WO2009036094A2 - Matériaux prothétiques magnétiques pour implantation par procédé endoscopique transluminal par orifice naturel - Google Patents

Matériaux prothétiques magnétiques pour implantation par procédé endoscopique transluminal par orifice naturel Download PDF

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Publication number
WO2009036094A2
WO2009036094A2 PCT/US2008/075898 US2008075898W WO2009036094A2 WO 2009036094 A2 WO2009036094 A2 WO 2009036094A2 US 2008075898 W US2008075898 W US 2008075898W WO 2009036094 A2 WO2009036094 A2 WO 2009036094A2
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WO
WIPO (PCT)
Prior art keywords
mesh
magnetic
prosthetic
prosthetic material
magnetically manipulatable
Prior art date
Application number
PCT/US2008/075898
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English (en)
Other versions
WO2009036094A3 (fr
Inventor
Christopher C. Thompson
Marvin Ryou
Original Assignee
The Brigham And Women's Hospital, Inc.
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 The Brigham And Women's Hospital, Inc. filed Critical The Brigham And Women's Hospital, Inc.
Publication of WO2009036094A2 publication Critical patent/WO2009036094A2/fr
Publication of WO2009036094A3 publication Critical patent/WO2009036094A3/fr

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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
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • 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
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/009—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic

Definitions

  • the invention relates to the field of medical devices, and more specifically, to magnetic prosthetic materials for implantation using natural orifice transluminal endoscopic methods.
  • NOTES Natural Orifice Transluminal Endoscopic Surgery
  • NOTES is potentially less invasive than laparoscopy because it eliminates abdominal incisions and incision-related complications such as wound infections, incisional hernias, post-operative pain, and adhesions.
  • a NOTES approach may represent a potentially less invasive alternative to transabdominal surgery.
  • advances in electrosurgical instruments and prototype suturing devices have allowed for dissection and resection of abdominal organs using NOTES
  • surgical procedures involving implants, such as hernia mesh present challenges because of the difficulty in manipulating and securing such implants.
  • One aspect of the invention relates to magnetically manipulatable prosthetic materials for implantation in human and animal bodies.
  • the materials comprise at least one layer of a biocompatible prosthetic material and one or more magnetic elements attached to the biocompatible prosthetic material at defined locations.
  • the prosthetic material may comprise a sheet of mesh material, and the magnetic elements may be attached around the periphery of the sheet of mesh material.
  • Another aspect of the invention relates to a system for manipulating and securing a magnetic prosthetic material inside a body cavity.
  • the system comprises a magnetically manipulatable prosthetic material, as described above, and a positionable magnetic manipulator.
  • the positionable magnetic manipulator has at least one magnetic element and is constructed and arranged to exert a magnetic manipulating force on the prosthetic material while the prosthetic material is positioned within a body cavity and the magnetic manipulator is positioned outside of the body cavity.
  • Yet another aspect of the invention relates to a method for implanting a magnetically manipulatable prosthetic material in a body cavity.
  • the method comprises accessing the body cavity by inserting a surgical instrument into an existing bodily lumen through a natural orifice and making an opening in a tissue wall associated with the bodily lumen to define a transluminal pathway into the body cavity.
  • the method further comprises deploying a magnetically manipulatable prosthetic material into the body cavity using the transluminal pathway, and manipulating the prosthetic material using a magnetic manipulator located outside of the body cavity.
  • FIG. 1 is a perspective view of a one embodiment of a magnetically manipulatable mesh according to an embodiment of the invention
  • FIG. 2 is a top plan view of another embodiment of a magnetically manipulatable mesh according to another embodiment of the invention.
  • FIG. 3 is a top plan view of a magnetically manipulatable mesh according to yet another embodiment of the invention.
  • FIG. 4 is a side elevational view of a deployment device suitable for use with the meshes of FIGS. 1-3;
  • FIG. 5 is an illustration of the magnetically manipulatable mesh of FIG. 1 in position and being manipulated using a magnetic manipulator.
