WO2006100372A1 - Kit for folding a flexible parietal implant and corresponding folding method - Google Patents

Kit for folding a flexible parietal implant and corresponding folding method Download PDF

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Publication number
WO2006100372A1
WO2006100372A1 PCT/FR2006/000605 FR2006000605W WO2006100372A1 WO 2006100372 A1 WO2006100372 A1 WO 2006100372A1 FR 2006000605 W FR2006000605 W FR 2006000605W WO 2006100372 A1 WO2006100372 A1 WO 2006100372A1
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WO
WIPO (PCT)
Prior art keywords
folding
parietal implant
implant
parietal
kit according
Prior art date
Application number
PCT/FR2006/000605
Other languages
French (fr)
Inventor
Richard Jean-Claude Guetty
Original Assignee
Compagnie De Recherche En Composants, Implants Et Materiels Pour L'application Clinique
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Filing date
Publication date
Application filed by Compagnie De Recherche En Composants, Implants Et Materiels Pour L'application Clinique filed Critical Compagnie De Recherche En Composants, Implants Et Materiels Pour L'application Clinique
Publication of WO2006100372A1 publication Critical patent/WO2006100372A1/en

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Classifications

    • 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
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • 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
    • A61F2/0095—Packages or dispensers for prostheses or other implants
    • 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
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0072—Delivery tools therefor

Definitions

  • the present invention relates to the general technical field of devices for folding parietal implants, in particular parietal reinforcements made of textile material, with a view to their introduction into a tube, of the trocar kind, in order to allow implantation of the implant to be performed. through a small diameter incision, by laparoscopy.
  • the present invention relates more particularly to a kit for folding a parietal implant and transferring it to an outer tube, trocar-like.
  • the present invention also relates to a method of folding a substantially flexible parietal implant stored in a deployed configuration within a housing and then transferring said parietal implant into a tube outside the housing, for example a trocar.
  • parietal implants and in particular the parietal prostheses made of flexible textile material, such as parietal reinforcements intended to be used in the treatment of hernias are generally in the form of a substantially flat textile plate (or sheet) presenting, at the expanded state, a substantially smooth appearance and free of wrinkles, to promote the adhesion and the intimate contact between the parietal prosthesis and the body wall to be treated.
  • a substantially flat textile plate or sheet
  • the folding operation of the parietal implant is often performed manually by the surgeon, in the moments preceding the installation of the parietal implant, and involves a significant risk of contamination of the parietal implant, the surgeon having to manipulate the parietal implant directly several times during this operation.
  • the latter is necessarily led to manipulate the parietal implant, either to extract it from its storage package or to introduce it into the trocar.
  • the objects assigned to the invention therefore aim to remedy the various disadvantages listed above and to propose a new kit for folding and transferring a parietal implant into an outer tube requiring, at no time, direct manipulation of the implant. implant by the surgeon and thus limiting the risk of contamination of the implant.
  • Another object of the invention is to propose a new folding kit intended to be used just before implantation of the parietal implant, and which leaves no permanent and irreversible fold on said implant.
  • Another object of the invention is to provide a new folding kit which is particularly simple to use and has a reduced number of parts.
  • Another object of the invention is to propose a new folding kit that can be used with any standard, single-use or multi-purpose trocar.
  • Another object of the invention is to propose a new folding kit which also makes it easier to introduce the parietal implant into the trocar.
  • Another object of the invention is to propose a new folding kit allowing the introduction of the parietal implant into the trocar without the implant coming into contact with the surgeon's hands.
  • the objects assigned to the invention also aim at proposing a new method of folding a parietal implant and then transferring said parietal implant in the folded state to a trocar, which makes it possible to automatically and quickly fold the implant without risk of contaminate and this substantially avoiding any direct contact between the implant and the hands of the surgeon.
  • Another object of the invention is to propose a new method of folding and transfer of a parietal implant which is particularly simple and can be implemented substantially with all standard trocars.
  • a folding kit of a parietal implant and of transferring said parietal implant to an outer tube, of the trocar type comprising a housing in which are arranged: a substantially flexible parietal implant, stored in a deployed configuration and provided with a gripping means,
  • an extractable support comprising a folding chamber, extending between an inlet opening and an outlet opening, and in which the parietal implant is made to pass when the gripping means is actuated, said bending chamber being shaped to ensure the folding of the parietal implant between the inlet opening and the outlet opening, so that towards the outlet opening, the parietal implant has a folded configuration, said ⁇ xtractible support being provided , at the outlet opening, means for cooperating with the outer tube, shaped to facilitate the connection of the extractable support with said outer tube and thus ensure the transfer of the folded parietal implant, from the folding chamber to the outer tube.
  • a substantially flexible parietal implant stored in a deployed configuration within a housing and then of transferring said parietal implant into a tube outside the housing.
  • FIG. 1 illustrates, in an exploded perspective view, a folding kit of a parietal implant according to the invention.
  • FIG. 2 illustrates, in a front view in section, the folding kit illustrated in Figure 1, in a ready-to-use configuration.
  • FIG. 3 illustrates, in a view from above, the folding kit according to the invention in a configuration corresponding to the folding step of the parietal implant.
  • FIG. 4 illustrates, in a front view, the extractable support according to the invention connected to the tube, in a vertical position.
  • the folding and transfer kit 1 according to the invention is illustrated in FIGS. 1 to 3. It comprises, according to the invention, a housing 4, advantageously in the form of a rectangular-shaped tray, provided with a bottom 5 and delimited by an outer rim 6 rising upwards from the bottom 5 so as to delimit a storage space 30 of a parietal implant 2.
  • the kit 1 thus comprises, according to the invention, a parietal implant 2 substantially flexible, that is to say, sufficiently flexible to be folded so as to allow its introduction into a tube 3 of small diameter, such as a trocar used in laparoscopy, outside the kit 1 that is to say not necessarily disposed within the housing 4.
  • the tube 3 can be formed by a trocar for non-unique use, reusable for other interventions.
  • tissue implant refers to implants intended to be applied to tissues within the body, in particular on walls such as the abdominal wall, with a view to strengthening them. This term also refers to implants, such as resorbable films or not, capable of separating tissues or organs, for example to prevent postoperative adhesions.
  • the parietal implant 2 may take different geometric shapes, and may in particular be in the form of a plate or a rectangular sheet.
  • the parietal implant 2 is even more preferably formed by a textile piece, then forming a textile prosthesis.
  • the parietal implant is formed by a flexible thin film and for example by a film, resorbable or not, intended to prevent postoperative adhesions.
  • the parietal implant 2 may also be formed by a textile piece impregnated with biopolymers, for example biopolymers with a sticky or non-adhering effect, or covered by a film of biopolymers.
  • the parietal implant 2 then has an extra thickness compared to conventional textile parts, hence the essential role of the kit 1 which should allow to sufficiently reduce the lateral expansion of the implant, despite its extra thickness, to allow its introduction through the trocar.
  • the parietal implant 2 is, according to the invention, stored in a deployed configuration, that is to say not folded, within the housing 4 to prevent the formation of permanent and irreversible folds during the storage period s flowing between the manufacture of the kit 1 and the implantation of the parietal implant 2.
  • the parietal implant 2 is also provided with a gripping means 7 allowing the surgeon to indirectly manipulate the parietal implant 2 while substantially avoiding any direct contact with the latter, thus limiting the risks of contamination and contamination. of the parietal implant 2.
  • the kit 1 further comprises an extractable support 9 removably disposed within the housing 4, so as to be easily extracted from the latter.
  • the extractable support 9 comprises, according to the invention, a folding chamber 10 which extends between an inlet opening 11 and an outlet opening 12 and which is shaped to ensure the folding of the parietal implant 2, by folding back on itself, between the inlet opening 11 and the outlet opening 12.
  • the folding chamber 10 is advantageously structurally integrated with the extractable support 9 and more precisely formed inside the latter and thus mobile with said extractable support 9.
  • the gripping means 7, preferably formed by a pulling thread 8 When the gripping means 7, preferably formed by a pulling thread 8, is actuated, for example by pulling on the pulling thread 8 in a direction F substantially parallel to the bottom 5 and situated in the extension of the folding chamber 10, the parietal implant 2 is driven towards the inlet opening 11 of the folding chamber 10 and is made to transit through the latter, thus passing from a substantially deployed configuration at the level of the inlet opening 11 to a substantially folded configuration at the outlet opening 12.
  • the extractable support 9 is provided, at the outlet opening 12, with cooperation means 13 with the outer tube 3, shaped to facilitate the connection of the extractable support 9 with the tube 3 outside and thus ensure the transfer of the parietal implant 2 folded from the folding chamber 10 to the tube 3 outside.
  • the cooperation means 13 thus make it possible to relate the extractable support 9 to an outer tube 3 of standard diameter.
  • the kit 1 is provided with a means for closing the casing 4, in the form of a cover 14 able to cover the casing 4 in a substantially watertight manner, thereby guaranteeing the sterility of the casing.
  • the casing 4 provided with its cover 14 thus forms a sterile package for the parietal implant 2.
  • the extractable support 9 is advantageously arranged to form a means for temporarily receiving the parietal implant 2 in the folded state, enabling the latter to be transferred from the housing 4 to the tube 3 outside the housing, without having to directly handle the parietal implant 2.
  • the extractable support 9 is thus manipulable to be extracted from the housing 4 to be attached to the outer tube 3.
  • the folding chamber 10 is provided with focusing means 15, arranged so as to delimit a substantially convergent space 16 between the inlet opening 11 and the outlet opening 12 in order to ensure the progressive folding of the parietal implant 2 during its passage through the folding chamber 10.
  • the focusing means 15 preferably extend substantially continuously between the inlet opening 11 and the outlet opening 12 and have a geometric curvature substantially continuous and without stopping points so as to limit the risk of blocking the parietal implant 2 during its introduction into the folding chamber 10 or during its transit through the latter. Even more preferably, the focusing means 15 extend in a rectilinear manner over substantially the entire length of the folding chamber 10 so as to ensure a substantially continuous folding of the parietal implant 2.
  • the focusing means 15 are formed by at least two walls 17, 18 arranged substantially in V.
  • the volume available for the parietal implant 2 thus decreases progressively between the inlet opening 11 and the outlet opening 12, the walls 17, 18 exerting a reaction force on the parietal implant 2 tending to fold on itself as it passes along the folding chamber 10.
  • the inlet opening 11 has a sufficient size to allow the introduction of the parietal implant 2 in its deployed configuration within the folding chamber 10.
  • the inlet opening 11 is preferably as wide as the parietal implant 2 in the deployed state.
  • the extractable support 9 is preferably formed by a cone 19 substantially flattened in a direction substantially perpendicular to the horizontal plane of extension of the bottom 5.
  • the cone 19 advantageously defines the boundaries of the folding chamber 10 , the inlet opening 11 being located at the base of the cone 19 and the outlet opening 12 being located at the top of the cone 19.
  • the cone 19 comprises, in its horizontal configuration within the housing 4, an upper wall 19A , and a lower wall 19B which join to form the walls 17, 18.
