchor systems |
US9622848B2 (en) | 2011-02-23 | 2017-04-18 | Boston Scientific Scimed, Inc. | Urethral stent system and method |
US9782245B2 (en) | 2011-03-30 | 2017-10-10 | James R. Mujwid | Implants, tools, and methods for treatment of pelvic conditions |
US9918816B2 (en) | 2008-08-25 | 2018-03-20 | Boston Scientific Scimed, Inc. | Minimally invasive implant and method |
US9943390B2 (en) | 2001-03-30 | 2018-04-17 | Coloplast A/S | Method of treating pelvic organ prolapse in a female patient by accessing a prolapsed organ trans-vaginally through a vagina |
US10028813B2 (en) | 2010-07-22 | 2018-07-24 | Boston Scientific Scimed, Inc. | Coated pelvic implant device and method |
US10034735B2 (en) | 2011-03-28 | 2018-07-31 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatments of pelvic conditions |
US10058240B2 (en) | 2011-06-29 | 2018-08-28 | Boston Scientific Scimed, Inc. | Systems, implants, tools, and methods for treatments of pelvic conditions |
US10098721B2 (en) | 2011-09-01 | 2018-10-16 | Boston Scientific Scimed, Inc. | Pelvic implant needle system and method |
US10390813B2 (en) | 2011-08-05 | 2019-08-27 | Boston Scientific Scimed, Inc. | Systems, implants, tools, and methods for treatments of pelvic conditions |
US10500027B2 (en) | 2011-06-30 | 2019-12-10 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatments of pelvic conditions |
US11284983B2 (en) | 2011-07-22 | 2022-03-29 | Boston Scientific Scimed, Inc. | Pelvic implant system and method |
Families Citing this family (123)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
SE506164C2 (en) | 1995-10-09 | 1997-11-17 | Medscand Medical Ab | Instruments for the treatment of urinary incontinence in women |
US6039686A (en) | 1997-03-18 | 2000-03-21 | Kovac; S. Robert | System and a method for the long term cure of recurrent urinary female incontinence |
US6599235B2 (en) | 1997-03-18 | 2003-07-29 | American Medical Systems Inc. | Transvaginal bone anchor implantation device |
US6382214B1 (en) | 1998-04-24 | 2002-05-07 | American Medical Systems, Inc. | Methods and apparatus for correction of urinary and gynecological pathologies including treatment of male incontinence and female cystocele |
US6932759B2 (en) | 1999-06-09 | 2005-08-23 | Gene W. Kammerer | Surgical instrument and method for treating female urinary incontinence |
US7226407B2 (en) * | 1999-06-09 | 2007-06-05 | Ethicon, Inc. | Surgical instrument and method for treating female urinary incontinence |
DK1581162T3 (en) | 1999-06-09 | 2011-08-01 | Ethicon Inc | Device for adjusting polymer implants on soft surfaces |
US7121997B2 (en) * | 1999-06-09 | 2006-10-17 | Ethicon, Inc. | Surgical instrument and method for treating female urinary incontinence |
GB2359256B (en) * | 2000-01-21 | 2004-03-03 | Sofradim Production | Percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape |
US7131943B2 (en) * | 2000-03-09 | 2006-11-07 | Ethicon, Inc. | Surgical instrument and method for treating organ prolapse conditions |
DE10019604C2 (en) * | 2000-04-20 | 2002-06-27 | Ethicon Gmbh | implant |
US6592515B2 (en) | 2000-09-07 | 2003-07-15 | Ams Research Corporation | Implantable article and method |
FR2814939B1 (en) * | 2000-10-05 | 2002-12-20 | Sofradim Production | SUB-URETRAL SUPPORT KIT FOR THE TREATMENT OF URINARY INCONTINENCE OF FEMALE EXERCISE |
US6689047B2 (en) * | 2000-11-15 | 2004-02-10 | Scimed Life Systems, Inc. | Treating urinary incontinence |
US20020161382A1 (en) * | 2001-03-29 | 2002-10-31 | Neisz Johann J. | Implant inserted without bone anchors |
DE10107520A1 (en) * | 2001-02-17 | 2002-10-02 | Siegfried Riek | Instruments for the operative treatment of urinary incontinence in women |
WO2002071931A1 (en) | 2001-03-09 | 2002-09-19 | Scimed Life Systems, Inc. | Medical slings |
DE60239188D1 (en) * | 2001-03-09 | 2011-03-31 | Boston Scient Ltd | SYSTEM FOR INSERTING A SLING |
US8033983B2 (en) | 2001-03-09 | 2011-10-11 | Boston Scientific Scimed, Inc. | Medical implant |
US7037255B2 (en) * | 2001-07-27 | 2006-05-02 | Ams Research Corporation | Surgical instruments for addressing pelvic disorders |
DE20204669U1 (en) * | 2002-03-23 | 2003-08-07 | Aesculap AG & Co. KG, 78532 Tuttlingen | Strip for treating urinary incontinence, especially for women, by implantation in abdomen, is flexible and preferably consists (partly) of resorbable material, e.g. polyvinyl alcohol |
DE10138955A1 (en) * | 2001-08-03 | 2003-02-20 | Aesculap Ag & Co Kg | Surgical instrument has curved shaft, handle with fastening, pointed shaft ends, locking slide-piece and sprung detents |
ES2269745T3 (en) | 2001-08-03 | 2007-04-01 | AESCULAP AG & CO. KG | BAND FOR THE TREATMENT OF URINARY INCONTINENCE. |
DE10138950A1 (en) * | 2001-08-03 | 2003-02-20 | Aesculap Ag & Co Kg | Strip for treating urinary incontinence, especially for women, by implantation in abdomen, is flexible and preferably consists (partly) of resorbable material, e.g. polyvinyl alcohol |
US7087065B2 (en) * | 2001-10-04 | 2006-08-08 | Ethicon, Inc. | Mesh for pelvic floor repair |
US6673010B2 (en) * | 2001-10-22 | 2004-01-06 | T. A. G. Medical Products Ltd. | Biological vessel suspending assembly and systems and methods utilizing same |
US8968178B2 (en) | 2002-03-07 | 2015-03-03 | Ams Research Corporation | Transobturator surgical articles and methods |
FR2836820B1 (en) * | 2002-03-08 | 2004-12-17 | Vincent Goria | SURGICAL DEVICE AND STRIP FOR THE TREATMENT OF URINARY EFFORT INCONTINENCE IN WOMEN |
DE10211360A1 (en) * | 2002-03-14 | 2003-10-09 | Ethicon Gmbh | Implantate band and surgical needle system to support female urethra has distal end region of needle narrower than implantate band |
AU2003229899A1 (en) * | 2002-04-11 | 2003-10-27 | Gyne Ideas Limited | Apparatus and method for treating female urinary incontinence |
WO2003092546A2 (en) | 2002-04-30 | 2003-11-13 | Cook Urological Inc. | Sling for supporting tissue |
US7371245B2 (en) | 2002-08-02 | 2008-05-13 | C R Bard, Inc | Transobturator introducer system for sling suspension system |
US7637384B2 (en) * | 2002-08-09 | 2009-12-29 | Crown Packaging Technology, Inc. | Tamper evident closure with locking band and container therefor |
CA2510570A1 (en) | 2002-12-17 | 2004-07-22 | Boston Scientific Limited | Spacer for sling delivery system |
US7494495B2 (en) | 2003-03-28 | 2009-02-24 | Coloplast A/S | Method and implant for curing cystocele |