  • FIG. 6 is a side elevational view of a magnetic manipulator
  • FIG. 7 is a photograph taken using an endoscope showing a prosthetic mesh implanted on the ventral abdominal wall; and FIG. 8 is a photograph illustrating the necropsy findings of the implanted mesh site of FIG. 7.
  • Embodiments of the invention provide magnetically manipulatable prosthetic materials suitable for implantation in human and other animal bodies. These magnetically manipulatable materials may take the form of single-layer continuous sheets, multi-layer sheets, meshes, plugs, or other shapes.
  • FIG. 1 is a schematic top plan view of a magnetically manipulatable material according to one embodiment of the invention, in the form of a magnetically manipulatable mesh for hernia repair, generally indicated at 10.
  • the mesh 10 comprises one or more layers of mesh material, in the illustrated embodiment, a first layer of mesh material 12, a second layer of mesh material 14, and a layer of ferromagnetic material 16 that is secured between the first and second layers of mesh material 12, 14 around the periphery of the mesh 10.
  • the mesh 10 may have any size or shape that is appropriate for the particular application or procedure.
  • the layers of mesh material 12, 14 are generally made of biocompatible materials and, for example, may be made of biocompatible polymers.
  • the layers of mesh material 12, 14 may be layers of polypropylene and expanded polytetrafluoroethylene (ePTFE) hernia mesh (e.g., COMPOSIX mesh, Davol Inc., Cranston, RI).
  • ePTFE expanded polytetrafluoroethylene
  • suitable materials for meshes include polypropylene and collagen; polyester and collagen; polypropylene, hyaluronic acid and carboxymethyl cellulose; and polypropylene, polydioxanone, and oxidized regenerated cellulose.
  • a mesh according to embodiments of the invention may have any number of layers, secured together in any suitable fashion. Magnetically manipulatable materials other than meshes may be made of any of the materials listed above or any other suitable biocompatible material.
  • the layers of mesh material 12, 14 may have any conventional features; for example, one layer of material 12, 14 may have a surface that is rough, barbed, textured, or otherwise adapted to facilitate tissue growth, while the other layer 12, 14 may be relatively smooth and adapted for adhesion.
  • the overall thickness of the mesh 10 may be several millimeters, for example 2-3 millimeters. It is advantageous, however, if the mesh 10 has at least some flexibility, regardless of its particular thickness.
  • the ferromagnetic material 16 may be any biocompatible ferromagnetic material, including surgical steels and other biocompatible ferromagnetic alloys.
  • the ferromagnetic material 16 may also have any shape or thickness, and may extend over the entirety or only a portion of the peripheral space into which it is sewn or otherwise attached, so long as it extends over a portion of the mesh 10 sufficient to allow the mesh 10 to be magnetically manipulated. Additionally, although the ferromagnetic material 16 and the mesh 10 as a whole may have any desired thickness, it is advantageous if the ferromagnetic material 16 allows the mesh 10 to be folded, rolled, or otherwise packed for delivery.
  • the ferromagnetic material 16 of the mesh 10 is shown as extending around the periphery of the mesh 10, in some embodiments, particularly with larger meshes, it may be desirable to have layers of ferromagnetic material 16 extending into the interior of the mesh 10, so as to make the mesh more easily manipulatable.
  • pockets of ferromagnetic material could be provided at particular or regularly-spaced locations along the mesh 10.
  • FIG. 2 is a schematic top plan view of another embodiment of a magnetically manipulatable mesh for hernia repair, generally indicated at 50.
  • Mesh 50 comprises a layer of mesh material 52 to which ferromagnetic materials 54 have been attached at discrete locations around its perimeter.
  • the ferromagnetic materials 54 may be attached, for example, by appropriate sutures 56.
  • FIG. 3 is a top plan view of a mesh 100 according to another embodiment of the invention.
  • Mesh 100 has ferromagnetic surgical clips 102 attached to its corners to allow it to be magnetically manipulated.
  • ferromagnetic materials that may be detached either by severing a connector that connects the two, as in mesh 50, or by operating a mechanism to release the ferromagnetic material 102 from the mesh, as in mesh 100.