  • the extractable support 9 is disposed within the housing 4 so as to rest, preferably directly, on the parietal implant 2 in the deployed state.
  • the bottom 5 of the housing 4 thus extends over a sufficient area so that the parietal implant 2 can lie flat in its deployed configuration.
  • the extractable support 9 comprises guide means 20 shaped and arranged in order to facilitate the introduction of the parietal implant 2 into the folding chamber 10.
  • the guiding means 20 are in particular shaped so as to prevent a possible blockage of the parietal implant 2 during its introduction into the folding chamber 10 and in particular when it is introduced into the cone 19.
  • the guide means 20 comprise at least one slide 21, extending substantially parallel to the folding chamber 10, and more precisely in the space between the folding chamber 10 and the parietal implant 2.
  • the slide 21 comes to bear, via a sliding face 21 'against the parietal implant 2 in the deployed state and thus ensures the maintenance of the parietal implant 2 flat within the storage box 4.
  • the extractable support 9 is advantageously held stationary, by compression, between the closed lid 14 and the bottom 5, thereby ensuring, by means of the slide 21, the immobility of the parietal implant 2 during the manipulation of the casing 4.
  • the slide 21 is particularly advantageously formed by a substantially flexible tongue 22, which is secured (by gluing, welding or by any other means) with the folding chamber 10 towards the 11, the junction between said tongue 22 and said folding chamber 10 forming a turning edge 23.
  • the tongue 22 is even more preferably integral with the folding chamber 10, and folded so as to extend under and along the latter (or under the cone 19).
  • the tongue 22 and the chamber of 10 extend away from each other by delimiting a passage 25, open on the outside so as to allow the gripping of the folding chamber 10.
  • the surgeon can introduce the hand within the passage 25 to maintain the extractable support 9, and more precisely the cone 19, facing the outer tube 3.
  • the tongue 22 and the folding chamber 10 are connected to the inlet opening 11 forming a loop 40, which thus allows a better maintenance of the extractable support 9 by the surgeon.
  • the tongue 22 is further preferably secured to the folding chamber 10 towards the outlet opening 12 so as to close the loop 40 on itself around the passage 25.
  • the handle 40 defines a passage 25 particularly narrow, and comes to grip the hand of the surgeon, thus facilitating the manipulation of the extractable support 9.
  • the end 22 'of the tongue 22, located substantially in line with the outlet opening 12, is preferably fixed, for example by means of an adhesive point 24 or by any other fastening means ( welding, clipping), on the bottom wall 19B of the cone 19.
  • the turning edge 23 has a substantially rounded curvature (FIG. 1) and thus makes it easier to introduce the parietal implant 2 inside the folding chamber 10, by turning it 180 ° with respect to its position in the deployed state on the bottom 5 of the casing 4.
  • the rounded shape of the turning edge 23 also makes it possible to slide the parietal implant 2 progressively towards the inside of the folding chamber 10, while limiting the risks wedging of the parietal implant 2 at the entrance of the folding chamber 10, when the surgeon pulls on the traction wire 8.
  • the parietal implant 2 is a textile prosthesis and has a mesh structure, it there is a significant risk of attachment of the prosthesis on the extractable support 9, and it is therefore appropriate to prefer, in the design of the extractable support 9, the blunt edges with the projecting edges.
  • the folding chamber 10 is sized to receive the entire the parietal implant 2 in an intermediate state between the fully deployed configuration and the fully folded configuration, and the distance separating the inlet opening 11 from the outlet opening 12 substantially corresponds to the length of the parietal implant 2.
  • the length of the folding chamber 10 is preferably greater than or equal to that of the parietal implant 2.
  • the cooperation means 13 are advantageously shaped to be introduced into the outer tube 3. Even more preferably, the cooperation means 13 are formed by a spout 26 sized to be introduced into a standard trocar, conventionally used for laparoscopies.
  • the extractable support 9 is provided, towards the outlet opening 12, with a substantially elongate guide member 50 projecting from the outside of the folding chamber 10 so as to facilitate the introduction pulling wire 8 in the tube 3, guiding it towards said tube 3.
  • the guide member 50 is preferably formed by a flexible tube 51 and substantially rectilinear, for example plastic material, secured to the end of the extractable support 9 located at the outlet opening 12 and s extending longitudinally in the extension of the folding chamber 10, coplanar with the latter.
  • the pulling thread 8 is then introduced into the split tube 51 during the assembly of the folding kit 1 so that the pulling thread 8 extends along the split tube 51 and is held inside the this last.
  • the guide member 50 further comprises a locking / unlocking means 52 shaped on the one hand to immobilize the pull wire 8 and hold it in position against the guide member 50, in order to prevent its movement to the outside. outside of said extractable support 9, and secondly to release it automatically when a tensile force is exerted on the pull wire 8.
  • the locking / unlocking means is preferably formed by a slot 52 formed in the guide member 50, and more precisely along the split tube 51, said slot 52 being adapted to receive the pull wire 8 to ensure its holding, by wedging.
  • the slot 52 extends longitudinally along the traction direction F 'of the traction wire 8.
  • the kit 1 comprises a holding means 60, able to hold the guide member 50 in folded position against the extractable support 9.
  • the holding means 60 is advantageously formed by a holding tab 61, fixed in a manner removable or not, by its two ends, on the extractable support 9 so as to maintain the guide member 50 flat against the extractable support 9.
  • the extractable support 9 is in the form of a preferably transparent monoblock structure, for example polyethylene terephthalate glycol (PETG), allowing the surgeon to visualize at any moment the parietal implant 2 during its folding, and thus enabling it to better control the folding operation of the parietal implant 2 and to avoid its blockage.
  • PETG polyethylene terephthalate glycol
  • the traction wire 8 is preferably formed by two parallel strands 8A, 8B, and extends between a first end portion 8 'secured to the parietal implant 2, and a second 8 "end portion, free and operable
  • the traction wire 8 is also disposed, before its actuation, so as to pass through the folding chamber ( Figures 1 and 2).
  • the first end portion 8 ' is laced at one of the edges 2A, 2B, 2C, 2D of the parietal implant 2 and advantageously winds through the latter in a geometric configuration such that when an effort traction is exerted on the traction wire 8, in a direction F substantially parallel to the bottom 5 and located in the extension of the folding chamber 10, the parietal implant 2 folds on itself in a fan forming a plurality of folds 27 (Figure 4).
  • the present invention also relates to a folding method of a substantially flexible parietal implant 2 stored in a deployed configuration within a housing 4, and transfer of the parietal implant 2 in a tube 3 outside the housing 4, for example a trocar, said method comprising: a step (a) of folding the parietal implant 2 during which a gripping means 7 is actuated, connected to the parietal implant 2 and preferably fixed thereto, so as to pass the parietal implant 2 through a folding chamber 10, formed in an extractable support 9 disposed within the housing 4, in order to fold said parietal implant 2 during its journey,
  • the step (b) of transfer also comprises a sub-step of actuating the gripping means 7 so as to transfer the parietal implant 2 of the folding chamber 10 to the tube 3.
  • the actuation of the means of gripping 7, preferably formed by the pull wire 8, is advantageously made by pulling on the latter.
  • the folding step (a) is carried out by making the parietal implant 2 progressively converge in a regularly continuous manner within the folding chamber 10, that is to say without abrupt change of direction in to avoid jamming against the extractable support 9.
  • the folding step (a) is carried out over substantially the entire length of the casing 4.
  • the method further comprises, in a particularly advantageous manner, a step (c) of tightening, preceding the folding step (a), during which the parietal implant 2 is tightened, by actuating the gripping means 7, in order to facilitate its introduction into the folding chamber 10. More specifically, the traction exerted on the gripping means 7 has the effect of folding the parietal implant 2 on itself to level of the edge 2A on which is laced the gripping means 7, formed by the traction wire 8.
  • the handling of the folding kit 1 according to the invention is carried out in the instant preceding the implantation of the parietal implant 2 into the body of the patient, with a view, for example, to repairing and reinforcing tissues, particularly in the part of the treatment of a hernia.
  • the surgeon begins by opening the lid 14 of the casing 4, enclosing the parietal implant 2 intended to be implanted and the folding assembly formed on the one hand by the pulling wire 8 and the extractable support 9, said casing resting on horizontally on a support, such as a table.
  • the surgeon can remove the retaining tab 61, which has the effect of releasing the guide member 50.
  • the surgeon then advantageously comes to bear, with one of his hands, on the retractable support 9, and more precisely on either side of the cone 19, on the tongue 22, and exert a downward force tending to press the tongue 22 on the parietal implant 2.
  • the surgeon can then pull, at the using his other free hand, on the second free end portion 8 "and actuable traction wire 8 in the direction F.
  • This traction operation has the effect of driving the parietal implant 2 to the folding chamber 10 extractable support 9, as shown in FIG. 3.
  • the tensile force exerted on the wire 8 has, advantageously, also the effect of starting to tighten the parietal implant 2 and to fold it on itself at the edge 2A on which is laced the traction wire 8
  • the parietal implant 2 then takes a slightly fan shape facilitating its introduction inside the folding chamber 10.
  • the parietal implant 2 undergoes a 180 ° turnaround on itself at the turning edge 23 and progressively penetrates inside the folding chamber 10 where the focusing means 15 and more precisely the walls 17, 18 of the cone 19 force it to fold more and more on itself, fan, as it approaches the outlet opening 12.
  • the surgeon can extract the extractable support 9, which then contains the parietal implant 2 substantially in its entirety, the housing 4 in view report it on the outer tube 3, preferably formed by a trocar.
  • the tube 3 is already positioned and introduced through an incision made on the body of the patient.
  • the surgeon introduces the pulling thread 8 into the tube 3 in such a way that the pulling thread 8 passes through the longitudinal passage 3 'formed in the tube 3 and to come into the cavity of the body where the treatment is practiced.
  • the surgeon passes the traction wire 8 within the slot 52 of the guide member 50, so as to immobilize it, then connects the extractable support 9 with the tube 3 by putting end to end the cooperation means 13, and in particular the spout 26, with the outer end 3E of the tube 3, located outside the body of the patient. More specifically, the surgeon comes to introduce the spout 26, the guide member 50 and the pull wire 8, held against or within the guide member 50, inside the passage 3 'of the tube 3 of such so that the folding chamber 10 is in alignment with the longitudinal passage 3 'of the tube 3.
  • the surgeon can then introduce a clamp through a second incision to enter the second end portion 8 "free of the pull wire 8 and exert a tensile force on the latter in a direction F 'preferably facing downwards ( 4) so as to transfer the folded parietal implant 2 from the folding chamber 10 to the tube 3, then to the body cavity where the parietal implant 2 is again free to deploy. then fixed on the tissues, for example as a reinforcement.
  • the step of transferring the parietal implant 2 from the folding chamber 10 to the body cavity can be carried out in two stages and comprise a first substep during which the surgeon transfers the parietal implant 2 of the folding chamber 10 to the tube 3 outside the body, and a second substep during which the surgeon comes to position the tube 3, comprising the parietal implant 2 in the folded state, within an incision through the patient's body.
  • the folding kit according to the invention therefore makes it possible to carry out a rapid and automatic folding of a parietal implant 2 and also makes it possible to avoid the direct manipulation of the parietal implant 2 by the surgeon.
  • folding kit 1 can be used on substantially any standard trocar, not necessarily intended for single use but also reusable.
  • folding kit 1 can be used for folding any type of implant in the form of a textile sheet or a flexible film, its components, apart from the implant itself, being able to be either single-use or multipurpose.
  • the invention finds its industrial application in the realization of packaging devices, in particular folding, parietal implants.