US8012080B2 (en) * | 2003-04-25 | 2011-09-06 | Boston Scientific Scimed, Inc. | Systems and methods for sling delivery and placement |
WO2005016184A1 (en) | 2003-08-14 | 2005-02-24 | Scimed Life System, Inc. | Surgical slings |
US8545386B2 (en) | 2003-08-14 | 2013-10-01 | Boston Scientific Scimed, Inc. | Surgical slings |
US7303525B2 (en) * | 2003-08-22 | 2007-12-04 | Ams Research Corporation | Surgical article and methods for treating female urinary incontinence |
FR2859624B1 (en) | 2003-09-16 | 2005-12-02 | Sofradim Production | PROTHETIC KNIT WITH VARIABLE PROPERTIES |
WO2005034765A2 (en) | 2003-10-03 | 2005-04-21 | Scimed Life Systems, Inc. | Systems for a delivering a medical implant to an anatomical location in a patient |
WO2005094721A1 (en) * | 2004-03-30 | 2005-10-13 | Proxy Biomedical Limited | A medical device |
WO2005094741A1 (en) * | 2004-03-30 | 2005-10-13 | Proxy Biomedical Limited | Sling for treatment of urinary stress incontinence and/or pelvic floor prolapse |
ES2546393T3 (en) | 2004-04-20 | 2015-09-23 | Genzyme Corporation | Surgical mesh implant |
US8439820B2 (en) | 2004-05-06 | 2013-05-14 | Boston Scientific Scimed, Inc. | Systems and methods for sling delivery and placement |
US8047982B2 (en) * | 2004-05-07 | 2011-11-01 | Ethicon, Inc. | Mesh tape with wing-like extensions for treating female urinary incontinence |
US8062206B2 (en) | 2004-05-07 | 2011-11-22 | Ams Research Corporation | Method and apparatus for treatment of vaginal anterior repairs |
EP1765218B1 (en) | 2004-06-14 | 2014-06-11 | Boston Scientific Limited | An implantable sling for treating urinary incontinence |
CN101027013B (en) | 2004-07-28 | 2010-06-16 | 伊西康公司 | Minimally invasive medical implant and insertion device and method for using the same |
US7914437B2 (en) | 2005-02-04 | 2011-03-29 | Ams Research Corporation | Transobturator methods for installing sling to treat incontinence, and related devices |
WO2006084167A1 (en) | 2005-02-04 | 2006-08-10 | Ams Research Corporation | Needle design for male transobturator sling |
US20060195006A1 (en) * | 2005-02-28 | 2006-08-31 | Daurelle Bernard Adrien S | Intraurethral incontinence device and methods |
US20060199996A1 (en) * | 2005-03-04 | 2006-09-07 | Ricardo Caraballo | Sling for supporting and occluding a tissue and method of using the same |
ES2536748T3 (en) | 2005-04-06 | 2015-05-28 | Boston Scientific Limited | Systems and devices to treat pelvic floor disorders |
US20060281967A1 (en) * | 2005-04-22 | 2006-12-14 | Sofradim Production | Prosthetic safeguard for support implants |
US7393320B2 (en) * | 2005-04-29 | 2008-07-01 | Ams Research Corporation | Pelvic floor health articles and procedures |
US8043205B2 (en) | 2005-07-13 | 2011-10-25 | Boston Scientific Scimed, Inc. | Snap fit sling anchor system |
US7878969B2 (en) | 2005-07-25 | 2011-02-01 | Boston Scientific Scimed, Inc. | Pelvic floor repair system |
US7935046B2 (en) * | 2005-08-11 | 2011-05-03 | Boston Scientific Scimed, Inc. | Systems, methods and devices relating to a removable sleeve for an implantable sling |
US7951066B2 (en) * | 2005-08-17 | 2011-05-31 | Boston Scientific Scimed, Inc. | Medical device positioning assemblies and methods |
US7878970B2 (en) * | 2005-09-28 | 2011-02-01 | Boston Scientific Scimed, Inc. | Apparatus and method for suspending a uterus |
US9144483B2 (en) * | 2006-01-13 | 2015-09-29 | Boston Scientific Scimed, Inc. | Placing fixation devices |
US7922648B1 (en) * | 2006-02-14 | 2011-04-12 | Pacesetter, Inc. | Myocardial infarction patch for minimally invasive implant |
US8195296B2 (en) * | 2006-03-03 | 2012-06-05 | Ams Research Corporation | Apparatus for treating stress and urge incontinence |
CA2644983C (en) | 2006-03-16 | 2015-09-29 | Boston Scientific Limited | System and method for treating tissue wall prolapse |
US8160710B2 (en) | 2006-07-10 | 2012-04-17 | Ams Research Corporation | Systems and methods for implanting tissue stimulation electrodes in the pelvic region |
WO2008042438A2 (en) * | 2006-10-03 | 2008-04-10 | Boston Scientific Scimed, Inc. | Systems and devices for treating pelvic floor disorders |
WO2008144451A1 (en) * | 2007-05-15 | 2008-11-27 | Generic Medical Devices, Inc. | Needle instruments and implantable sling assembly; kits comprising these components; and methods for use |
US8933290B2 (en) * | 2007-06-26 | 2015-01-13 | Sofradim Production Sas | Mesh implant |
CA2691137C (en) * | 2007-06-29 | 2015-06-02 | Ams Research Corporation | Surgical articles and methods for treating pelvic conditions |
US9427573B2 (en) | 2007-07-10 | 2016-08-30 | Astora Women's Health, Llc | Deployable electrode lead anchor |
US20100049289A1 (en) | 2007-07-10 | 2010-02-25 | Ams Research Corporation | Tissue anchor |
US8623034B2 (en) | 2007-10-19 | 2014-01-07 | Ethicon, Gmbh | Soft tissue repair implant |
US9282958B2 (en) | 2007-12-28 | 2016-03-15 | Boston Scientific Scimed, Inc. | Devices and method for treating pelvic dysfunctions |
US8430807B2 (en) | 2007-12-28 | 2013-04-30 | Boston Scientific Scimed, Inc. | Devices and methods for treating pelvic floor dysfunctions |
US8920306B2 (en) | 2007-12-28 | 2014-12-30 | Boston Scientific Scimed, Inc. | Devices and methods for delivering a pelvic implant |
US9078728B2 (en) * | 2007-12-28 | 2015-07-14 | Boston Scientific Scimed, Inc. | Devices and methods for delivering female pelvic floor implants |
US9271706B2 (en) | 2008-08-12 | 2016-03-01 | Covidien Lp | Medical device for wound closure and method of use |
US8241654B2 (en) * | 2008-09-26 | 2012-08-14 | Tyco Healthcare Group Lp | Reactive surgical implant |
US20100104608A1 (en) * | 2008-09-26 | 2010-04-29 | Tyco Healthcare Group Lp | Reactive surgical implant |
US20100111919A1 (en) * | 2008-10-31 | 2010-05-06 | Tyco Healthcare Group Lp | Delayed gelation compositions and methods of use |
US8449573B2 (en) | 2008-12-05 | 2013-05-28 | Boston Scientific Scimed, Inc. | Insertion device and method for delivery of a mesh carrier |
US9539433B1 (en) | 2009-03-18 | 2017-01-10 | Astora Women's Health, Llc | Electrode implantation in a pelvic floor muscular structure |
US9125716B2 (en) | 2009-04-17 | 2015-09-08 | Boston Scientific Scimed, Inc. | Delivery sleeve for pelvic floor implants |
US8968334B2 (en) | 2009-04-17 | 2015-03-03 | Boston Scientific Scimed, Inc. | Apparatus for delivering and anchoring implantable medical devices |
US8298187B2 (en) | 2009-07-07 | 2012-10-30 | Cook Medical Technologies Llc | Fluid injection device |