  • These configurations may be particularly advantageous, in that the meshes 50, 100 may be implanted and manipulated magnetically, after which (for example, after suturing in place) the ferromagnetic materials 54, 102 may be detached from the mesh 50, 100 and withdrawn, so that the mesh 50, 100, as implanted, is not susceptible to electromagnetic forces.
  • FIGS. 1-3 illustrate specific examples of magnetically manipulatable meshes using distinct ferromagnetic materials
  • any mechanism by which a mesh may be made responsive to magnetic fields may be used in embodiments of the invention.
  • a mesh 10, 50, 100 may be implanted in a body cavity by inserting a surgical instrument, such as an endoscope, into an existing bodily lumen through a natural orifice and making an incision in a tissue wall associated with the bodily lumen to define a transluminal pathway into the body cavity, a type of procedure sometimes referred to as Natural Orifice Transluminal Endoscopic Surgery (NOTES).
  • NOTES Natural Orifice Transluminal Endoscopic Surgery
  • the associated tissue wall may be contiguous or substantially contiguous with the bodily lumen. This arrangement may be most advantageously used to deploy and manipulate a mesh in the peritoneal cavity or abdomen.
  • a magnetically manipulatable mesh 10, 50, 100 may be folded, rolled, bunched, compressed, or otherwise stowed in an appropriate deployment device.
  • One such device 110 is illustrated in FIG. 4.
  • the device 110 has an outer tubing member 112, formed of flexible tubing in the illustrated embodiment, an inner pusher member 114 formed of semirigid tubing in the illustrated embodiment, and a tip 116 that covers the end of the outer tubing member 112 and serves to prevent the mesh 10, 50, 100 from becoming fouled, soiled, or damaged during the insertion process prior to deployment. Once the tip 116 is positioned in the appropriate location, the pusher member 114 would be advanced to eject the mesh 10, 50, 100 from the device 110.
  • FIG. 5 illustrates the general principle of operation of a magnetically manipulatable mesh 10, 50 once deployed.
  • the mesh 10 would be deployed inside a body cavity 61 by an appropriate instrument (not shown in FIG. 5), and then a magnetic manipulator 60 having a magnet of appropriate field strength and polar orientation could be used to move and manipulate the mesh 10, 50 within the body from a position outside of the body.
  • the mesh 10, 50 is positioned inside the abdomen, and the abdominal wall 63 lies between the mesh 10, 50, 100 and the manipulator 60.
  • the magnetic manipulator 60 also referred to as a magnetic retractor, may comprise one or more permanent magnets or electromagnets arranged on a jointed arm or another such movement mechanism that allows the position of the magnets to be changed so as to change the position or orientation of the mesh 10, 50, 100.
  • FIG. 6 illustrates one example of a magnetic manipulator 60. It includes a support portion 62 that is adapted to be anchored to a fixed surface, such as an operating room table or a floor, and a positionable portion 64 connected to and supported by the support portion 62. The positionable portion 64 itself has a first end 66 and a second end 68 that is spaced from the first end 66.
  • the joints 70, 72, 74, 76 are single and double ball joints; specifically, the two middle joints 72, 74 are double ball joints, while the joints proximate to the first and second ends 70, 76 are single ball joints.
  • the joints of the magnetic manipulator 60 may be of essentially any sort, including ball joints, hinge joints, and sliding joints, to name a few.
  • the magnetic manipulator 60 also includes structures to fix it in a desired position once that position has been set.
  • set screws 78, 80, 82 which are also useful as positioning handles, are provided.
  • the joints 70, 72, 74, 76 may employ friction to maintain the positionable portion 64 in position, or the positionable portion 64 may include counterweights or other conventional elements to maintain position. Additionally, any combination of conventional elements may be used to maintain position, particularly of the first end 66.
  • the magnetic manipulator 60 is preferably of a construction that can support relatively heavy loads (e.g., about 10 kg) in a desired position. It is also advantageous if the magnetic manipulator 60 is made of a rigid, non-magnetic material, such as aluminum.