Abstract

The invention concerns a kit for folding a parietal implant (2) and for transferring said parietal implant (2) to an outer tube, such as a trocar, comprising a housing wherein are arranged: a parietal implant (2) provided with gripping means (7), an extractable support (9) comprising a folding chamber (10) inside which the parietal implant (2) is caused to pass through when the gripping means (7) is actuated, said folding chamber (10) being configured to fold the parietal implant (2), said extractable support (9) being provided with means co-operating (13) with the outer tube, configured to transfer the folded parietal bone implant, from the folding chamber (10) to the outer tube. The invention is applicable to devices for folding parietal implants.

Description

KIT DE PLIAGE D'UN IMPLANT PARIETAL SOUPLE ET PROCEDE DE PLIAGE CORRESPONDANT FOLDING KIT FOR A SOFT PARIETAL IMPLANT AND CORRESPONDING FOLDING METHOD
DOMAINE TECHNIQUETECHNICAL AREA
La présente invention se rapporte au domaine technique général des dispositifs de pliage d'implants pariétaux, notamment de renforts pariétaux en matière textile, en vue de leur introduction dans un tube, du genre trocart, afin de permettre l'implantation de l'implant à travers une incision de petit diamètre, par cœlioscopie.The present invention relates to the general technical field of devices for folding parietal implants, in particular parietal reinforcements made of textile material, with a view to their introduction into a tube, of the trocar kind, in order to allow implantation of the implant to be performed. through a small diameter incision, by laparoscopy.
La présente invention concerne plus particulièrement un kit de pliage d'un implant pariétal et de transfert de ce dernier vers un tube extérieur, du genre trocart.The present invention relates more particularly to a kit for folding a parietal implant and transferring it to an outer tube, trocar-like.
La présente invention concerne également un procédé de pliage d'un implant pariétal sensiblement souple stocké dans une configuration déployée au sein d'un boîtier puis de transfert dudit implant pariétal dans un tube extérieur au boîtier, par exemple un trocart.The present invention also relates to a method of folding a substantially flexible parietal implant stored in a deployed configuration within a housing and then transferring said parietal implant into a tube outside the housing, for example a trocar.
TECHNIQUE ANTERIEUREPRIOR ART
Les implants pariétaux et notamment les prothèses pariétales en matière textile souple, telles que les renforts pariétaux destinés à être utilisés dans le traitement des hernies, se présentent généralement sous la forme d'une plaque (ou feuille) textile sensiblement plane présentant, à l'état déployé, un aspect sensiblement lisse et dépourvu de plis, afin de favoriser l'adhérence et le contact intime entre la prothèse pariétale et la paroi du corps à traiter. C'est la raison pour laquelle les prothèses pariétales connues sont généralement stockées à l'état déployé, c'est-à-dire à plat, dans des boîtes d'emballage protectrices, et ce afin d'éviter la formation de plis permanents et irréversibles susceptibles de se maintenir une fois la prothèse pariétale mise en place au sein du corps du patient.The parietal implants and in particular the parietal prostheses made of flexible textile material, such as parietal reinforcements intended to be used in the treatment of hernias, are generally in the form of a substantially flat textile plate (or sheet) presenting, at the expanded state, a substantially smooth appearance and free of wrinkles, to promote the adhesion and the intimate contact between the parietal prosthesis and the body wall to be treated. This is the reason why known parietal prostheses are generally stored in an expanded state, ie flat, in protective packaging boxes, in order to avoid the formation of permanent folds and irreversible that can be maintained once the parietal prosthesis is placed in the body of the patient.
Il est néanmoins nécessaire, notamment dans le cas du traitement des hernies par cœlioscopie, de procéder à une opération de pliage de l'implant pariétal sur lui-même, en vue de permettre son introduction dans un tube de faible diamètre, connu sous l'appellation « trocart ». Le pliage au préalable de l'implant pariétal permet ainsi son implantation à travers une incision de taille limitée, ce qui présente de nombreux avantages. En particulier, en diminuant la taille de l'incision, on réduit le risque de complications et l'opération s'avère moins traumatisante pour le patient. En outre, la pratique des interventions par cœlioscopie présente également des avantages sur le plan esthétique, en diminuant la taille des cicatrices.It is nevertheless necessary, particularly in the case of the treatment of hernias by laparoscopy, to carry out a folding operation of the parietal implant on itself, in order to allow its introduction into a small diameter tube, known as name "trocar". The prior folding of the parietal implant thus allows its implantation through an incision of limited size, which has many advantages. In particular, by reducing the size of the incision, the risk of complications is reduced and the operation is less traumatic for the patient. In addition, the practice of laparoscopic procedures also has aesthetic advantages in reducing the size of scars.
Lors de ces interventions, l'opération de pliage de l'implant pariétal est souvent réalisée manuellement par le chirurgien, dans les instants précédant la pose de l'implant pariétal, et comporte un risque non négligeable de contamination de l'implant pariétal, le chirurgien étant amené à manipuler directement l'implant pariétal à plusieurs reprises au cours de cette opération.During these interventions, the folding operation of the parietal implant is often performed manually by the surgeon, in the moments preceding the installation of the parietal implant, and involves a significant risk of contamination of the parietal implant, the surgeon having to manipulate the parietal implant directly several times during this operation.
Il est connu, pour éviter cette manipulation directe de l'implant pariétal par le chirurgien, d'équiper l'implant pariétal d'un fil de traction, serpentant à travers l'implant pariétal de telle manière qu'en tirant sur l'extrémité libre du fil de traction, l'implant pariétal se replie automatiquement sur lui-même en accordéon. Cette solution, si elle permet de réduire le temps de manipulation de l'implant pariétal par le chirurgien, ne permet pas d'éliminer totalement tout contact direct entre l'implant pariétal et le chirurgien.It is known, to avoid this direct manipulation of the parietal implant by the surgeon, to equip the parietal implant with a traction wire, snaking through the parietal implant in such a way that by pulling on the end free of the traction wire, the parietal implant folds automatically on itself in accordion. This solution, if it reduces the time of manipulation of the parietal implant by the surgeon, does not completely eliminate any direct contact between the parietal implant and the surgeon.
En particulier, ce dernier est nécessairement amené à manipuler l'implant pariétal, que ce soit pour l'extraire de son emballage de stockage ou pour l'introduire dans le trocart. Ces étapes, même limitées dans le temps, peuvent suffire à contaminer l'implant et entraîner une aggravation parfois dramatique de l'état de santé du patient.In particular, the latter is necessarily led to manipulate the parietal implant, either to extract it from its storage package or to introduce it into the trocar. These steps, even limited in time, may be enough to contaminate the implant and lead to sometimes dramatic deterioration of the patient's health.
EXPOSE DE L'INVENTIONSUMMARY OF THE INVENTION
Les objets assignés à l'invention visent par conséquent à porter remède aux différents inconvénients énumérés précédemment et à proposer un nouveau kit de pliage et de transfert d'un implant pariétal dans un tube extérieur ne nécessitant, à aucun moment, une manipulation directe de l'implant par le chirurgien et permettant ainsi de limiter les risques de contamination de l'implant.The objects assigned to the invention therefore aim to remedy the various disadvantages listed above and to propose a new kit for folding and transferring a parietal implant into an outer tube requiring, at no time, direct manipulation of the implant. implant by the surgeon and thus limiting the risk of contamination of the implant.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage destiné à être utilisé juste avant l'implantation de l'implant pariétal, et qui ne laisse aucun pli permanent et irréversible sur ledit implant.Another object of the invention is to propose a new folding kit intended to be used just before implantation of the parietal implant, and which leaves no permanent and irreversible fold on said implant.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage qui soit particulièrement simple à utiliser et comporte un nombre réduit de pièces.Another object of the invention is to provide a new folding kit which is particularly simple to use and has a reduced number of parts.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage permettant de plier automatiquement l'implant pariétal sans l'extraire de son emballage de stockage. Un autre objet de l'invention vise à proposer un nouveau kit de pliage permettant de transférer l'implant pariétal plié de son boîtier d'emballage vers un tube extérieur, sans contact avec l'implant.Another object of the invention is to propose a new folding kit for automatically folding the parietal implant without extracting it from its storage package. Another object of the invention is to propose a new folding kit for transferring the folded parietal implant from its packaging housing to an outer tube, without contact with the implant.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage susceptible d'être utilisé avec n'importe quel trocart standard, à usage unique ou à usages multiples.Another object of the invention is to propose a new folding kit that can be used with any standard, single-use or multi-purpose trocar.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage permettant en outre de faciliter l'introduction de l'implant pariétal dans le trocart.Another object of the invention is to propose a new folding kit which also makes it easier to introduce the parietal implant into the trocar.
Un autre objet de l'invention vise à proposer un nouveau kit de pliage permettant l'introduction de l'implant pariétal dans le trocart sans que l'implant n'entre en contact avec les mains du chirurgien.Another object of the invention is to propose a new folding kit allowing the introduction of the parietal implant into the trocar without the implant coming into contact with the surgeon's hands.
Les objets assignés à l'invention visent également à proposer un nouveau procédé de pliage d'un implant pariétal puis de transfert dudit implant pariétal à l'état plié vers un trocart, qui permette de plier automatiquement et rapidement l'implant sans risque de le contaminer et ce en évitant sensiblement tout contact direct entre l'implant et les mains du chirurgien.The objects assigned to the invention also aim at proposing a new method of folding a parietal implant and then transferring said parietal implant in the folded state to a trocar, which makes it possible to automatically and quickly fold the implant without risk of contaminate and this substantially avoiding any direct contact between the implant and the hands of the surgeon.
Un autre objet de l'invention vise à proposer un nouveau procédé de pliage et de transfert d'un implant pariétal qui soit particulièrement simple et susceptible d'être mis en œuvre sensiblement avec tous les trocarts standards.Another object of the invention is to propose a new method of folding and transfer of a parietal implant which is particularly simple and can be implemented substantially with all standard trocars.
Les objets assignés à l'invention sont atteints à l'aide d'un kit de pliage d'un implant pariétal et de transfert dudit implant pariétal vers un tube extérieur, du genre trocart, comportant un boîtier au sein duquel sont disposés : - un implant pariétal sensiblement souple, stocké dans une configuration déployée et pourvu d'un moyen de préhension,The objects assigned to the invention are achieved by means of a folding kit of a parietal implant and of transferring said parietal implant to an outer tube, of the trocar type, comprising a housing in which are arranged: a substantially flexible parietal implant, stored in a deployed configuration and provided with a gripping means,
