WO2007101970A1 - Instrument chirurgical et son utilisation - Google Patents

Instrument chirurgical et son utilisation Download PDF

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Publication number
WO2007101970A1
WO2007101970A1 PCT/GB2006/000804 GB2006000804W WO2007101970A1 WO 2007101970 A1 WO2007101970 A1 WO 2007101970A1 GB 2006000804 W GB2006000804 W GB 2006000804W WO 2007101970 A1 WO2007101970 A1 WO 2007101970A1
Authority
WO
WIPO (PCT)
Prior art keywords
mesh
instrument
elements
urethra
female
Prior art date
Application number
PCT/GB2006/000804
Other languages
English (en)
Inventor
Rajiv Varma
Original Assignee
Rajiv Varma
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Rajiv Varma filed Critical Rajiv Varma
Priority to PCT/GB2006/000804 priority Critical patent/WO2007101970A1/fr
Publication of WO2007101970A1 publication Critical patent/WO2007101970A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00805—Treatment of female stress urinary incontinence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045—Support slings

Definitions

  • the present invention relates to a surgical method and related instrument for use in the treatment of female stress urinary incontinence. More particularly, the invention provides a minimally invasive mechanism for the treatment of female stress urinary incontinence comprising a biocompatible smaller strip of mesh, one or two curved needle-like elements which are deployed simultaneously or separately to place the said mesh around the mid-urethra region without any exit points through the skin and without the use of additional anchoring equipments, and supporting device for insertion of mesh inside the female body via vagina.
  • Urinary incontinence is caused by anatomical defect function in the tissues or ligaments connecting the vagina wall with the pelvic muscles and pubic bone. Urinary incontinence not only affects number of female patients worldwide but also disturbs their normal day-to-day lifestyle and social appearances. Such a defect results in an improperly functioning urethra.
  • the urethra when properly supported by strong pelvic floor muscles and healthy connective tissue, maintains a tight seal to prevent involuntary loss of urine. But during urinary incontinence, however, weakened muscle and pelvic tissues are unable to adequately support the urethra in its correct position, permitting urine to escape. Most often, the incontinence occurs during coughing, sneezing, or physical activity in females afflicted with this problem.
  • retropubic space means that region of the female body that is posterior to the pubic bone (i.e. the region that is posterior to the pubic ramus and pubic symphysis). This is an area of loose connective tissue between the bladder with its related fascia and the pubis. It includes endopelvic fascia.
  • the retropubic space extends upward to the rectus fascia, but does not include the suprapubic area with the rectus fascia itself.
  • the retropubic space does not extend beyond the sacrum.
  • the phrases "space of Retzius” or “cave of Retzius” is also used to describe portions of the retropubic space.
  • endopelvic fascia means tissue that covers the pelvic organs and surrounds vessels and nerves in the pelvic region (e.g. in the subperitoneal space). Endopelvic fascia includes collagen, elastin and smooth muscle. These structures surround and support the viscera in the pelvic cavity and extend from the pelvic floor to the rectus fascia and respiratory diaphragm. As used herein, endopelvic fascia can include pubocervical fascia and periurethral fascia. Endopelvic fascia is also referred to as visceral pelvic fascia.
  • Pubocervical fascia means a sheet of thick fibrous tissue that is located on the vagina underneath the bladder. Pubocervical fascia is anterior vaginal fascia that fuses with vaginal tissue, providing a hammock for the urethra and bladder. Proximally, the pubocervical fascia attaches to the cervix; distally it extends beneath the urethra and fuses with the perineal membrane of the ureogenital triangle; and laterally, it is connected to the pelvic wall at the fascial white line (arcus tendineus fasciae pelvis). The pubocervical fascia forms a horizontal platform that supports the bladder, and its anterior portion supports the urethra. With increased abdominal pressure, the lower urinary tract is forced inferiorly and compressed against the pubocervical fascia while this fascial layer displaces to a lesser degree because of its elastic suspensory characteristics.
  • US Patent No. 5,112,344 discloses a method for treating female urinary incontinence without the necessity of opening the abdomen, which would require hospital care for may be four days.
  • a filamentary element or mesh tape
  • the tape is left in the body in order that fibrous tissue shall develop around the tape, said scar tissue functioning as a supporting ligament in the soft tissue.
