CA2475910A1 - Surgical instrument and method for treating organ prolapse conditions - Google Patents

Surgical instrument and method for treating organ prolapse conditions Download PDF

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Publication number
CA2475910A1
CA2475910A1 CA002475910A CA2475910A CA2475910A1 CA 2475910 A1 CA2475910 A1 CA 2475910A1 CA 002475910 A CA002475910 A CA 002475910A CA 2475910 A CA2475910 A CA 2475910A CA 2475910 A1 CA2475910 A1 CA 2475910A1
Authority
CA
Canada
Prior art keywords
distal end
attachment strips
guide needle
mesh
patient
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002475910A
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French (fr)
Other versions
CA2475910C (en
Inventor
Gene W. Kammerer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Inc
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Individual
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Filing date
Publication date
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Publication of CA2475910A1 publication Critical patent/CA2475910A1/en
Application granted granted Critical
Publication of CA2475910C publication Critical patent/CA2475910C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

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
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045—Support slings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • 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
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00805—Treatment of female stress urinary incontinence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06028—Means for attaching suture to needle by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06047—Means for attaching suture to needle located at the middle of the 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
    • A61B2017/06057—Double-armed sutures, i.e. sutures having a needle attached to each end
    • 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
    • A61B2017/06076—Needles, e.g. needle tip configurations helically or spirally coiled
    • 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
    • A61B2017/0608—J-shaped
    • 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
    • A61B2017/06085—Needles, e.g. needle tip configurations having a blunt tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre

Abstract

A mesh (200), a surgical kit including a mesh (200), and a method for using the same to restore a prolapsed organ (54) within a patient's pelvic cavity are provided. The surgical kit includes a mesh (200) for supporting the organ (54) including a support sheet (202) portion to be positioned beneath the organ (54), and first and second front attachment strips (208) extending from a proximal region of the mesh (200) and first and second rear attachment strips (210) extending form a distal region of the mesh (200). The kit also includes a first guide needle (300) for penetrating tissue to create a passageway through which the attachment strips (208, 210) can be pulled, and coupling means (320) for coupling the ends of the mesh (200) to the attachment strips.

Claims (29)