- un support extractible comportant une chambre de pliage, s'étendant entre une ouverture d'entrée et une ouverture de sortie, et au sein de laquelle l'implant pariétal est amené à transiter lorsque le moyen de préhension est actionné, ladite chambre de pliage étant conformée pour assurer le pliage de l'implant pariétal entre l'ouverture d'entrée et l'ouverture de sortie, de telle sorte que vers l'ouverture de sortie, l'implant pariétal présente une configuration pliée, ledit support βxtractible étant pourvu, au niveau de l'ouverture de sortie, de moyens de coopération avec le tube extérieur, conformés pour faciliter la connexion du support extractible avec ledit tube extérieur et assurer ainsi le transfert de l'implant pariétal plié, de la chambre de pliage vers le tube extérieur.an extractable support comprising a folding chamber, extending between an inlet opening and an outlet opening, and in which the parietal implant is made to pass when the gripping means is actuated, said bending chamber being shaped to ensure the folding of the parietal implant between the inlet opening and the outlet opening, so that towards the outlet opening, the parietal implant has a folded configuration, said βxtractible support being provided , at the outlet opening, means for cooperating with the outer tube, shaped to facilitate the connection of the extractable support with said outer tube and thus ensure the transfer of the folded parietal implant, from the folding chamber to the outer tube.
Les objets assignés à l'invention sont également atteints à l'aide d'un procédé de pliage d'un implant pariétal sensiblement souple stocké dans une configuration déployée au sein d'un boîtier puis de transfert dudit implant pariétal dans un tube extérieur au boîtier, par exemple un trocart, comportant :The objects assigned to the invention are also achieved by means of a folding method of a substantially flexible parietal implant stored in a deployed configuration within a housing and then of transferring said parietal implant into a tube outside the housing. , for example a trocar, comprising:
- une étape (a) de pliage de l'implant pariétal, au cours de laquelle on actionne un moyen de préhension, relié à l'implant pariétal, de manière à faire passer ledit implant pariétal à travers une chambre de pliage, ménagée dans un support extractible disposé au sein du boîtier, afin de plier ledit implant pariétal au cours de son trajet,a step (a) for folding the parietal implant, during which a gripping means is actuated, connected to the parietal implant, so as to pass said parietal implant through a folding chamber formed in a extractable support disposed within the housing, for folding said parietal implant during its journey,
- une étape (b) de transfert de l'implant pariétal plié de la chambre de pliage vers le tube au cours de laquelle on extrait le support extractible du boîtier et on le rapporte sur le tube. DESCRIPTIF SOMMAIRE DES DESSINSa step (b) for transferring the folded parietal implant from the bending chamber to the tube during which the extractable support is extracted from the housing and transferred to the tube. SUMMARY DESCRIPTION OF THE DRAWINGS
D'autres objets et avantages de l'invention apparaîtront plus en détails à la lecture de la description qui suit, ainsi qu'à l'aide des dessins annexés, fournis à titre purement illustratif et non limitatif, dans lesquels :Other objects and advantages of the invention will appear in more detail on reading the description which follows, and with the aid of the accompanying drawings, provided for purely illustrative and non-limiting purposes, in which:
- La figure 1 illustre, selon une vue en perspective éclatée, un kit de pliage d'un implant pariétal conforme à l'invention.- Figure 1 illustrates, in an exploded perspective view, a folding kit of a parietal implant according to the invention.
- La figure 2 illustre, selon une vue de face en coupe, le kit de pliage illustré sur la figure 1 , dans une configuration prête à l'emploi.- Figure 2 illustrates, in a front view in section, the folding kit illustrated in Figure 1, in a ready-to-use configuration.
- La figure 3 illustre, selon une vue de dessus, le kit de pliage conforme à l'invention dans une configuration correspondant à l'étape de pliage de l'implant pariétal.- Figure 3 illustrates, in a view from above, the folding kit according to the invention in a configuration corresponding to the folding step of the parietal implant.
- La figure 4 illustre, selon une vue de face, le support extractible conforme à l'invention raccordé sur le tube, dans une position verticale.- Figure 4 illustrates, in a front view, the extractable support according to the invention connected to the tube, in a vertical position.
MEILLEURE MANIERE DE REALISER L'INVENTIONBEST MODE OF REALIZING THE INVENTION
Le kit 1 de pliage et de transfert conforme à l'invention est illustré sur les figures 1 à 3. Il comporte, selon l'invention, un boîtier 4, se présentant avantageusement sous la forme d'un plateau de forme rectangulaire, pourvu d'un fond 5 et délimité par un rebord extérieur 6 s'élevant vers le haut à partir du fond 5 de manière à délimiter un espace de stockage 30 d'un implant pariétal 2.The folding and transfer kit 1 according to the invention is illustrated in FIGS. 1 to 3. It comprises, according to the invention, a housing 4, advantageously in the form of a rectangular-shaped tray, provided with a bottom 5 and delimited by an outer rim 6 rising upwards from the bottom 5 so as to delimit a storage space 30 of a parietal implant 2.
Le kit 1 comprend ainsi, selon l'invention, un implant pariétal 2 sensiblement souple, c'est-à-dire suffisamment souple pour pouvoir être plié de manière à permettre son introduction dans un tube 3 de petit diamètre, tel qu'un trocart utilisé en cœlioscopie, extérieur au kit 1 c'est-à-dire non nécessairement disposé au sein du boîtier 4. Le tube 3 peut ainsi être formé par un trocart à usage non unique, réutilisable pour d'autres interventions.The kit 1 thus comprises, according to the invention, a parietal implant 2 substantially flexible, that is to say, sufficiently flexible to be folded so as to allow its introduction into a tube 3 of small diameter, such as a trocar used in laparoscopy, outside the kit 1 that is to say not necessarily disposed within the housing 4. The tube 3 can be formed by a trocar for non-unique use, reusable for other interventions.
Le terme « implant pariétal » fait référence à des implants destinés à être appliqués sur des tissus à l'intérieur du corps, notamment sur des parois telles que la paroi abdominale, en vue de les renforcer. Ce terme désigne également des implants, tels que des films résorbables ou non, aptes à séparer des tissus ou des organes, par exemple pour empêcher les adhérences post-opératoires.The term "parietal implant" refers to implants intended to be applied to tissues within the body, in particular on walls such as the abdominal wall, with a view to strengthening them. This term also refers to implants, such as resorbable films or not, capable of separating tissues or organs, for example to prevent postoperative adhesions.
L'implant pariétal 2 peut prendre différentes formes géométriques, et peut notamment se présenter sous la forme d'une plaque ou d'une feuille rectangulaire.The parietal implant 2 may take different geometric shapes, and may in particular be in the form of a plate or a rectangular sheet.
L'implant pariétal 2 est encore plus préférentiellement formé par une pièce textile, formant alors une prothèse textile. Il est toutefois bien évidemment envisageable que l'implant pariétal soit formé par un film souple de faible épaisseur et par exemple par un film, résorbable ou non, destiné à empêcher les adhérences post-opératoires. L'implant pariétal 2 peut également être formé par une pièce textile imprégnée avec des biopolymères, par exemple des biopolymères à effet collant ou anti-adhérent, ou recouverte par un film de biopolymères. L'implant pariétal 2 présente alors une surépaisseur par rapport aux pièces textiles classiques, d'où le rôle essentiel du kit 1 qui doit permettre de réduire suffisamment l'expansion latérale de l'implant, malgré sa surépaisseur, pour permettre son introduction à travers le trocart.The parietal implant 2 is even more preferably formed by a textile piece, then forming a textile prosthesis. However, it is of course conceivable that the parietal implant is formed by a flexible thin film and for example by a film, resorbable or not, intended to prevent postoperative adhesions. The parietal implant 2 may also be formed by a textile piece impregnated with biopolymers, for example biopolymers with a sticky or non-adhering effect, or covered by a film of biopolymers. The parietal implant 2 then has an extra thickness compared to conventional textile parts, hence the essential role of the kit 1 which should allow to sufficiently reduce the lateral expansion of the implant, despite its extra thickness, to allow its introduction through the trocar.
L'implant pariétal 2 est, selon l'invention, stocké dans une configuration déployée, c'est-à-dire non pliée, au sein du boîtier 4 afin d'éviter Ia formation de plis permanents et irréversibles pendant la durée de stockage s'écoulant entre la fabrication du kit 1 et l'implantation de l'implant pariétal 2. Selon l'invention, l'implant pariétal 2 est également pourvu d'un moyen de préhension 7 permettant au chirurgien de manipuler indirectement l'implant pariétal 2 en évitant sensiblement tout contact direct avec ce dernier, limitant ainsi les risques de souillure et de contamination de l'implant pariétal 2.The parietal implant 2 is, according to the invention, stored in a deployed configuration, that is to say not folded, within the housing 4 to prevent the formation of permanent and irreversible folds during the storage period s flowing between the manufacture of the kit 1 and the implantation of the parietal implant 2. According to the invention, the parietal implant 2 is also provided with a gripping means 7 allowing the surgeon to indirectly manipulate the parietal implant 2 while substantially avoiding any direct contact with the latter, thus limiting the risks of contamination and contamination. of the parietal implant 2.
Selon l'invention, le kit 1 comporte en outre un support extractible 9 disposé de manière amovible au sein du boîtier 4, de manière à pouvoir être facilement extrait de ce dernier. Le support extractible 9 comporte, selon l'invention, une chambre de pliage 10 qui s'étend entre une ouverture d'entrée 11 et une ouverture de sortie 12 et qui est conformée pour assurer le pliage de l'implant pariétal 2, en le repliant sur lui-même, entre l'ouverture d'entrée 11 et l'ouverture de sortie 12. La chambre de pliage 10 est avantageusement intégrée structurellement au support extractible 9 et plus précisément ménagée à l'intérieur de ce dernier et donc mobile avec ledit support extractible 9.According to the invention, the kit 1 further comprises an extractable support 9 removably disposed within the housing 4, so as to be easily extracted from the latter. The extractable support 9 comprises, according to the invention, a folding chamber 10 which extends between an inlet opening 11 and an outlet opening 12 and which is shaped to ensure the folding of the parietal implant 2, by folding back on itself, between the inlet opening 11 and the outlet opening 12. The folding chamber 10 is advantageously structurally integrated with the extractable support 9 and more precisely formed inside the latter and thus mobile with said extractable support 9.
Lorsque le moyen de préhension 7, préférentiellement formé par un fil de traction 8, est actionné, par exemple en tirant sur le fil de traction 8 suivant une direction F sensiblement parallèle au fond 5 et située dans le prolongement de la chambre de pliage 10, l'implant pariétal 2 est entraîné vers l'ouverture d'entrée 11 de la chambre de pliage 10 et est amené à transiter à travers cette dernière, passant ainsi d'une configuration sensiblement déployée au niveau de l'ouverture d'entrée 11 à une configuration sensiblement pliée au niveau de l'ouverture de sortie 12.When the gripping means 7, preferably formed by a pulling thread 8, is actuated, for example by pulling on the pulling thread 8 in a direction F substantially parallel to the bottom 5 and situated in the extension of the folding chamber 10, the parietal implant 2 is driven towards the inlet opening 11 of the folding chamber 10 and is made to transit through the latter, thus passing from a substantially deployed configuration at the level of the inlet opening 11 to a substantially folded configuration at the outlet opening 12.
Selon une caractéristique essentielle de l'invention, le support extractible 9 est pourvu, au niveau de l'ouverture de sortie 12, de moyens de coopération 13 avec le tube 3 extérieur, conformés pour faciliter la connexion du support extractible 9 avec le tube 3 extérieur et assurer ainsi le transfert de l'implant pariétal 2 plié de la chambre de pliage 10 vers le tube 3 extérieur. Les moyens de coopération 13 permettent ainsi de rapporter le support extractible 9 sur un tube 3 extérieur de diamètre standard.According to an essential characteristic of the invention, the extractable support 9 is provided, at the outlet opening 12, with cooperation means 13 with the outer tube 3, shaped to facilitate the connection of the extractable support 9 with the tube 3 outside and thus ensure the transfer of the parietal implant 2 folded from the folding chamber 10 to the tube 3 outside. The cooperation means 13 thus make it possible to relate the extractable support 9 to an outer tube 3 of standard diameter.