  • the tape is removed from the body when such scar tissue has developed, which may take about two months.
  • a surgical instrument of special construction is also proposed for use with this method, comprising a shank having a handle at one end thereof and a curved portion at the other end thereof said portion being intended to be passed into the body via the vagina.
  • FIG. 5 Another US Patent No. 5,899,909 discloses a surgical instrument comprising a shank having a handle at one end and connecting means at the other ends to receive, one at a time, two curved needle-like elements which are connected at one end to one end of a mesh intended to be implanted into the body.
  • a tape-free end of one of the needle-like elements is inserted through the vaginal incision and into the paraurethral space, through the rectus sheath and out through the lower anterior abdominal wall.
  • the needle is angulated laterally (for example, to the right) to perforate the endopelvic fascia, guided through the retropubic space and passed through the abdominal incision.
  • the handle is disconnected and the needle is then withdrawn through the abdominal wall, thereby threading a portion of the tape through the tissue of the patient.
  • This technique is repeated with the other needle on the other side (for example, to the left), so that the tape is looped beneath the bladder neck or urethra.
  • the tape is adjusted to provide appropriate support to the bladder neck or urethra.
  • the tape ends are then cut at the abdominal wall leaving the ends of the sling anchored in the abdominal (rectus) fascia.
  • This trans-vaginal procedure is exemplified by the TVT product sold by Gynecare franchise of Ethicon Inc, a Johnson & Johnson Co., of Somerville, NJ., USA. It has been suggested that retro-pubic TVT may stabilize the mid-urethra at the time of an abdominal pressure increase without modifying cervico-urethral mobility.
  • the procedure relies on tightening of the tape around the urethra.
  • the mesh itself provides a "velcro-like" effect within the pelvic musculature to hold the mesh in place while the scar tissue forms. A resulting over tightening may result in de novo urgency.
  • This and similar procedures similar to this also have the risk of bladder injury due to the passage of this rather large mesh into the abdominal wall.
  • De Leval (US 2004/0097974 Al) describes a surgical technique for the treatment of female stress urinary incontinence, in which the posterior urethra is supported using a tape passed through the obturator orifices from inside (underneath the urethra) to outside (thigh folds).
  • an incision is made of the vaginal wall, a pare-urethral dissection towards the ischio pubic ramus is performed while avoiding a perforation of the vaginal wall.
  • a surgical needle is rotated around the ischio pubic ramus, and exits from a previously identified surgical exit point.
  • An outside in approach is roughly performed in the opposite manner.
  • This procedure may be safer than the outside-in obturator approach but still carries the risk of injury to the obturator bundles if not done correctly. Moreover, due to the exit of the needles into the thigh folds, this procedure results in transient pain as a side effect. Further more, the obturator approach also uses the "Velcro-like" effect within the obturator musculature to hold the tape under the urethra.
  • Anchors and/or the "Velcro-like" effect are deemed necessary to keep the mesh in place while tissue in-growth occurs and a scar forms under the urethra.
  • the mesh may be dislodged or move out of place if not attached.
  • Carey WO 2004/045457
  • the mesh can be kept in-place while the tissue in-growth occurs using a pessary or a splint without the need for anchoring.
  • the present invention is novel and relates to use of a surgical instrument for treatment of female urinary incontinence.
  • the present invention relates to a method and related surgical instrument for use in the treatment of female stress urinary incontinence. More particularly, the present invention provides a safe, effective and minimally invasive surgical procedure for deploying and implanting a biocompatible smaller strip of mesh inside the female body around the mid- urethra region without the additional use of anchoring equipments and without exit points through the skin.
  • the surgical procedure can be suitably carried out under local anesthesia in the office setting or an operating room suite.
  • a surgical instrument comprises a biocompatible and a smaller strip of mesh to be implanted in vivo, two curved needle-like elements to be deployed simultaneously or separately for the said mesh to be placed around the mid- urethral region and supporting device for insertion of mesh and needle-like element assembly in vivo via female vagina.