US20110087273A1 (en) | 2009-10-08 | 2011-04-14 | Tyco Healthcare Group Lp | Wound Closure Device |
US20110087274A1 (en) * | 2009-10-08 | 2011-04-14 | Tyco Healtcare Group LP, New Haven, Ct | Wound Closure Device |
US8617206B2 (en) | 2009-10-08 | 2013-12-31 | Covidien Lp | Wound closure device |
US9833225B2 (en) | 2009-10-08 | 2017-12-05 | Covidien Lp | Wound closure device |
US9301750B2 (en) | 2009-11-03 | 2016-04-05 | Boston Scientific Scimed, Inc. | Device and method for delivery of mesh-based devices |
WO2011079222A2 (en) * | 2009-12-23 | 2011-06-30 | Boston Scientific Scimed, Inc. | Less traumatic method of delivery of mesh-based devices into human body |
US8380312B2 (en) | 2009-12-31 | 2013-02-19 | Ams Research Corporation | Multi-zone stimulation implant system and method |
US9277936B2 (en) * | 2010-01-11 | 2016-03-08 | Kenneth Finkelstein | Surgical instrument having an integrated local anesthetic delivery system |
AU2011252893B9 (en) | 2010-05-13 | 2015-11-19 | Boston Scientific Scimed, Inc. | Implantable mechanical support |
US9381030B2 (en) * | 2010-07-15 | 2016-07-05 | Nuvectra Corporation | Tunneling tool for implantable leads |
US8684908B2 (en) * | 2010-08-26 | 2014-04-01 | Ethicon, Inc. | Centering aid for implantable sling |
US8911348B2 (en) | 2010-09-02 | 2014-12-16 | Boston Scientific Scimed, Inc. | Pelvic implants and methods of implanting the same |
US9968428B2 (en) | 2010-12-16 | 2018-05-15 | Boston Scientific Scimed, Inc. | Surgical tools, systems, and related implants and methods |
US9636201B2 (en) | 2011-05-12 | 2017-05-02 | Boston Scientific Scimed, Inc. | Delivery members for delivering an implant into a body of a patient |
US9113991B2 (en) | 2011-05-12 | 2015-08-25 | Boston Scientific Scimed, Inc. | Anchors for bodily implants and methods for anchoring bodily implants into a patient's body |
US9220887B2 (en) | 2011-06-09 | 2015-12-29 | Astora Women's Health LLC | Electrode lead including a deployable tissue anchor |
US9750839B2 (en) | 2011-06-30 | 2017-09-05 | Covidien Lp | Drug eluting medical devices |
EP2753397B1 (en) | 2011-09-08 | 2017-01-11 | AMS Research Corporation | Implantable electrode assembly |
US9168120B2 (en) | 2011-09-09 | 2015-10-27 | Boston Scientific Scimed, Inc. | Medical device and methods of delivering the medical device |
AU2012313984B2 (en) | 2011-09-30 | 2016-02-11 | Covidien Lp | Reversible stiffening of light weight mesh |
US20130156935A1 (en) | 2011-12-14 | 2013-06-20 | Rachit Ohri | Methods for Coating Medical Devices |
US10278694B2 (en) | 2012-02-23 | 2019-05-07 | Northwestern University | Indirect attachment of a needle to a mesh suture |
ES2655821T3 (en) | 2012-02-23 | 2018-02-21 | Northwestern University | Enhanced Suture |
EP2633876B1 (en) | 2012-03-02 | 2014-09-24 | Cook Medical Technologies LLC | Dilation cap for endoluminal device |
EP2908768A4 (en) | 2012-10-22 | 2016-06-08 | Ams Res Corp | System and method for treatment of anal and fecal incontinence |
US9078730B2 (en) * | 2013-03-08 | 2015-07-14 | Ethicon, Inc. | Surgical instrument and method for the treatment of urinary incontinence |
US9814555B2 (en) | 2013-03-12 | 2017-11-14 | Boston Scientific Scimed, Inc. | Medical device for pelvic floor repair and method of delivering the medical device |
WO2014162432A1 (en) | 2013-04-01 | 2014-10-09 | テルモ株式会社 | Medical tube and medical tube assembly |
US20160051354A1 (en) * | 2013-05-02 | 2016-02-25 | Mangesh Patankar | Sling system with removable string |
WO2014178979A2 (en) | 2013-05-03 | 2014-11-06 | Cullison James W | Urological Implant |
US9867733B2 (en) | 2013-08-01 | 2018-01-16 | Cook Medical Technologies Llc | Tissue adjustment implant |
US9962251B2 (en) | 2013-10-17 | 2018-05-08 | Boston Scientific Scimed, Inc. | Devices and methods for delivering implants |
US9364311B2 (en) | 2013-12-13 | 2016-06-14 | Covidien Lp | Endoscopic system for winding and inserting a mesh |
CN106137331B (en) * | 2015-03-22 | 2018-08-07 | 周星 | Puncturing lever and puncture outfit |
EP3398554A1 (en) | 2017-05-02 | 2018-11-07 | Sofradim Production | Prosthesis for inguinal hernia repair |
US11576666B2 (en) | 2019-10-04 | 2023-02-14 | Arthrex, Inc | Surgical constructs for tissue fixation and methods of tissue repairs |
US20220202551A1 (en) * | 2020-12-31 | 2022-06-30 | Mickey M. Karram | Device for treating urinary stress incontinence |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5112344A (en) * | 1988-10-04 | 1992-05-12 | Petros Peter E | Surgical instrument and method of utilization of such |
US5836314A (en) * | 1991-12-03 | 1998-11-17 | Boston Scientific Technology, Inc. | Surgical treatment of stress urinary incontinence |
US5899909A (en) * | 1994-08-30 | 1999-05-04 | Medscand Medical Ab | Surgical instrument for treating female urinary incontinence |
US6091995A (en) * | 1996-11-08 | 2000-07-18 | Surx, Inc. | Devices, methods, and systems for shrinking tissues |
US6099547A (en) * | 1997-02-13 | 2000-08-08 | Scimed Life Systems, Inc. | Method and apparatus for minimally invasive pelvic surgery |
US6406423B1 (en) * | 2000-01-21 | 2002-06-18 | Sofradim Production | Method for surgical treatment of urinary incontinence and device for carrying out said method |
US6478727B2 (en) * | 2000-01-21 | 2002-11-12 | Sofradim Production | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
ES2064291B1 (en) * | 1993-07-08 | 1995-08-01 | Lopez Francisco Garcia | VAGINAL AUTOSUTURE DEVICE TO PREVENT INCONTINENCE OF WOMEN'S URINE. |
DE69808614T2 (en) * | 1997-02-13 | 2003-06-18 | Boston Scientific Ltd., St. Michael | STABILIZATION SLING FOR USE IN MINIMALLY INVASIVE PELVIC SURGERY |
EP1083831B1 (en) * | 1998-06-03 | 2010-09-29 | Medtronic, Inc. | Tissue connector apparatus |
US6010447A (en) * | 1998-07-31 | 2000-01-04 | Kardjian; Paul M. | Bladder sling |
DK1581162T3 (en) * | 1999-06-09 | 2011-08-01 | Ethicon Inc | Device for adjusting polymer implants on soft surfaces |
US6273852B1 (en) | 1999-06-09 | 2001-08-14 | Ethicon, Inc. | Surgical instrument and method for treating female urinary incontinence |
-
2001
- 2001-01-09 GB GB0100554A patent/GB2359256B/en not_active Revoked
- 2001-01-16 IT IT2001MI000067A patent/ITMI20010067A1/en unknown
- 2001-01-18 AT AT01907632T patent/ATE262835T1/en not_active IP Right Cessation
- 2001-01-18 ES ES01907632T patent/ES2217117T3/en not_active Expired - Lifetime
- 2001-01-18 AU AU35548/01A patent/AU777013B2/en not_active Ceased
- 2001-01-18 DK DK01907632T patent/DK1248567T3/en active