Selon une caractéristique avantageuse de l'invention, le kit 1 est pourvu d'un moyen de fermeture du boîtier 4, se présentant sous la forme d'un opercule 14 apte à recouvrir le boîtier 4 de manière sensiblement étanche, garantissant ainsi la stérilité de l'implant pariétal 2, du support extractible 9 et plus généralement de tous les composants du kit 1 disposés au sein du boîtier 4. Le boîtier 4 pourvu de son opercule 14 forme ainsi un emballage stérile pour l'implant pariétal 2.According to an advantageous characteristic of the invention, the kit 1 is provided with a means for closing the casing 4, in the form of a cover 14 able to cover the casing 4 in a substantially watertight manner, thereby guaranteeing the sterility of the casing. the parietal implant 2, the extractable support 9 and more generally all the components of the kit 1 disposed within the casing 4. The casing 4 provided with its cover 14 thus forms a sterile package for the parietal implant 2.
Le support extractible 9 est avantageusement agencé pour former un moyen de réception temporaire de l'implant pariétal 2 à l'état plié, permettant de transférer cet dernier depuis le boîtier 4 vers le tube 3 extérieur au boîtier, sans avoir à manipuler directement l'implant pariétal 2. Le support extractible 9 est ainsi manipulable pour être extrait du boîtier 4 en vue d'être rapporté sur le tube 3 extérieur.The extractable support 9 is advantageously arranged to form a means for temporarily receiving the parietal implant 2 in the folded state, enabling the latter to be transferred from the housing 4 to the tube 3 outside the housing, without having to directly handle the parietal implant 2. The extractable support 9 is thus manipulable to be extracted from the housing 4 to be attached to the outer tube 3.
Avantageusement, la chambre de pliage 10 est pourvue de moyens de focalisation 15, disposés de manière à délimiter un espace 16 sensiblement convergent entre l'ouverture d'entrée 11 et l'ouverture de sortie 12 afin d'assurer le pliage progressif de l'implant pariétal 2 lors de son passage à travers la chambre de pliage 10. Les moyens de focalisation 15 s'étendent de préférence de façon sensiblement continue entre l'ouverture d'entrée 11 et l'ouverture de sortie 12 et présentent une courbure géométrique sensiblement continue et sans points d'arrêt de manière limiter le risque de blocage de l'implant pariétal 2 lors de son introduction dans la chambre de pliage 10 ou lors de son transit à travers cette dernière. De façon encore plus préférentielle, les moyens de focalisation 15 s'étendent, de façon rectiligne, sur sensiblement toute la longueur de la chambre de pliage 10 de manière à assurer un pliage sensiblement continu de l'implant pariétal 2. Avantageusement, les moyens de focalisation 15 sont formés par au moins deux parois 17, 18 disposées sensiblement en V. Le volume disponible pour l'implant pariétal 2 diminue ainsi progressivement entre l'ouverture d'entrée 11 et l'ouverture de sortie 12, les parois 17, 18 exerçant une force de réaction sur l'implant pariétal 2 tendant à le replier sur lui-même au fur et à mesure de son transit le long de la chambre de pliage 10.Advantageously, the folding chamber 10 is provided with focusing means 15, arranged so as to delimit a substantially convergent space 16 between the inlet opening 11 and the outlet opening 12 in order to ensure the progressive folding of the parietal implant 2 during its passage through the folding chamber 10. The focusing means 15 preferably extend substantially continuously between the inlet opening 11 and the outlet opening 12 and have a geometric curvature substantially continuous and without stopping points so as to limit the risk of blocking the parietal implant 2 during its introduction into the folding chamber 10 or during its transit through the latter. Even more preferably, the focusing means 15 extend in a rectilinear manner over substantially the entire length of the folding chamber 10 so as to ensure a substantially continuous folding of the parietal implant 2. Advantageously, the focusing means 15 are formed by at least two walls 17, 18 arranged substantially in V. The volume available for the parietal implant 2 thus decreases progressively between the inlet opening 11 and the outlet opening 12, the walls 17, 18 exerting a reaction force on the parietal implant 2 tending to fold on itself as it passes along the folding chamber 10.
De façon préférentielle, l'ouverture d'entrée 11 présente une taille suffisante pour permettre l'introduction de l'implant pariétal 2 dans sa configuration déployée au sein de la chambre de pliage 10. En particulier, l'ouverture d'entrée 11 est préférentiellement aussi large que l'implant pariétal 2 à l'état déployé.Preferably, the inlet opening 11 has a sufficient size to allow the introduction of the parietal implant 2 in its deployed configuration within the folding chamber 10. In particular, the inlet opening 11 is preferably as wide as the parietal implant 2 in the deployed state.
Tel que cela est représenté sur les figures, le support extractible 9 est préférentiellement formé par un cône 19 sensiblement aplati suivant une direction sensiblement perpendiculaire au plan horizontal d'extension du fond 5. Le cône 19 définit avantageusement les frontières de la chambre de pliage 10, l'ouverture d'entrée 11 étant située à la base du cône 19 et l'ouverture de sortie 12 étant située au sommet du cône 19. Le cône 19 comporte, dans sa configuration horizontale au sein du boîtier 4, une paroi supérieure 19A, et une paroi inférieure 19B qui se rejoignent pour former les parois 17, 18.As shown in the figures, the extractable support 9 is preferably formed by a cone 19 substantially flattened in a direction substantially perpendicular to the horizontal plane of extension of the bottom 5. The cone 19 advantageously defines the boundaries of the folding chamber 10 , the inlet opening 11 being located at the base of the cone 19 and the outlet opening 12 being located at the top of the cone 19. The cone 19 comprises, in its horizontal configuration within the housing 4, an upper wall 19A , and a lower wall 19B which join to form the walls 17, 18.
Selon une caractéristique particulièrement avantageuse de l'invention, le support extractible 9 est disposé au sein du boîtier 4 de manière à reposer, de préférence directement, sur l'implant pariétal 2 à l'état déployé. Le fond 5 du boîtier 4 s'étend ainsi sur une surface suffisante pour que l'implant pariétal 2 puisse y reposer à plat, dans sa configuration déployée.According to a particularly advantageous characteristic of the invention, the extractable support 9 is disposed within the housing 4 so as to rest, preferably directly, on the parietal implant 2 in the deployed state. The bottom 5 of the housing 4 thus extends over a sufficient area so that the parietal implant 2 can lie flat in its deployed configuration.
Selon une autre caractéristique avantageuse de l'invention, le support extractible 9 comporte des moyens de guidage 20 conformés et disposés de manière à faciliter l'introduction de l'implant pariétal 2 au sein de la chambre de pliage 10.According to another advantageous characteristic of the invention, the extractable support 9 comprises guide means 20 shaped and arranged in order to facilitate the introduction of the parietal implant 2 into the folding chamber 10.
Les moyens de guidage 20 sont notamment conformés de manière à empêcher un éventuel blocage de l'implant pariétal 2 lors de son introduction dans la chambre de pliage 10 et notamment lors de son introduction dans le cône 19.The guiding means 20 are in particular shaped so as to prevent a possible blockage of the parietal implant 2 during its introduction into the folding chamber 10 and in particular when it is introduced into the cone 19.
Avantageusement, les moyens de guidage 20 comportent au moins une glissière 21 , s'étendant sensiblement parallèlement à la chambre de pliage 10, et plus précisément dans l'espace situé entre la chambre de pliage 10 et l'implant pariétal 2. De façon encore plus préférentielle, la glissière 21 vient en appui, par l'intermédiaire d'une face de glissement 21', contre l'implant pariétal 2 à l'état déployé et assure ainsi le maintien de l'implant pariétal 2 à plat au sein du boîtier 4 de stockage. Le support extractible 9 est avantageusement maintenu immobile, par compression, entre l'opercule 14 fermé et le fond 5, garantissant ainsi, par l'intermédiaire de la glissière 21 , l'immobilité de l'implant pariétal 2 lors de la manipulation du boîtier 4.Advantageously, the guide means 20 comprise at least one slide 21, extending substantially parallel to the folding chamber 10, and more precisely in the space between the folding chamber 10 and the parietal implant 2. more preferably, the slide 21 comes to bear, via a sliding face 21 'against the parietal implant 2 in the deployed state and thus ensures the maintenance of the parietal implant 2 flat within the storage box 4. The extractable support 9 is advantageously held stationary, by compression, between the closed lid 14 and the bottom 5, thereby ensuring, by means of the slide 21, the immobility of the parietal implant 2 during the manipulation of the casing 4.
Tel que cela est illustré sur les figures, la glissière 21 est, de façon particulièrement avantageuse, formée par une languette 22, sensiblement souple, laquelle est solidarisée (par collage, soudure ou par tout autre moyen) avec la chambre de pliage 10 vers l'ouverture d'entrée 11 , la jonction entre ladite languette 22 et ladite chambre de pliage 10 formant un bord de retournement 23. La languette 22 est de façon encore plus préférentielle venue de matière avec la chambre de pliage 10, et repliée de manière à s'étendre sous et le long de cette dernière (ou sous le cône 19).As illustrated in the figures, the slide 21 is particularly advantageously formed by a substantially flexible tongue 22, which is secured (by gluing, welding or by any other means) with the folding chamber 10 towards the 11, the junction between said tongue 22 and said folding chamber 10 forming a turning edge 23. The tongue 22 is even more preferably integral with the folding chamber 10, and folded so as to extend under and along the latter (or under the cone 19).
Afin de faciliter la manipulation et la préhension du support extractible 9 en vue de le rapporter sur le tube 3 extérieur, la languette 22 et la chambre de pliage 10 s'étendent à distance l'une de l'autre en délimitant un passage 25, ouvert sur l'extérieur de manière à permettre la préhension de la chambre de pliage 10. En particulier, le chirurgien peut introduire la main au sein du passage 25 afin de maintenir le support extractible 9, et plus précisément le cône 19, en regard du tube 3 extérieur.In order to facilitate handling and gripping of the extractable support 9 in order to bring it back to the outer tube 3, the tongue 22 and the chamber of 10 extend away from each other by delimiting a passage 25, open on the outside so as to allow the gripping of the folding chamber 10. In particular, the surgeon can introduce the hand within the passage 25 to maintain the extractable support 9, and more precisely the cone 19, facing the outer tube 3.
De façon particulièrement avantageuse, la languette 22 et la chambre de pliage 10 sont reliées vers l'ouverture d'entrée 11 en formant une anse 40, laquelle permet ainsi un meilleur maintien du support extractible 9 par le chirurgien. La languette 22 est en outre de préférence solidarisée avec la chambre de pliage 10 vers l'ouverture de sortie 12 de manière à refermer l'anse 40 sur elle-même autour du passage 25. Dans ces conditions, l'anse 40 délimite un passage 25 particulièrement étroit, et vient enserrer la main du chirurgien, facilitant ainsi la manipulation du support extractible 9.Particularly advantageously, the tongue 22 and the folding chamber 10 are connected to the inlet opening 11 forming a loop 40, which thus allows a better maintenance of the extractable support 9 by the surgeon. The tongue 22 is further preferably secured to the folding chamber 10 towards the outlet opening 12 so as to close the loop 40 on itself around the passage 25. Under these conditions, the handle 40 defines a passage 25 particularly narrow, and comes to grip the hand of the surgeon, thus facilitating the manipulation of the extractable support 9.