  • At the first end 66 of the positionable portion 64 are one or more magnets 84.
  • the magnets 84 may be permanent magnets, conventional coil electromagnets, or superconducting magnets (i.e., electromagnets cooled by cryogenic fluids to reduce electrical resistance in the coils). If the magnets 84 are permanent magnets, then they would generally be through-magnetized, such that there are north (N) and south (S) poles, allowing two or more of them to be stacked and magnetically adhered, clamped or otherwise cooperatively attached to increase the total magnetic field and magnetic force levels incrementally.
  • Neodymium permanent magnets are one type of magnet that is suitable for use in embodiments of the present invention.
  • neodymium magnets are capable of producing strong forces relative to their size and also have a high degree of coercivity (i.e., resistance to demagnetization) .
  • the magnets 84 may be attached to the first end 64 using adhesives (such as epoxy), clamps, straps, mechanical fasteners, or some other conventional method of attachment. (In the illustrated embodiment, the magnets 84 are secured by straps 86.) If adhesives are used to secure permanent magnets, it is advantageous if the chemical reactions involved in curing the adhesives are not strongly exothermic, as high temperatures may have a deleterious effect on the magnetic properties of permanent magnets.
  • the first end 66 includes a generally flat attachment plate 88 that is connected to the joint 76 nearest the first end 66 and is thus itself positionable.
  • the attachment plate 88 may, in some embodiments, be magnetic.
  • the magnets 84 may be covered by an appropriate cover so as to maintain sterility, prevent corrosion, and make cleaning easier.
  • the cover itself may be removable and replaceable for easy cleaning, or it may be disposable.
  • magnetically manipulatable prosthetic materials may be used to bolster anastomotic sites, re-route bypass sections in gastric bypass surgical procedures, repair fistulas, and act as a tissue plug, to name a few uses.
  • the following example demonstrates one potential surgical technique for implanting a magnetically manipulatable prosthetic mesh.
  • Suturing system consisted of a 19 gauge hollow needle and pusher wire from a standard Bard EndoCinch kit (Davol Inc., Cranston, RI). 3-0 monofilament sutures with attached T-tags were also utilized.
  • Composite hernia mesh Polypropylene and expanded polytetrafluoroethylene (ePTFE) hernia mesh (Composix mesh, Davol Inc., Cranston, RI) were received sterile and cut to size ranging from 1.5 to 2 cm by 2.5 to 3 cm rectangular pieces.
  • ePTFE expanded polytetrafluoroethylene
  • the mesh delivery device comprised a delivery tube with a pusher shaft mechanism, as in FIG. 4.
  • the device was constructed from medical grade clear flexible plastic tubing with an outer diameter of 1.2 mm, an inner diameter of 10 mm, and a length of 50 cm. A tapered tip of soft plastic was fixed onto the end of the tube. A semi-rigid piece of plastic tubing was used as the pusher shaft.
  • the magnetic manipulator comprised a magnetic manipulator 60 similar to that shown in FIG. 6.
  • the manipulator 60 included four rare earth neodymium block magnets measuring 4" x 2" x 8", stacked together to generate a pull force of 640.5 lbs and a surface field measuring 5120 Gauss (K&J Magnetics, Jamison, PA).
  • Colonic preparation included copious tap water enema lavage followed by the instillation of a 1 gm cefazolin suspension and 60 mL of 10% povidone-iodine solution. The external anal and gluteal surfaces were then scrubbed with 10% povidone-iodine and sterile drapes applied.
  • a guidewire was advanced into the peritoneal cavity and the endoscope was removed.
  • the loaded mesh delivery device was then advanced over the wire through the colotomy and into the peritoneal cavity.
  • the pusher shaft was then advanced through the delivery tube to deposit the mesh into the peritoneal cavity and the device was removed.
