US20030036676A1 - Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape - Google Patents

Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape Download PDF

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Publication number
US20030036676A1
US20030036676A1 US10/268,960 US26896002A US2003036676A1 US 20030036676 A1 US20030036676 A1 US 20030036676A1 US 26896002 A US26896002 A US 26896002A US 2003036676 A1 US2003036676 A1 US 2003036676A1
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United States
Prior art keywords
tape
sheath
needle
urethra
traction element
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Abandoned
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US10/268,960
Inventor
Victor Scetbon
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Sofradim Production SAS
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Sofradim Production SAS
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Publication date
Priority claimed from US09/489,336 external-priority patent/US6406423B1/en
Application filed by Sofradim Production SAS filed Critical Sofradim Production SAS
Priority to US10/268,960 priority Critical patent/US20030036676A1/en
Publication of US20030036676A1 publication Critical patent/US20030036676A1/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure 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
    • A61F2/0036Closure 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
    • A61F2/0045Support slings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00805Treatment of female stress urinary incontinence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004Means for attaching suture to needle
    • A61B2017/06009Means for attaching suture to needle having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle

Definitions

  • the present invention relates to the problems of urinary incontinence in women and more specifically to the problems of urinary stress incontinence.
  • the invention relates more particularly to a percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape.
  • a flexible and elongate urethra support means comprising a tape and a protective sheath lying flat and enveloping the tape
  • a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate urethra support means.
  • U.S. Pat. No. 5,899,909 discloses a treatment method and a treatment device for incontinence.
  • the device described which allows a tape to be placed under the urethra, comprises two special needles. These are mounted in turn, by screw fastening, on a reusable steel insertion tool made of a handle and of a threaded manipulator rod which allows each of the needles to be manipulated in turn. Each needle is fixed to one of the ends of the tape-sheath assembly.
  • Each end of the tape-sheath assembly is fixed to a frustoconical part of one end of the corresponding needle, using a shrunk or bonded polymer ring.
  • the tape is therefore implanted by introducing each of the needles through a short incision in the anterior vaginal wall, these incisions being one on each side of the central position of the urethra.
  • the needles implanted in turn using the manipulator rod then travel up around the bladder and the pubic bone and reemerge from the body through incisions made in the abdominal wall in the suprapubic region.
  • a device such as this requires the use of ancillaries of the insertion handle and rigid intravesical catheter guide types especially designed for this type of surgical intervention.
  • the known surgical intervention also has a disadvantage insofar as the needles are introduced into the anterior wall of the vagina to reemerge in the suprapubic region. This bottom-upward path cannot be controlled precisely for going around the base of the bladder. Vesical perforations are far from uncommon. They need to be recognized preoperatively through the use of two cystoscopies and entail repeating the maneuvers under more difficult conditions.
  • the sheath-tape assembly has therefore to be cut and the device can no longer be used to take a different path. It also carries the risk of no longer being sterile as it may have been contaminated during these additional maneuvers.
  • the present invention provides a device for treating urinary stress incontinence in women comprising a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free.
  • a method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence comprising (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (
  • the object of the present invention is to overcome the drawbacks of the prior art so as to obtain a different operative technique which is easier, quicker and safer (as far as the bladder and vessels are concerned).
  • the risk of vascular lesion is minimised because of the orientation and the given direction of the needle from the start of the procedure.
  • the risk of vesical puncture is small even in the case of previous interventions in this regard, as is particularly frequent in this type of pathology.
  • the percutaneous route is used to form top-to-bottom tracks using the needle, i.e., penetrating via abdominal cutaneous mini-incisions to exit via a previously formed vaginal opening. Detachment of the vagina allows the index finger of the surgeon to be insinuated up to the lower rim of the pubis and thus enables the track of the needle to be precisely directed.
  • the device of the invention enables tracks to be made from top to bottom on both sides of the abdomen and enables the absence of vesical puncturing to be confirmed by cystoscopy before engaging the sheath-tape system.
  • the present device makes it possible to employ the techniques that will be described in detail later on in this description.
  • Another object of the present invention is to produce a device for treating urinary incontinence which can be reused easily if it is introduced into the body in a non-optimum path, an eventuality which, according to the present invention, can occur only under exceptional circumstances if there is very strong adhesion between the bladder and the pubis, generally as the result of earlier interventions.
  • the proximal end of the puncturing needle is connected to the first end of the flexible means by virtue of an intermediate traction element, the second end of the flexible means being free or extended by an additional intermediate traction element.
  • the protective sheath completely envelopes the tape, including its first and second ends.
  • the sheath can be split into two parts that can be separated by sliding them in two opposite directions relative to the tape, the device comprising a splinable means between the two central and adjacent ends of the sheath.
  • the device comprises a filament arranged roughly at right angles to the longitudinal axis of the sheath, configured to cut the sheath when traction is exerted on the filament.
  • the sheath is made of a fluoropolymer-based heat-shrinkable material.
  • the tape is formed from a macroporous knitted material.
  • the tape in its central region has resorbable hydrophilic film reducing the risk of adhesion to or the risk of erosion of the urethra.
  • the puncturing needle has a curved part continuously adjacent to a roughly straight part ending in its proximal end.
  • the intermediate traction element is a traction lace.
  • the device according to the invention comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches.
  • the traction lace has a length roughly equal to the length of the flexible means.
  • the intermediate traction element is tubular.
  • the intermediate traction element and the puncturing needle are assembled by screwing.
  • the traction element consists of two parts of roughly the same length, placed end to end and joined together removably, for example by screwing, using a coupling.
  • the puncturing needle with an active distal end and a proximal end attached to a flexible and elongate means is the only puncturing needle.
  • FIG. 1 depicts a view in section of the flexible means of the device according to the invention
  • FIG. 2 depicts a view from above, with partial cutaway, of the flexible means shown in FIG. 1;
  • FIG. 3 depicts, in part, another exemplary embodiment of the flexible means of FIG. 2;
  • FIG. 4 depicts a partial view of a device according to the invention
  • FIGS. 5 and 6 depict details of FIG. 4;
  • FIGS. 7 and 8 depict another embodiment of the flexible means of the device according to the invention.
  • FIG. 9 depicts a partial view of another embodiment of the device according to the invention.
  • FIGS. 10, 11 a , 11 b and 11 c depict details of the device depicted in FIG. 9;
  • FIGS. 12 to 19 diagrammatically depict the surgical method employed using the device according to the invention.
  • FIGS. 20 and 21 diagrammatically depict the position of the device according to the invention in the body of a patient.
  • the device depicted in FIGS. 1, 2, 3 and 4 comprises an elongate flexible means 1 generally comprising a composite band.
  • the flexible means 1 is shown only in part and not in its entire length. It generally has a flattened and elongate shape.
  • the first end 1 a of the flexible means 1 can be connected to an intermediate traction element 2 (cf. FIG. 4) and the second end 1 b is free or extended by an additional intermediate traction element (not depicted).
  • the device according to the invention also comprises a puncturing needle 3 , for example made of stainless steel, connected to the intermediate traction element.
  • the flexible means 1 comprises a protective sheath 5 lying flat and enveloping a tape 6 .
  • the single puncturing needle 3 has an active distal end 3 a and a proximal end 3 b connected to the first end 1 a of the flexible means 1 .
  • the proximal end 3 b of the puncturing needle 3 is connected to the first end 1 a by virtue of an intermediate traction element 2 .
  • the proximal end 3 b is thus a non-puncturing end.
  • the proximal end 3 b of the puncturing needle may have a substantially rectangular cross-section and may be flattened and/or ribbed. These features allow the surgeon to grip the needle and allows the needle to be oriented correctly.
  • the distal end 3 a is at the end of a curved part continuously adjacent to a roughly straight part, approximately between points 3 b and 3 d, ending in the proximal end 3 b.
  • the distal end 3 a may be partially curved and preferably has a round cross-section.
  • Distal end 3 a may have a diameter of, for example, 0.5 mm.
  • the roughly straight part may be, for example, 20 to 25 cm in length and may, in embodiments, be ribbed over at least a portion thereof.
  • the puncturing needle has, for example, a diameter of 3.5 mm in its curved part.
  • the proximal end 3 b is also equipped with an attachment means allowing it to make a connection with the intermediate traction element.
  • the intermediate traction element is constituted by a hollow PVC tube with a diameter that is identical to, or closely similar in diameter to, that of the needle.
  • the intermediate traction element or tubing may be approximately 40 to 50 cm long. Its distal end 19 and proximal end 20 comprise a male screw connecting piece. This screw connecting piece is integrally fixed to the traction element by adhesion and/or screwing.
  • the intermediate traction element may be colored, for example blue, so that it can readily be located during cystoscopy in the event of a vesical puncture.
  • the protective sheath 5 completely envelopes the tape 6 , including its first end 6 a and its second end 6 b.
  • the sheath 5 is made, for example, of a fluoropolymer-based heat-shrinkable material.
  • the material of which the sheath 5 is made is chosen so that it is impervious, for example hermetically sealed, to isolate the tape 6 intended to be implanted in the body of the patient from contact with the skin and mucosa when following the implantation paths through the body.
  • the sheath 5 may also exhibit properties of low coefficient of friction. These properties are therefore found both on the inside and on the outside of the sheath 5 , so as, on the one hand, to ensure good separation from the tape 6 and, on the other hand, to reduce the friction inside the body of the patient when the flexible means 1 is being pulled.
  • the tape 6 advantageously has a width of between 6 and 14 mm, preferably between 10 and 12 mm and a length of between 30 and 50 cm, preferably around 40 cm.
  • the tape 6 is preferably formed from a macroporous knitted material.
  • the macroporous knitted material comprises, for example, an open knit made of single stranded polypropylene of between 0.12 and 0.16 millimeter thick and made up of two layers formed by two threaded guide bars each—one full guide and one empty guide—these two guides being moved symmetrically for open mesh according to the following chart:
  • bar II 32-21-01.
  • the tape 6 is cut to length in the warp direction of the knit.
  • the tape 6 with a width of for example 12 mm, has the following properties:
  • curling is intended to mean the property whereby the tape 6 rolls up on itself spontaneously about its longitudinal axis under longitudinal tensile stress.
  • the tape 6 has attractive advantages and, in particular, low emission of particles as it is stretched, and curling which occurs only under high stress (6N). None of these aforementioned properties in any way detracts from the porosity of the tape 6 .
  • Tape 6 can have a resorbable hydrophilic film in its central portion that reduces the risk of erosion or sclerosis of the urethra to a minimum. This central zone may be indicated by a colored marker.
  • the tape may comprise other biologically acceptable materials.
  • the sheath 5 can preferably be split into two parts 51 , 52 that can be separated by sliding them in two opposite directions with respect to the tape 6 .
  • the device according to the invention has a splittable means 15 , roughly at the middle of the sheath 5 and the two ends of which are secured to the corresponding and adjacent central ends 5 c, 5 d of the sheath 5 .
  • the material of the splittable means 15 is chosen from materials of the thermoplastic type approved for surgical application.
  • connection between, on the one hand, the central ends 5 c, 5 d of the two parts 51 and 52 respectively and, on the other hand, the splittable center 15 may be obtained by any means able to make the sheath 5 impervious.
  • the same is true of the free end 5 b of the sheath 5 which may be plugged and/or sealed.
  • the splittable means 15 comprises a flat slit 15 a passing through it from one longitudinal end to the other, for the free passage of the tape 6 .
  • the splittable means 15 may be replaced in an embodiment depicted in figures 7 and 8 , by an adhesive sleeve 16 a joining the ends of the two splittable parts 51 and 52 of the sheath 5 .
  • This sleeve may be weakened, for example by a partial broken cut or a line of weakness in the sheath 5 .
  • the adhesive sleeve 16 a made of a flexible material which sticks firmly to the central ends 5 c, 5 d and has a precut tab 16 b to make the sleeve 16 a easier to tear and therefore make the sheath 5 easier to split into the two parts 51 and 52 .
  • the one-piece sheath 5 incorporates a filament 16 c arranged roughly at right angles to the longitudinal axis of the sheath 5 , configured to cut the sheath 5 when traction is exerted on the filament 16 c.
  • a filament 16 c may be advantageously in color so that it can easily be identified.
  • the sheath 5 can thus be split in the central zone 1 c of the flexible means 1 so release the tape 6 inside the body of the patient.
  • the intermediate traction element is, according to one embodiment of the invention, configured, for example, with a traction lace 2 depicted in FIG. 4.
  • the device according to the invention may also comprise an end piece 4 to which the sheath 5 is attached by heat-shrinking.
  • the sheath 5 more particularly its first end 5 a, may be heat shrunk in a sealed manner onto the end piece 4 .
  • the end piece 4 comprises anchoring notches 4 a into which the heat-shrunk material of the sheath 5 engages.
  • the end piece 4 is made, for example, of a piece of stainless steel or any other rigid material capable of contacting with intracorporal tissue.
  • the flexible means 1 comprises a knotting eye 4 b (cf. FIG. 4) arranged on the outside of the sheath 5 .
  • Knotting eye 4 b consists, for example, of a closed loop and may, as appropriate, have a point 4 c intended to pass through and catch on one end of the traction lace 2 or any other intermediate traction element.
  • the knotting eye 4 b may, for example, be made integrally in the end piece 4 .
  • the latter may also have a roughly flattened and partially frustoconical shape so as to achieve continuity between the various thicknesses of the traction lace 2 and the flexible means 1 .
  • the latter has a greater width than the traction lace 2 .
  • the traction lace may for example be made of a Teflon-coated material.
  • FIG. 4 diagrammatically depicts one exemplary embodiment of the device according to the invention.
  • the needle 3 comprises the proximal end 3 b onto which the first end 2 a of the traction lace 2 is attached.
  • the latter has, for example, at each of its ends 2 a and 2 b, a loop 2 c (cf. FIGS. 5 and 6 respectively) obtained by ultrasonic welding, stitching or any other means.
  • One of these loops, 2 c, is mounted on the proximal end 3 b of the needle 3 while the other is mounted in the eye 4 b.
  • the device according to the invention therefore, for example, has a traction lace 2 , the length of which is, for example, roughly equal to the length of the flexible means 1 , namely a length of between 30 and 60 cm, for example 40 cm.
  • a traction lace 2 the length of which is, for example, roughly equal to the length of the flexible means 1 , namely a length of between 30 and 60 cm, for example 40 cm.
  • Such dimensions or lengths of the traction lace 2 make it possible, if reference is made to the operative procedure, to avoid engaging the flexible means 1 in the body before being sure that the path taken by the needle 3 and the traction lace 2 is optimum.
  • the long available length of traction lace 2 for carrying out the operative actions described thus makes it possible for another path to be taken through the body if need be, without having to manipulate the flexible means 1 .
  • An additional traction lace 2 secured to the free end 1 b which may also have an end piece 4 for this purpose, allows traction to be exerted in the opposite direction to its introduction on the flexible means 1 , and allows it to back-track along its path if it is penetrating incorrectly.
  • the intermediate traction element is a tubular element 20 .
  • the material of which the latter is made may be, for example, PVC.
  • Tubular element 20 may be, for example, 2.5 mm in diameter.
  • the tubular element 20 is preferably semirigid, so that it can be screwed onto a threaded end 3 c secured to the proximal end 3 b of the needle 3 .
  • the other end of the tubular element 20 is connected, for example by screwing, to the flexible means 1 comprising an end piece 30 secured to the sheath 5 , for example by heat shrinking.
  • the end piece 30 for this purpose has a complementary threaded part 30 a (see FIGS. 7 and 8).
  • the flexible means 1 , the tubular element 20 and the two parts 3 a, 3 b of the puncturing needle 3 may thus be assembled removably by screw fastening.
  • the tubular element consists for example of a number of parts of roughly the same length, for example 20 and 41 , placed end to end and joined together removably by screw fastening. This end-to-end joining is obtained using a coupling 40 depicted in FIGS. 10, 11 a, 11 b and 11 c.
  • the coupling 40 is made up of two elements, namely an internal connecting mandrel 42 and an external clamping bush 43 .
  • the mandrel 42 has a threaded nipple 42 b engaged in the tubular element part 41 and at the other end has a stud 42 a with teeth 42 c intended to be engaged in the tubular element part 20 as depicted in FIGS. 11 b and 11 c.
  • the shape and dimensions of the teeth 42 c tend to oppose separation of the tubular element part 20 from the mandrel 42 .
  • Each mandrel 42 is associated with a bush 43 engaged on the tubular element part 41 so as to clamp part of tubular element part 41 between the threaded nipple 42 b and bush 43 .
  • Bush 43 may also be provided on the anterior end with a tapping 43 a which bites by screwing into the material of which the abutting end of part 20 is made.
  • part 41 of the tubular element is screwed onto the nipple 42 b.
  • Bush 43 is then attached to this end of the part 41 , with the constituent material trapped between the screw thread of the nipple 42 b and the sleeve 43 , the latter also clamping the rest of the mandrel 42 except for the projecting stud 42 a.
  • the two tubular element parts 20 and 41 are assembled by engaging the stud 42 a in one end of part 20 (FIG. 11 b ) and then by screwing the end of bush 43 onto the exterior periphery of part 20 (FIG. 11 c ).
  • the turning of bush 43 is depicted diagrammatically by the arrow R in FIG. 11 c.
  • the mechanical connection between the tubular element part 20 and the coupling 40 is thus improved.
  • the device according to the present invention makes it possible to implement a method for treating women suffering from urinary stress incontinence. This method will be specified herein below and allows the tape 6 to be fitted in the patient's body.
  • the treatment method comprises:
  • the method comprises guiding the paths of the puncturing needle 3 along the posterior surface 105 a of the pubis, by contact with the finger 50 of the surgeon introduced through the opening 103 a, formed in the anterior vaginal wall 103 , as far as the lower edge 105 b of the same side of the pubis 105 .
  • a one-piece needle may be used that can terminate in a male screw connecting piece. Passage of a track on the right and left side is made by screwing a portion of the traction element to the proximal end of the needle. Cystoscopy verifies the absence of punctures; then the two tubular halves are connected to each other using the small metal part to form a single traction element disposed in a loop beneath the urethra. The remainder of the intervention is identical.
  • the flexible means 1 is attached to the intermediate element 2 or 20 after the check provided for in step (e) has been made.
  • the opening 103 a made in the anterior vaginal wall 103 is vertical.
  • a urethral probe 60 for example of the FOLEY balloon type, may be inserted into the patient beforehand.
  • step (f) use is made of two intermediate traction elements 2 or 20 connected end to end during step (f).
  • the puncturing needle 3 and the intermediate traction element 2 or 20 are separated once the check according to step (e) has been made and once the flexible means 1 has been introduced along the first path. This separation then makes it possible to create the second path using the puncturing needle 3 connected to the intermediate traction element 2 or 20 .
  • the first step (a) is illustrated in FIG. 12.
  • the patient is placed in a gynecological position and a sterile operating zone is formed.
  • a urethral balloon probe 60 is positioned in the bladder 101 and is connected to a sterile collecting bag to empty and flatten the bladder 101 .
  • a short vertical incision 103 a is made in the middle of the vaginal wall 103 , for example in a T or I shape, centered in the central third of the urethral canal 100 opening to the urinary meatus 100 a.
  • Each lip 103 b of the vaginal incision 103 a is detached from the underlying tissues using scissors 71 and appropriate instruments 70 , as illustrated in FIG. 13.
  • a very small cutaneous incision 106 , 107 less than 10 mm long is made in the abdominal skin immediately above the pubis 105 , on each side of the centerline and about 20 mm away from the latter, to allow the percutaneous passage of the needle 3 just off the posterior face 105 a of the pubis 30 in the direction of the vagina 104 .
  • the surgeon's index finger 50 is introduced into the vaginal passage thus prepared by detachment, and the active distal end 3 a of the needle 3 follows a path to come into direct contact with index finger 50 .
  • the path of the puncturing needle 3 is therefore controlled.
  • the needle 3 can then reemerge through the vaginal opening 103 a and the bladder 101 has remained safe from any injury by the needle.
  • the straight percutaneous path is made first.
  • the end of the intermediate traction element for example the tubular element 20 , reemerges behind the needle 3 via the vaginal opening 103 a.
  • This end of the traction element 20 is for example unscrewed from the proximal end 3 b of the needle 3 and is detached from the latter in the direction of the arrow S in FIG. 15.
  • the needle 3 is then passed along the second path (on the left-hand side in FIG. 16) in the same way as for the first side (right-hand side).
  • the distal part 3 a of the needle is well away from the vaginal opening 103 a, it can be detached by unscrewing its proximal portion 3 b. This separation is depicted diagrammatically by the arrow T in FIG. 16.
  • proximal portion 3 b is long enough to project when the percutaneous incision 107 is made.
  • the proximal portion 3 b may be extended by an additional tubular element 20 which projects out of the abdominal incision 107 .
  • the next step consists in connecting the end of the tubular traction element 20 that follows the first path to the proximal portion 3 b or to the additional tubular element 20 that follows the second path.
  • proximal portion 3 b is then led back out through the abdomen by pulling in the direction of the arrow V illustrated in FIG. 18.
  • the tubular element 20 Before the flexible means 1 penetrates the patient's body, the tubular element 20 thus forms a loop around the urethra and its two ends reemerge respectively through the two abdominal cutaneous incisions 106 and 107 (FIG. 18).
  • the urethral probe 60 may then be removed and cystoscopy is used to check for the absence of vesical perforation.
  • the end of the tubular element 20 that emerges from the abdominal incision 106 is assembled by screw fastening on the threaded end 30 a of the flexible means 1 (sheath 5 plus tape 6 ) and the assembly is pulled (arrow V in FIG. 18) through the right and left paths to position the flexible means 1 under the urethra 100 .
  • this positioning which corresponds to step (g) is complete, the ends 1 a , 1 b of the flexible means 1 reemerge from the abdominal incisions 106 , 107 as depicted in FIG. 21.
  • the sheath 5 may then be separated from the tape 6 by cutting the sheath 5 in its central zone 1 c and withdrawing each of the halves 51 and 52 thus obtained through the corresponding abdominal incision 106 , 107 according to step (h) (arrows W in FIG. 19).
  • the tape 6 may thus be released, positioned and adjusted under the underside of the urethra 100 , usually in a central position, without tension and without being squashed, as depicted in FIG. 20.
  • the cutaneous incisions may be closed up using conventional methods.
  • the tape 6 advantageously runs around the pubic bone 105 via its pelvic or deep face, and heads towards the contralateral abdominal wall.
  • the resulting vaginal incision 103 a made in the vaginal wall 103 may then be closed once the definitive position of the tape 6 under the urethra 100 has been checked.
  • the traction lace 2 can also be used for implementing the method.
  • the operating procedure thus used is notable in that it is a percutaneous operating technique because the dimension of the abdominal cutaneous incisions is minimal, intended to be just enough to allow the needles to pass through and because the paths taken by the needle 3 are downwards, in other words entering through abdominal incisions 106 and 107 to emerge through the predetermined and prepared corresponding vaginal opening 103 a.
  • the surgical technique described requires neither the use of an insertion tool for the needle, nor the use of an endovesical rod to move the bladder 101 and the urethra 100 away each time the needle 3 passes on a downward path.
  • the device according to the invention is a percutaneous device, which is advantageous when compared with the known device which enters via the vaginal mucosa and emerges through the skin in the abdominal suprapubic region.
  • the operator chooses the position of the tape 6 with respect to the urethral duct 100 according to the clinical case being studied.