Plus précisément, l'extrémité 22' de la languette 22, située sensiblement au droit de l'ouverture de sortie 12, est préférentiellement fixée, par exemple à l'aide d'un point de colle 24 ou par tout autre moyen de fixation (soudure, clipage), sur la paroi inférieure 19B du cône 19.More specifically, the end 22 'of the tongue 22, located substantially in line with the outlet opening 12, is preferably fixed, for example by means of an adhesive point 24 or by any other fastening means ( welding, clipping), on the bottom wall 19B of the cone 19.
Avantageusement, le bord de retournement 23 présente une courbure sensiblement arrondie (figure 1) et permet ainsi de faciliter l'introduction de l'implant pariétal 2 à l'intérieur de la chambre de pliage 10, en le retournant de 180° par rapport à sa position à l'état déployé sur Ie fond 5 du boîtier 4. La forme arrondie du bord de retournement 23 permet en outre de faire glisser l'implant pariétal 2 progressivement vers l'intérieur de la chambre de pliage 10, en limitant les risques de coincement de l'implant pariétal 2 à l'entrée de la chambre de pliage 10, lorsque le chirurgien tire sur le fil de traction 8. En particulier, lorsque l'implant pariétal 2 est une prothèse textile et présente une structure maillée, il existe une risque non négligeable d'accrochage de la prothèse sur Ie support extractible 9, et il convient donc de préférer, lors de la conception du support extractible 9, les bords émoussés aux bords saillants.Advantageously, the turning edge 23 has a substantially rounded curvature (FIG. 1) and thus makes it easier to introduce the parietal implant 2 inside the folding chamber 10, by turning it 180 ° with respect to its position in the deployed state on the bottom 5 of the casing 4. The rounded shape of the turning edge 23 also makes it possible to slide the parietal implant 2 progressively towards the inside of the folding chamber 10, while limiting the risks wedging of the parietal implant 2 at the entrance of the folding chamber 10, when the surgeon pulls on the traction wire 8. In particular, when the parietal implant 2 is a textile prosthesis and has a mesh structure, it there is a significant risk of attachment of the prosthesis on the extractable support 9, and it is therefore appropriate to prefer, in the design of the extractable support 9, the blunt edges with the projecting edges.
Afin de limiter encore les risques d'accrochage ou de blocage de l'implant pariétal 2 lors de son introduction dans le support extractible 9 et plus précisément dans la chambre de pliage 10, la chambre de pliage 10 est dimensionnée pour recevoir l'intégralité de l'implant pariétal 2 dans un état intermédiaire entre la configuration totalement déployée et la configuration totalement pliée, et la distance séparant l'ouverture d'entrée 11 de l'ouverture de sortie 12 correspond sensiblement à la longueur de l'implant pariétal 2. En d'autres termes, la longueur de la chambre de pliage 10 est de préférence supérieure ou égale à celle de l'implant pariétal 2.In order to further limit the risks of attachment or blockage of the parietal implant 2 when it is introduced into the extractable support 9 and more precisely into the folding chamber 10, the folding chamber 10 is sized to receive the entire the parietal implant 2 in an intermediate state between the fully deployed configuration and the fully folded configuration, and the distance separating the inlet opening 11 from the outlet opening 12 substantially corresponds to the length of the parietal implant 2. In other words, the length of the folding chamber 10 is preferably greater than or equal to that of the parietal implant 2.
Afin de faciliter le raccordement entre le support extractible 9 et le tube 3 extérieur, les moyens de coopération 13 sont avantageusement conformés pour être introduits dans le tube 3 extérieur. De façon encore plus préférentielle, les moyens de coopération 13 sont formés par un bec 26 dimensionné pour pouvoir être introduit dans un trocart standard, classiquement utilisé pour les cœlioscopies.In order to facilitate the connection between the extractable support 9 and the outer tube 3, the cooperation means 13 are advantageously shaped to be introduced into the outer tube 3. Even more preferably, the cooperation means 13 are formed by a spout 26 sized to be introduced into a standard trocar, conventionally used for laparoscopies.
De façon particulièrement avantageuse, le support extractible 9 est pourvu, vers l'ouverture de sortie 12, d'un organe de guidage 50, sensiblement allongé et faisant saillie à l'extérieur de la chambre de pliage 10 de manière à faciliter l'introduction du fil de traction 8 dans le tube 3 en assurant son guidage vers ledit tube 3.Particularly advantageously, the extractable support 9 is provided, towards the outlet opening 12, with a substantially elongate guide member 50 projecting from the outside of the folding chamber 10 so as to facilitate the introduction pulling wire 8 in the tube 3, guiding it towards said tube 3.
A cet effet, l'organe de guidage 50 est préférentiellement formé par un tube fendu 51 souple et sensiblement rectiligne, par exemple en matériau plastique, solidarisé avec l'extrémité du support extractible 9 située au niveau de l'ouverture de sortie 12 et s'étendant longitudinalement dans le prolongement de la chambre de pliage 10, de façon coplanaire avec cette dernière.For this purpose, the guide member 50 is preferably formed by a flexible tube 51 and substantially rectilinear, for example plastic material, secured to the end of the extractable support 9 located at the outlet opening 12 and s extending longitudinally in the extension of the folding chamber 10, coplanar with the latter.
Le fil de traction 8 est alors introduit au sein du tube fendu 51 lors de l'assemblage du kit 1 de pliage de telle sorte que le fil de traction 8 s'étende le long du tube fendu 51 et soit maintenu à l'intérieur de ce dernier.The pulling thread 8 is then introduced into the split tube 51 during the assembly of the folding kit 1 so that the pulling thread 8 extends along the split tube 51 and is held inside the this last.
L'organe de guidage 50 comporte en outre un moyen de blocage / déblocage 52 conformé d'une part pour immobiliser le fil de traction 8 et le maintenir en position contre l'organe de guidage 50, en vue d'empêcher son débattement à l'extérieur dudit support extractible 9, et d'autre part pour le libérer automatiquement lorsqu'un effort de traction est exercé sur le fil de traction 8.The guide member 50 further comprises a locking / unlocking means 52 shaped on the one hand to immobilize the pull wire 8 and hold it in position against the guide member 50, in order to prevent its movement to the outside. outside of said extractable support 9, and secondly to release it automatically when a tensile force is exerted on the pull wire 8.
Le moyen de blocage / déblocage est préférentiellement formé par une fente 52 ménagée dans l'organe de guidage 50, et plus précisément le long du tube fendu 51 , ladite fente 52 étant adaptée pour recevoir le fil de traction 8 en vue d'assurer son maintien, par coincement. Avantageusement, la fente 52 s'étend longitudinalement suivant la direction F' de traction du fil de traction 8.The locking / unlocking means is preferably formed by a slot 52 formed in the guide member 50, and more precisely along the split tube 51, said slot 52 being adapted to receive the pull wire 8 to ensure its holding, by wedging. Advantageously, the slot 52 extends longitudinally along the traction direction F 'of the traction wire 8.
De façon préférentielle, le kit 1 comporte un moyen de maintien 60, apte à maintenir l'organe de guidage 50 en position repliée contre le support extractible 9. Le moyen de maintien 60 est avantageusement formé par une languette de maintien 61 , fixée de manière amovible ou non, par ses deux extrémités, sur le support extractible 9 de manière à maintenir l'organe de guidage 50 à plat contre le support extractible 9.Preferably, the kit 1 comprises a holding means 60, able to hold the guide member 50 in folded position against the extractable support 9. The holding means 60 is advantageously formed by a holding tab 61, fixed in a manner removable or not, by its two ends, on the extractable support 9 so as to maintain the guide member 50 flat against the extractable support 9.
Pour libérer l'organe de guidage 50, il suffit au chirurgien soit de retirer la languette de maintien 61 , soit de faire glisser l'organe de guidage 50 hors du logement délimité par la languette de maintien 61 d'une part et la surface extérieure du support extractible 9 d'autre part.To release the guide member 50, it is sufficient for the surgeon either to remove the retaining tab 61 or to slide the guide member 50 out of housing delimited by the retaining tab 61 on the one hand and the outer surface of the extractable support 9 on the other.
Avantageusement, le support extractible 9 se présente sous la forme d'une structure monobloc préférentiellement transparente, par exemple en polyéthylène téréphtalate glycol (PETG), permettant au chirurgien de visualiser à tout instant l'implant pariétal 2 pendant son pliage, et lui permettant ainsi de mieux contrôler l'opération de pliage de l'implant pariétal 2 et d'éviter son blocage.Advantageously, the extractable support 9 is in the form of a preferably transparent monoblock structure, for example polyethylene terephthalate glycol (PETG), allowing the surgeon to visualize at any moment the parietal implant 2 during its folding, and thus enabling it to better control the folding operation of the parietal implant 2 and to avoid its blockage.
Tel que cela est illustré sur la figure 1 , le fil de traction 8 est préférentiellement formé par deux brins 8A, 8B parallèles, et s'étend entre une première portion d'extrémité 8' solidarisée avec l'implant pariétal 2, et une deuxième portion d'extrémité 8", libre et actionnable. Le fil de traction 8 est par ailleurs disposé, avant son actionnement, de manière à traverser la chambre de pliage (figures 1 et 2).As shown in FIG. 1, the traction wire 8 is preferably formed by two parallel strands 8A, 8B, and extends between a first end portion 8 'secured to the parietal implant 2, and a second 8 "end portion, free and operable The traction wire 8 is also disposed, before its actuation, so as to pass through the folding chamber (Figures 1 and 2).
Avantageusement, la première portion d'extrémité 8' est lacée au niveau de l'un des bords 2A, 2B, 2C, 2D de l'implant pariétal 2 et serpente avantageusement à travers ce dernier selon une configuration géométrique telle que lorsqu'un effort de traction est exercé sur le fil de traction 8, suivant une direction F sensiblement parallèle au fond 5 et située dans le prolongement de la chambre de pliage 10, l'implant pariétal 2 se replie sur lui-même en éventail en formant une pluralité de plis 27 (figure 4).Advantageously, the first end portion 8 'is laced at one of the edges 2A, 2B, 2C, 2D of the parietal implant 2 and advantageously winds through the latter in a geometric configuration such that when an effort traction is exerted on the traction wire 8, in a direction F substantially parallel to the bottom 5 and located in the extension of the folding chamber 10, the parietal implant 2 folds on itself in a fan forming a plurality of folds 27 (Figure 4).
La présente invention concerne également un procédé de pliage d'un implant pariétal 2 sensiblement souple stocké dans une configuration déployée au sein d'un boîtier 4, et de transfert de l'implant pariétal 2 dans un tube 3 extérieur au boîtier 4, par exemple un trocart, ledit procédé comportant : - une étape (a) de pliage de l'implant pariétal 2 au cours de laquelle on actionne un moyen de préhension 7, relié à l'implant pariétal 2 et de préférence fixé à ce dernier, de manière à faire passer l'implant pariétal 2 à travers une chambre de pliage 10, ménagée dans un support extractible 9 disposé au sein du boîtier 4, afin de plier ledit implant pariétal 2 au cours de son trajet,The present invention also relates to a folding method of a substantially flexible parietal implant 2 stored in a deployed configuration within a housing 4, and transfer of the parietal implant 2 in a tube 3 outside the housing 4, for example a trocar, said method comprising: a step (a) of folding the parietal implant 2 during which a gripping means 7 is actuated, connected to the parietal implant 2 and preferably fixed thereto, so as to pass the parietal implant 2 through a folding chamber 10, formed in an extractable support 9 disposed within the housing 4, in order to fold said parietal implant 2 during its journey,
- une étape (b) de transfert de l'implant pariétal plié de la chambre de pliage 10 vers le tube 3 au cours de laquelle on extrait le support extractible 9 du boîtier 4, et on le rapporte sur le tube 3.a step (b) for transferring the folded parietal implant from the folding chamber 10 to the tube 3 during which the extractable support 9 is extracted from the casing 4, and is transferred to the tube 3.