  • the magnetic manipulator 60 was attached to the operating table and was then positioned externally over the anterior abdominal wall to transcutaneously manipulate the mesh. In conjunction with two endoscopic forceps internally, the external magnetic manipulator was used to position the mesh over the mid abdominal wall. Using the 19 gauge hollow needle and pusher wire, suture T-tags were used to secure the four corners of the mesh with a goal of transfascial fixation. To facilitate needle puncture, the endoscope was positioned in as much of a perpendicular orientation as possible, relative to the abdominal wall. In subsequent experiments, carefully applied external counter pressure was used to facilitate deeper needle insertion and T-tag deployment through the abdominal layers without breaching the abdominal wall.
  • FIG. 7 is an endoscopic view of the ventral wall with an implanted mesh. Four ceramic plugs from suture T-tags are visible at the corners of the mesh.
  • Post Operative Care and Necropsy Survival animals were recovered from anesthesia and allowed to resume a regular diet immediately.
  • Cephalexin 250mg was administered orally twice a day for three days.
  • the pigs were electively sacrificed and necropsies performed.
  • Necropsies were performed immediately after surgery in the two acute experiments. Gross examination of the peritoneal cavity was performed to identify signs of organ injury and evidence of bleeding or suppurative complications. An assessment of tissue healing and incorporation of the mesh was made including presence of any adhesions. Peritoneal biopsies and tissue samples from the mesh site were obtained for histopathologic examination.
  • the total time for suture placement ranged from 15 to 25 minutes.
  • Closure of the colonic incision was greatly facilitated by the placement of suture T-tags proximal and distal/lateral to the incision site.
  • closure was often challenging due to difficulty bringing the incision margins completely into the endo- loop with a single grasping forcep. Modification of this technique with the suture T- tags allowed for enhanced eversion of the incision margins into the open endo-loop.
  • a single endoscopic clip was used to close a residual defect. Closure times ranged from 5 to 10 minutes in this study. Total procedure times from scope insertion to closure ranged from 45 to 60 minutes.
  • transfascial sutures were within the pre-peritoneal space, four sutures were within the abdominal musculature, and two sutures were through the anterior fascia and into the subcutaneous tissue layer. Histopathologic examination of peritoneal biopsies and tissues from the mesh revealed evidence of collagen deposition, lymphocytic infiltration, and foreign body giant cell reaction around the mesh material consistent with the expected stage of tissue healing and mesh incorporation.
  • FIG. 8 is a photograph illustrating the necropsy findings of the implanted mesh site.
  • the white arrows in FIG. 8 illustrate the outlines of the endoscopic clips at the corners of the mesh; the black arrow illustrates the ceramic plug from the suture T-tag.
  • the delivery of surgical implants is preferably done by aseptic passage through the gastrointestinal tract.
  • the pusher mechanism and delivery tube proved to be an effective conduit for the rolled mesh.
  • Strengths of this design include the simplicity and adaptability to other collapsible or compressible objects that can be back-loaded into a tube.
  • the flexible nature of the plastic tubing also allowed for the creation of a gentle curve to facilitate passage.
  • the device was designed to minimize potential contamination, the extent to which "aseptic" transfer was achieved is unclear.
  • a workable transgastric mesh delivery device may also potentially allow for a transgastric NOTES approach.
  • the system was highly effective in facilitating mesh positioning within the abdominal cavity.
  • the magnet also served to stabilize the mesh during suture T-tag placement.
  • the ability to stabilize the mesh would likely be useful in formal hernia repairs since precise and stable positioning will be highly advantageous during fixation of the mesh.
  • One unexpected benefit of the magnetic manipulator was that it also proved to be instrumental in locating deposited mesh within the abdominal cavity by simply "floating" the magnet across the abdomen.
  • One unintended consequence of the powerful magnets was the magnetic pull on the ferromagnetic forceps, which necessitated intermittent repositioning of the magnets in order to limit the unintended instrument pull. Therefore, it may be advantageous to use non-ferromagnetic surgical instruments with this system, for example, titanium instruments.
  • a true ventral wall hernia repair would involve the creation of a ventral wall hernia, the precise placement of mesh over the ventral wall defect, and secure fixation with both transfascial sutures and the equivalent of tacking sutures to seal the borders of the mesh.
  • the pieces of mesh used in this example were small, and much larger pieces of mesh would be used for formal repairs.