- 2001-01-18 PT PT01907632T patent/PT1248567E/en unknown
- 2001-01-18 TR TR2004/00694T patent/TR200400694T4/en unknown
- 2001-01-18 EP EP01907632A patent/EP1248567B1/en not_active Expired - Lifetime
- 2001-01-18 NZ NZ520883A patent/NZ520883A/en not_active IP Right Cessation
- 2001-01-18 WO PCT/FR2001/000167 patent/WO2001052750A1/en active IP Right Grant
- 2001-01-18 CA CA002397753A patent/CA2397753C/en not_active Expired - Fee Related
- 2001-01-18 DE DE60102557T patent/DE60102557T2/en not_active Expired - Lifetime
- 2001-01-19 ES ES200100121A patent/ES2187336B1/en not_active Expired - Fee Related
- 2001-01-19 DE DE10103179A patent/DE10103179A1/en not_active Withdrawn
- 2001-01-22 US US09/765,351 patent/US6478727B2/en not_active Expired - Lifetime
-
2002
- 2002-10-11 US US10/268,960 patent/US20030036676A1/en not_active Abandoned
-
2003
- 2003-04-11 HK HK03102668A patent/HK1051798A1/en not_active IP Right Cessation
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5112344A (en) * | 1988-10-04 | 1992-05-12 | Petros Peter E | Surgical instrument and method of utilization of such |
US5836314A (en) * | 1991-12-03 | 1998-11-17 | Boston Scientific Technology, Inc. | Surgical treatment of stress urinary incontinence |
US6056688A (en) * | 1991-12-03 | 2000-05-02 | Boston Scientific Technology, Inc. | Device and method for transvaginally suspending the bladder neck |
US5899909A (en) * | 1994-08-30 | 1999-05-04 | Medscand Medical Ab | Surgical instrument for treating female urinary incontinence |
US6091995A (en) * | 1996-11-08 | 2000-07-18 | Surx, Inc. | Devices, methods, and systems for shrinking tissues |
US6099547A (en) * | 1997-02-13 | 2000-08-08 | Scimed Life Systems, Inc. | Method and apparatus for minimally invasive pelvic surgery |
US6406423B1 (en) * | 2000-01-21 | 2002-06-18 | Sofradim Production | Method for surgical treatment of urinary incontinence and device for carrying out said method |
US6478727B2 (en) * | 2000-01-21 | 2002-11-12 | Sofradim Production | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape |
Cited By (228)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050131274A1 (en) * | 2000-05-07 | 2005-06-16 | Mentor Corporation, Minnesota Corporation | Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence |
US7927342B2 (en) | 2000-06-05 | 2011-04-19 | Boston Scientific Scimed, Inc. | Methods and devices for the treatment of urinary incontinence |
US20090209994A1 (en) * | 2000-06-05 | 2009-08-20 | Boston Scientific Scimed, Inc. | Methods and devices for the treatment of urinary incontinence |
US8469875B2 (en) | 2000-07-05 | 2013-06-25 | Coloplast A/S | Method and device for treating urinary incontinence |
US20030199732A1 (en) * | 2000-07-05 | 2003-10-23 | Mentor Corporation, A Minnesota Corporation | Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence |
US8920304B2 (en) | 2000-07-05 | 2014-12-30 | Coloplast A/S | Method and device for treating urinary incontinence |
US10278800B2 (en) | 2000-07-05 | 2019-05-07 | Coloplast A/S | Method and device for treating urinary incontinence |
US20040054253A1 (en) * | 2000-09-07 | 2004-03-18 | Snitkin Eva S. | Coated sling material |
US8147478B2 (en) | 2000-09-07 | 2012-04-03 | Ams Research Corporation | Coated sling material |
US7025063B2 (en) | 2000-09-07 | 2006-04-11 | Ams Research Corporation | Coated sling material |
US8469877B2 (en) | 2000-10-12 | 2013-06-25 | Coloplast A/S | System for introducing a pelvic implant |
US8449450B2 (en) | 2000-10-12 | 2013-05-28 | Coloplast A/S | Pass through introducer and sling |
US8118728B2 (en) | 2000-10-12 | 2012-02-21 | Coloplast A/S | Method for implanting an adjustable surgical implant for treating urinary incontinence |
US8047983B2 (en) | 2000-10-12 | 2011-11-01 | Coloplast A/S | Surgical system for supporting pelvic anatomy |
US10449025B2 (en) | 2000-10-12 | 2019-10-22 | Coloplast A/S | Surgical device implantable to treat female urinary incontinence |
US8123673B2 (en) | 2000-10-12 | 2012-02-28 | Coloplast A/S | Adjustable surgical implant for treating urinary incontinence |
US8128554B2 (en) | 2000-10-12 | 2012-03-06 | Coloplast A/S | System for introducing a pelvic implant |
US20110237874A1 (en) * | 2000-10-12 | 2011-09-29 | Coloplast A/S | Adjustable surgical implant and method for treating urinary incontinence |
US8007430B2 (en) | 2000-10-12 | 2011-08-30 | Coloplast A/S | Apparatus and method for treating female urinary incontinence |
US8162818B2 (en) | 2000-10-12 | 2012-04-24 | Coloplast A/S | Adjustable surgical implant for pelvic anatomy |
US8167785B2 (en) | 2000-10-12 | 2012-05-01 | Coloplast A/S | Urethral support system |
US8182412B2 (en) | 2000-10-12 | 2012-05-22 | Coloplast A/S | Pelvic implant with fibrous anchor |
US10076394B2 (en) | 2000-10-12 | 2018-09-18 | Coloplast A/S | Method of treating urinary incontinence |
US9968430B2 (en) | 2000-10-12 | 2018-05-15 | Coloplast A/S | Surgical device implantable to treat female urinary incontinence |
US8182413B2 (en) | 2000-10-12 | 2012-05-22 | Coloplast A/S | Method for fibrous anchoring of a pelvic support |
US9918817B2 (en) | 2000-10-12 | 2018-03-20 | Coloplast A/S | Method of post-operatively adjusting a urethral support in treating urinary incontinence of a woman |
US8273011B2 (en) | 2000-10-12 | 2012-09-25 | Coloplast A/S | Adjustable surgical implant and method for treating urinary incontinence |
US8454492B2 (en) | 2000-10-12 | 2013-06-04 | Coloplast A/S | Absorbable anchor and method for mounting mesh to tissue |
US8118727B2 (en) | 2000-10-12 | 2012-02-21 | Coloplast A/S | Method for supporting pelvic anatomy |
US8512223B2 (en) | 2000-10-12 | 2013-08-20 | Coloplast A/S | Pelvic implant with selective locking anchor |
US9113992B2 (en) | 2000-10-12 | 2015-08-25 | Coloplast A/S | Apparatus and method for treating urinary incontinence |
US9089396B2 (en) | 2000-10-12 | 2015-07-28 | Coloplast A/S | Urinary incontinence treatment and devices |
US8574148B2 (en) | 2000-10-12 | 2013-11-05 | Coloplast A/S | System for introducing soft tissue anchors |
US9089394B2 (en) | 2000-10-12 | 2015-07-28 | Coloplast A/S | Pelvic implant with suspending system |
US8668635B2 (en) | 2000-10-12 | 2014-03-11 | Coloplast A/S | Pelvic implant with suspending system |
US8932202B2 (en) | 2000-10-12 | 2015-01-13 | Coloplast A/S | Incontinence implant with soft tissue anchors and length not allowing abdominal wall penetration |