Avantageusement, l'étape (b) de transfert comporte également une sous- étape d'actionnement du moyen de préhension 7 de manière à transférer l'implant pariétal 2 de la chambre de pliage 10 vers le tube 3. L'actionnement du moyen de préhension 7, préférentiellement formé par le fil de traction 8, s'effectue avantageusement en tirant sur ce dernier.Advantageously, the step (b) of transfer also comprises a sub-step of actuating the gripping means 7 so as to transfer the parietal implant 2 of the folding chamber 10 to the tube 3. The actuation of the means of gripping 7, preferably formed by the pull wire 8, is advantageously made by pulling on the latter.
De façon préférentielle, l'étape (a) de pliage s'effectue en faisant converger progressivement et de manière régulièrement continue l'implant pariétal 2 au sein de la chambre de pliage 10 c'est-à-dire sans changement brutal de direction en vue d'éviter son coincement contre le support extractible 9.Preferably, the folding step (a) is carried out by making the parietal implant 2 progressively converge in a regularly continuous manner within the folding chamber 10, that is to say without abrupt change of direction in to avoid jamming against the extractable support 9.
De façon encore plus préférentielle, l'étape (a) de pliage s'effectue sur sensiblement toute la longueur du boîtier 4.Even more preferably, the folding step (a) is carried out over substantially the entire length of the casing 4.
Le procédé comporte en outre, de façon particulièrement avantageuse, une étape (c) de resserrement, précédant l'étape (a) de pliage, au cours de laquelle on vient resserrer l'implant pariétal 2, en actionnant le moyen de préhension 7, de manière à faciliter son introduction dans la chambre de pliage 10. Plus précisément, la traction exercée sur le moyen de préhension 7 a pour effet de replier l'implant pariétal 2 sur lui-même au niveau du bord 2A sur lequel est lacé le moyen de préhension 7, formé par le fil de traction 8.The method further comprises, in a particularly advantageous manner, a step (c) of tightening, preceding the folding step (a), during which the parietal implant 2 is tightened, by actuating the gripping means 7, in order to facilitate its introduction into the folding chamber 10. More specifically, the traction exerted on the gripping means 7 has the effect of folding the parietal implant 2 on itself to level of the edge 2A on which is laced the gripping means 7, formed by the traction wire 8.
Les modes de fonctionnement et d'utilisation du kit de pliage 1 conforme à l'invention vont maintenant être décrits en se référant aux figures 1 à 4.The modes of operation and use of the folding kit 1 according to the invention will now be described with reference to Figures 1 to 4.
La manipulation du kit 1 de pliage conforme à l'invention s'effectue dans l'instant précédant l'implantation de l'implant pariétal 2 au sein du corps du patient, en vue par exemple de réparer et renforcer des tissus, notamment dans le cadre du traitement d'une hernie.The handling of the folding kit 1 according to the invention is carried out in the instant preceding the implantation of the parietal implant 2 into the body of the patient, with a view, for example, to repairing and reinforcing tissues, particularly in the part of the treatment of a hernia.
Le chirurgien commence par ouvrir l'opercule 14 du boîtier 4, renfermant l'implant pariétal 2 destiné à être implanté et l'ensemble de pliage formé d'une part par le fil de traction 8 et le support extractible 9, ledit boîtier reposant à l'horizontale sur un support, tel qu'une table. Une fois l'opercule 14 retiré, le chirurgien peut retirer la languette de maintien 61 , ce qui a pour effet de libérer l'organe de guidage 50. Le chirurgien vient alors avantageusement prendre appui, avec l'une de ses mains, sur le support extractible 9, et plus précisément de part et d'autre du cône 19, sur la languette 22, et exercer un effort vers le bas tendant à plaquer Ia languette 22 sur l'implant pariétal 2. Le chirurgien peut alors tirer, à l'aide son autre main libre, sur la deuxième portion d'extrémité 8" libre et actionnable du fil de traction 8 suivant la direction F. Cette opération de traction a pour effet d'entraîner l'implant pariétal 2 vers la chambre de pliage 10 du support extractible 9, tel que cela est illustré sur la figure 3.The surgeon begins by opening the lid 14 of the casing 4, enclosing the parietal implant 2 intended to be implanted and the folding assembly formed on the one hand by the pulling wire 8 and the extractable support 9, said casing resting on horizontally on a support, such as a table. Once the cap 14 has been removed, the surgeon can remove the retaining tab 61, which has the effect of releasing the guide member 50. The surgeon then advantageously comes to bear, with one of his hands, on the retractable support 9, and more precisely on either side of the cone 19, on the tongue 22, and exert a downward force tending to press the tongue 22 on the parietal implant 2. The surgeon can then pull, at the using his other free hand, on the second free end portion 8 "and actuable traction wire 8 in the direction F. This traction operation has the effect of driving the parietal implant 2 to the folding chamber 10 extractable support 9, as shown in FIG. 3.
L'effort de traction exercé sur le fil 8 a, de façon avantageuse, également pour effet de commencer à resserrer l'implant pariétal 2 et à le replier sur lui- même au niveau du bord 2A sur lequel est lacé le fil de traction 8. L'implant pariétal 2 prend alors une forme légèrement en éventail facilitant son introduction à l'intérieur de la chambre de pliage 10. L'effort de traction se poursuivant, l'implant pariétal 2 subit un retournement sur lui-même de 180° au niveau du bord de retournement 23 et pénètre progressivement à l'intérieur de la chambre de pliage 10 où les moyens de focalisation 15 et plus précisément les parois 17, 18 du cône 19 le contraignent à se replier de plus en plus sur lui-même, en éventail, à mesure qu'il se rapproche de l'ouverture de sortie 12.The tensile force exerted on the wire 8 has, advantageously, also the effect of starting to tighten the parietal implant 2 and to fold it on itself at the edge 2A on which is laced the traction wire 8 The parietal implant 2 then takes a slightly fan shape facilitating its introduction inside the folding chamber 10. As the traction force continues, the parietal implant 2 undergoes a 180 ° turnaround on itself at the turning edge 23 and progressively penetrates inside the folding chamber 10 where the focusing means 15 and more precisely the walls 17, 18 of the cone 19 force it to fold more and more on itself, fan, as it approaches the outlet opening 12.
Lorsque le bord avant 2A, auquel est rattaché le fil de traction 8, atteint l'ouverture de sortie 12, le chirurgien peut extraire le support extractible 9, qui contient alors l'implant pariétal 2 sensiblement dans son intégralité, du boîtier 4 en vue de le rapporter sur le tube 3 extérieur, de préférence formé par un trocart.When the front edge 2A, to which the traction wire 8 is attached, reaches the outlet opening 12, the surgeon can extract the extractable support 9, which then contains the parietal implant 2 substantially in its entirety, the housing 4 in view report it on the outer tube 3, preferably formed by a trocar.
Selon une première variante, le tube 3 est déjà positionné et introduit à travers une incision ménagée sur le corps du patient. Avant de rapporter le support extractible 9 sur le tube 3 extérieur, le chirurgien introduit le fil de traction 8 à l'intérieur du tube 3 de telle manière que le fil de traction 8 traverse le passage longitudinal 3' ménagé au sein du tube 3 et vienne déboucher dans la cavité du corps où est pratiqué le traitement.According to a first variant, the tube 3 is already positioned and introduced through an incision made on the body of the patient. Before bringing the extractable support 9 onto the outer tube 3, the surgeon introduces the pulling thread 8 into the tube 3 in such a way that the pulling thread 8 passes through the longitudinal passage 3 'formed in the tube 3 and to come into the cavity of the body where the treatment is practiced.
A cet effet, Ie chirurgien fait passer le fil de traction 8 au sein de la fente 52 de l'organe de guidage 50, de manière à l'immobiliser, puis vient connecter le support extractible 9 avec le tube 3 en mettant bout à bout les moyens de coopération 13, et notamment le bec 26, avec l'extrémité externe 3E du tube 3, située à l'extérieur du corps du patient. Plus précisément, le chirurgien vient introduire le bec 26, l'organe de guidage 50 et le fil de traction 8, maintenu contre ou au sein de l'organe de guidage 50, à l'intérieur du passage 3' du tube 3 de telle sorte que la chambre de pliage 10 se trouve en alignement avec le passage longitudinal 3' du tube 3. Le chirurgien peut alors introduire une pince à travers une seconde incision pour venir saisir la deuxième portion d'extrémité 8" libre du fil de traction 8 et exercer un effort de traction sur ce dernier suivant une direction F' de préférence orientée vers le bas (figure 4) de manière à transférer l'implant pariétal 2 plié de la chambre de pliage 10 vers le tube 3, puis vers la cavité du corps où l'implant pariétal 2 est à nouveau libre de se déployer. L'implant pariétal 2 est alors fixé sur les tissus, par exemple en guise de renfort.For this purpose, the surgeon passes the traction wire 8 within the slot 52 of the guide member 50, so as to immobilize it, then connects the extractable support 9 with the tube 3 by putting end to end the cooperation means 13, and in particular the spout 26, with the outer end 3E of the tube 3, located outside the body of the patient. More specifically, the surgeon comes to introduce the spout 26, the guide member 50 and the pull wire 8, held against or within the guide member 50, inside the passage 3 'of the tube 3 of such so that the folding chamber 10 is in alignment with the longitudinal passage 3 'of the tube 3. The surgeon can then introduce a clamp through a second incision to enter the second end portion 8 "free of the pull wire 8 and exert a tensile force on the latter in a direction F 'preferably facing downwards ( 4) so as to transfer the folded parietal implant 2 from the folding chamber 10 to the tube 3, then to the body cavity where the parietal implant 2 is again free to deploy. then fixed on the tissues, for example as a reinforcement.
Selon une deuxième variante, l'étape de transfert de l'implant pariétal 2 de la chambre de pliage 10 vers la cavité du corps peut s'effectuer en deux temps et comporter une première sous-étape au cours de laquelle le chirurgien transfère l'implant pariétal 2 de la chambre de pliage 10 vers le tube 3 à l'extérieur du corps, et une deuxième sous-étape au cours de laquelle le chirurgien vient positionner le tube 3, comportant l'implant pariétal 2 à l'état plié, au sein d'une incision ménagée à travers le corps du patient.According to a second variant, the step of transferring the parietal implant 2 from the folding chamber 10 to the body cavity can be carried out in two stages and comprise a first substep during which the surgeon transfers the parietal implant 2 of the folding chamber 10 to the tube 3 outside the body, and a second substep during which the surgeon comes to position the tube 3, comprising the parietal implant 2 in the folded state, within an incision through the patient's body.
Le kit de pliage conforme à l'invention permet donc d'effectuer un pliage rapide et automatique d'un implant pariétal 2 et permet également d'éviter la manipulation directe de l'implant pariétal 2 par le chirurgien.The folding kit according to the invention therefore makes it possible to carry out a rapid and automatic folding of a parietal implant 2 and also makes it possible to avoid the direct manipulation of the parietal implant 2 by the surgeon.
Un autre avantage du kit 1 de pliage conforme à l'invention est qu'il est utilisable sur sensiblement n'importe quel trocart standard, non nécessairement destiné à l'usage unique mais également réutilisable.Another advantage of the folding kit 1 according to the invention is that it can be used on substantially any standard trocar, not necessarily intended for single use but also reusable.
Un autre avantage du kit 1 de pliage conforme à l'invention est qu'il est utilisable pour le pliage de tout type d'implant en forme de feuille textile ou de film souple, ses composants, hormis l'implant lui-même, pouvant être soit à usage unique, soit à usages multiples. POSSIBILITE D'APPLICATION INDUSTRIELLEAnother advantage of the folding kit 1 according to the invention is that it can be used for folding any type of implant in the form of a textile sheet or a flexible film, its components, apart from the implant itself, being able to be either single-use or multipurpose. POSSIBILITY OF INDUSTRIAL APPLICATION
L'invention trouve son application industrielle dans la réalisation de dispositifs de conditionnement, notamment de pliage, d'implants pariétaux. The invention finds its industrial application in the realization of packaging devices, in particular folding, parietal implants.

Claims

REVENDICATIONS
- Kit de pliage d'un implant pariétal (2) et de transfert dudit implant pariétal (2) vers un tube (3) extérieur, du genre trocart, comportant un boîtier (4) au sein duquel sont disposés : - un implant pariétal (2) sensiblement souple, stocké dans une configuration déployée et pourvu d'un moyen de préhension (7),- Kit for folding a parietal implant (2) and transferring said parietal implant (2) to an outer tube (3) of the trocar type, comprising a housing (4) in which are disposed: - a parietal implant ( 2) substantially flexible, stored in a deployed configuration and provided with a gripping means (7),
- un support extractible (9) comportant une chambre de pliage (10), s'étendant entre une ouverture d'entrée (11) et une ouverture de sortie (12), et au sein de laquelle l'implant pariétal (2) est amené à transiter lorsque le moyen de préhension (7) est actionné, ladite chambre de pliage (10) étant conformée pour assurer le pliage de l'implant pariétal (2) entre l'ouverture d'entrée (11) et l'ouverture de sortie (12), de telle sorte que vers l'ouverture de sortie (12), l'implant pariétal (2) présente une configuration pliée, ledit support extractible (9) étant pourvu, au niveau de l'ouverture de sortie (12), de moyens de coopération (13) avec le tube (3) extérieur, conformés pour faciliter la connexion du support extractible (9) avec ledit tube (3) extérieur et assurer ainsi le transfert de l'implant pariétal (2) plié, de la chambre de pliage (10) vers le tube (3) extérieur.an extractable support (9) comprising a folding chamber (10), extending between an inlet opening (11) and an outlet opening (12), and in which the parietal implant (2) is caused to transit when the gripping means (7) is actuated, said folding chamber (10) being shaped to ensure the folding of the parietal implant (2) between the inlet opening (11) and the opening of outlet (12), so that towards the outlet opening (12), the parietal implant (2) has a folded configuration, said extractable support (9) being provided at the outlet opening (12). ), cooperation means (13) with the outer tube (3), shaped to facilitate the connection of the extractable support (9) with said tube (3) outside and thus ensure the transfer of the folded parietal implant (2), from the bending chamber (10) to the outer tube (3).
- Kit selon la revendication 1 caractérisé en ce que la chambre de pliage (10) est pourvue de moyens de focalisation (15), disposés de manière à délimiter un espace (16) sensiblement convergent entre l'ouverture d'entrée (11) et l'ouverture de sortie (12) afin d'assurer le pliage progressif de l'implant pariétal (2) lors de son passage à travers la chambre de pliage (10).Kit according to claim 1, characterized in that the folding chamber (10) is provided with focusing means (15), arranged so as to delimit a substantially convergent space (16) between the inlet opening (11) and the outlet opening (12) to ensure the progressive folding of the parietal implant (2) as it passes through the folding chamber (10).
3 - Kit selon la revendication 2 caractérisé en ce que les moyens de focalisation (15) sont formés par au moins deux parois (17, 18) disposées sensiblement en V.3 - Kit according to claim 2 characterized in that the focusing means (15) are formed by at least two walls (17, 18) disposed substantially in V.
4 - Kit selon l'une des revendications précédentes caractérisé en ce que l'ouverture d'entrée (11) présente une taille suffisante pour permettre l'introduction de l'implant pariétal (2) dans sa configuration déployée au sein de la chambre de pliage (10).4 - Kit according to one of the preceding claims characterized in that the inlet opening (11) has a size sufficient to allow the introduction of the parietal implant (2) in its deployed configuration within the chamber of folding (10).
5 - Kit selon l'une des revendications précédentes caractérisé en ce que le support extractible (9) est formé par un cône (19) sensiblement aplati.5 - Kit according to one of the preceding claims characterized in that the extractable support (9) is formed by a cone (19) substantially flattened.
6 - Kit selon les revendications 4 et 5 caractérisé en ce que l'ouverture d'entrée (11) est située à la base du cône (19) et en ce que l'ouverture de sortie (12) est située au sommet du cône (19).6 - Kit according to claims 4 and 5 characterized in that the inlet opening (11) is located at the base of the cone (19) and in that the outlet opening (12) is located at the top of the cone (19).
7 - Kit selon l'une des revendications précédentes caractérisé en ce que le support extractible (9) comporte des moyens de guidage (20), conformés et disposés de manière à faciliter l'introduction de l'implant pariétal (2) au sein de la chambre de pliage (10).7 - Kit according to one of the preceding claims characterized in that the extractable support (9) comprises guide means (20), shaped and arranged to facilitate the introduction of the parietal implant (2) within the folding chamber (10).
8 - Kit selon la revendication 7 caractérisé en ce que les moyens de guidage (20) comportent au moins une glissière (21), s'étendant sensiblement parallèlement à la chambre de pliage (10).8 - Kit according to claim 7 characterized in that the guide means (20) comprise at least one slide (21) extending substantially parallel to the bending chamber (10).
9 - Kit selon la revendication 8 caractérisé en ce que la glissière (21) est formée par une languette (22). 10 -Kit selon la revendication 9 caractérisé en ce que la languette (22) est solidarisée avec la chambre de pliage (10) vers l'ouverture d'entrée (11), la jonction entre ladite languette (22) et ladite chambre de pliage (10) formant un bord de retournement (23).9 - Kit according to claim 8 characterized in that the slide (21) is formed by a tongue (22). 10-Kit according to claim 9 characterized in that the tongue (22) is secured to the folding chamber (10) to the inlet opening (11), the junction between said tongue (22) and said folding chamber (10) forming a turning edge (23).
11 -Kit selon la revendication 10 caractérisé en ce que le bord de retournement (23) présente une courbure sensiblement arrondie.11-Kit according to claim 10 characterized in that the turning edge (23) has a substantially rounded curvature.
12 -Kit selon l'une des revendications 9 à 11 caractérisé en ce que la languette (22) et la chambre de pliage (10) s'étendent à distance l'une de l'autre en délimitant un passage (25), ledit passage (25) étant ouvert sur l'extérieur de manière à permettre la préhension de la chambre de pliage (10).12-Kit according to one of claims 9 to 11 characterized in that the tongue (22) and the folding chamber (10) extend at a distance from one another by delimiting a passage (25), said passage (25) being open on the outside so as to allow gripping of the folding chamber (10).
13 -Kit selon l'une des revendications 9 à 12 caractérisé en ce que la languette (22) est solidarisée avec la chambre de pliage (10) vers l'ouverture de sortie (12).13-Kit according to one of claims 9 to 12 characterized in that the tongue (22) is secured to the bending chamber (10) to the outlet opening (12).
14 -Kit selon l'une des revendications précédentes caractérisé en ce que les moyens de coopération (13) sont conformés pour être introduits dans le tube (3) extérieur.14-Kit according to one of the preceding claims characterized in that the cooperation means (13) are shaped to be introduced into the tube (3) outside.
15 -Kit selon la revendication 14 caractérisé en ce que les moyens de coopération (13) sont formés par un bec (26).15-Kit according to claim 14 characterized in that the cooperation means (13) are formed by a spout (26).
16 -Kit selon l'une des revendications précédentes caractérisé en ce que le support extractible (9) se présente sous la forme d'une structure monobloc.16-Kit according to one of the preceding claims characterized in that the extractable support (9) is in the form of a monobloc structure.
17 -Kit selon l'une des revendications précédentes caractérisé en ce que le boîtier (4) comporte un fond (5) s'étendant sur une surface suffisante pour que l'implant pariétal (2) puisse y reposer à plat, le support extractible (9) étant disposé au sein du boîtier (4) de manière à reposer, de préférence directement, sur l'implant pariétal (2).17-Kit according to one of the preceding claims characterized in that the housing (4) has a bottom (5) extending over a sufficient surface so that the parietal implant (2) can rest flat, the extractable support (9) being disposed within the housing (4) so as to rest, preferably directly on the parietal implant (2).
18 -Kit selon l'une des revendications précédentes caractérisé en ce que le moyen de préhension (7) est formé par un fil de traction (8), s'étendant entre une première portion d'extrémité (8'), solidarisée avec l'implant pariétal (2) et une deuxième portion d'extrémité (8"), libre et actionnable, ledit fil de traction (8) étant disposé, avant son actionnement, de manière à traverser la chambre de pliage (10).18-Kit according to one of the preceding claims characterized in that the gripping means (7) is formed by a pull wire (8), extending between a first end portion (8 '), secured to the l parietal implant (2) and a second end portion (8 "), free and operable, said traction wire (8) being disposed, before its actuation, so as to pass through the folding chamber (10).
19 -Kit selon la revendication 18 caractérisé en ce que la première portion d'extrémité (8') est lacée au niveau de l'un des bords (2A, 2B, 2C, 2D) de l'implant pariétal (2) de telle manière que lorsqu'un effort de traction est exercé sur le fil de traction (8), l'implant pariétal (2) se replie sur lui- même en éventail.19-Kit according to claim 18 characterized in that the first end portion (8 ') is laced at one of the edges (2A, 2B, 2C, 2D) of the parietal implant (2) of such so that when a tensile force is exerted on the pull wire (8), the parietal implant (2) folds on itself fan.
20 -Kit selon la revendication 18 ou 19 caractérisé en ce que le support extractible (9) est pourvu, vers l'ouverture de sortie (12), d'un organe de guidage (50) sensiblement allongé et faisant saillie à l'extérieur de la chambre de pliage (10) de manière à faciliter l'introduction du fil de traction (8) dans le tube (3) en assurant son guidage vers ledit tube (3).20-Kit according to claim 18 or 19 characterized in that the extractable support (9) is provided, towards the outlet opening (12), a guide member (50) substantially elongated and projecting outside the folding chamber (10) so as to facilitate the introduction of the pull wire (8) into the tube (3) by guiding it towards said tube (3).
21 -Kit selon la revendication 20 caractérisé en ce que l'organe de guidage (50) comporte un moyen de blocage / déblocage (52) conformé d'une part pour immobiliser le fil de traction (8) en vue d'empêcher son débattement à l'extérieur du support extractible (9), et d'autre part pour le libérer automatiquement lorsqu'un effort de traction est exercé sur le fil de traction (8). -Kit selon la revendication 20 ou 21 caractérisé en ce que l'organe de guidage est formé par un tube fendu (51).21-Kit according to claim 20 characterized in that the guide member (50) comprises a locking / unlocking means (52) shaped on the one hand to immobilize the pull wire (8) to prevent its movement outside the extractable support (9), and secondly to release it automatically when a traction force is exerted on the pull wire (8). -Kit according to claim 20 or 21 characterized in that the guide member is formed by a split tube (51).
-Kit selon l'une des revendications 20 à 22 caractérisé en ce qu'il comporte un moyen de maintien (60), apte à maintenir l'organe de guidage (50) en position repliée contre le support extractible (9).-Kit according to one of claims 20 to 22 characterized in that it comprises a holding means (60), adapted to maintain the guide member (50) in the folded position against the extractable support (9).
-Kit selon l'une des revendications précédentes caractérisé en ce que la chambre de pliage (10) est dimensionnée pour recevoir l'intégralité de l'implant pariétal (2).-Kit according to one of the preceding claims characterized in that the folding chamber (10) is dimensioned to receive the entire parietal implant (2).
-Kit selon l'une des revendications précédentes caractérisé en ce que la longueur de la chambre de pliage (10) est supérieure ou égale à celle de l'implant pariétal (2).-Kit according to one of the preceding claims characterized in that the length of the bending chamber (10) is greater than or equal to that of the parietal implant (2).
-Kit selon l'une des revendications précédentes caractérisé en ce que l'implant pariétal (2) est formé par une pièce textile.-Kit according to one of the preceding claims characterized in that the parietal implant (2) is formed by a textile piece.
-Procédé de pliage d'un implant pariétal (2) sensiblement souple stocké dans une configuration déployée au sein d'un boîtier (4) puis de transfert dudit implant pariétal (2) dans un tube (3) extérieur au boîtier (4), par exemple un trocart, comportant :-Bring method of a substantially flexible parietal implant (2) stored in a deployed configuration within a housing (4) and then transferring said parietal implant (2) into a tube (3) outside the housing (4), for example a trocar, comprising:
- une étape (a) de pliage de l'implant pariétal (2), au cours de laquelle on actionne un moyen de préhension (7), relié à l'implant pariétal (2), de manière à faire passer ledit implant pariétal (2) à travers une chambre de pliage (10), ménagée dans un support extractible (9) disposé au sein du boîtier (4), afin de plier ledit implant pariétal (2) au cours de son trajet,a step (a) for folding the parietal implant (2), during which a gripping means (7) is actuated, connected to the parietal implant (2), so as to pass said parietal implant ( 2) through a bending chamber (10), formed in an extractable support (9) disposed within the housing (4), for folding said parietal implant (2) during its journey,
- une étape (b) de transfert de l'implant pariétal (2) plié de la chambre de pliage (10) vers le tube (3) au cours de laquelle on extrait le support extractible (9) du boîtier (4) et on le rapporte sur le tube (3).a step (b) of transferring the folded parietal implant (2) from the folding chamber (10) to the tube (3) during which one extracting the extractable support (9) from the housing (4) and feeding it onto the tube (3).
-Procédé selon la revendication 27 caractérisé en ce que l'étape (b) de transfert comporte une sous-étape d'actionnement du moyen de préhension (7) de manière à transférer l'implant pariétal (2) plié de la chambre de pliage (10) vers le tube (3).-Procédé according to claim 27 characterized in that the step (b) of transfer comprises a sub-step of actuating the gripping means (7) so as to transfer the folded parietal implant (2) of the bending chamber (10) to the tube (3).
-Procédé selon la revendication 27 ou 28 caractérisé en ce que l'étape (a) de pliage s'effectue en faisant converger progressivement et de manière régulièrement continue l'implant pariétal (2) au sein de la chambre de pliage (10) en vue d'éviter son coincement contre le support extractible (9).-Procédé according to claim 27 or 28 characterized in that the step (a) of folding is performed by converging progressively and regularly continuous parietal implant (2) within the bending chamber (10) in to avoid jamming against the extractable support (9).
-Procédé selon la revendication 29 caractérisé en ce que l'étape (a) de pliage s'effectue sur sensiblement toute la longueur du boîtier (4).-Procédé according to claim 29 characterized in that the step (a) of bending is carried out over substantially the entire length of the housing (4).
-Procédé selon l'une des revendications 27 à 30 caractérisé en ce qu'il comporte une étape (c) de resserrement, précédant l'étape (a) de pliage, au cours de laquelle on vient resserrer l'implant pariétal (2), en actionnant le moyen de préhension (7), de manière à faciliter son introduction dans la chambre de pliage (10). -Procédé according to one of claims 27 to 30 characterized in that it comprises a step (c) of tightening, preceding the step (a) of folding, during which one comes tighten the parietal implant (2) by actuating the gripping means (7) so as to facilitate its insertion into the folding chamber (10).
PCT/FR2006/000605 2005-03-22 2006-03-20 Kit for folding a flexible parietal implant and corresponding folding method WO2006100372A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0502816A FR2883467B1 (en) 2005-03-22 2005-03-22 FOLDING KIT FOR A SOFT PARIETAL IMPLANT AND CORRESPONDING FOLDING METHOD
FR0502816 2005-03-22

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WO2006100372A1 true WO2006100372A1 (en) 2006-09-28

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Cited By (3)

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Publication number Priority date Publication date Assignee Title
EP2712579A1 (en) * 2012-09-28 2014-04-02 Covidien LP Package for a surgical repair kit
WO2014049446A3 (en) * 2012-09-28 2014-07-17 Sofradim Production Packaging for a hernia repair device
US11376109B2 (en) 2015-04-23 2022-07-05 Sofradim Production Flat package for a surgical mesh and a method of packaging a surgical mesh in said package

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EP1262154A1 (en) * 2001-06-01 2002-12-04 Nidek Co., Ltd. Intraocular lens injection instrument
US20030045928A1 (en) * 2001-08-30 2003-03-06 Jibin Yang Container and method for storing and delivering minimally-invasive heart valves
WO2003041614A1 (en) * 2001-11-15 2003-05-22 Sofradim Production Device for packaging and folding a flexible material part, in particular a parietal reinforcement

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Publication number Priority date Publication date Assignee Title
EP1262154A1 (en) * 2001-06-01 2002-12-04 Nidek Co., Ltd. Intraocular lens injection instrument
US20030045928A1 (en) * 2001-08-30 2003-03-06 Jibin Yang Container and method for storing and delivering minimally-invasive heart valves
WO2003041614A1 (en) * 2001-11-15 2003-05-22 Sofradim Production Device for packaging and folding a flexible material part, in particular a parietal reinforcement

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2712579A1 (en) * 2012-09-28 2014-04-02 Covidien LP Package for a surgical repair kit
WO2014049446A3 (en) * 2012-09-28 2014-07-17 Sofradim Production Packaging for a hernia repair device
US9956068B2 (en) 2012-09-28 2018-05-01 Covidien Lp Package for a surgical repair kit
US10159555B2 (en) 2012-09-28 2018-12-25 Sofradim Production Packaging for a hernia repair device
US11376109B2 (en) 2015-04-23 2022-07-05 Sofradim Production Flat package for a surgical mesh and a method of packaging a surgical mesh in said package

Also Published As

Publication number Publication date
FR2883467A1 (en) 2006-09-29
FR2883467B1 (en) 2007-06-22

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