1. A surgical kit for performing a surgical procedure on a patient to restore a prolapsed organ within a patient's pelvic region comprising:
a mesh for supporting the organ, the mesh including a support sheet portion to be positioned substantially beneath the organ having a distal end region and a proximal end region, first and second front attachment strips extending from the proximal end region, and first and second rear attachment strips extending from the distal end region;
a first guide needle for penetrating tissue within the patient's body to create a passageway through the patient's pelvic region through which the first or second front or rear attachment strips can be pulled, the guide needle having a proximal end and a tissue penetrating blunt tip at a distal end, and defining in part a curved shaft having a first curvature; and coupling means for coupling a distal end of each of the first and second front and rear attachment strips to the distal end of the guide needle.
2. The surgical kit according to claim 1, wherein, for each of the first and second front and rear attachment strips, the coupling means is a coupling element fixedly secured at a first end to a distal end of the attachment strips, and having an opening at a second end dimensioned to receive therein and securely engage the distal end of the guide needle.
3. The surgical kit according to claim 1, wherein the coupling element can be detachably coupled to the distal end of the guide needle.
4. The surgical kit according to claim 1, wherein, for each of the first and second front and rear attachment strips, the coupling means comprises a needle element fixedly coupled at a proximal end to a distal end of the attachment strip, and a coupling device for coupling a distal end of the needle element to the distal end of the guide needle.
5. The surgical kit according to claim 4, wherein the coupling device has a first opening at a first end dimensioned to receive therein and securely engage the distal end of the needle element and a second opening at a second end dimensioned to receive therein and securely engage the distal end of the guide needle.
6. The surgical kit according to claim 1, wherein the distal end region of the support sheet portion has a recess therein between the first and second rear attachment strips.
7. The surgical kit according to claim 6, wherein the proximal end region of the support sheet portion has a recess therein between the first and second front attachment strips.
8. The surgical kit according to claim 1, wherein the first and second front and rear attachment strips extend outwardly from the proximal and distal end regions respectively at an angle of approximately 30-60 degrees relative to a midline of the mesh.
9. The surgical kit according to claim 8, wherein the first and second rear attachment strips extend outwardly from the distal end region at an angle of approximately 40 degrees relative to the midline of the mesh.
10. The surgical kit according to claim 9, wherein the first and second front attachment strips extend outwardly from the proximal end region at an angle of approximately 60 degrees relative to the midline of the mesh.
11. The surgical kit according to claim 1, further comprising a second guide needle for penetrating tissue within the patient's body to create a passageway through the patient's pelvic region through which the first or second front or rear attachment strips can be pulled, the guide needle having a proximal end and a tissue penetrating blunt tip at a distal end and defining in part a curved shaft.
12. The surgical kit according to claim 11, wherein the curved shaft of the second guide needle has a curvature different than that of the first guide needle, and wherein the passageway created by the first guide needle is different than that of the second guide needle.
13. The surgical kit according to claim 12, wherein the organ is the patient's bladder, and wherein the curvature of the first guide needle is such it can extend from an exterior of the abdomen, around the pubic bone, and into the vagina.
14. The surgical kit according to claim 13, wherein the curvature of the second guide needle is such that it can extend from an exterior of the abdomen at a location caudal and lateral to that of the first guide needle, around the side of the bladder, and out into the vagina.
15. The surgical kit according to claim 14, wherein the curvature of the second guide needle forms a compound curve.
16. The surgical kit according to claim 1, further comprising, for each of the first and second front and rear attachment strips, a removable sheath substantially covering the attachment strip.
17. A mesh for supporting a prolapsed bladder comprising:
a support sheet portion to be positioned substantially beneath the bladder having a distal end region and a proximal end region, the proximal end region having a first recess therein and the distal end region having a second recess therein so that, when the mesh is positioned within a patient's body, the proximal end region is positioned substantially under the bladder with the bladder neck positioned substantially within the first recess, and the distal end region is positioned under a posterior end of the bladder with the second recess positioned above the apex of the vagina and/or proximal of the cervix;

first and second front attachment strips extending from the proximal end region at an angle of between approximately 30 and 60 degrees relative to a midline of the mesh; and first and second rear attachment strips extending from the distal end region at an angle of between approximately 30 and 60 degrees relative to the midline.
18. The mesh according to claim 17, further comprising, for each of the first and second front and rear attachment strips, a removable sheath substantially covering the attachment strip.
19. The mesh according to claim 17, wherein the first and second front attachment strips extend from the proximal end region at an angle of approximately 60 degrees relative to the midline.
20. The mesh according to claim 19, wherein the first and second rear attachment strips extend from the proximal end region at an angle of approximately 40 degrees relative to the midline.
21. The mesh according to claim 17, further comprising coupling elements coupled to a distal end of each of the first and second front and rear attachment strips, the coupling elements each further having a means for attaching to the distal end of a guide needle to couple it thereto, and each being dimensioned to pass through a passageway through the patient's body created by the guide needle.
22. A method for restoring a prolapsed organ within a patient's pelvic cavity comprising the steps of:
providing a mesh for supporting the prolapsed organ, the mesh including a support sheet portion to be positioned substantially beneath the organ having a distal end region and a proximal end region, first and second front attachment strips extending from the proximal end region, and first and second rear attachment strips extending from the distal end region;
for each of the first and second front and rear attachment strips, using the guide needle to create a passageway through the patient's body from an exterior of the body and into the patient's vagina, coupling the guide needle to a distal end of the attachment strip using a coupling means, and retracting the guide needle and attached attachment strip through the body through the passageway;
adjusting the mesh using ends of the attachment strips so that the mesh supports the prolapsed organ;
removing a portion of the attachments strips that are outside of the body;
and leaving the mesh and remaining attachment strips within the body.
23. The method according to claim 22, wherein, for the first and second front attachment strips, the passageway through the patient's body extends from an exterior of the abdomen, around the pubic bone and out of the vagina, on first and second sides of the bladder respectively.
24. The method according to claim 23, wherein, for the first and second rear attachment strips, the passageway through the patient's body extends from an exterior of the abdomen at a location caudal and lateral to the location of the first and second front attachment strips, around the bladder and out through the vagina, on first and second sides of the bladder respectively.
25. The method according to claim 23, wherein, for the first and second front attachment strips, the passageway through the patient's body extends from an exterior of the medial side of the hip, through the obturator fossa, around the obturator bone, and out thought the vagina, on first and second sides of the bladder respectively.
26. The method according to claim 22, wherein a first guide needle is used to create the passageway for the first and second front attachment strips, and as second guide needle is used to create the passageway for the first and second rear attachment strips, and wherein the first guide needle has a curvature different than the second guide needle.
27. The method according to claim 22, wherein, for each of the first and second front and rear attachment strips, the coupling means is a coupling member fixedly secured at one end to a distal end of the attachment strip, and having an opening at a second end for receiving therein and securely engaging a distal end of the guide needle.
28. The method according to claim 22, wherein, for each of the first and second front and rear attachment strips, the coupling means comprises a needle element fixedly attached at a proximal end to a distal end of the attachment strip, and a coupling device for coupling the distal end of the needle element with the distal end of the guide needle.
29. The method according to claim 28, wherein the coupling device has an opening at a first end for receiving therein and securely engaging the distal end of the needle element, and an opening at a second end for receiving therein and securely engaging the distal end of the guide needle.
CA2475910A 2002-02-14 2003-02-12 Surgical instrument and method for treating organ prolapse conditions Expired - Fee Related CA2475910C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US35669702P 2002-02-14 2002-02-14
US60/356,697 2002-02-14
US10/359,406 2003-02-06
US10/359,406 US7131943B2 (en) 2000-03-09 2003-02-06 Surgical instrument and method for treating organ prolapse conditions
PCT/US2003/004181 WO2003068107A1 (en) 2002-02-14 2003-02-12 Surgical instrument and method for treating organ prolapse conditions

Publications (2)

Publication Number Publication Date
CA2475910A1 true CA2475910A1 (en) 2003-08-21
CA2475910C CA2475910C (en) 2012-04-24

Family

ID=27737550

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2475910A Expired - Fee Related CA2475910C (en) 2002-02-14 2003-02-12 Surgical instrument and method for treating organ prolapse conditions

Country Status (9)

Country Link
US (2) US7131943B2 (en)
EP (1) EP1474073B1 (en)
JP (1) JP4330998B2 (en)
KR (1) KR100943400B1 (en)
AU (1) AU2003216249B2 (en)
CA (1) CA2475910C (en)
DE (1) DE60331892D1 (en)
ES (1) ES2341099T3 (en)
WO (1) WO2003068107A1 (en)

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CN110584756B (en) * 2019-08-14 2022-08-05 韩清 Support device for umbilical cord prolapse

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EP1474073A1 (en) 2004-11-10
AU2003216249B2 (en) 2008-04-03
CA2475910C (en) 2012-04-24
ES2341099T3 (en) 2010-06-15
AU2003216249A1 (en) 2003-09-04
JP2006506104A (en) 2006-02-23
KR100943400B1 (en) 2010-02-22
EP1474073A4 (en) 2007-03-28
DE60331892D1 (en) 2010-05-12
US7131943B2 (en) 2006-11-07
EP1474073B1 (en) 2010-03-31
US20030176762A1 (en) 2003-09-18
US20040267088A1 (en) 2004-12-30
KR20040093057A (en) 2004-11-04
JP4330998B2 (en) 2009-09-16
WO2003068107A1 (en) 2003-08-21

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