  • a surgical instrument in another aspect of the invention, includes a biocompatible and smaller strip of mesh of polypropylene, optionally a removable protective sleeve designed to assist deployment of the mesh into the body, and two curved needle-like element having upwardly directional projections or hooks for easy deployment of the said mesh around the mid-urethra region.
  • the sleeve is optional.
  • the sleeve can be made of soluble material which dissolves as the needles are inserted and kept in the body for short time.
  • the mesh is between 0.1cm to 0.8cm in width and 3 cm to 10 cm in length and placed under the urethra without the need of additional anchoring equipments and with or without the need for a pessary or splint in the vagina.
  • two curved needle-like elements are positioned at a predetermined angle to the horizontal, to be inserted into a cut made in the vagina at the mid-urethra.
  • One end of each needle-like element is coupled with supporting device and other end is intended to pass into the body via the female vagina.
  • the needle-like elements can be curved parallel to each other to form U-shaped profile to be inserted in the direction of the pubic bone or obturator foramen or area in between around the mid-urethra region. In yet another aspect of the invention, the needle-like elements can be curved into a V- shape profile to be inserted in the direction of the pubic bone or obturator foramen or area in between around the mid-urethra region.
  • the needle-like elements can be straight, curved or made of shape memory alloy, which can change its shape as the needle-like elements are deployed.
  • the supporting device has mechanism to protect the urethra as the needles are deployed.
  • a supporting device which may or may not be automated to deploy the needles simultaneously or separately.
  • a method for mechanically or automatically deploying biocompatible smaller strip of mesh around the mid-urethral region for the treatment of the female urinary incontinence is provided.
  • Fig. 1 is example embodiment of needle with hooks/ projections and a piece of mesh
  • Fig.2 is example embodiment of the a mesh mounted on a needle
  • Fig. 3 is example embodiment of mesh wrapped around needle assembly and held by hooks. The figure also shows the one of the two sleeves and placement of the sleeve on the needle.
  • Fig.4 is example embodiment of needle with plurality of holes and illustrates a mesh placed around the needles
  • Fig. 5 is example embodiment of an alternative method of holding and selectively releasing the mesh.
  • Fig. 6 illustrates an example embodiment of supporting device for placing the mesh
  • Fig 7 illustrates an example embodiment of supporting device and the mesh mounted on the said supporting device.
  • Fig 8 illustrates an example embodiment of the procedure of placing the mesh in female body
  • Fig 9 illustrates how the mesh is placed in the body
  • Fig 10 illustrates and example embodiment of a manual device to place a mesh in female body.
  • a smaller strip of mesh 100 is implanted in the body 137 through a incision on anterior vaginal wall 136 and placed in the mid-urethral region between vaginal facia and urethra and pointing upwards.
  • the mesh can be placed pointing to retropubic space or obturator foramen or in between.
  • fig 9 it is shown pointing towards the retropubic space.
  • there are no anchors used to hold the mesh is place.
  • the mesh is of small enough size not to require any exit points. The mesh is left in the body and it produces scar tissue which makes the female continent.
  • a surgical instrument is devised to be inserted in vivo via female vagina and positioned in the vicinity of mid-urethral region for deploying and implanting biocompatible smaller strip of mesh (hereinafter referred as "Mesh” or “mesh”) 100 optionally covered by removable protective sleeve 108 without the use of external anchoring equipments.
  • the mesh 100 width can range from 0.1 cm to 0.8 cm with length ranging from 1 cm to 10 cm, preferable size is 0.3 cm to 0.6cm in width and 5cm to 6 cm in length.
  • the curved needle-like elements (hereinafter referred as "Needle” or “needle”) 102 made of rigid or semi-rigid material has projections 104 which point upwards, towards the tip or outwards, away from the center as illustrated in Fig. 3.
  • Mesh 100 is wrapped around the needle 102 and held in place by the hooks 104 as illustrated in Fig. 2.
  • a sleeve 108 which can be made of rigid, semi-rigid or thin material, encloses the mesh 100.
  • the material of the sleeve 108 can be biocompatible polymer or metals like stainless steel.
  • the novel concept of the sleeve 108 provides low friction when the device is inserted into the tissue.
  • the sleeve 108 can be ripped off or slide back while deploying the mesh.