US8920308B2 (en) | 2000-10-12 | 2014-12-30 | Coloplast A/S | Surgical implant with anchor introducer channel |
US20080200751A1 (en) * | 2000-10-12 | 2008-08-21 | James Browning | Urethral support system |
US8801596B2 (en) | 2000-10-12 | 2014-08-12 | Coloplast A/S | Sling with support and suspending members formed from same polymer |
US8821369B2 (en) | 2000-10-12 | 2014-09-02 | Colorplast A/S | Method for soft tissue anchoring with introducer |
US8911347B2 (en) | 2000-10-12 | 2014-12-16 | Coloplast A/S | System and method for treating urinary incontinence |
US8888678B2 (en) | 2000-10-12 | 2014-11-18 | Coloplast A/S | Pelvic implant with suspending system |
US8821370B2 (en) | 2000-10-12 | 2014-09-02 | Coloplast A/S | Device, system and methods for introducing soft tissue anchors |
US8852075B2 (en) | 2000-10-12 | 2014-10-07 | Coloplast A/S | Pelvic implant systems and methods with expandable anchors |
US7972262B2 (en) | 2001-01-23 | 2011-07-05 | Ams Research Corporation | Sling assembly with secure and convenient attachment |
US20110230704A1 (en) * | 2001-01-23 | 2011-09-22 | Ams Research Corporation | Sling Assembly with Secure and Convenient Attachment |
US8864646B2 (en) | 2001-01-23 | 2014-10-21 | Ams Research Corporation | Surgical articles and methods |
US20040106845A1 (en) * | 2001-01-23 | 2004-06-03 | American Medical Systems | Surgical instrument and method |
US6641525B2 (en) | 2001-01-23 | 2003-11-04 | Ams Research Corporation | Sling assembly with secure and convenient attachment |
US8784295B2 (en) | 2001-01-23 | 2014-07-22 | Ams Research Corporation | Sling assembly with secure and convenient attachment |
US7867161B2 (en) | 2001-01-23 | 2011-01-11 | Ams Research Corporation | Sling delivery system and method of use |
US20030050530A1 (en) * | 2001-01-23 | 2003-03-13 | Neisz Johann J. | Surgical articles and methods |
US6652450B2 (en) | 2001-01-23 | 2003-11-25 | American Medical Systems, Inc. | Implantable article and method for treating urinary incontinence using means for repositioning the implantable article |
US8852077B2 (en) | 2001-01-23 | 2014-10-07 | Ams Research Corporation | Sling delivery system and method of use |
US20070225546A1 (en) * | 2001-01-23 | 2007-09-27 | Ams Research Corporation | Pelvic floor implant system and method of assembly |
US20110105831A1 (en) * | 2001-01-23 | 2011-05-05 | Ams Research Corporation | Sling Delivery System and Method of Use |
US7762942B2 (en) | 2001-01-23 | 2010-07-27 | Ams Research Corporation | Implantable article for the treatment of incontinence |
US20030130670A1 (en) * | 2001-01-23 | 2003-07-10 | Anderson Kimberly A. | Pelvic floor implant system and method of assembly |
US20030045774A1 (en) * | 2001-01-23 | 2003-03-06 | Staskin David R. | Sling delivery system and method of use |
US8475357B2 (en) | 2001-01-23 | 2013-07-02 | Ams Research Corporation | Sling delivery system and method of use |
US6612977B2 (en) | 2001-01-23 | 2003-09-02 | American Medical Systems Inc. | Sling delivery system and method of use |
US9717580B2 (en) | 2001-01-23 | 2017-08-01 | Astora Women's Health, Llc | Pelvic floor implant system and method of assembly |
US6802807B2 (en) | 2001-01-23 | 2004-10-12 | American Medical Systems, Inc. | Surgical instrument and method |
US10117733B2 (en) | 2001-03-09 | 2018-11-06 | Boston Scientific Scimed, Inc. | Systems, methods and devices relating to delivery of medical implants |
US20050131392A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US20050131391A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US8915927B2 (en) | 2001-03-09 | 2014-12-23 | Boston Scientific Scimed, Inc. | Systems, methods and devices relating to delivery of medical implants |
US9149261B2 (en) | 2001-03-09 | 2015-10-06 | Boston Scientific Scimed, Inc. | Systems, methods and devices relating to delivery of medical implants |
US8602965B2 (en) | 2001-03-09 | 2013-12-10 | Boston Scientific Scimed, Inc. | System, methods and devices relating to delivery of medical implants |
US20050131393A1 (en) * | 2001-03-09 | 2005-06-16 | Scimed Life Systems, Inc. | Systems, methods and devices relating to delivery of medical implants |
US9943390B2 (en) | 2001-03-30 | 2018-04-17 | Coloplast A/S | Method of treating pelvic organ prolapse in a female patient by accessing a prolapsed organ trans-vaginally through a vagina |
US10682213B2 (en) | 2001-03-30 | 2020-06-16 | Coloplast A/S | Surgical implant consisting of non-absorbable material |
US8777836B2 (en) | 2001-07-27 | 2014-07-15 | Ams Research Corporation | Pelvic health implants and methods |
US20080103351A1 (en) * | 2001-07-27 | 2008-05-01 | Montpetit Karen P | Pelvic health implants and methods |
US20040039453A1 (en) * | 2001-07-27 | 2004-02-26 | Anderson Kimberly A. | Pelvic health implants and methods |
US8702585B2 (en) | 2001-07-27 | 2014-04-22 | Ams Research Corporation | Pelvic health implants and methods |
US10206771B2 (en) | 2001-07-27 | 2019-02-19 | David STASKIN | Pelvic health implants and methods |
US6648921B2 (en) | 2001-10-03 | 2003-11-18 | Ams Research Corporation | Implantable article |
US8460170B2 (en) | 2002-03-01 | 2013-06-11 | Ethicon, Inc. | Method and apparatus for treating pelvic organ prolapses in female patients |
US20060173237A1 (en) * | 2002-03-01 | 2006-08-03 | Bernard Jacquetin | Method and apparatus for treating pelvic organ prolapses in female patients |
US20030220538A1 (en) * | 2002-03-01 | 2003-11-27 | Bernard Jacquetin | Method and apparatus for treating pelvic organ prolapses in female patients |
US8480556B2 (en) | 2002-03-01 | 2013-07-09 | Ethicon, Inc. | Method and apparatus for treating pelvic organ prolapses in female patients |
US7985173B2 (en) | 2002-03-01 | 2011-07-26 | Ethicon, Inc. | Method and apparatus for treating pelvic organ prolapses in female patients |
US20100191039A1 (en) * | 2002-03-07 | 2010-07-29 | Anderson Kimberly A | Transobturator surgical articles and methods |
US8043204B2 (en) | 2002-03-07 | 2011-10-25 | Ams Research Corporation | Transobturator surgical articles and methods |
US9433487B2 (en) | 2002-03-07 | 2016-09-06 | Astora Women's Health, Llc | Transobturator surgical articles and methods |
US20060063968A1 (en) * | 2002-03-07 | 2006-03-23 | Ams Research Corporation | Transobturator surgical articles and methods |
US7988615B2 (en) | 2002-03-07 | 2011-08-02 | Ams Research Corporation | Transobturator surgical articles and methods |