  • Transfascial suture placement through the posterior fascia was achieved in 10 of 12 sutures using the 19 gauge needle, pusher wire, and T-tags suture system from a Bard EndoCinch device. However, only two of the ten transfascial sutures were anchored through the anterior fascia, which would have been preferred.

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  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Surgery (AREA)
  • Epidemiology (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne des matériaux prothétiques manipulables magnétiquement, tels que des treillis prothétiques, ainsi que des procédés d'implantation des matériaux dans une cavité corporelle par chirurgie endoscopique transluminale par orifice naturel (NOTES). L'invention se rapporte également à des procédés et systèmes de manipulation des matériaux prothétiques manipulables magnétiquement depuis l'extérieur du corps.
PCT/US2008/075898 2007-09-12 2008-09-10 Matériaux prothétiques magnétiques pour implantation par procédé endoscopique transluminal par orifice naturel WO2009036094A2 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US97188307P 2007-09-12 2007-09-12
US60/971,883 2007-09-12
US97598207P 2007-09-28 2007-09-28
US60/975,982 2007-09-28

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Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011094251A1 (fr) * 2010-01-26 2011-08-04 Danbury Hospital Tulle chirurgical manipulable magnétiquement et appareil pour sa manipulation
US8317808B2 (en) 2008-02-18 2012-11-27 Covidien Lp Device and method for rolling and inserting a prosthetic patch into a body cavity
US8371308B2 (en) 2009-02-17 2013-02-12 Ethicon, Inc. Magnetic implants and methods for treating an oropharyngeal condition
US8632488B2 (en) 2009-12-15 2014-01-21 Ethicon, Inc. Fluid filled implants for treating medical conditions
US8678008B2 (en) 2008-07-30 2014-03-25 Ethicon, Inc Methods and devices for forming an auxiliary airway for treating obstructive sleep apnea
US8753359B2 (en) 2008-02-18 2014-06-17 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US8758373B2 (en) 2008-02-18 2014-06-24 Covidien Lp Means and method for reversibly connecting a patch to a patch deployment device
US8808314B2 (en) 2008-02-18 2014-08-19 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US20140309626A1 (en) * 2013-04-12 2014-10-16 Covidien Lp System and method having an electromagnetic manipulator with a uv tacking mechanism
US8888811B2 (en) 2008-10-20 2014-11-18 Covidien Lp Device and method for attaching an implant to biological tissue
US8905033B2 (en) 2011-09-28 2014-12-09 Ethicon, Inc. Modular tissue securement systems
US8906045B2 (en) 2009-08-17 2014-12-09 Covidien Lp Articulating patch deployment device and method of use
US8915252B2 (en) 2008-12-01 2014-12-23 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US8973582B2 (en) 2011-11-30 2015-03-10 Ethicon, Inc. Tongue suspension device and method
US9034002B2 (en) 2008-02-18 2015-05-19 Covidien Lp Lock bar spring and clip for implant deployment device
US9044235B2 (en) 2008-02-18 2015-06-02 Covidien Lp Magnetic clip for implant deployment device
US9144511B2 (en) 2008-08-14 2015-09-29 Ethicon, Inc. Methods and devices for treatment of obstructive sleep apnea
US9161855B2 (en) 2011-10-24 2015-10-20 Ethicon, Inc. Tissue supporting device and method
US9173766B2 (en) 2012-06-01 2015-11-03 Ethicon, Inc. Systems and methods to treat upper pharyngeal airway of obstructive sleep apnea patients
US9301826B2 (en) 2008-02-18 2016-04-05 Covidien Lp Lock bar spring and clip for implant deployment device
US9393093B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9393002B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9398944B2 (en) 2008-02-18 2016-07-26 Covidien Lp Lock bar spring and clip for implant deployment device