  • the assembly of needle 102, mesh 100 and optional sleeve 108, is inserted into the predefined anatomical space. Once the assembly is in right position, the sleeve 108 can be removed from the mesh, if the sleeve 108 exists on the instrument. This exposes the mesh 100, which comes in contact with the tissue.
  • the hooks 104 help to keep the mesh in place while the instrument is inserted. The specific direction of hooks 104 releases the mesh 100 while the needle 102 is pulled out. As the friction between mesh 100 and tissue is more than the mesh 100 and needle 102, it prevents major movement of mesh 100 when the needle 102 is pulled out, placing mesh 100 in desired place in a desired manner.
  • mesh is selectively released by using string 114, which passes through plurality of holes 112 made on the needle 102 and holds the mesh 100 in place as illustrated in Fig.4.
  • string 114 can hold only at the distal end through the holes 109 provided at the distal end of the needle 102. As the string 114 is pulled out, the mesh 100 becomes free and is deployed.
  • the mesh 100 is held in place on the needle 102 by using dissolving adhesive.
  • dissolving adhesive can be like a dissolving sleeve made of gelatin or other such material.
  • mesh 100 is selectively releases using a device 120 in the form of medical stapler or gun or any other appropriate resembling shape.
  • a device 120 in the form of medical stapler or gun or any other appropriate resembling shape.
  • Fig. 6 and Fig. 7 exemplifies a device 120 having a gear mechanism or such mechanical force transmitting mechanism 124, which allows the needles 102 to be deployed as desired.
  • the device 120 has a mechanical trigger 122 or other power source 124 to move said mechanism to deploy the mesh 100 and needle 102.
  • the device has optional urethral probe 128 which guides the device and also prevents any damage to the tissue when the needles 102 are deployed.
  • the fire the device 120, the vaginal probe 126 of the device is placed in the female vagina 136, the probe 128 is inserted into the urethra 135.
  • the trigger 122 moves the gear train 124, which in turn ejects the needle 102 out of the vaginal probe 126.
  • the needle 102 then travels into the tissue at a predetermined angle.
  • the needle 102 can be made to travel either in direction of retro pubic space or obturator foramen or in between.
  • the needle 102 can be made of memory retaining material (or shape memory alloy) like Nitinol or biomedical grade polymer or biomedical grade metal.
  • This assembly then travels through the predetermined direction in the tissue.
  • the sleeve 108 shown in Fig 7 will be retracted in the device 120, exposing the mesh 100 to the surrounding tissue.
  • the needle 102 is withdrawn leaving the mesh 100 in tissue.
  • the needle 102, mesh 100 and optional sleeve 108 assembly is deployed in the tissue when the trigger or powering mechanism 124 is pulled and later when released, the sleeve 108 retracts first and then the needle 102 retract in the same stroke.
  • an optional urethral probe 128 is inserted into the urethra before deploying the device, to prevent the puncture during deployment of needle 102.
  • an anvil as shown in Fig 10 is provided on the vaginal probe, which rests against the urethra and prevents the needle 102 from accidentally puncturing the urethra.
  • pushing the manual slider 145 deploys the needles.
  • the device 140 houses the slider, the needles, mesh and optional sleeve and optional urethral probe.
  • the needles 102 are deployed in the body.
  • the slider can also be used to slide back the needles to deploy the mesh.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gynecology & Obstetrics (AREA)
  • Pregnancy & Childbirth (AREA)
  • Reproductive Health (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un instrument chirurgical à utiliser dans le traitement d'une incontinence urinaire d'effort chez la femme. Plus particulièrement, l'invention a pour objet un mécanisme très peu invasif pour le traitement de l'incontinence urinaire d'effort chez la femme qui consiste en une petite bandelette biocompatible en maille, en deux éléments recourbés en aiguille qui sont déployés simultanément pour placer ladite maille autour de la région moyenne de l'urètre sans aucun point de sortie par la peau et sans utiliser de matériel d'ancrage supplémentaire, et en un appareil de support à cette fin.
PCT/GB2006/000804 2006-03-07 2006-03-07 Instrument chirurgical et son utilisation WO2007101970A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/GB2006/000804 WO2007101970A1 (fr) 2006-03-07 2006-03-07 Instrument chirurgical et son utilisation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/GB2006/000804 WO2007101970A1 (fr) 2006-03-07 2006-03-07 Instrument chirurgical et son utilisation