US8864648B2 (en) | 2002-03-07 | 2014-10-21 | Ams Research Corporation | Transobturator surgical articles and methods |
US20030176875A1 (en) * | 2002-03-07 | 2003-09-18 | Anderson Kimberly A. | Transobturator surgical articles and methods |
US9532862B2 (en) | 2002-08-02 | 2017-01-03 | Coloplast A/S | Self-anchoring sling and introducer system |
US9872750B2 (en) | 2002-08-02 | 2018-01-23 | Coloplast A/S | Self-anchoring sling and introducer system |
US9532861B2 (en) | 2002-08-02 | 2017-01-03 | Coloplast A/S | Self-anchoring sling and introducer system |
US9005222B2 (en) | 2002-08-02 | 2015-04-14 | Coloplast A/S | Self-anchoring sling and introducer system |
US8709471B2 (en) | 2003-03-27 | 2014-04-29 | Coloplast A/S | Medicament delivery device and a method of medicament delivery |
US9345867B2 (en) | 2003-03-27 | 2016-05-24 | Coloplast A/S | Device implantable in tissue of a prostate gland or a bladder |
US9555168B2 (en) | 2003-03-27 | 2017-01-31 | Coloplast A/S | System for delivery of medication in treatment of disorders of the pelvis |
US9186489B2 (en) | 2003-03-27 | 2015-11-17 | Coloplast A/S | Implantable delivery device system for delivery of a medicament to a bladder |
US20050004427A1 (en) * | 2003-04-30 | 2005-01-06 | Mauro Cervigni | Prosthesis for use in the surgical treatment of urogenital prolapse and female urinary incontinence |
US10070860B2 (en) | 2003-06-13 | 2018-09-11 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US9259221B2 (en) | 2003-06-13 | 2016-02-16 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US9987010B2 (en) | 2003-06-13 | 2018-06-05 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US8292933B2 (en) | 2003-06-13 | 2012-10-23 | Tyco Healthcare Group Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US8926637B2 (en) | 2003-06-13 | 2015-01-06 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20080281336A1 (en) * | 2003-06-13 | 2008-11-13 | Zergiebel Earl M | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20060241622A1 (en) * | 2003-06-13 | 2006-10-26 | Zergiebel Earl M | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US9788833B2 (en) | 2003-06-13 | 2017-10-17 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US20100191294A1 (en) * | 2003-06-13 | 2010-07-29 | Tyco Healthcare Group Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US9364274B2 (en) | 2003-06-13 | 2016-06-14 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US7670362B2 (en) | 2003-06-13 | 2010-03-02 | Tyco Healthcare Group Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US7824326B2 (en) | 2003-07-31 | 2010-11-02 | Boston Scientific Scimed, Inc. | Bioabsorbable casing for surgical sling assembly |
US20050027220A1 (en) * | 2003-07-31 | 2005-02-03 | James Wagner | Bioabsorbable casing for surgical sling assembly |
US8038594B2 (en) | 2003-09-22 | 2011-10-18 | Ams Research Corporation | Prolapse repair |
US20080119863A1 (en) * | 2003-09-22 | 2008-05-22 | Ams Research Corporation | Prolapse Repair |
US8753260B2 (en) | 2003-09-22 | 2014-06-17 | Ams Research Corporation | Prolapse repair |
US20090192540A1 (en) * | 2003-11-17 | 2009-07-30 | Boston Scientific Scimed, Inc. | Systems and methods relating to associating a medical implant with a delivery device |
US8323179B2 (en) | 2003-11-17 | 2012-12-04 | Boston Scientific Scimed, Inc. | Systems and methods relating to associating a medical implant with a delivery device |
US7338432B2 (en) | 2003-11-17 | 2008-03-04 | Konstantin Valtchev | Urethral sling introducer and method of use |
US20090137864A1 (en) * | 2004-04-30 | 2009-05-28 | Cox James E | Method and apparatus for treating pelvic organ prolapse |
US20050245787A1 (en) * | 2004-04-30 | 2005-11-03 | Ams Research Corporation | Method and apparatus for treating pelvic organ prolapse |
US8206281B2 (en) | 2004-04-30 | 2012-06-26 | Ams Research Corporation | Method and apparatus for treating pelvic organ prolapse |
US8211005B2 (en) | 2004-04-30 | 2012-07-03 | Ams Research Corporation | Method and apparatus for treating pelvic organ prolapse |
US20110015479A1 (en) * | 2004-04-30 | 2011-01-20 | Anderson Kimberly A | Method and apparatus for treating pelvic organ prolapse |
US7993261B2 (en) | 2004-05-07 | 2011-08-09 | Ams Research Corporation | Method and apparatus for cystocele repair |
US20080183031A1 (en) * | 2004-05-07 | 2008-07-31 | Ams Research Corporation | Method and Apparatus for Cystocele Repair |
US20050250977A1 (en) * | 2004-05-07 | 2005-11-10 | Ams Research Corporation | Method and apparatus for cystocele repair |
US8215310B2 (en) | 2004-05-21 | 2012-07-10 | Coloplast A/S | Implant for treatment of vaginal and/or uterine prolapse |
US20080196729A1 (en) * | 2004-05-21 | 2008-08-21 | Mpathy Medical Devices Limited | Implant for Treatment of Vaginal and/or Uterine Prolapse |
US10064714B2 (en) | 2004-05-21 | 2018-09-04 | Coloplast A/S | Implantable device configured to treat pelvic organ prolapse |
US9060838B2 (en) | 2004-05-21 | 2015-06-23 | Coloplast A/S | Tissue supported implantable device |
US7975698B2 (en) | 2004-05-21 | 2011-07-12 | Coloplast A/S | Implant for treatment of vaginal and/or uterine prolapse |
US20050278037A1 (en) * | 2004-06-11 | 2005-12-15 | Analytic Biosurgical Solutions-Abiss | Implant for the treatment of cystocele and rectocele |
US20050288708A1 (en) * | 2004-06-25 | 2005-12-29 | Kammerer Gene W | Soft tissue fastener having integral biasing section |
US20060058575A1 (en) * | 2004-09-15 | 2006-03-16 | Vincenza Zaddem | System and method for surgical implant placement |
US20060173468A1 (en) * | 2005-01-28 | 2006-08-03 | Marc Simmon | Obturator introducer with snare |
US20060196788A1 (en) * | 2005-02-02 | 2006-09-07 | Peter Komarnycky | Packaging assembly for surgical mesh implants |
US20100094079A1 (en) * | 2005-06-21 | 2010-04-15 | Ams Research Corporation | Method and Apparatus for Securing a Urethral Sling to Pubic Bone |
US9549799B2 (en) | 2005-06-21 | 2017-01-24 | Boston Scientific Scimed, Inc. | Surgical kit for securing an implantable sling in a pubic region |
US20100168505A1 (en) * | 2005-06-21 | 2010-07-01 | Ams Research Corporation | Methods and apparatus for securing a urethral sling to a pubic bone |
US8864650B2 (en) | 2005-06-21 | 2014-10-21 | Ams Research Corporation | Methods and apparatus for securing a urethral sling to a pubic bone |
US20090192347A1 (en) * | 2005-07-26 | 2009-07-30 | Ams Research Corporation | Methods and Systems for Treatment of Prolapse |