DE102016201022A1 (de) * 2016-01-25 2017-07-27 Igor IGOV Hernien-reparaturvorrichtung, -system und -verfahren
US9833240B2 (en) 2008-02-18 2017-12-05 Covidien Lp Lock bar spring and clip for implant deployment device
US9877862B2 (en) 2009-10-29 2018-01-30 Ethicon, Inc. Tongue suspension system with hyoid-extender for treating obstructive sleep apnea
US9974683B2 (en) 2009-10-30 2018-05-22 Ethicon, Inc. Flexible implants having internal volume shifting capabilities for treating obstructive sleep apnea
US9999424B2 (en) 2009-08-17 2018-06-19 Covidien Lp Means and method for reversibly connecting an implant to a deployment device
CN109589187A (zh) * 2019-01-18 2019-04-09 姚飞 一种疝气补片
CN109589185A (zh) * 2019-01-18 2019-04-09 姚飞 一种双层疝气补片
WO2019092475A1 (fr) * 2017-11-07 2019-05-16 Thd S.P.A. Dispositif de support de positionnement pour une maille chirurgicale, dispositif médical pour réparer une paroi tissulaire et son kit
US10470760B2 (en) 2011-12-08 2019-11-12 Ethicon, Inc. Modified tissue securement fibers
EP3900673A1 (fr) * 2020-04-23 2021-10-27 Sofradim Production Kits de réparation chirurgicale de défauts de tissus mous et composants, emballage et leurs procédés d'utilisation

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8556797B2 (en) 2008-07-31 2013-10-15 Ethicon, Inc. Magnetic implants for treating obstructive sleep apnea and methods therefor
US8561616B2 (en) 2008-10-24 2013-10-22 Ethicon, Inc. Methods and devices for the indirect displacement of the hyoid bone for treating obstructive sleep apnea
US8561617B2 (en) 2008-10-30 2013-10-22 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US8783258B2 (en) 2008-12-01 2014-07-22 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US9326886B2 (en) 2009-10-29 2016-05-03 Ethicon, Inc. Fluid filled implants for treating obstructive sleep apnea

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147374A (en) * 1991-12-05 1992-09-15 Alfredo Fernandez Prosthetic mesh patch for hernia repair
US5813975A (en) * 1994-11-09 1998-09-29 Valenti; Gabriele Double layer dynamic prosthesis for surgical treatment of the inguinal hernia
US5824082A (en) * 1997-07-14 1998-10-20 Brown; Roderick B. Patch for endoscopic repair of hernias
US5972007A (en) * 1997-10-31 1999-10-26 Ethicon Endo-Surgery, Inc. Energy-base method applied to prosthetics for repairing tissue defects
US6270530B1 (en) * 1997-05-01 2001-08-07 C.R. Bard, Inc. Prosthetic repair fabric

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147374A (en) * 1991-12-05 1992-09-15 Alfredo Fernandez Prosthetic mesh patch for hernia repair
US5813975A (en) * 1994-11-09 1998-09-29 Valenti; Gabriele Double layer dynamic prosthesis for surgical treatment of the inguinal hernia
US6270530B1 (en) * 1997-05-01 2001-08-07 C.R. Bard, Inc. Prosthetic repair fabric
US5824082A (en) * 1997-07-14 1998-10-20 Brown; Roderick B. Patch for endoscopic repair of hernias
US5972007A (en) * 1997-10-31 1999-10-26 Ethicon Endo-Surgery, Inc. Energy-base method applied to prosthetics for repairing tissue defects

Cited By (45)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10182898B2 (en) 2008-02-18 2019-01-22 Covidien Lp Clip for implant deployment device
US10159554B2 (en) 2008-02-18 2018-12-25 Covidien Lp Clip for implant deployment device
US10695155B2 (en) 2008-02-18 2020-06-30 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US9301826B2 (en) 2008-02-18 2016-04-05 Covidien Lp Lock bar spring and clip for implant deployment device
US9034002B2 (en) 2008-02-18 2015-05-19 Covidien Lp Lock bar spring and clip for implant deployment device