Publications (1)

Publication Number Publication Date
WO2007101970A1 true WO2007101970A1 (fr) 2007-09-13

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ID=37416212

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2006/000804 WO2007101970A1 (fr) 2006-03-07 2006-03-07 Instrument chirurgical et son utilisation

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WO (1) WO2007101970A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009046289A1 (fr) * 2007-10-03 2009-04-09 Boston Scientific Scimed, Inc. Implants pelviens et dispositifs et procédés de pose les employant
WO2011026494A3 (fr) * 2009-09-01 2011-04-28 Coloplast A/S Appareil, système et procédé de réparation minimalement invasive d'un prolapsus d'organe pelvien

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5474543A (en) * 1993-05-17 1995-12-12 Mckay; Hunter A. Single needle apparatus and method for performing retropublic urethropexy
US20020161382A1 (en) * 2001-03-29 2002-10-31 Neisz Johann J. Implant inserted without bone anchors
US20030062052A1 (en) * 2001-10-03 2003-04-03 Surx, Inc. Urethral support for incontinence
US20050038451A1 (en) * 2003-08-14 2005-02-17 Scimed Life Systems, Inc. Medical slings
EP1516596A1 (fr) * 2002-05-29 2005-03-23 Jesus Romero Maroto Systeme ameliore destine au traitement de l'incontinence urinaire d'effort
US20050148813A1 (en) * 1994-08-30 2005-07-07 Jan Claren Surgical instrument for treating female urinary incontinence
US20050277806A1 (en) * 2004-06-10 2005-12-15 Cristalli Bernard G R Prosthetic implant for sub-urethral support, an instrument, an insertion kit, and a surgical method for implanting it

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5474543A (en) * 1993-05-17 1995-12-12 Mckay; Hunter A. Single needle apparatus and method for performing retropublic urethropexy
US20050148813A1 (en) * 1994-08-30 2005-07-07 Jan Claren Surgical instrument for treating female urinary incontinence
US20020161382A1 (en) * 2001-03-29 2002-10-31 Neisz Johann J. Implant inserted without bone anchors
US20030062052A1 (en) * 2001-10-03 2003-04-03 Surx, Inc. Urethral support for incontinence
EP1516596A1 (fr) * 2002-05-29 2005-03-23 Jesus Romero Maroto Systeme ameliore destine au traitement de l'incontinence urinaire d'effort
US20050038451A1 (en) * 2003-08-14 2005-02-17 Scimed Life Systems, Inc. Medical slings
US20050277806A1 (en) * 2004-06-10 2005-12-15 Cristalli Bernard G R Prosthetic implant for sub-urethral support, an instrument, an insertion kit, and a surgical method for implanting it

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009046289A1 (fr) * 2007-10-03 2009-04-09 Boston Scientific Scimed, Inc. Implants pelviens et dispositifs et procédés de pose les employant
US20090093672A1 (en) * 2007-10-03 2009-04-09 Chu Michael S H Pelvic implants and delivery devices and methods of using the same
US8317675B2 (en) 2007-10-03 2012-11-27 Boston Scientific Scimed, Inc. Pelvic implants and delivery devices and methods of using the same
WO2011026494A3 (fr) * 2009-09-01 2011-04-28 Coloplast A/S Appareil, système et procédé de réparation minimalement invasive d'un prolapsus d'organe pelvien
US8585581B2 (en) 2009-09-01 2013-11-19 Coloplast A/S Apparatus, system and method of minimally invasive repair of pelvic organ prolapse

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