US9283064B2 (en) | 2005-07-26 | 2016-03-15 | Ams Research Corporation | Methods and systems for treatment of prolapse |
US9060839B2 (en) | 2005-07-26 | 2015-06-23 | Ams Research Corporation | Methods and systems for treatment of prolapse |
US8535217B2 (en) | 2005-07-26 | 2013-09-17 | Ams Research Corporation | Methods and systems for treatment of prolapse |
US8123671B2 (en) | 2005-08-04 | 2012-02-28 | C.R. Bard, Inc. | Pelvic implant systems and methods |
US20100241105A1 (en) * | 2005-08-04 | 2010-09-23 | C.R. Bard, Inc. | System for introducing implants |
US20080207989A1 (en) * | 2005-08-29 | 2008-08-28 | Ams Research Corporation | System For Positioning Support Mesh in a Patient |
US7909753B1 (en) * | 2005-10-05 | 2011-03-22 | Ams Research Corporation | Connector for mesh support insertion |
US9877717B2 (en) | 2005-10-05 | 2018-01-30 | Boston Scientific Scimed, Inc. | Connector for mesh support insertion |
US8845512B2 (en) | 2005-11-14 | 2014-09-30 | C. R. Bard, Inc. | Sling anchor system |
US7637860B2 (en) | 2005-11-16 | 2009-12-29 | Boston Scientific Scimed, Inc. | Devices for minimally invasive pelvic surgery |
US20070123746A1 (en) * | 2005-11-16 | 2007-05-31 | Boston Scientific Scimed, Inc. | Devices for minimally invasive pelvic surgery |
US20090318752A1 (en) * | 2006-03-15 | 2009-12-24 | C. R. Bard, Inc. | Implants for the treatment of pelvic floor disorders |
US20100010631A1 (en) * | 2006-05-19 | 2010-01-14 | John Fritz Otte | Method and articles for treatment of stress urinary incontinence |
US9084664B2 (en) | 2006-05-19 | 2015-07-21 | Ams Research Corporation | Method and articles for treatment of stress urinary incontinence |
US10271936B2 (en) | 2006-06-16 | 2019-04-30 | Boston Scientific Scimed, Inc. | Surgical implants, tools, and methods for treating pelvic conditions |
US8834350B2 (en) | 2006-06-16 | 2014-09-16 | Ams Research Corporation | Surgical implants, tools, and methods for treating pelvic conditions |
US20110112357A1 (en) * | 2006-06-16 | 2011-05-12 | Ams Research Corporation | Surgical implants, tools, and methods for treating pelvic conditions |
US20090259092A1 (en) * | 2006-06-22 | 2009-10-15 | Ogdahl Jason W | Adjustable Sling and Method of Treating Pelvic Conditions |
US8628463B2 (en) | 2006-06-22 | 2014-01-14 | Ams Research Corporation | Adjustable tension incontinence sling assemblies |
US8460169B2 (en) | 2006-06-22 | 2013-06-11 | Ams Research Corporation | Adjustable tension incontinence sling assemblies |
US20100261950A1 (en) * | 2006-06-22 | 2010-10-14 | Ams Research Corporation | Adjustable Tension Incontinence Sling Assemblies |
US20110124954A1 (en) * | 2006-06-22 | 2011-05-26 | Ams Research Corporation | Adjustable tension incontinence sling assemblies |
US10441400B2 (en) | 2006-06-22 | 2019-10-15 | Boston Scientific Scimed, Inc. | Adjustable tension incontinence sling assembles |
US9375302B2 (en) | 2006-06-22 | 2016-06-28 | Astora Women's Health, Llc | Adjustable tension incontinence sling assemblies |
US8480559B2 (en) | 2006-09-13 | 2013-07-09 | C. R. Bard, Inc. | Urethral support system |
US9585739B2 (en) | 2006-10-26 | 2017-03-07 | Ams Research Corporation | Surgical articles and methods for treating pelvic conditions |
US20110034759A1 (en) * | 2006-10-26 | 2011-02-10 | Ogdahl Jason W | Surgical articles and methods for treating pelvic conditions |
US8777837B2 (en) | 2006-10-26 | 2014-07-15 | Ams Research Corporation | Surgical articles and methods for treating pelvic |
US8388514B2 (en) | 2006-10-26 | 2013-03-05 | Ams Research Corporation | Surgical articles and methods for treating pelvic conditions |
US8986188B2 (en) | 2007-04-28 | 2015-03-24 | The Board Of Trustees Of The Leland Stanford Junior University | Dynamic and adjustable support devices |
US9113989B2 (en) | 2007-08-14 | 2015-08-25 | The Board Of Trustees Of The Leland Stanford Junior University | Methods and devices for supporting, elevating, or compressing internal structures |
US20090082617A1 (en) * | 2007-08-14 | 2009-03-26 | Vecchiotti Richard G | Methods and devices for supporting, elevating, or compressing internal structures |
US8708885B2 (en) | 2007-09-21 | 2014-04-29 | Ams Research Corporation | Pelvic floor treatments and related tools and implants |
US10010394B2 (en) | 2007-09-21 | 2018-07-03 | Boston Scientific Scimed, Inc. | Pelvic floor treatments and related tools and implants |
US9333065B2 (en) | 2007-09-21 | 2016-05-10 | Astora Women's Health, Llc | Pelvic floor treatments and related tools and implants |
US20090240104A1 (en) * | 2007-10-26 | 2009-09-24 | Ams Research Corporation | Surgical Articles and Methods for Treating Pelvic Conditions |
US8951185B2 (en) | 2007-10-26 | 2015-02-10 | Ams Research Corporation | Surgical articles and methods for treating pelvic conditions |
US8574149B2 (en) | 2007-11-13 | 2013-11-05 | C. R. Bard, Inc. | Adjustable tissue support member |
US10639138B2 (en) | 2008-02-28 | 2020-05-05 | Coloplast A/S | Method for providing support to a urethra in treating urinary incontinence |
US20100030016A1 (en) * | 2008-07-31 | 2010-02-04 | Knoll L Dean | Methods and Implants for Treating Urinary Incontinence |
US8727963B2 (en) | 2008-07-31 | 2014-05-20 | Ams Research Corporation | Methods and implants for treating urinary incontinence |
US9022922B2 (en) | 2008-07-31 | 2015-05-05 | Ams Research Corporation | Methods and implants for treating urinary incontinence |
US10039628B2 (en) | 2008-07-31 | 2018-08-07 | L. Dean Knoll | Methods and implants for treating urinary incontinence |
US10537416B2 (en) | 2008-08-25 | 2020-01-21 | Boston Scientific Scimed, Inc. | Minimally invasive implant and method |
US11547542B2 (en) | 2008-08-25 | 2023-01-10 | Boston Scientific Scimed, Inc. | Minimally invasive implant and method |
US9918816B2 (en) | 2008-08-25 | 2018-03-20 | Boston Scientific Scimed, Inc. | Minimally invasive implant and method |
US9017243B2 (en) | 2008-08-25 | 2015-04-28 | Ams Research Corporation | Minimally invasive implant and method |
US8944990B2 (en) | 2008-10-27 | 2015-02-03 | Ams Research Corporation | Surgical needle and anchor system with retractable features |
US20100105979A1 (en) * | 2008-10-27 | 2010-04-29 | Ams Research Corporation | Surgical Needle and Anchor System with Retractable Features |
US9226809B2 (en) | 2009-02-10 | 2016-01-05 | Ams Research Corporation | Surgical articles and methods for treating urinary incontinence |
US9345473B2 (en) | 2009-12-30 | 2016-05-24 | Astora Women's Health, Llc | Implantable sling systems and methods |