Abstract

A device for treating urinary stress incontinence in women includes a flexible and elongate mechanism including a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free. A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence is also provided including (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra.

Description

    BACKGROUND OF THE INVENTION
  • 1. Field of Invention [0001]
  • The present invention relates to the problems of urinary incontinence in women and more specifically to the problems of urinary stress incontinence. The invention relates more particularly to a percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape. [0002]
  • 2. Description of Related Art [0003]
  • These problems are currently treated during surgical interventions under local, regional or general anesthetic and consist in implanting a tape in such a way as to support the urethra without tension. [0004]
  • Thanks to the regional or local anesthesia, the surgeon can immediately check that continence has been restored, with the participation of the patient. [0005]
  • An intervention such as this is performed using an appropriate device including special instruments. [0006]
  • In particular, it is a known practice in treating urinary incontinence to use a tape that can be implanted under the urethral canal, and a sheath surrounding the tape, where the sheath is withdrawn from the tape after the latter has been implanted. [0007]
  • There is a known device for treating urinary stress incontinence in women, comprising: [0008]
  • a flexible and elongate urethra support means comprising a tape and a protective sheath lying flat and enveloping the tape, and [0009]
  • a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate urethra support means. [0010]
  • Thus, U.S. Pat. No. 5,899,909 discloses a treatment method and a treatment device for incontinence. The device described, which allows a tape to be placed under the urethra, comprises two special needles. These are mounted in turn, by screw fastening, on a reusable steel insertion tool made of a handle and of a threaded manipulator rod which allows each of the needles to be manipulated in turn. Each needle is fixed to one of the ends of the tape-sheath assembly. [0011]
  • Each end of the tape-sheath assembly is fixed to a frustoconical part of one end of the corresponding needle, using a shrunk or bonded polymer ring. [0012]
  • The tape is therefore implanted by introducing each of the needles through a short incision in the anterior vaginal wall, these incisions being one on each side of the central position of the urethra. [0013]
  • The needles implanted in turn using the manipulator rod, then travel up around the bladder and the pubic bone and reemerge from the body through incisions made in the abdominal wall in the suprapubic region. [0014]
  • The two halves of the sheath which overlap at the middle of the tape are withdrawn by pulling on the ends that emerge from the suprapubic incisions. [0015]
  • A device such as this requires the use of ancillaries of the insertion handle and rigid intravesical catheter guide types especially designed for this type of surgical intervention. [0016]
  • The known surgical intervention also has a disadvantage insofar as the needles are introduced into the anterior wall of the vagina to reemerge in the suprapubic region. This bottom-upward path cannot be controlled precisely for going around the base of the bladder. Vesical perforations are far from uncommon. They need to be recognized preoperatively through the use of two cystoscopies and entail repeating the maneuvers under more difficult conditions. [0017]
  • The two accessories (manipulator handle and rigid probe guide) must therefore be available to the surgical team during each intervention, having been previously washed, packaged and sterilized prior to each use. In addition, this lateral passage with respect to the bladder, with a vaginal point of entry runs the risk that the point of the needle will injure the iliac vessels in the retrocrural region. These vascular lesions have been observed and have led to fatalities. [0018]
  • Another drawback of the known device lies in the difficulty of repeating the intervention, using the same device, when cystoscopy reveals that the sheath-tape assembly has taken the wrong course. Retreat may prove difficult and tricky for the sheath, and especially for the bulky needles. [0019]
  • The sheath-tape assembly has therefore to be cut and the device can no longer be used to take a different path. It also carries the risk of no longer being sterile as it may have been contaminated during these additional maneuvers. [0020]
  • Thus no percutaneous treatment exists for female urinary stress incontinence which uses a tape which can lead to the devices and technique of the present invention. [0021]
  • SUMMARY OF THE INVENTION
  • The present invention provides a device for treating urinary stress incontinence in women comprising a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping the tape; and a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism, wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free. [0022]
  • A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence is also provided by the present invention comprising (a) forming an opening in an anterior vaginal wall; (b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall; (c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle; (d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra; (e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra; (f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra; (g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and (h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra. [0023]
  • The object of the present invention is to overcome the drawbacks of the prior art so as to obtain a different operative technique which is easier, quicker and safer (as far as the bladder and vessels are concerned). The risk of vascular lesion is minimised because of the orientation and the given direction of the needle from the start of the procedure. The risk of vesical puncture is small even in the case of previous interventions in this regard, as is particularly frequent in this type of pathology. Using the device and operating method of the invention, the percutaneous route is used to form top-to-bottom tracks using the needle, i.e., penetrating via abdominal cutaneous mini-incisions to exit via a previously formed vaginal opening. Detachment of the vagina allows the index finger of the surgeon to be insinuated up to the lower rim of the pubis and thus enables the track of the needle to be precisely directed. [0024]
  • The device of the invention enables tracks to be made from top to bottom on both sides of the abdomen and enables the absence of vesical puncturing to be confirmed by cystoscopy before engaging the sheath-tape system. The present device makes it possible to employ the techniques that will be described in detail later on in this description. [0025]
  • Another object of the present invention is to produce a device for treating urinary incontinence which can be reused easily if it is introduced into the body in a non-optimum path, an eventuality which, according to the present invention, can occur only under exceptional circumstances if there is very strong adhesion between the bladder and the pubis, generally as the result of earlier interventions. [0026]
  • According to an embodiment of the invention, the proximal end of the puncturing needle is connected to the first end of the flexible means by virtue of an intermediate traction element, the second end of the flexible means being free or extended by an additional intermediate traction element. [0027]
  • According to one embodiment of the device according to the invention, the protective sheath completely envelopes the tape, including its first and second ends. [0028]
  • According to one embodiment of the invention, the sheath can be split into two parts that can be separated by sliding them in two opposite directions relative to the tape, the device comprising a splinable means between the two central and adjacent ends of the sheath. [0029]
  • According to another embodiment of the device according to the invention, the device comprises a filament arranged roughly at right angles to the longitudinal axis of the sheath, configured to cut the sheath when traction is exerted on the filament. [0030]
  • According to one embodiment of the device according to the invention, the sheath is made of a fluoropolymer-based heat-shrinkable material. [0031]
  • According to one embodiment of the device according to the invention, the tape is formed from a macroporous knitted material. [0032]
  • According to one embodiment of the invention, the tape in its central region has resorbable hydrophilic film reducing the risk of adhesion to or the risk of erosion of the urethra. [0033]
  • According to one embodiment of the device according to the invention, the puncturing needle has a curved part continuously adjacent to a roughly straight part ending in its proximal end. [0034]
  • According to one embodiment of the invention, the intermediate traction element is a traction lace. [0035]
  • According to one embodiment, the device according to the invention comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches. [0036]
  • According to one embodiment according to the invention, the traction lace has a length roughly equal to the length of the flexible means. [0037]
  • According to a preferred embodiment of the device according to the invention, the intermediate traction element is tubular. [0038]
  • According to one embodiment of the device according to the invention, the intermediate traction element and the puncturing needle are assembled by screwing. [0039]
  • According to one embodiment of the device according to the invention, the traction element consists of two parts of roughly the same length, placed end to end and joined together removably, for example by screwing, using a coupling. [0040]
  • According to one embodiment of the device according to the invention, the puncturing needle with an active distal end and a proximal end attached to a flexible and elongate means is the only puncturing needle.[0041]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • Other features and advantages of the invention will become apparent from the detailed non-limiting description given hereinafter with reference to the appended drawings, in which: [0042]
  • FIG. 1 depicts a view in section of the flexible means of the device according to the invention; [0043]
  • FIG. 2 depicts a view from above, with partial cutaway, of the flexible means shown in FIG. 1; [0044]
  • FIG. 3 depicts, in part, another exemplary embodiment of the flexible means of FIG. 2; [0045]
  • FIG. 4 depicts a partial view of a device according to the invention; [0046]
  • FIGS. 5 and 6 depict details of FIG. 4; [0047]
  • FIGS. 7 and 8 depict another embodiment of the flexible means of the device according to the invention; [0048]
  • FIG. 9 depicts a partial view of another embodiment of the device according to the invention; [0049]
  • FIGS. 10, 11[0050] a, 11 b and 11 c depict details of the device depicted in FIG. 9;
  • FIGS. [0051] 12 to 19 diagrammatically depict the surgical method employed using the device according to the invention; and
  • FIGS. 20 and 21 diagrammatically depict the position of the device according to the invention in the body of a patient.[0052]
  • DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
  • The device depicted in FIGS. 1, 2, [0053] 3 and 4 comprises an elongate flexible means 1 generally comprising a composite band.
  • The flexible means [0054] 1 is shown only in part and not in its entire length. It generally has a flattened and elongate shape.
  • The [0055] first end 1 a of the flexible means 1 can be connected to an intermediate traction element 2 (cf. FIG. 4) and the second end 1 b is free or extended by an additional intermediate traction element (not depicted).
  • The device according to the invention also comprises a puncturing [0056] needle 3, for example made of stainless steel, connected to the intermediate traction element.
  • The flexible means [0057] 1 comprises a protective sheath 5 lying flat and enveloping a tape 6.
  • The [0058] single puncturing needle 3 has an active distal end 3 a and a proximal end 3 b connected to the first end 1 a of the flexible means 1.
  • The [0059] proximal end 3 b of the puncturing needle 3 is connected to the first end 1 a by virtue of an intermediate traction element 2. The proximal end 3 b is thus a non-puncturing end. The proximal end 3 b of the puncturing needle may have a substantially rectangular cross-section and may be flattened and/or ribbed. These features allow the surgeon to grip the needle and allows the needle to be oriented correctly.
  • The [0060] distal end 3 a is at the end of a curved part continuously adjacent to a roughly straight part, approximately between points 3 b and 3 d, ending in the proximal end 3 b. The distal end 3 a may be partially curved and preferably has a round cross-section. Distal end 3 a may have a diameter of, for example, 0.5 mm. The roughly straight part may be, for example, 20 to 25 cm in length and may, in embodiments, be ribbed over at least a portion thereof.
  • The puncturing needle has, for example, a diameter of 3.5 mm in its curved part. [0061]
  • The [0062] proximal end 3 b is also equipped with an attachment means allowing it to make a connection with the intermediate traction element.
  • The intermediate traction element is constituted by a hollow PVC tube with a diameter that is identical to, or closely similar in diameter to, that of the needle. The intermediate traction element or tubing may be approximately 40 to 50 cm long. Its distal end [0063] 19 and proximal end 20 comprise a male screw connecting piece. This screw connecting piece is integrally fixed to the traction element by adhesion and/or screwing. The intermediate traction element may be colored, for example blue, so that it can readily be located during cystoscopy in the event of a vesical puncture.
  • The [0064] protective sheath 5 completely envelopes the tape 6, including its first end 6 a and its second end 6 b.
  • The [0065] sheath 5 is made, for example, of a fluoropolymer-based heat-shrinkable material. The material of which the sheath 5 is made is chosen so that it is impervious, for example hermetically sealed, to isolate the tape 6 intended to be implanted in the body of the patient from contact with the skin and mucosa when following the implantation paths through the body.
  • The [0066] sheath 5 may also exhibit properties of low coefficient of friction. These properties are therefore found both on the inside and on the outside of the sheath 5, so as, on the one hand, to ensure good separation from the tape 6 and, on the other hand, to reduce the friction inside the body of the patient when the flexible means 1 is being pulled.
  • The [0067] tape 6 advantageously has a width of between 6 and 14 mm, preferably between 10 and 12 mm and a length of between 30 and 50 cm, preferably around 40 cm.
  • The [0068] tape 6 is preferably formed from a macroporous knitted material.
  • The macroporous knitted material comprises, for example, an open knit made of single stranded polypropylene of between 0.12 and 0.16 millimeter thick and made up of two layers formed by two threaded guide bars each—one full guide and one empty guide—these two guides being moved symmetrically for open mesh according to the following chart: [0069]
  • bar I: 01-12-32 [0070]
  • bar II: 32-21-01. [0071]
  • The [0072] tape 6 is cut to length in the warp direction of the knit.
  • The [0073] tape 6, with a width of for example 12 mm, has the following properties:
  • a breaking strength in the warp direction of 105N±20%, [0074]
  • an elongation at break in the warp direction of 92%±20% [0075]
  • an elongation of 36% under a force of 20N [0076]
  • an onset of curling with a force of 6N and an elongation of [0077]
  • 15%. [0078]
  • The expression “curling” is intended to mean the property whereby the [0079] tape 6 rolls up on itself spontaneously about its longitudinal axis under longitudinal tensile stress.
  • The [0080] tape 6 has attractive advantages and, in particular, low emission of particles as it is stretched, and curling which occurs only under high stress (6N). None of these aforementioned properties in any way detracts from the porosity of the tape 6.
  • [0081] Tape 6 can have a resorbable hydrophilic film in its central portion that reduces the risk of erosion or sclerosis of the urethra to a minimum. This central zone may be indicated by a colored marker.
  • In a variation, the tape may comprise other biologically acceptable materials. [0082]
  • The [0083] sheath 5 can preferably be split into two parts 51, 52 that can be separated by sliding them in two opposite directions with respect to the tape 6.
  • For this purpose, the device according to the invention has a splittable means [0084] 15, roughly at the middle of the sheath 5 and the two ends of which are secured to the corresponding and adjacent central ends 5 c, 5 d of the sheath 5.
  • The material of the splittable means [0085] 15 is chosen from materials of the thermoplastic type approved for surgical application.
  • The connection between, on the one hand, the central ends [0086] 5 c, 5 d of the two parts 51 and 52 respectively and, on the other hand, the splittable center 15, may be obtained by any means able to make the sheath 5 impervious. The same is true of the free end 5 b of the sheath 5, which may be plugged and/or sealed.
  • The splittable means [0087] 15 comprises a flat slit 15 a passing through it from one longitudinal end to the other, for the free passage of the tape 6.
  • The splittable means [0088] 15 may be replaced in an embodiment depicted in figures 7 and 8, by an adhesive sleeve 16a joining the ends of the two splittable parts 51 and 52 of the sheath 5. This sleeve may be weakened, for example by a partial broken cut or a line of weakness in the sheath 5. The adhesive sleeve 16 a made of a flexible material which sticks firmly to the central ends 5 c, 5 d and has a precut tab 16 b to make the sleeve 16 a easier to tear and therefore make the sheath 5 easier to split into the two parts 51 and 52.
  • According to another embodiment of the device according to the invention, the one-[0089] piece sheath 5 incorporates a filament 16 c arranged roughly at right angles to the longitudinal axis of the sheath 5, configured to cut the sheath 5 when traction is exerted on the filament 16 c. An example such as this is depicted, for example, in figure 3. The filament 16 c may be advantageously in color so that it can easily be identified.
  • The [0090] sheath 5 can thus be split in the central zone 1 c of the flexible means 1 so release the tape 6 inside the body of the patient.
  • The intermediate traction element is, according to one embodiment of the invention, configured, for example, with a [0091] traction lace 2 depicted in FIG. 4.
  • The device according to the invention may also comprise an [0092] end piece 4 to which the sheath 5 is attached by heat-shrinking. The sheath 5, more particularly its first end 5 a, may be heat shrunk in a sealed manner onto the end piece 4.
  • As depicted in FIG. 2. the [0093] end piece 4 comprises anchoring notches 4 a into which the heat-shrunk material of the sheath 5 engages. The end piece 4 is made, for example, of a piece of stainless steel or any other rigid material capable of contacting with intracorporal tissue.
  • Advantageously, the [0094] flexible means 1 comprises a knotting eye 4 b (cf. FIG. 4) arranged on the outside of the sheath 5. Knotting eye 4 b consists, for example, of a closed loop and may, as appropriate, have a point 4 c intended to pass through and catch on one end of the traction lace 2 or any other intermediate traction element.
  • The [0095] knotting eye 4 b may, for example, be made integrally in the end piece 4. The latter may also have a roughly flattened and partially frustoconical shape so as to achieve continuity between the various thicknesses of the traction lace 2 and the flexible means 1. The latter has a greater width than the traction lace 2. Thus a certain continuity between the dimensions of the traction lace 2 and of the flexible means 1 is obtained. The traction lace may for example be made of a Teflon-coated material.
  • FIG. 4 diagrammatically depicts one exemplary embodiment of the device according to the invention. [0096]
  • The [0097] needle 3 comprises the proximal end 3 b onto which the first end 2 a of the traction lace 2 is attached. The latter has, for example, at each of its ends 2 a and 2 b, a loop 2 c (cf. FIGS. 5 and 6 respectively) obtained by ultrasonic welding, stitching or any other means.
  • One of these loops, [0098] 2 c, is mounted on the proximal end 3 b of the needle 3 while the other is mounted in the eye 4 b.
  • During the procedure, it is thus possible to attach the [0099] end 2 a of the traction lace 2 to the eye 4 b either using the point 4 c secured to the eye 4 b or simply by running it through the closed loop that forms the eye 4 b.
  • The device according to the invention therefore, for example, has a [0100] traction lace 2, the length of which is, for example, roughly equal to the length of the flexible means 1, namely a length of between 30 and 60 cm, for example 40 cm. Such dimensions or lengths of the traction lace 2 make it possible, if reference is made to the operative procedure, to avoid engaging the flexible means 1 in the body before being sure that the path taken by the needle 3 and the traction lace 2 is optimum. The long available length of traction lace 2 for carrying out the operative actions described thus makes it possible for another path to be taken through the body if need be, without having to manipulate the flexible means 1.
  • By way of variation, it is possible to provide the [0101] second end 1 b of the flexible means 1 with an additional intermediate traction element, such as an additional lace like the one previously described under reference 2.
  • An [0102] additional traction lace 2 secured to the free end 1 b, which may also have an end piece 4 for this purpose, allows traction to be exerted in the opposite direction to its introduction on the flexible means 1, and allows it to back-track along its path if it is penetrating incorrectly.
  • According to another embodiment of the device according to the invention, depicted for example in FIG. 9, the intermediate traction element is a [0103] tubular element 20. The material of which the latter is made may be, for example, PVC. Tubular element 20 may be, for example, 2.5 mm in diameter.
  • The [0104] tubular element 20 is preferably semirigid, so that it can be screwed onto a threaded end 3 c secured to the proximal end 3 b of the needle 3. The other end of the tubular element 20 is connected, for example by screwing, to the flexible means 1 comprising an end piece 30 secured to the sheath 5, for example by heat shrinking. The end piece 30 for this purpose has a complementary threaded part 30 a (see FIGS. 7 and 8).
  • The flexible means [0105] 1, the tubular element 20 and the two parts 3 a, 3 b of the puncturing needle 3 may thus be assembled removably by screw fastening.
  • Other known removable means of connection or attachment may also be suitable in the context of the present invention. [0106]
  • The tubular element consists for example of a number of parts of roughly the same length, for example [0107] 20 and 41, placed end to end and joined together removably by screw fastening. This end-to-end joining is obtained using a coupling 40 depicted in FIGS. 10, 11a, 11 b and 11 c.
  • The [0108] coupling 40 is made up of two elements, namely an internal connecting mandrel 42 and an external clamping bush 43.
  • At one end, the [0109] mandrel 42 has a threaded nipple 42 b engaged in the tubular element part 41 and at the other end has a stud 42 a with teeth 42 c intended to be engaged in the tubular element part 20 as depicted in FIGS. 11b and 11 c. The shape and dimensions of the teeth 42 c tend to oppose separation of the tubular element part 20 from the mandrel 42.
  • Each [0110] mandrel 42 is associated with a bush 43 engaged on the tubular element part 41 so as to clamp part of tubular element part 41 between the threaded nipple 42 b and bush 43.
  • [0111] Bush 43 may also be provided on the anterior end with a tapping 43 a which bites by screwing into the material of which the abutting end of part 20 is made.
  • To begin with, one end of [0112] part 41 of the tubular element is screwed onto the nipple 42 b. Bush 43 is then attached to this end of the part 41, with the constituent material trapped between the screw thread of the nipple 42 b and the sleeve 43, the latter also clamping the rest of the mandrel 42 except for the projecting stud 42 a.
  • The two [0113] tubular element parts 20 and 41 are assembled by engaging the stud 42 a in one end of part 20 (FIG. 11b) and then by screwing the end of bush 43 onto the exterior periphery of part 20 (FIG. 11c). The turning of bush 43 is depicted diagrammatically by the arrow R in FIG. 11c. The mechanical connection between the tubular element part 20 and the coupling 40 is thus improved.
  • The device according to the present invention makes it possible to implement a method for treating women suffering from urinary stress incontinence. This method will be specified herein below and allows the [0114] tape 6 to be fitted in the patient's body.
  • The treatment method comprises: [0115]
  • a) forming an [0116] opening 103 a in the anterior vaginal wall 103;
  • b) making two small [0117] suprapubic incisions 106, 107;
  • c) using the puncturing [0118] needle 3 connected to an intermediate traction means 2 or 20 to create a first path traveling around the pubic bone 105 and emerging in the opening 103 a formed in the anterior vaginal wall 103;
  • d) using the puncturing [0119] needle 3 connected to an intermediate traction means to create a second path around the pubic bone 105 and emerging in the opening 103 a formed in the anterior vaginal wall 103;
  • e) using cystoscopy to check that the making of these paths has not punctured the [0120] bladder 101 or the urethra 100;
  • f) connecting the parts of the device emerging from the opening [0121] 103 a formed in the anterior vaginal wall 103;
  • g) pulling on the [0122] intermediate traction element 2 or 20 to adjust the loop formed by the flexible means 1 on the underside of the urethra 100;
  • h) separating and withdrawing the two halves of the [0123] sheath 5; and
  • i) leaving the [0124] tape 6 between the first suprapubic incision 106 and the second suprapubic incision 107 passing under the underside of the urethra 100.
  • According to one embodiment of the invention, the method comprises guiding the paths of the puncturing [0125] needle 3 along the posterior surface 105 a of the pubis, by contact with the finger 50 of the surgeon introduced through the opening 103 a, formed in the anterior vaginal wall 103, as far as the lower edge 105 b of the same side of the pubis 105.
  • In a variation, a one-piece needle may be used that can terminate in a male screw connecting piece. Passage of a track on the right and left side is made by screwing a portion of the traction element to the proximal end of the needle. Cystoscopy verifies the absence of punctures; then the two tubular halves are connected to each other using the small metal part to form a single traction element disposed in a loop beneath the urethra. The remainder of the intervention is identical. [0126]
  • According to one embodiment of the method according to the invention, the [0127] flexible means 1 is attached to the intermediate element 2 or 20 after the check provided for in step (e) has been made.
  • According to one embodiment of the method according to the invention, the opening [0128] 103 a made in the anterior vaginal wall 103 is vertical.
  • According to a method of the invention, a [0129] urethral probe 60, for example of the FOLEY balloon type, may be inserted into the patient beforehand.
  • According to one embodiment of the treatment method according to the invention, use is made of two [0130] intermediate traction elements 2 or 20 connected end to end during step (f).
  • According to another embodiment of the treatment method according to the invention, the puncturing [0131] needle 3 and the intermediate traction element 2 or 20 are separated once the check according to step (e) has been made and once the flexible means 1 has been introduced along the first path. This separation then makes it possible to create the second path using the puncturing needle 3 connected to the intermediate traction element 2 or 20.
  • All of the above defined steps are now described with a device according to FIGS. [0132] 7 to 11 and the description relating thereto.
  • The first step (a) is illustrated in FIG. 12. The patient is placed in a gynecological position and a sterile operating zone is formed. A [0133] urethral balloon probe 60 is positioned in the bladder 101 and is connected to a sterile collecting bag to empty and flatten the bladder 101. A short vertical incision 103 a, at most 30 mm long, is made in the middle of the vaginal wall 103, for example in a T or I shape, centered in the central third of the urethral canal 100 opening to the urinary meatus 100 a. Each lip 103 b of the vaginal incision 103 a is detached from the underlying tissues using scissors 71 and appropriate instruments 70, as illustrated in FIG. 13.
  • Detachment is performed until the surgeon's [0134] index finger 50, introduced through the resulting opening 103 a, can reach the lower edge 105 b of the pubis 105, away from the urethra 100 and the periurethral tissue (FIG. 14).
  • Next, a very small [0135] cutaneous incision 106, 107 less than 10 mm long is made in the abdominal skin immediately above the pubis 105, on each side of the centerline and about 20 mm away from the latter, to allow the percutaneous passage of the needle 3 just off the posterior face 105 a of the pubis 30 in the direction of the vagina 104.
  • The surgeon's [0136] index finger 50 is introduced into the vaginal passage thus prepared by detachment, and the active distal end 3 a of the needle 3 follows a path to come into direct contact with index finger 50. The path of the puncturing needle 3 is therefore controlled. The needle 3 can then reemerge through the vaginal opening 103 a and the bladder 101 has remained safe from any injury by the needle.
  • In general, the straight percutaneous path is made first. The end of the intermediate traction element, for example the [0137] tubular element 20, reemerges behind the needle 3 via the vaginal opening 103 a. This end of the traction element 20 is for example unscrewed from the proximal end 3 b of the needle 3 and is detached from the latter in the direction of the arrow S in FIG. 15.
  • The [0138] needle 3 is then passed along the second path (on the left-hand side in FIG. 16) in the same way as for the first side (right-hand side). Once the distal part 3 a of the needle is well away from the vaginal opening 103 a, it can be detached by unscrewing its proximal portion 3 b. This separation is depicted diagrammatically by the arrow T in FIG. 16.
  • The so-called [0139] proximal portion 3 b is long enough to project when the percutaneous incision 107 is made.
  • By way of an alternative form according to the invention, the [0140] proximal portion 3 b may be extended by an additional tubular element 20 which projects out of the abdominal incision 107.
  • The next step consists in connecting the end of the [0141] tubular traction element 20 that follows the first path to the proximal portion 3 b or to the additional tubular element 20 that follows the second path.
  • Connection is made using the [0142] coupling 40 depicted in FIG. 17.
  • The [0143] proximal portion 3 b is then led back out through the abdomen by pulling in the direction of the arrow V illustrated in FIG. 18.
  • Before the [0144] flexible means 1 penetrates the patient's body, the tubular element 20 thus forms a loop around the urethra and its two ends reemerge respectively through the two abdominal cutaneous incisions 106 and 107 (FIG. 18).
  • The [0145] urethral probe 60 may then be removed and cystoscopy is used to check for the absence of vesical perforation.
  • Once the check has been made, the end of the [0146] tubular element 20 that emerges from the abdominal incision 106 is assembled by screw fastening on the threaded end 30 a of the flexible means 1 (sheath 5 plus tape 6) and the assembly is pulled (arrow V in FIG. 18) through the right and left paths to position the flexible means 1 under the urethra 100. When this positioning which corresponds to step (g) is complete, the ends 1 a, 1 b of the flexible means 1 reemerge from the abdominal incisions 106, 107 as depicted in FIG. 21.
  • The [0147] sheath 5 may then be separated from the tape 6 by cutting the sheath 5 in its central zone 1 c and withdrawing each of the halves 51 and 52 thus obtained through the corresponding abdominal incision 106, 107 according to step (h) (arrows W in FIG. 19).
  • The [0148] tape 6 may thus be released, positioned and adjusted under the underside of the urethra 100, usually in a central position, without tension and without being squashed, as depicted in FIG. 20.
  • Once the [0149] sheath 5 has been withdrawn through each abdominal incision 106 and 107, the parts of the tape 6 which project out of the incisions 106 and 107 are cut off flush with the abdominal wall, the parts being left at the subcutaneous site.
  • The cutaneous incisions may be closed up using conventional methods. [0150]
  • The [0151] tape 6 advantageously runs around the pubic bone 105 via its pelvic or deep face, and heads towards the contralateral abdominal wall.
  • The resulting [0152] vaginal incision 103 a made in the vaginal wall 103 may then be closed once the definitive position of the tape 6 under the urethra 100 has been checked.
  • By way of a variation, the [0153] traction lace 2 can also be used for implementing the method.
  • The operating procedure thus used is notable in that it is a percutaneous operating technique because the dimension of the abdominal cutaneous incisions is minimal, intended to be just enough to allow the needles to pass through and because the paths taken by the [0154] needle 3 are downwards, in other words entering through abdominal incisions 106 and 107 to emerge through the predetermined and prepared corresponding vaginal opening 103 a.
  • This presents an enormous advantage from the safety point of view with respect to the risks of puncturing the [0155] bladder 101 on the one hand, and the iliac vessels on the other hand.
  • This is a considerable advantage over the known operating technique. The path can be checked by cystoscopy. [0156]
  • When it becomes apparent that the path is not appropriate, it is possible to withdraw the [0157] intermediate traction element 2 or 20 to make a second path through the abdominal cutaneous incision 106, and to do so without introducing the flexible means 1 into the body.
  • All of the elements of the device according to the invention can thus be reused if the manipulation is incorrect, or if the path inside the patient's body needs to be improved or optimized. This represents a considerable advantage over the state of the prior art. [0158]
  • Furthermore, the surgical technique described requires neither the use of an insertion tool for the needle, nor the use of an endovesical rod to move the [0159] bladder 101 and the urethra 100 away each time the needle 3 passes on a downward path. This constitutes an advantageous simplification insofar as the surgical technique put forward in the state of the art entails the use of an endovesical rod twice, namely after each passage of each of the two needles which are making an upward path.
  • It is to be noted that the device according to the invention is a percutaneous device, which is advantageous when compared with the known device which enters via the vaginal mucosa and emerges through the skin in the abdominal suprapubic region. [0160]
  • It is notable that the extreme simplicity of the device according to the invention contributes not only to reducing its cost price and the number of its constituent parts but also to increasing the safety for the patient and the quality of the result when the operating technique described in the present invention is implemented. [0161]
  • Checking the effect obtained on continence and adjusting the tension of the [0162] tape 6 are not justified for two main reasons. Specifically, continence in a lying-down position is not comparable to the upright position, and the effectiveness of the tape is explained not by a gripping effect (which carries the risk of leading to stenosis) but by an effect of providing uplifting support.
  • Furthermore, the operator chooses the position of the [0163] tape 6 with respect to the urethral duct 100 according to the clinical case being studied.
  • In the state of the art, this choice cannot be made, and continence tests are carried out after the bladder has been filled and coughing stress applied in order to adjust the tension in the tape, even though the technique is supposedly said to be “tension free”. [0164]

Claims (26)

What is claimed is:
1. A device for treating urinary stress incontinence in women, comprising:
a flexible and elongate mechanism comprising a tape for supporting a urethra and a flat protective sheath enveloping said tape; and
a puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism,
wherein the proximal end of the puncturing needle is connected to a first end of the flexible and elongate mechanism by an intermediate traction element, a second end of the flexible and elongate mechanism being free.
2. The device of claim 1, wherein the free second end of the flexible and elongate mechanism is attached to an extended by an additional intermediate traction element.
3. The device of claim 1, wherein the tape has a first end and a second end and wherein the protective sheath completely envelopes the tape, including said first and second ends of the tape.
4. The device of claim 1, wherein the sheath is capable of being split into two parts that are separable by sliding them in opposite directions relative to the tape, and wherein said device comprises a splinable mechanism between central and adjacent ends of the sheath.
5. The device of claim 1, wherein the sheath is capable of being split into two parts that are separable by sliding them in opposite directions relative to the tape, and wherein said device comprises a filament arranged roughly at right angles to a longitudinal axis of the sheath, wherein said filament is configured to cut said sheath when traction is exerted on said filament.
6. The device of claim 1, wherein the sheath comprises a fluoropolymer-based heat-shrinkable material.
7. The device of claim 1, wherein the tape comprises a macroporous knitted material.
8. The device of claim 1, wherein a central region of the tape has a resorbable hydrophilic film that reduces the risk of adhesion to or the risk of erosion of the urethra.
9. The device of claim 1, wherein the puncturing needle has a curved part adjacent to a roughly straight part that ends at the proximal end of the puncturing needle.
10. The device of claim 1, wherein the intermediate traction element is a traction lace.
11. The device of claim 9, wherein said device further comprises an end piece onto which the sheath is heat shrunk and to which the traction lace attaches.
12. The device of claim 9, wherein the traction lace has a length roughly equal to the length of the flexible and elongate mechanism.
13. The device of claim 1, wherein the intermediate traction element is a tubular traction element.
14. The device of claim 12, wherein the tubular traction element and the puncturing needle are attached by screwing them together.
15. The device of claim 12, wherein the tubular traction element comprises two parts of roughly equal length, placed end to end and joined together removably.
16. The device of claim 15, wherein said two parts of roughly equal length are joined together by screwing them together using a coupling.
17. The device of claim 1, wherein the puncturing needle with an active distal end and a proximal end connected to a first end of the flexible and elongate mechanism is the only puncturing needle present in the device.
18. The device of claim 1, wherein the tape comprises an open knit made up of two layers formed by two threaded guide bars each, one full guide and one empty guide, the two threaded guide bars being movable symmetrically for an open mesh.
19. A method for treating urinary stress incontinence in a woman suffering from urinary stress incontinence, said method comprising:
(a) forming an opening in an anterior vaginal wall;
(b) creating, from two small suprapubic incisions formed in the abdominal wall, a right track and a left track from the abdominal skin to the opening formed in the anterior vaginal wall;
(c) using a needle and an intermediate traction element to follow one of the tracks and following the other track with at least a needle;
(d) verifying by cystoscopy that the paths of the tracks are outside the bladder and the urethra;
(e) using a support tape surrounded by a plastic sheath to follow the tracks by passage under an inferior surface of the urethra;
(f) adjusting a loop formed by the sheathed tape under the inferior surface of the urethra;
(g) removing the sheath by pulling the sheath toward the outside of the woman's body through the small suprapubic incisions; and
(h) leaving the tape implanted from the first to the second incision and around the urethra to support the urethra.
20. The method of claim 19, wherein a needle and an intermediate traction element are used to follow one of the tracks, and a needle and a second intermediate traction element are used to follow the other track.
21. The method of claim 19, wherein each track is produced using a needle inserted through a suprapubic incision and guided along a posterior surface of a pubis in contact with a finger of a surgeon and introduced through an opening to a lower rim of the pubis on the same side as the suprapubic incision through which the needle was inserted.
22. The method of claim 19, wherein a distal end of the tape is connected to a proximal end of the intermediate traction element after verifying by cystoscopy.
23. The method of claim 19, wherein the sheath is cut in a central region.
24. The method of claim 19, wherein the incision in the anterior vaginal wall is T or I shaped.
25. The method of claim 19, in which vaginal detachment is performed.
26. The method of claim 19, in which a urethral probe is inserted prior to performing a first incision.
US10/268,960 2000-01-21 2002-10-11 Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape Abandoned US20030036676A1 (en)

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US09/489,336 US6406423B1 (en) 2000-01-21 2000-01-21 Method for surgical treatment of urinary incontinence and device for carrying out said method
FR0012753 2000-10-05
FR0012753A FR2804010B1 (en) 2000-01-21 2000-10-05 PERCUTANEOUS DEVICE FOR THE TREATMENT OF URINARY INCONTINENCE OF WOMAN'S EFFORT BY URETRAL STRIP
US09/765,351 US6478727B2 (en) 2000-01-21 2001-01-22 Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape
US10/268,960 US20030036676A1 (en) 2000-01-21 2002-10-11 Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape

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Cited By (93)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030045774A1 (en) * 2001-01-23 2003-03-06 Staskin David R. Sling delivery system and method of use
US20030050530A1 (en) * 2001-01-23 2003-03-13 Neisz Johann J. Surgical articles and methods
US20030130670A1 (en) * 2001-01-23 2003-07-10 Anderson Kimberly A. Pelvic floor implant system and method of assembly
US20030176875A1 (en) * 2002-03-07 2003-09-18 Anderson Kimberly A. Transobturator surgical articles and methods
US20030199732A1 (en) * 2000-07-05 2003-10-23 Mentor Corporation, A Minnesota Corporation Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
US6641525B2 (en) 2001-01-23 2003-11-04 Ams Research Corporation Sling assembly with secure and convenient attachment
US6648921B2 (en) 2001-10-03 2003-11-18 Ams Research Corporation Implantable article
US6652450B2 (en) 2001-01-23 2003-11-25 American Medical Systems, Inc. Implantable article and method for treating urinary incontinence using means for repositioning the implantable article
US20030220538A1 (en) * 2002-03-01 2003-11-27 Bernard Jacquetin Method and apparatus for treating pelvic organ prolapses in female patients
US20040039453A1 (en) * 2001-07-27 2004-02-26 Anderson Kimberly A. Pelvic health implants and methods
US20040054253A1 (en) * 2000-09-07 2004-03-18 Snitkin Eva S. Coated sling material
US20050004427A1 (en) * 2003-04-30 2005-01-06 Mauro Cervigni Prosthesis for use in the surgical treatment of urogenital prolapse and female urinary incontinence
US20050027220A1 (en) * 2003-07-31 2005-02-03 James Wagner Bioabsorbable casing for surgical sling assembly
US20050131393A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US20050131391A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US20050131392A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US20050245787A1 (en) * 2004-04-30 2005-11-03 Ams Research Corporation Method and apparatus for treating pelvic organ prolapse
US20050250977A1 (en) * 2004-05-07 2005-11-10 Ams Research Corporation Method and apparatus for cystocele repair
US20050278037A1 (en) * 2004-06-11 2005-12-15 Analytic Biosurgical Solutions-Abiss Implant for the treatment of cystocele and rectocele
US20050288708A1 (en) * 2004-06-25 2005-12-29 Kammerer Gene W Soft tissue fastener having integral biasing section
US20060058575A1 (en) * 2004-09-15 2006-03-16 Vincenza Zaddem System and method for surgical implant placement
US20060173468A1 (en) * 2005-01-28 2006-08-03 Marc Simmon Obturator introducer with snare
US20060196788A1 (en) * 2005-02-02 2006-09-07 Peter Komarnycky Packaging assembly for surgical mesh implants
US20060241622A1 (en) * 2003-06-13 2006-10-26 Zergiebel Earl M Multiple member interconnect for surgical instrument and absorbable screw fastener
US20070123746A1 (en) * 2005-11-16 2007-05-31 Boston Scientific Scimed, Inc. Devices for minimally invasive pelvic surgery
US7338432B2 (en) 2003-11-17 2008-03-04 Konstantin Valtchev Urethral sling introducer and method of use
US20080119863A1 (en) * 2003-09-22 2008-05-22 Ams Research Corporation Prolapse Repair
US20080196729A1 (en) * 2004-05-21 2008-08-21 Mpathy Medical Devices Limited Implant for Treatment of Vaginal and/or Uterine Prolapse
US20080200751A1 (en) * 2000-10-12 2008-08-21 James Browning Urethral support system
US20080207989A1 (en) * 2005-08-29 2008-08-28 Ams Research Corporation System For Positioning Support Mesh in a Patient
US20080281336A1 (en) * 2003-06-13 2008-11-13 Zergiebel Earl M Multiple member interconnect for surgical instrument and absorbable screw fastener
US20090082617A1 (en) * 2007-08-14 2009-03-26 Vecchiotti Richard G Methods and devices for supporting, elevating, or compressing internal structures
US20090192347A1 (en) * 2005-07-26 2009-07-30 Ams Research Corporation Methods and Systems for Treatment of Prolapse
US20090192540A1 (en) * 2003-11-17 2009-07-30 Boston Scientific Scimed, Inc. Systems and methods relating to associating a medical implant with a delivery device
US20090209994A1 (en) * 2000-06-05 2009-08-20 Boston Scientific Scimed, Inc. Methods and devices for the treatment of urinary incontinence
US20090240104A1 (en) * 2007-10-26 2009-09-24 Ams Research Corporation Surgical Articles and Methods for Treating Pelvic Conditions
US20090259092A1 (en) * 2006-06-22 2009-10-15 Ogdahl Jason W Adjustable Sling and Method of Treating Pelvic Conditions
US20090318752A1 (en) * 2006-03-15 2009-12-24 C. R. Bard, Inc. Implants for the treatment of pelvic floor disorders
US20100010631A1 (en) * 2006-05-19 2010-01-14 John Fritz Otte Method and articles for treatment of stress urinary incontinence
US20100030016A1 (en) * 2008-07-31 2010-02-04 Knoll L Dean Methods and Implants for Treating Urinary Incontinence
US20100094079A1 (en) * 2005-06-21 2010-04-15 Ams Research Corporation Method and Apparatus for Securing a Urethral Sling to Pubic Bone
US20100105979A1 (en) * 2008-10-27 2010-04-29 Ams Research Corporation Surgical Needle and Anchor System with Retractable Features
US20100168505A1 (en) * 2005-06-21 2010-07-01 Ams Research Corporation Methods and apparatus for securing a urethral sling to a pubic bone
US20100191039A1 (en) * 2002-03-07 2010-07-29 Anderson Kimberly A Transobturator surgical articles and methods
US20100241105A1 (en) * 2005-08-04 2010-09-23 C.R. Bard, Inc. System for introducing implants
US20100261950A1 (en) * 2006-06-22 2010-10-14 Ams Research Corporation Adjustable Tension Incontinence Sling Assemblies
US20110015479A1 (en) * 2004-04-30 2011-01-20 Anderson Kimberly A Method and apparatus for treating pelvic organ prolapse
US20110034759A1 (en) * 2006-10-26 2011-02-10 Ogdahl Jason W Surgical articles and methods for treating pelvic conditions
US7909753B1 (en) * 2005-10-05 2011-03-22 Ams Research Corporation Connector for mesh support insertion
US20110112357A1 (en) * 2006-06-16 2011-05-12 Ams Research Corporation Surgical implants, tools, and methods for treating pelvic conditions
US20110160527A1 (en) * 2009-12-31 2011-06-30 Ams Research Corporation Suture-less Tissue Fixation for Implantable Device
US8007430B2 (en) 2000-10-12 2011-08-30 Coloplast A/S Apparatus and method for treating female urinary incontinence
US20120046517A1 (en) * 2010-08-18 2012-02-23 Konstantin Lazarov Valtchev Second generation tape
US8123671B2 (en) 2005-08-04 2012-02-28 C.R. Bard, Inc. Pelvic implant systems and methods
US8128554B2 (en) 2000-10-12 2012-03-06 Coloplast A/S System for introducing a pelvic implant
US8469875B2 (en) 2000-07-05 2013-06-25 Coloplast A/S Method and device for treating urinary incontinence
US8480559B2 (en) 2006-09-13 2013-07-09 C. R. Bard, Inc. Urethral support system
US8574149B2 (en) 2007-11-13 2013-11-05 C. R. Bard, Inc. Adjustable tissue support member
US8602965B2 (en) 2001-03-09 2013-12-10 Boston Scientific Scimed, Inc. System, methods and devices relating to delivery of medical implants
US8708885B2 (en) 2007-09-21 2014-04-29 Ams Research Corporation Pelvic floor treatments and related tools and implants
US8709471B2 (en) 2003-03-27 2014-04-29 Coloplast A/S Medicament delivery device and a method of medicament delivery
US8808162B2 (en) 2011-03-28 2014-08-19 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
US8845512B2 (en) 2005-11-14 2014-09-30 C. R. Bard, Inc. Sling anchor system
USD721175S1 (en) 2011-09-08 2015-01-13 Ams Research Corporation Backers for surgical indicators
USD721807S1 (en) 2011-09-08 2015-01-27 Ams Research Corporation Surgical indicators
US8986188B2 (en) 2007-04-28 2015-03-24 The Board Of Trustees Of The Leland Stanford Junior University Dynamic and adjustable support devices
US9005222B2 (en) 2002-08-02 2015-04-14 Coloplast A/S Self-anchoring sling and introducer system
US9017243B2 (en) 2008-08-25 2015-04-28 Ams Research Corporation Minimally invasive implant and method
US9089393B2 (en) 2011-03-28 2015-07-28 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
USD736382S1 (en) 2011-09-08 2015-08-11 Ams Research Corporation Surgical indicator with backers
US9125717B2 (en) 2011-02-23 2015-09-08 Ams Research Corporation Implant tension adjustment system and method
US9226809B2 (en) 2009-02-10 2016-01-05 Ams Research Corporation Surgical articles and methods for treating urinary incontinence
US9345473B2 (en) 2009-12-30 2016-05-24 Astora Women's Health, Llc Implantable sling systems and methods
US9351723B2 (en) 2011-06-30 2016-05-31 Astora Women's Health, Llc Implants, tools, and methods for treatments of pelvic conditions
US9364308B2 (en) 2009-12-30 2016-06-14 Astora Women's Health, Llc Implant systems with tensioning feedback
US9381076B2 (en) 2010-02-23 2016-07-05 Boston Scientific Scimed, Inc. Surgical articles and methods
US9414903B2 (en) 2011-07-22 2016-08-16 Astora Women's Health, Llc Pelvic implant system and method
US9445881B2 (en) 2010-02-23 2016-09-20 Boston Scientific Scimed, Inc. Surgical articles and methods
US9468512B2 (en) 2010-10-06 2016-10-18 Astora Women's Health, Llc Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions
US9492191B2 (en) 2011-08-04 2016-11-15 Astora Women's Health, Llc Tools and methods for treatment of pelvic conditions
US9492259B2 (en) 2011-03-30 2016-11-15 Astora Women's Health, Llc Expandable implant system
US9572648B2 (en) 2010-12-21 2017-02-21 Justin M. Crank Implantable slings and anchor systems
US9622848B2 (en) 2011-02-23 2017-04-18 Boston Scientific Scimed, Inc. Urethral stent system and method
US9782245B2 (en) 2011-03-30 2017-10-10 James R. Mujwid Implants, tools, and methods for treatment of pelvic conditions
US9918816B2 (en) 2008-08-25 2018-03-20 Boston Scientific Scimed, Inc. Minimally invasive implant and method
US9943390B2 (en) 2001-03-30 2018-04-17 Coloplast A/S Method of treating pelvic organ prolapse in a female patient by accessing a prolapsed organ trans-vaginally through a vagina
US10028813B2 (en) 2010-07-22 2018-07-24 Boston Scientific Scimed, Inc. Coated pelvic implant device and method
US10034735B2 (en) 2011-03-28 2018-07-31 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatments of pelvic conditions
US10058240B2 (en) 2011-06-29 2018-08-28 Boston Scientific Scimed, Inc. Systems, implants, tools, and methods for treatments of pelvic conditions
US10098721B2 (en) 2011-09-01 2018-10-16 Boston Scientific Scimed, Inc. Pelvic implant needle system and method
US10390813B2 (en) 2011-08-05 2019-08-27 Boston Scientific Scimed, Inc. Systems, implants, tools, and methods for treatments of pelvic conditions
US10500027B2 (en) 2011-06-30 2019-12-10 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatments of pelvic conditions
US11284983B2 (en) 2011-07-22 2022-03-29 Boston Scientific Scimed, Inc. Pelvic implant system and method

Families Citing this family (123)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SE506164C2 (en) 1995-10-09 1997-11-17 Medscand Medical Ab Instruments for the treatment of urinary incontinence in women
US6599235B2 (en) 1997-03-18 2003-07-29 American Medical Systems Inc. Transvaginal bone anchor implantation device
US6039686A (en) 1997-03-18 2000-03-21 Kovac; S. Robert System and a method for the long term cure of recurrent urinary female incontinence
US6382214B1 (en) 1998-04-24 2002-05-07 American Medical Systems, Inc. Methods and apparatus for correction of urinary and gynecological pathologies including treatment of male incontinence and female cystocele
US7121997B2 (en) 1999-06-09 2006-10-17 Ethicon, Inc. Surgical instrument and method for treating female urinary incontinence
US6932759B2 (en) 1999-06-09 2005-08-23 Gene W. Kammerer Surgical instrument and method for treating female urinary incontinence
US7226407B2 (en) * 1999-06-09 2007-06-05 Ethicon, Inc. Surgical instrument and method for treating female urinary incontinence
WO2000074633A2 (en) 1999-06-09 2000-12-14 Ethicon, Inc. Method and apparatus for adjusting flexible areal polymer implants
GB2359256B (en) * 2000-01-21 2004-03-03 Sofradim Production Percutaneous device for treating urinary stress incontinence in women using a sub-urethral tape
US7131943B2 (en) * 2000-03-09 2006-11-07 Ethicon, Inc. Surgical instrument and method for treating organ prolapse conditions
DE10019604C2 (en) * 2000-04-20 2002-06-27 Ethicon Gmbh implant
US6592515B2 (en) 2000-09-07 2003-07-15 Ams Research Corporation Implantable article and method
FR2814939B1 (en) * 2000-10-05 2002-12-20 Sofradim Production SUB-URETRAL SUPPORT KIT FOR THE TREATMENT OF URINARY INCONTINENCE OF FEMALE EXERCISE
WO2003086205A2 (en) * 2002-04-11 2003-10-23 Gyne Ideas Limited Apparatus and method for treating female urinary incontinence
WO2002039914A1 (en) * 2000-11-15 2002-05-23 Scimed Life Systems, Inc. Device and method for treating female urinary incontinence
US20020161382A1 (en) * 2001-03-29 2002-10-31 Neisz Johann J. Implant inserted without bone anchors
DE10107520A1 (en) * 2001-02-17 2002-10-02 Siegfried Riek Instruments for the operative treatment of urinary incontinence in women
US8033983B2 (en) * 2001-03-09 2011-10-11 Boston Scientific Scimed, Inc. Medical implant
EP1913896B1 (en) 2001-03-09 2012-12-26 Boston Scientific Limited Method for making a medical sling
EP1365688B1 (en) * 2001-03-09 2011-02-16 Boston Scientific Limited System for implanting a sling
US7037255B2 (en) * 2001-07-27 2006-05-02 Ams Research Corporation Surgical instruments for addressing pelvic disorders
EP1411858B1 (en) 2001-08-03 2006-07-12 Aesculap AG & Co. KG Incontinence strip for treating urinary incontinence
DE10138955A1 (en) * 2001-08-03 2003-02-20 Aesculap Ag & Co Kg Surgical instrument has curved shaft, handle with fastening, pointed shaft ends, locking slide-piece and sprung detents
DE10138950A1 (en) * 2001-08-03 2003-02-20 Aesculap Ag & Co Kg Strip for treating urinary incontinence, especially for women, by implantation in abdomen, is flexible and preferably consists (partly) of resorbable material, e.g. polyvinyl alcohol
DE20204669U1 (en) * 2002-03-23 2003-08-07 Aesculap Ag & Co Kg Strip for treating urinary incontinence, especially for women, by implantation in abdomen, is flexible and preferably consists (partly) of resorbable material, e.g. polyvinyl alcohol
US7087065B2 (en) * 2001-10-04 2006-08-08 Ethicon, Inc. Mesh for pelvic floor repair
US6673010B2 (en) * 2001-10-22 2004-01-06 T. A. G. Medical Products Ltd. Biological vessel suspending assembly and systems and methods utilizing same
US8968178B2 (en) 2002-03-07 2015-03-03 Ams Research Corporation Transobturator surgical articles and methods
FR2836820B1 (en) * 2002-03-08 2004-12-17 Vincent Goria SURGICAL DEVICE AND STRIP FOR THE TREATMENT OF URINARY EFFORT INCONTINENCE IN WOMEN
DE10211360A1 (en) * 2002-03-14 2003-10-09 Ethicon Gmbh Implantate band and surgical needle system to support female urethra has distal end region of needle narrower than implantate band
AU2003231229A1 (en) 2002-04-30 2003-11-17 Cook Biotech Incorporated Sling for supporting tissue
US7371245B2 (en) 2002-08-02 2008-05-13 C R Bard, Inc Transobturator introducer system for sling suspension system
US7637384B2 (en) * 2002-08-09 2009-12-29 Crown Packaging Technology, Inc. Tamper evident closure with locking band and container therefor
DE60331358D1 (en) 2002-12-17 2010-04-01 Boston Scient Ltd SPACER FOR A SURGICAL SLEDDING INTAKE SYSTEM
US7494495B2 (en) 2003-03-28 2009-02-24 Coloplast A/S Method and implant for curing cystocele
CA2523580C (en) * 2003-04-25 2012-03-20 Boston Scientific Limited Systems and methods for sling delivery and placement
DE602004023314D1 (en) 2003-08-14 2009-11-05 Boston Scient Ltd SURGICAL SLINGS
US8545386B2 (en) 2003-08-14 2013-10-01 Boston Scientific Scimed, Inc. Surgical slings
US7303525B2 (en) * 2003-08-22 2007-12-04 Ams Research Corporation Surgical article and methods for treating female urinary incontinence
FR2859624B1 (en) 2003-09-16 2005-12-02 Sofradim Production PROTHETIC KNIT WITH VARIABLE PROPERTIES
WO2005034765A2 (en) 2003-10-03 2005-04-21 Scimed Life Systems, Inc. Systems for a delivering a medical implant to an anatomical location in a patient
DE602005025637D1 (en) * 2004-03-30 2011-02-10 Proxy Biomedical Ltd TREATED SURGICAL MESH FROM MONOFILES FIBERS
WO2005094741A1 (en) * 2004-03-30 2005-10-13 Proxy Biomedical Limited Sling for treatment of urinary stress incontinence and/or pelvic floor prolapse
JP4977600B2 (en) 2004-04-20 2012-07-18 ジェンザイム・コーポレーション Surgical mesh implant
US8439820B2 (en) 2004-05-06 2013-05-14 Boston Scientific Scimed, Inc. Systems and methods for sling delivery and placement
US8062206B2 (en) 2004-05-07 2011-11-22 Ams Research Corporation Method and apparatus for treatment of vaginal anterior repairs
US8047982B2 (en) * 2004-05-07 2011-11-01 Ethicon, Inc. Mesh tape with wing-like extensions for treating female urinary incontinence
CA2570305C (en) 2004-06-14 2015-03-10 Boston Scientific Scimed, Inc. Systems, methods and devices relating to implantable supportive slings
KR101259770B1 (en) 2004-07-28 2013-05-03 에디컨인코포레이티드 Minimally invasive medical implant and insertion device and method for using the same
CA2878309C (en) 2005-02-04 2017-11-21 Ams Research Corporation Surgical implants and related methods and systems
US7914437B2 (en) 2005-02-04 2011-03-29 Ams Research Corporation Transobturator methods for installing sling to treat incontinence, and related devices
US20060195006A1 (en) * 2005-02-28 2006-08-31 Daurelle Bernard Adrien S Intraurethral incontinence device and methods
US20060199996A1 (en) * 2005-03-04 2006-09-07 Ricardo Caraballo Sling for supporting and occluding a tissue and method of using the same
US8016741B2 (en) 2005-04-06 2011-09-13 Boston Scientific Scimed, Inc. Systems, devices, and methods for sub-urethral support
US20060281967A1 (en) * 2005-04-22 2006-12-14 Sofradim Production Prosthetic safeguard for support implants
US7393320B2 (en) 2005-04-29 2008-07-01 Ams Research Corporation Pelvic floor health articles and procedures
WO2007008209A1 (en) 2005-07-13 2007-01-18 Boston Scientific Scimed Inc. Snap fit sling anchor system and related methods
EP3533416A1 (en) 2005-07-25 2019-09-04 Boston Scientific Limited Pelvic floor repair system
US7935046B2 (en) * 2005-08-11 2011-05-03 Boston Scientific Scimed, Inc. Systems, methods and devices relating to a removable sleeve for an implantable sling
US7951066B2 (en) * 2005-08-17 2011-05-31 Boston Scientific Scimed, Inc. Medical device positioning assemblies and methods
US7878970B2 (en) * 2005-09-28 2011-02-01 Boston Scientific Scimed, Inc. Apparatus and method for suspending a uterus
US9144483B2 (en) * 2006-01-13 2015-09-29 Boston Scientific Scimed, Inc. Placing fixation devices
US7922648B1 (en) * 2006-02-14 2011-04-12 Pacesetter, Inc. Myocardial infarction patch for minimally invasive implant
US8195296B2 (en) 2006-03-03 2012-06-05 Ams Research Corporation Apparatus for treating stress and urge incontinence
EP2617385B1 (en) 2006-03-16 2017-07-19 Boston Scientific Limited System for treating tissue wall prolapse
US8160710B2 (en) 2006-07-10 2012-04-17 Ams Research Corporation Systems and methods for implanting tissue stimulation electrodes in the pelvic region
WO2008042438A2 (en) * 2006-10-03 2008-04-10 Boston Scientific Scimed, Inc. Systems and devices for treating pelvic floor disorders
US20080287731A1 (en) * 2007-05-15 2008-11-20 Generic Medical Devices, Inc. Needle instruments and implantable sling assembly; kits comprising these components; and methods for use
US8933290B2 (en) * 2007-06-26 2015-01-13 Sofradim Production Sas Mesh implant
AU2008271061B2 (en) 2007-06-29 2013-11-14 Boston Scientific Scimed, Inc. Surgical articles and methods for treating pelvic conditions
US9427573B2 (en) 2007-07-10 2016-08-30 Astora Women's Health, Llc Deployable electrode lead anchor
US20100049289A1 (en) 2007-07-10 2010-02-25 Ams Research Corporation Tissue anchor
US8623034B2 (en) 2007-10-19 2014-01-07 Ethicon, Gmbh Soft tissue repair implant
US8920306B2 (en) 2007-12-28 2014-12-30 Boston Scientific Scimed, Inc. Devices and methods for delivering a pelvic implant
US8430807B2 (en) 2007-12-28 2013-04-30 Boston Scientific Scimed, Inc. Devices and methods for treating pelvic floor dysfunctions
US9282958B2 (en) 2007-12-28 2016-03-15 Boston Scientific Scimed, Inc. Devices and method for treating pelvic dysfunctions
US9078728B2 (en) * 2007-12-28 2015-07-14 Boston Scientific Scimed, Inc. Devices and methods for delivering female pelvic floor implants
US9271706B2 (en) 2008-08-12 2016-03-01 Covidien Lp Medical device for wound closure and method of use
US8241654B2 (en) * 2008-09-26 2012-08-14 Tyco Healthcare Group Lp Reactive surgical implant
US20100104608A1 (en) * 2008-09-26 2010-04-29 Tyco Healthcare Group Lp Reactive surgical implant
US20100111919A1 (en) * 2008-10-31 2010-05-06 Tyco Healthcare Group Lp Delayed gelation compositions and methods of use
US8449573B2 (en) 2008-12-05 2013-05-28 Boston Scientific Scimed, Inc. Insertion device and method for delivery of a mesh carrier
US9539433B1 (en) 2009-03-18 2017-01-10 Astora Women's Health, Llc Electrode implantation in a pelvic floor muscular structure
US9125716B2 (en) 2009-04-17 2015-09-08 Boston Scientific Scimed, Inc. Delivery sleeve for pelvic floor implants
US8968334B2 (en) 2009-04-17 2015-03-03 Boston Scientific Scimed, Inc. Apparatus for delivering and anchoring implantable medical devices
US8298187B2 (en) 2009-07-07 2012-10-30 Cook Medical Technologies Llc Fluid injection device
US9833225B2 (en) 2009-10-08 2017-12-05 Covidien Lp Wound closure device
US20110087273A1 (en) 2009-10-08 2011-04-14 Tyco Healthcare Group Lp Wound Closure Device
US8617206B2 (en) * 2009-10-08 2013-12-31 Covidien Lp Wound closure device
US20110087274A1 (en) * 2009-10-08 2011-04-14 Tyco Healtcare Group LP, New Haven, Ct Wound Closure Device
US9301750B2 (en) 2009-11-03 2016-04-05 Boston Scientific Scimed, Inc. Device and method for delivery of mesh-based devices
WO2011079222A2 (en) * 2009-12-23 2011-06-30 Boston Scientific Scimed, Inc. Less traumatic method of delivery of mesh-based devices into human body
US8380312B2 (en) 2009-12-31 2013-02-19 Ams Research Corporation Multi-zone stimulation implant system and method
US9277936B2 (en) * 2010-01-11 2016-03-08 Kenneth Finkelstein Surgical instrument having an integrated local anesthetic delivery system
WO2011143572A1 (en) 2010-05-13 2011-11-17 Ams Research Corporation Implantable mechanical support
US9381030B2 (en) * 2010-07-15 2016-07-05 Nuvectra Corporation Tunneling tool for implantable leads
US8684908B2 (en) * 2010-08-26 2014-04-01 Ethicon, Inc. Centering aid for implantable sling
US8911348B2 (en) 2010-09-02 2014-12-16 Boston Scientific Scimed, Inc. Pelvic implants and methods of implanting the same
CA2818945A1 (en) 2010-12-16 2012-06-21 Ams Research Corporation Surgical tools, systems, and related implants and methods
US9636201B2 (en) 2011-05-12 2017-05-02 Boston Scientific Scimed, Inc. Delivery members for delivering an implant into a body of a patient
US9113991B2 (en) 2011-05-12 2015-08-25 Boston Scientific Scimed, Inc. Anchors for bodily implants and methods for anchoring bodily implants into a patient's body
US9220887B2 (en) 2011-06-09 2015-12-29 Astora Women's Health LLC Electrode lead including a deployable tissue anchor
US9750839B2 (en) 2011-06-30 2017-09-05 Covidien Lp Drug eluting medical devices
WO2013036399A2 (en) 2011-09-08 2013-03-14 Ams Research Corporation Implantable electrode assembly
US9168120B2 (en) 2011-09-09 2015-10-27 Boston Scientific Scimed, Inc. Medical device and methods of delivering the medical device
WO2013046058A2 (en) 2011-09-30 2013-04-04 Sofradim Production Reversible stiffening of light weight mesh
US20130156935A1 (en) 2011-12-14 2013-06-20 Rachit Ohri Methods for Coating Medical Devices
CN109602468B (en) 2012-02-23 2021-10-01 高级缝合有限公司 Improved suture
US10278694B2 (en) 2012-02-23 2019-05-07 Northwestern University Indirect attachment of a needle to a mesh suture
EP2633876B1 (en) 2012-03-02 2014-09-24 Cook Medical Technologies LLC Dilation cap for endoluminal device
CA2886882A1 (en) 2012-10-22 2014-05-01 Ams Research Corporation System and method for treatment of anal and fecal incontinence
US9078730B2 (en) * 2013-03-08 2015-07-14 Ethicon, Inc. Surgical instrument and method for the treatment of urinary incontinence
US9814555B2 (en) 2013-03-12 2017-11-14 Boston Scientific Scimed, Inc. Medical device for pelvic floor repair and method of delivering the medical device
WO2014162432A1 (en) * 2013-04-01 2014-10-09 テルモ株式会社 Medical tube and medical tube assembly
US20160051354A1 (en) * 2013-05-02 2016-02-25 Mangesh Patankar Sling system with removable string
CA2911312A1 (en) * 2013-05-03 2014-11-06 James W. Cullison Urological implant
CA2919504A1 (en) 2013-08-01 2015-02-05 Christine BRONIKOWSKI Tissue adjustment implant
US9962251B2 (en) 2013-10-17 2018-05-08 Boston Scientific Scimed, Inc. Devices and methods for delivering implants
US9364311B2 (en) 2013-12-13 2016-06-14 Covidien Lp Endoscopic system for winding and inserting a mesh
CN106137331B (en) * 2015-03-22 2018-08-07 周星 Puncturing lever and puncture outfit
EP3398554A1 (en) 2017-05-02 2018-11-07 Sofradim Production Prosthesis for inguinal hernia repair
US11576666B2 (en) 2019-10-04 2023-02-14 Arthrex, Inc Surgical constructs for tissue fixation and methods of tissue repairs
US20220202551A1 (en) * 2020-12-31 2022-06-30 Mickey M. Karram Device for treating urinary stress incontinence

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5112344A (en) * 1988-10-04 1992-05-12 Petros Peter E Surgical instrument and method of utilization of such
US5836314A (en) * 1991-12-03 1998-11-17 Boston Scientific Technology, Inc. Surgical treatment of stress urinary incontinence
US5899909A (en) * 1994-08-30 1999-05-04 Medscand Medical Ab Surgical instrument for treating female urinary incontinence
US6091995A (en) * 1996-11-08 2000-07-18 Surx, Inc. Devices, methods, and systems for shrinking tissues
US6099547A (en) * 1997-02-13 2000-08-08 Scimed Life Systems, Inc. Method and apparatus for minimally invasive pelvic surgery
US6406423B1 (en) * 2000-01-21 2002-06-18 Sofradim Production Method for surgical treatment of urinary incontinence and device for carrying out said method
US6478727B2 (en) * 2000-01-21 2002-11-12 Sofradim Production Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2064291B1 (en) * 1993-07-08 1995-08-01 Lopez Francisco Garcia VAGINAL AUTOSUTURE DEVICE TO PREVENT INCONTINENCE OF WOMEN'S URINE.
EP0983033B1 (en) * 1997-02-13 2002-10-09 Boston Scientific Limited Stabilization sling for use in minimally invasive pelvic surgery
WO1999062406A2 (en) * 1998-06-03 1999-12-09 Coalescent Surgical, Inc. Tissue connector apparatus and methods
US6010447A (en) * 1998-07-31 2000-01-04 Kardjian; Paul M. Bladder sling
US6273852B1 (en) 1999-06-09 2001-08-14 Ethicon, Inc. Surgical instrument and method for treating female urinary incontinence
WO2000074633A2 (en) * 1999-06-09 2000-12-14 Ethicon, Inc. Method and apparatus for adjusting flexible areal polymer implants

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5112344A (en) * 1988-10-04 1992-05-12 Petros Peter E Surgical instrument and method of utilization of such
US5836314A (en) * 1991-12-03 1998-11-17 Boston Scientific Technology, Inc. Surgical treatment of stress urinary incontinence
US6056688A (en) * 1991-12-03 2000-05-02 Boston Scientific Technology, Inc. Device and method for transvaginally suspending the bladder neck
US5899909A (en) * 1994-08-30 1999-05-04 Medscand Medical Ab Surgical instrument for treating female urinary incontinence
US6091995A (en) * 1996-11-08 2000-07-18 Surx, Inc. Devices, methods, and systems for shrinking tissues
US6099547A (en) * 1997-02-13 2000-08-08 Scimed Life Systems, Inc. Method and apparatus for minimally invasive pelvic surgery
US6406423B1 (en) * 2000-01-21 2002-06-18 Sofradim Production Method for surgical treatment of urinary incontinence and device for carrying out said method
US6478727B2 (en) * 2000-01-21 2002-11-12 Sofradim Production Percutaneous device and method for treating urinary stress incontinence in women using a sub-urethral tape

Cited By (228)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050131274A1 (en) * 2000-05-07 2005-06-16 Mentor Corporation, Minnesota Corporation Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
US7927342B2 (en) 2000-06-05 2011-04-19 Boston Scientific Scimed, Inc. Methods and devices for the treatment of urinary incontinence
US20090209994A1 (en) * 2000-06-05 2009-08-20 Boston Scientific Scimed, Inc. Methods and devices for the treatment of urinary incontinence
US8469875B2 (en) 2000-07-05 2013-06-25 Coloplast A/S Method and device for treating urinary incontinence
US20030199732A1 (en) * 2000-07-05 2003-10-23 Mentor Corporation, A Minnesota Corporation Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
US8920304B2 (en) 2000-07-05 2014-12-30 Coloplast A/S Method and device for treating urinary incontinence
US10278800B2 (en) 2000-07-05 2019-05-07 Coloplast A/S Method and device for treating urinary incontinence
US20040054253A1 (en) * 2000-09-07 2004-03-18 Snitkin Eva S. Coated sling material
US8147478B2 (en) 2000-09-07 2012-04-03 Ams Research Corporation Coated sling material
US7025063B2 (en) 2000-09-07 2006-04-11 Ams Research Corporation Coated sling material
US8469877B2 (en) 2000-10-12 2013-06-25 Coloplast A/S System for introducing a pelvic implant
US8449450B2 (en) 2000-10-12 2013-05-28 Coloplast A/S Pass through introducer and sling
US8118728B2 (en) 2000-10-12 2012-02-21 Coloplast A/S Method for implanting an adjustable surgical implant for treating urinary incontinence
US8047983B2 (en) 2000-10-12 2011-11-01 Coloplast A/S Surgical system for supporting pelvic anatomy
US10449025B2 (en) 2000-10-12 2019-10-22 Coloplast A/S Surgical device implantable to treat female urinary incontinence
US8123673B2 (en) 2000-10-12 2012-02-28 Coloplast A/S Adjustable surgical implant for treating urinary incontinence
US8128554B2 (en) 2000-10-12 2012-03-06 Coloplast A/S System for introducing a pelvic implant
US20110237874A1 (en) * 2000-10-12 2011-09-29 Coloplast A/S Adjustable surgical implant and method for treating urinary incontinence
US8007430B2 (en) 2000-10-12 2011-08-30 Coloplast A/S Apparatus and method for treating female urinary incontinence
US8162818B2 (en) 2000-10-12 2012-04-24 Coloplast A/S Adjustable surgical implant for pelvic anatomy
US8167785B2 (en) 2000-10-12 2012-05-01 Coloplast A/S Urethral support system
US8182413B2 (en) 2000-10-12 2012-05-22 Coloplast A/S Method for fibrous anchoring of a pelvic support
US10076394B2 (en) 2000-10-12 2018-09-18 Coloplast A/S Method of treating urinary incontinence
US9968430B2 (en) 2000-10-12 2018-05-15 Coloplast A/S Surgical device implantable to treat female urinary incontinence
US8182412B2 (en) 2000-10-12 2012-05-22 Coloplast A/S Pelvic implant with fibrous anchor
US9918817B2 (en) 2000-10-12 2018-03-20 Coloplast A/S Method of post-operatively adjusting a urethral support in treating urinary incontinence of a woman
US8273011B2 (en) 2000-10-12 2012-09-25 Coloplast A/S Adjustable surgical implant and method for treating urinary incontinence
US8454492B2 (en) 2000-10-12 2013-06-04 Coloplast A/S Absorbable anchor and method for mounting mesh to tissue
US8118727B2 (en) 2000-10-12 2012-02-21 Coloplast A/S Method for supporting pelvic anatomy
US8512223B2 (en) 2000-10-12 2013-08-20 Coloplast A/S Pelvic implant with selective locking anchor
US9113992B2 (en) 2000-10-12 2015-08-25 Coloplast A/S Apparatus and method for treating urinary incontinence
US9089394B2 (en) 2000-10-12 2015-07-28 Coloplast A/S Pelvic implant with suspending system
US8574148B2 (en) 2000-10-12 2013-11-05 Coloplast A/S System for introducing soft tissue anchors
US9089396B2 (en) 2000-10-12 2015-07-28 Coloplast A/S Urinary incontinence treatment and devices
US8668635B2 (en) 2000-10-12 2014-03-11 Coloplast A/S Pelvic implant with suspending system
US8932202B2 (en) 2000-10-12 2015-01-13 Coloplast A/S Incontinence implant with soft tissue anchors and length not allowing abdominal wall penetration
US8801596B2 (en) 2000-10-12 2014-08-12 Coloplast A/S Sling with support and suspending members formed from same polymer
US8920308B2 (en) 2000-10-12 2014-12-30 Coloplast A/S Surgical implant with anchor introducer channel
US20080200751A1 (en) * 2000-10-12 2008-08-21 James Browning Urethral support system
US8821369B2 (en) 2000-10-12 2014-09-02 Colorplast A/S Method for soft tissue anchoring with introducer
US8911347B2 (en) 2000-10-12 2014-12-16 Coloplast A/S System and method for treating urinary incontinence
US8888678B2 (en) 2000-10-12 2014-11-18 Coloplast A/S Pelvic implant with suspending system
US8821370B2 (en) 2000-10-12 2014-09-02 Coloplast A/S Device, system and methods for introducing soft tissue anchors
US8852075B2 (en) 2000-10-12 2014-10-07 Coloplast A/S Pelvic implant systems and methods with expandable anchors
US7972262B2 (en) 2001-01-23 2011-07-05 Ams Research Corporation Sling assembly with secure and convenient attachment
US20110230704A1 (en) * 2001-01-23 2011-09-22 Ams Research Corporation Sling Assembly with Secure and Convenient Attachment
US8864646B2 (en) 2001-01-23 2014-10-21 Ams Research Corporation Surgical articles and methods
US20040106845A1 (en) * 2001-01-23 2004-06-03 American Medical Systems Surgical instrument and method
US6641525B2 (en) 2001-01-23 2003-11-04 Ams Research Corporation Sling assembly with secure and convenient attachment
US8784295B2 (en) 2001-01-23 2014-07-22 Ams Research Corporation Sling assembly with secure and convenient attachment
US7867161B2 (en) 2001-01-23 2011-01-11 Ams Research Corporation Sling delivery system and method of use
US6652450B2 (en) 2001-01-23 2003-11-25 American Medical Systems, Inc. Implantable article and method for treating urinary incontinence using means for repositioning the implantable article
US20030050530A1 (en) * 2001-01-23 2003-03-13 Neisz Johann J. Surgical articles and methods
US8852077B2 (en) 2001-01-23 2014-10-07 Ams Research Corporation Sling delivery system and method of use
US20070225546A1 (en) * 2001-01-23 2007-09-27 Ams Research Corporation Pelvic floor implant system and method of assembly
US20110105831A1 (en) * 2001-01-23 2011-05-05 Ams Research Corporation Sling Delivery System and Method of Use
US7762942B2 (en) 2001-01-23 2010-07-27 Ams Research Corporation Implantable article for the treatment of incontinence
US9717580B2 (en) 2001-01-23 2017-08-01 Astora Women's Health, Llc Pelvic floor implant system and method of assembly
US20030045774A1 (en) * 2001-01-23 2003-03-06 Staskin David R. Sling delivery system and method of use
US8475357B2 (en) 2001-01-23 2013-07-02 Ams Research Corporation Sling delivery system and method of use
US6612977B2 (en) 2001-01-23 2003-09-02 American Medical Systems Inc. Sling delivery system and method of use
US20030130670A1 (en) * 2001-01-23 2003-07-10 Anderson Kimberly A. Pelvic floor implant system and method of assembly
US6802807B2 (en) 2001-01-23 2004-10-12 American Medical Systems, Inc. Surgical instrument and method
US10117733B2 (en) 2001-03-09 2018-11-06 Boston Scientific Scimed, Inc. Systems, methods and devices relating to delivery of medical implants
US20050131391A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US20050131392A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US8915927B2 (en) 2001-03-09 2014-12-23 Boston Scientific Scimed, Inc. Systems, methods and devices relating to delivery of medical implants
US9149261B2 (en) 2001-03-09 2015-10-06 Boston Scientific Scimed, Inc. Systems, methods and devices relating to delivery of medical implants
US8602965B2 (en) 2001-03-09 2013-12-10 Boston Scientific Scimed, Inc. System, methods and devices relating to delivery of medical implants
US20050131393A1 (en) * 2001-03-09 2005-06-16 Scimed Life Systems, Inc. Systems, methods and devices relating to delivery of medical implants
US9943390B2 (en) 2001-03-30 2018-04-17 Coloplast A/S Method of treating pelvic organ prolapse in a female patient by accessing a prolapsed organ trans-vaginally through a vagina
US10682213B2 (en) 2001-03-30 2020-06-16 Coloplast A/S Surgical implant consisting of non-absorbable material
US8777836B2 (en) 2001-07-27 2014-07-15 Ams Research Corporation Pelvic health implants and methods
US8702585B2 (en) 2001-07-27 2014-04-22 Ams Research Corporation Pelvic health implants and methods
US20040039453A1 (en) * 2001-07-27 2004-02-26 Anderson Kimberly A. Pelvic health implants and methods
US20080103351A1 (en) * 2001-07-27 2008-05-01 Montpetit Karen P Pelvic health implants and methods
US10206771B2 (en) 2001-07-27 2019-02-19 David STASKIN Pelvic health implants and methods
US6648921B2 (en) 2001-10-03 2003-11-18 Ams Research Corporation Implantable article
US8460170B2 (en) 2002-03-01 2013-06-11 Ethicon, Inc. Method and apparatus for treating pelvic organ prolapses in female patients
US20060173237A1 (en) * 2002-03-01 2006-08-03 Bernard Jacquetin Method and apparatus for treating pelvic organ prolapses in female patients
US20030220538A1 (en) * 2002-03-01 2003-11-27 Bernard Jacquetin Method and apparatus for treating pelvic organ prolapses in female patients
US8480556B2 (en) 2002-03-01 2013-07-09 Ethicon, Inc. Method and apparatus for treating pelvic organ prolapses in female patients
US7985173B2 (en) 2002-03-01 2011-07-26 Ethicon, Inc. Method and apparatus for treating pelvic organ prolapses in female patients
US20100191039A1 (en) * 2002-03-07 2010-07-29 Anderson Kimberly A Transobturator surgical articles and methods
US20060063968A1 (en) * 2002-03-07 2006-03-23 Ams Research Corporation Transobturator surgical articles and methods
US8043204B2 (en) 2002-03-07 2011-10-25 Ams Research Corporation Transobturator surgical articles and methods
US9433487B2 (en) 2002-03-07 2016-09-06 Astora Women's Health, Llc Transobturator surgical articles and methods
US8864648B2 (en) 2002-03-07 2014-10-21 Ams Research Corporation Transobturator surgical articles and methods
US7988615B2 (en) 2002-03-07 2011-08-02 Ams Research Corporation Transobturator surgical articles and methods
US20030176875A1 (en) * 2002-03-07 2003-09-18 Anderson Kimberly A. Transobturator surgical articles and methods
US9005222B2 (en) 2002-08-02 2015-04-14 Coloplast A/S Self-anchoring sling and introducer system
US9532861B2 (en) 2002-08-02 2017-01-03 Coloplast A/S Self-anchoring sling and introducer system
US9532862B2 (en) 2002-08-02 2017-01-03 Coloplast A/S Self-anchoring sling and introducer system
US9872750B2 (en) 2002-08-02 2018-01-23 Coloplast A/S Self-anchoring sling and introducer system
US8709471B2 (en) 2003-03-27 2014-04-29 Coloplast A/S Medicament delivery device and a method of medicament delivery
US9186489B2 (en) 2003-03-27 2015-11-17 Coloplast A/S Implantable delivery device system for delivery of a medicament to a bladder
US9555168B2 (en) 2003-03-27 2017-01-31 Coloplast A/S System for delivery of medication in treatment of disorders of the pelvis
US9345867B2 (en) 2003-03-27 2016-05-24 Coloplast A/S Device implantable in tissue of a prostate gland or a bladder
US20050004427A1 (en) * 2003-04-30 2005-01-06 Mauro Cervigni Prosthesis for use in the surgical treatment of urogenital prolapse and female urinary incontinence
US10070860B2 (en) 2003-06-13 2018-09-11 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US7670362B2 (en) 2003-06-13 2010-03-02 Tyco Healthcare Group Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US9364274B2 (en) 2003-06-13 2016-06-14 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US9259221B2 (en) 2003-06-13 2016-02-16 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US9788833B2 (en) 2003-06-13 2017-10-17 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US8292933B2 (en) 2003-06-13 2012-10-23 Tyco Healthcare Group Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US20080281336A1 (en) * 2003-06-13 2008-11-13 Zergiebel Earl M Multiple member interconnect for surgical instrument and absorbable screw fastener
US20060241622A1 (en) * 2003-06-13 2006-10-26 Zergiebel Earl M Multiple member interconnect for surgical instrument and absorbable screw fastener
US8926637B2 (en) 2003-06-13 2015-01-06 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US20100191294A1 (en) * 2003-06-13 2010-07-29 Tyco Healthcare Group Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US9987010B2 (en) 2003-06-13 2018-06-05 Covidien Lp Multiple member interconnect for surgical instrument and absorbable screw fastener
US7824326B2 (en) 2003-07-31 2010-11-02 Boston Scientific Scimed, Inc. Bioabsorbable casing for surgical sling assembly
US20050027220A1 (en) * 2003-07-31 2005-02-03 James Wagner Bioabsorbable casing for surgical sling assembly
US8038594B2 (en) 2003-09-22 2011-10-18 Ams Research Corporation Prolapse repair
US8753260B2 (en) 2003-09-22 2014-06-17 Ams Research Corporation Prolapse repair
US20080119863A1 (en) * 2003-09-22 2008-05-22 Ams Research Corporation Prolapse Repair
US7338432B2 (en) 2003-11-17 2008-03-04 Konstantin Valtchev Urethral sling introducer and method of use
US20090192540A1 (en) * 2003-11-17 2009-07-30 Boston Scientific Scimed, Inc. Systems and methods relating to associating a medical implant with a delivery device
US8323179B2 (en) 2003-11-17 2012-12-04 Boston Scientific Scimed, Inc. Systems and methods relating to associating a medical implant with a delivery device
US20050245787A1 (en) * 2004-04-30 2005-11-03 Ams Research Corporation Method and apparatus for treating pelvic organ prolapse
US8211005B2 (en) 2004-04-30 2012-07-03 Ams Research Corporation Method and apparatus for treating pelvic organ prolapse
US8206281B2 (en) 2004-04-30 2012-06-26 Ams Research Corporation Method and apparatus for treating pelvic organ prolapse
US20110015479A1 (en) * 2004-04-30 2011-01-20 Anderson Kimberly A Method and apparatus for treating pelvic organ prolapse
US20090137864A1 (en) * 2004-04-30 2009-05-28 Cox James E Method and apparatus for treating pelvic organ prolapse
US7993261B2 (en) 2004-05-07 2011-08-09 Ams Research Corporation Method and apparatus for cystocele repair
US20080183031A1 (en) * 2004-05-07 2008-07-31 Ams Research Corporation Method and Apparatus for Cystocele Repair
US20050250977A1 (en) * 2004-05-07 2005-11-10 Ams Research Corporation Method and apparatus for cystocele repair
US9060838B2 (en) 2004-05-21 2015-06-23 Coloplast A/S Tissue supported implantable device
US7975698B2 (en) 2004-05-21 2011-07-12 Coloplast A/S Implant for treatment of vaginal and/or uterine prolapse
US20080196729A1 (en) * 2004-05-21 2008-08-21 Mpathy Medical Devices Limited Implant for Treatment of Vaginal and/or Uterine Prolapse
US8215310B2 (en) 2004-05-21 2012-07-10 Coloplast A/S Implant for treatment of vaginal and/or uterine prolapse
US10064714B2 (en) 2004-05-21 2018-09-04 Coloplast A/S Implantable device configured to treat pelvic organ prolapse
US20050278037A1 (en) * 2004-06-11 2005-12-15 Analytic Biosurgical Solutions-Abiss Implant for the treatment of cystocele and rectocele
US20050288708A1 (en) * 2004-06-25 2005-12-29 Kammerer Gene W Soft tissue fastener having integral biasing section
US20060058575A1 (en) * 2004-09-15 2006-03-16 Vincenza Zaddem System and method for surgical implant placement
US20060173468A1 (en) * 2005-01-28 2006-08-03 Marc Simmon Obturator introducer with snare
US20060196788A1 (en) * 2005-02-02 2006-09-07 Peter Komarnycky Packaging assembly for surgical mesh implants
US20100168505A1 (en) * 2005-06-21 2010-07-01 Ams Research Corporation Methods and apparatus for securing a urethral sling to a pubic bone
US8864650B2 (en) 2005-06-21 2014-10-21 Ams Research Corporation Methods and apparatus for securing a urethral sling to a pubic bone
US9549799B2 (en) 2005-06-21 2017-01-24 Boston Scientific Scimed, Inc. Surgical kit for securing an implantable sling in a pubic region
US20100094079A1 (en) * 2005-06-21 2010-04-15 Ams Research Corporation Method and Apparatus for Securing a Urethral Sling to Pubic Bone
US9283064B2 (en) 2005-07-26 2016-03-15 Ams Research Corporation Methods and systems for treatment of prolapse
US20090192347A1 (en) * 2005-07-26 2009-07-30 Ams Research Corporation Methods and Systems for Treatment of Prolapse
US9060839B2 (en) 2005-07-26 2015-06-23 Ams Research Corporation Methods and systems for treatment of prolapse
US8535217B2 (en) 2005-07-26 2013-09-17 Ams Research Corporation Methods and systems for treatment of prolapse
US20100241105A1 (en) * 2005-08-04 2010-09-23 C.R. Bard, Inc. System for introducing implants
US8123671B2 (en) 2005-08-04 2012-02-28 C.R. Bard, Inc. Pelvic implant systems and methods
US20080207989A1 (en) * 2005-08-29 2008-08-28 Ams Research Corporation System For Positioning Support Mesh in a Patient
US9877717B2 (en) 2005-10-05 2018-01-30 Boston Scientific Scimed, Inc. Connector for mesh support insertion
US7909753B1 (en) * 2005-10-05 2011-03-22 Ams Research Corporation Connector for mesh support insertion
US8845512B2 (en) 2005-11-14 2014-09-30 C. R. Bard, Inc. Sling anchor system
US7637860B2 (en) 2005-11-16 2009-12-29 Boston Scientific Scimed, Inc. Devices for minimally invasive pelvic surgery
US20070123746A1 (en) * 2005-11-16 2007-05-31 Boston Scientific Scimed, Inc. Devices for minimally invasive pelvic surgery
US20090318752A1 (en) * 2006-03-15 2009-12-24 C. R. Bard, Inc. Implants for the treatment of pelvic floor disorders
US20100010631A1 (en) * 2006-05-19 2010-01-14 John Fritz Otte Method and articles for treatment of stress urinary incontinence
US9084664B2 (en) 2006-05-19 2015-07-21 Ams Research Corporation Method and articles for treatment of stress urinary incontinence
US8834350B2 (en) 2006-06-16 2014-09-16 Ams Research Corporation Surgical implants, tools, and methods for treating pelvic conditions
US10271936B2 (en) 2006-06-16 2019-04-30 Boston Scientific Scimed, Inc. Surgical implants, tools, and methods for treating pelvic conditions
US20110112357A1 (en) * 2006-06-16 2011-05-12 Ams Research Corporation Surgical implants, tools, and methods for treating pelvic conditions
US10441400B2 (en) 2006-06-22 2019-10-15 Boston Scientific Scimed, Inc. Adjustable tension incontinence sling assembles
US8628463B2 (en) 2006-06-22 2014-01-14 Ams Research Corporation Adjustable tension incontinence sling assemblies
US20090259092A1 (en) * 2006-06-22 2009-10-15 Ogdahl Jason W Adjustable Sling and Method of Treating Pelvic Conditions
US20100261950A1 (en) * 2006-06-22 2010-10-14 Ams Research Corporation Adjustable Tension Incontinence Sling Assemblies
US8460169B2 (en) 2006-06-22 2013-06-11 Ams Research Corporation Adjustable tension incontinence sling assemblies
US9375302B2 (en) 2006-06-22 2016-06-28 Astora Women's Health, Llc Adjustable tension incontinence sling assemblies
US20110124954A1 (en) * 2006-06-22 2011-05-26 Ams Research Corporation Adjustable tension incontinence sling assemblies
US8480559B2 (en) 2006-09-13 2013-07-09 C. R. Bard, Inc. Urethral support system
US20110034759A1 (en) * 2006-10-26 2011-02-10 Ogdahl Jason W Surgical articles and methods for treating pelvic conditions
US8777837B2 (en) 2006-10-26 2014-07-15 Ams Research Corporation Surgical articles and methods for treating pelvic
US9585739B2 (en) 2006-10-26 2017-03-07 Ams Research Corporation Surgical articles and methods for treating pelvic conditions
US8388514B2 (en) 2006-10-26 2013-03-05 Ams Research Corporation Surgical articles and methods for treating pelvic conditions
US8986188B2 (en) 2007-04-28 2015-03-24 The Board Of Trustees Of The Leland Stanford Junior University Dynamic and adjustable support devices
US9113989B2 (en) 2007-08-14 2015-08-25 The Board Of Trustees Of The Leland Stanford Junior University Methods and devices for supporting, elevating, or compressing internal structures
US20090082617A1 (en) * 2007-08-14 2009-03-26 Vecchiotti Richard G Methods and devices for supporting, elevating, or compressing internal structures
US10010394B2 (en) 2007-09-21 2018-07-03 Boston Scientific Scimed, Inc. Pelvic floor treatments and related tools and implants
US8708885B2 (en) 2007-09-21 2014-04-29 Ams Research Corporation Pelvic floor treatments and related tools and implants
US9333065B2 (en) 2007-09-21 2016-05-10 Astora Women's Health, Llc Pelvic floor treatments and related tools and implants
US8951185B2 (en) 2007-10-26 2015-02-10 Ams Research Corporation Surgical articles and methods for treating pelvic conditions
US20090240104A1 (en) * 2007-10-26 2009-09-24 Ams Research Corporation Surgical Articles and Methods for Treating Pelvic Conditions
US8574149B2 (en) 2007-11-13 2013-11-05 C. R. Bard, Inc. Adjustable tissue support member
US10639138B2 (en) 2008-02-28 2020-05-05 Coloplast A/S Method for providing support to a urethra in treating urinary incontinence
US9022922B2 (en) 2008-07-31 2015-05-05 Ams Research Corporation Methods and implants for treating urinary incontinence
US8727963B2 (en) 2008-07-31 2014-05-20 Ams Research Corporation Methods and implants for treating urinary incontinence
US10039628B2 (en) 2008-07-31 2018-08-07 L. Dean Knoll Methods and implants for treating urinary incontinence
US20100030016A1 (en) * 2008-07-31 2010-02-04 Knoll L Dean Methods and Implants for Treating Urinary Incontinence
US9918816B2 (en) 2008-08-25 2018-03-20 Boston Scientific Scimed, Inc. Minimally invasive implant and method
US11547542B2 (en) 2008-08-25 2023-01-10 Boston Scientific Scimed, Inc. Minimally invasive implant and method
US10537416B2 (en) 2008-08-25 2020-01-21 Boston Scientific Scimed, Inc. Minimally invasive implant and method
US9017243B2 (en) 2008-08-25 2015-04-28 Ams Research Corporation Minimally invasive implant and method
US20100105979A1 (en) * 2008-10-27 2010-04-29 Ams Research Corporation Surgical Needle and Anchor System with Retractable Features
US8944990B2 (en) 2008-10-27 2015-02-03 Ams Research Corporation Surgical needle and anchor system with retractable features
US9226809B2 (en) 2009-02-10 2016-01-05 Ams Research Corporation Surgical articles and methods for treating urinary incontinence
US9364308B2 (en) 2009-12-30 2016-06-14 Astora Women's Health, Llc Implant systems with tensioning feedback
US9345473B2 (en) 2009-12-30 2016-05-24 Astora Women's Health, Llc Implantable sling systems and methods
US20110160527A1 (en) * 2009-12-31 2011-06-30 Ams Research Corporation Suture-less Tissue Fixation for Implantable Device
US9393091B2 (en) 2009-12-31 2016-07-19 Astora Women's Health, Llc Suture-less tissue fixation for implantable device
US11446129B2 (en) 2010-02-23 2022-09-20 Boston Scientific Scimed, Inc. Surgical articles and methods
US10478278B2 (en) 2010-02-23 2019-11-19 Boston Scientific Scimed, Inc. Surgical articles and methods
US9381076B2 (en) 2010-02-23 2016-07-05 Boston Scientific Scimed, Inc. Surgical articles and methods
US9445881B2 (en) 2010-02-23 2016-09-20 Boston Scientific Scimed, Inc. Surgical articles and methods
US10028813B2 (en) 2010-07-22 2018-07-24 Boston Scientific Scimed, Inc. Coated pelvic implant device and method
US20120046517A1 (en) * 2010-08-18 2012-02-23 Konstantin Lazarov Valtchev Second generation tape
US10492897B2 (en) 2010-10-06 2019-12-03 Boston Scientific Scimed, Inc. Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions
US9468512B2 (en) 2010-10-06 2016-10-18 Astora Women's Health, Llc Implants with absorbable and non-absorbable features for the treatment of female pelvic conditions
US9572648B2 (en) 2010-12-21 2017-02-21 Justin M. Crank Implantable slings and anchor systems
US9125717B2 (en) 2011-02-23 2015-09-08 Ams Research Corporation Implant tension adjustment system and method
US9622848B2 (en) 2011-02-23 2017-04-18 Boston Scientific Scimed, Inc. Urethral stent system and method
US10034735B2 (en) 2011-03-28 2018-07-31 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatments of pelvic conditions
US10039629B2 (en) 2011-03-28 2018-08-07 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatment of pelvic conditions
US9750590B2 (en) 2011-03-28 2017-09-05 Andrew P. VanDeWeghe Implants, tools, and methods for treatment of pelvic conditions
US9737388B2 (en) 2011-03-28 2017-08-22 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
US8808162B2 (en) 2011-03-28 2014-08-19 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
US9179992B2 (en) 2011-03-28 2015-11-10 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
US9089393B2 (en) 2011-03-28 2015-07-28 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
US9492259B2 (en) 2011-03-30 2016-11-15 Astora Women's Health, Llc Expandable implant system
US9782245B2 (en) 2011-03-30 2017-10-10 James R. Mujwid Implants, tools, and methods for treatment of pelvic conditions
US10058240B2 (en) 2011-06-29 2018-08-28 Boston Scientific Scimed, Inc. Systems, implants, tools, and methods for treatments of pelvic conditions
US10653411B2 (en) 2011-06-30 2020-05-19 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatments of pelvic conditions
US10500027B2 (en) 2011-06-30 2019-12-10 Boston Scientific Scimed, Inc. Implants, tools, and methods for treatments of pelvic conditions
US9351723B2 (en) 2011-06-30 2016-05-31 Astora Women's Health, Llc Implants, tools, and methods for treatments of pelvic conditions
US9414903B2 (en) 2011-07-22 2016-08-16 Astora Women's Health, Llc Pelvic implant system and method
US11284983B2 (en) 2011-07-22 2022-03-29 Boston Scientific Scimed, Inc. Pelvic implant system and method
US9492191B2 (en) 2011-08-04 2016-11-15 Astora Women's Health, Llc Tools and methods for treatment of pelvic conditions
US10390813B2 (en) 2011-08-05 2019-08-27 Boston Scientific Scimed, Inc. Systems, implants, tools, and methods for treatments of pelvic conditions
US10098721B2 (en) 2011-09-01 2018-10-16 Boston Scientific Scimed, Inc. Pelvic implant needle system and method
USD746462S1 (en) 2011-09-08 2015-12-29 Ams Research Corporation Surgical indicators
USD721175S1 (en) 2011-09-08 2015-01-13 Ams Research Corporation Backers for surgical indicators
USD721807S1 (en) 2011-09-08 2015-01-27 Ams Research Corporation Surgical indicators
USD736382S1 (en) 2011-09-08 2015-08-11 Ams Research Corporation Surgical indicator with backers

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