US8753359B2 (en) 2008-02-18 2014-06-17 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US8758373B2 (en) 2008-02-18 2014-06-24 Covidien Lp Means and method for reversibly connecting a patch to a patch deployment device
US8808314B2 (en) 2008-02-18 2014-08-19 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US8317808B2 (en) 2008-02-18 2012-11-27 Covidien Lp Device and method for rolling and inserting a prosthetic patch into a body cavity
US9393002B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9833240B2 (en) 2008-02-18 2017-12-05 Covidien Lp Lock bar spring and clip for implant deployment device
US9398944B2 (en) 2008-02-18 2016-07-26 Covidien Lp Lock bar spring and clip for implant deployment device
US9044235B2 (en) 2008-02-18 2015-06-02 Covidien Lp Magnetic clip for implant deployment device
US9393093B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9107726B2 (en) 2008-02-18 2015-08-18 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US9005241B2 (en) 2008-02-18 2015-04-14 Covidien Lp Means and method for reversibly connecting a patch to a patch deployment device
US8678008B2 (en) 2008-07-30 2014-03-25 Ethicon, Inc Methods and devices for forming an auxiliary airway for treating obstructive sleep apnea
US9144511B2 (en) 2008-08-14 2015-09-29 Ethicon, Inc. Methods and devices for treatment of obstructive sleep apnea
US8888811B2 (en) 2008-10-20 2014-11-18 Covidien Lp Device and method for attaching an implant to biological tissue
US8915252B2 (en) 2008-12-01 2014-12-23 Ethicon, Inc. Implant systems and methods for treating obstructive sleep apnea
US8371308B2 (en) 2009-02-17 2013-02-12 Ethicon, Inc. Magnetic implants and methods for treating an oropharyngeal condition
US8813754B2 (en) 2009-02-17 2014-08-26 Ethicon, Inc. Magnetic implants and methods for treating an oropharyngeal condition
US8906045B2 (en) 2009-08-17 2014-12-09 Covidien Lp Articulating patch deployment device and method of use
US9999424B2 (en) 2009-08-17 2018-06-19 Covidien Lp Means and method for reversibly connecting an implant to a deployment device
US9877862B2 (en) 2009-10-29 2018-01-30 Ethicon, Inc. Tongue suspension system with hyoid-extender for treating obstructive sleep apnea
US9974683B2 (en) 2009-10-30 2018-05-22 Ethicon, Inc. Flexible implants having internal volume shifting capabilities for treating obstructive sleep apnea
US8632488B2 (en) 2009-12-15 2014-01-21 Ethicon, Inc. Fluid filled implants for treating medical conditions
WO2011094251A1 (fr) * 2010-01-26 2011-08-04 Danbury Hospital Tulle chirurgical manipulable magnétiquement et appareil pour sa manipulation
US9592046B2 (en) 2011-09-28 2017-03-14 Ethicon, Inc. Modular tissue securement systems
US8905033B2 (en) 2011-09-28 2014-12-09 Ethicon, Inc. Modular tissue securement systems
US9161855B2 (en) 2011-10-24 2015-10-20 Ethicon, Inc. Tissue supporting device and method
US8973582B2 (en) 2011-11-30 2015-03-10 Ethicon, Inc. Tongue suspension device and method
US10470760B2 (en) 2011-12-08 2019-11-12 Ethicon, Inc. Modified tissue securement fibers
US9173766B2 (en) 2012-06-01 2015-11-03 Ethicon, Inc. Systems and methods to treat upper pharyngeal airway of obstructive sleep apnea patients
US10314682B2 (en) * 2013-04-12 2019-06-11 Covidien Lp System and method having an electromagnetic manipulator with a UV tacking mechanism
US20140309626A1 (en) * 2013-04-12 2014-10-16 Covidien Lp System and method having an electromagnetic manipulator with a uv tacking mechanism
DE102016201022A1 (de) * 2016-01-25 2017-07-27 Igor IGOV Hernien-reparaturvorrichtung, -system und -verfahren
WO2019092475A1 (fr) * 2017-11-07 2019-05-16 Thd S.P.A. Dispositif de support de positionnement pour une maille chirurgicale, dispositif médical pour réparer une paroi tissulaire et son kit
CN109589187A (zh) * 2019-01-18 2019-04-09 姚飞 一种疝气补片
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