US9364308B2 (en) | 2009-12-30 | 2016-06-14 | Astora Women's Health, Llc | Implant systems with tensioning feedback |
US20110160527A1 (en) * | 2009-12-31 | 2011-06-30 | Ams Research Corporation | Suture-less Tissue Fixation for Implantable Device |
US9393091B2 (en) | 2009-12-31 | 2016-07-19 | Astora Women's Health, Llc | Suture-less tissue fixation for implantable device |
US11446129B2 (en) | 2010-02-23 | 2022-09-20 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US10478278B2 (en) | 2010-02-23 | 2019-11-19 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US9445881B2 (en) | 2010-02-23 | 2016-09-20 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US9381076B2 (en) | 2010-02-23 | 2016-07-05 | Boston Scientific Scimed, Inc. | Surgical articles and methods |
US10028813B2 (en) | 2010-07-22 | 2018-07-24 | Boston Scientific Scimed, Inc. | Coated pelvic implant device and method |
US20120046517A1 (en) * | 2010-08-18 | 2012-02-23 | Konstantin Lazarov Valtchev | Second generation tape |
US10492897B2 (en) | 2010-10-06 | 2019-12-03 | Boston Scientific Scimed, Inc. | Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions |
US9468512B2 (en) | 2010-10-06 | 2016-10-18 | Astora Women's Health, Llc | Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions |
US9572648B2 (en) | 2010-12-21 | 2017-02-21 | Justin M. Crank | Implantable slings and anchor systems |
US9125717B2 (en) | 2011-02-23 | 2015-09-08 | Ams Research Corporation | Implant tension adjustment system and method |
US9622848B2 (en) | 2011-02-23 | 2017-04-18 | Boston Scientific Scimed, Inc. | Urethral stent system and method |
US8808162B2 (en) | 2011-03-28 | 2014-08-19 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
US10034735B2 (en) | 2011-03-28 | 2018-07-31 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatments of pelvic conditions |
US9179992B2 (en) | 2011-03-28 | 2015-11-10 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
US10039629B2 (en) | 2011-03-28 | 2018-08-07 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatment of pelvic conditions |
US9089393B2 (en) | 2011-03-28 | 2015-07-28 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
US9750590B2 (en) | 2011-03-28 | 2017-09-05 | Andrew P. VanDeWeghe | Implants, tools, and methods for treatment of pelvic conditions |
US9737388B2 (en) | 2011-03-28 | 2017-08-22 | Ams Research Corporation | Implants, tools, and methods for treatment of pelvic conditions |
US9492259B2 (en) | 2011-03-30 | 2016-11-15 | Astora Women's Health, Llc | Expandable implant system |
US9782245B2 (en) | 2011-03-30 | 2017-10-10 | James R. Mujwid | Implants, tools, and methods for treatment of pelvic conditions |
US10058240B2 (en) | 2011-06-29 | 2018-08-28 | Boston Scientific Scimed, Inc. | Systems, implants, tools, and methods for treatments of pelvic conditions |
US10653411B2 (en) | 2011-06-30 | 2020-05-19 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatments of pelvic conditions |
US9351723B2 (en) | 2011-06-30 | 2016-05-31 | Astora Women's Health, Llc | Implants, tools, and methods for treatments of pelvic conditions |
US10500027B2 (en) | 2011-06-30 | 2019-12-10 | Boston Scientific Scimed, Inc. | Implants, tools, and methods for treatments of pelvic conditions |
US9414903B2 (en) | 2011-07-22 | 2016-08-16 | Astora Women's Health, Llc | Pelvic implant system and method |
US11284983B2 (en) | 2011-07-22 | 2022-03-29 | Boston Scientific Scimed, Inc. | Pelvic implant system and method |
US9492191B2 (en) | 2011-08-04 | 2016-11-15 | Astora Women's Health, Llc | Tools and methods for treatment of pelvic conditions |
US10390813B2 (en) | 2011-08-05 | 2019-08-27 | Boston Scientific Scimed, Inc. | Systems, implants, tools, and methods for treatments of pelvic conditions |
US10098721B2 (en) | 2011-09-01 | 2018-10-16 | Boston Scientific Scimed, Inc. | Pelvic implant needle system and method |
USD721175S1 (en) | 2011-09-08 | 2015-01-13 | Ams Research Corporation | Backers for surgical indicators |
USD746462S1 (en) | 2011-09-08 | 2015-12-29 | Ams Research Corporation | Surgical indicators |
USD721807S1 (en) | 2011-09-08 | 2015-01-27 | Ams Research Corporation | Surgical indicators |
USD736382S1 (en) | 2011-09-08 | 2015-08-11 | Ams Research Corporation | Surgical indicator with backers |
Also Published As
Publication number | Publication date |
---|---|
GB2359256A (en) | 2001-08-22 |
EP1248567A1 (en) | 2002-10-16 |
CA2397753C (en) | 2008-09-30 |
NZ520883A (en) | 2005-04-29 |
GB2359256B (en) | 2004-03-03 |
EP1248567B1 (en) | 2004-03-31 |
US20010018549A1 (en) | 2001-08-30 |
ATE262835T1 (en) | 2004-04-15 |
DE10103179A1 (en) | 2001-07-26 |
US6478727B2 (en) | 2002-11-12 |
DE60102557T2 (en) | 2004-09-23 |
AU777013B2 (en) | 2004-09-30 |
TR200400694T4 (en) | 2004-06-21 |
AU3554801A (en) | 2001-07-31 |
DK1248567T3 (en) | 2004-08-02 |
ES2187336B1 (en) | 2004-10-16 |
PT1248567E (en) | 2004-07-30 |
GB0100554D0 (en) | 2001-02-21 |
ITMI20010067A1 (en) | 2002-07-16 |
ES2217117T3 (en) | 2004-11-01 |
WO2001052750A1 (en) | 2001-07-26 |
CA2397753A1 (en) | 2001-07-26 |
HK1051798A1 (en) | 2003-08-22 |
DE60102557D1 (en) | 2004-05-06 |
ES2187336A1 (en) | 2003-06-01 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6478727B2 (en) | Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape | |
JP4777572B2 (en) | Transcutaneous device for treating female stress incontinence with suburethral tape | |
JP3776083B2 (en) | Suburethral support assembly in the treatment of female stress urinary incontinence | |
CA2523580C (en) | Systems and methods for sling delivery and placement | |
JP2961139B2 (en) | Suture passer | |
CA2423188C (en) | Surgical apparatus and methods for delivery of a sling in the treatment of female urinary incontinence | |
US20050000523A1 (en) | Introducer and perforator guide for placing a tape in the human body | |
AU2001293085A1 (en) | Surgical apparatus and methods for delivery of a sling in the treatment of female urinary incontinence | |
US9072584B2 (en) | Medical device positioning assemblies and methods | |
US9775699B2 (en) | Adjustable implant for the treatment of urinary incontinence | |
WO2015014909A1 (en) | Surgical device and method for treatment of female urinary incontinence under local anesthesia | |
US9737390B2 (en) | Medical assembly for delivering an implant | |
EP1922020B1 (en) | Medical device positioning assemblies |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |