CA2541069A1 - Systems and methods for delivering a medical implant to an anatomical location in a patient - Google Patents

Systems and methods for delivering a medical implant to an anatomical location in a patient Download PDF

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Publication number
CA2541069A1
CA2541069A1 CA002541069A CA2541069A CA2541069A1 CA 2541069 A1 CA2541069 A1 CA 2541069A1 CA 002541069 A CA002541069 A CA 002541069A CA 2541069 A CA2541069 A CA 2541069A CA 2541069 A1 CA2541069 A1 CA 2541069A1
Authority
CA
Canada
Prior art keywords
shaft
delivery device
sling
handle
sleeve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002541069A
Other languages
French (fr)
Other versions
CA2541069C (en
Inventor
Michael S. H. Chu
Alfred P. Intoccia, Jr.
Tim Moore
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boston Scientific Ltd Barbados
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2541069A1 publication Critical patent/CA2541069A1/en
Application granted granted Critical
Publication of CA2541069C publication Critical patent/CA2541069C/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045—Support slings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00805—Treatment of female stress urinary incontinence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06009—Means for attaching suture to needle having additional means for releasably clamping the suture to the needle, e.g. actuating rod slideable within the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06019—Means for attaching suture to needle by means of a suture-receiving lateral eyelet machined in the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/06076—Needles, e.g. needle tip configurations helically or spirally coiled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/0608—J-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/06085—Needles, e.g. needle tip configurations having a blunt tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0072—Delivery tools therefor

Abstract

Medical implant delivery devices and systems are disclosed. In general, an exemplary delivery device comprises a shaft and a handle. An exemplary system includes any number of the following: a delivery device, a sling assembly, guide members, and connectors that interconnect the above. Embodiments of all the above components and their combinations are disclosed. Methods of using the above system in trans-obturator approaches are disclosed.

Claims (44)

1. A delivery device for delivering a supportive sling to periurethral tissue of a patient via an obturator foramen of the patient, the delivery device including, a handle, a shaft having a first curved portion and terminating in a substantially conical tip at a distal most end, and an transitional portion for affixing a proximal end of the shaft to a distal end of the handle, the transitional portion including a first and second substantially straight sections, the first straight section extending from the distal end of the handle and having an outside diameter greater than an outside diameter of the proximal end of the shaft, and the second substantially straight section having a distal end axially adjacent to the proximal end of the shaft and having a diameter that decreases distally.
2. The delivery device of claim 1, wherein at least part of the transitional portion is formed as part of the shaft.
3. The delivery device of claim 1, wherein at least part of the transitional portion is formed as part of the handle.
4. The delivery device of claim 1, wherein the first and second substantially straight sections of the transitional portion are angled relative to each other.
5. The delivery device of claim 1, wherein the first substantially straight section has a substantially constant outside diameter.
6. The delivery device of claim 1, wherein the first substantially straight section has an outside diameter that decreases distally.
7. The delivery device of claim 1, wherein the transitional section includes a curved section located axially between the first and second substantially straight sections for angling the first and second substantially straight sections of the transitional portion relative to each other.
8. The delivery device of claim 6, wherein the curved section of the transitional portion has a substantially constant outside diameter.
9. The delivery device of claim 1, wherein the shaft includes a slot located in its distal end, the slot being shaped for associating the delivery device with the supportive sling.
10. The delivery device of claim 9, wherein the slot is substantially L-shaped.
11. The delivery device of claim 1, wherein the handle and the shaft are substantially coplanar.
12. The delivery device of claim 1, wherein the shaft is rotatable about a longitudinal axis of the handle.
13. The delivery device of claim 1, wherein the shaft is tiltable about an axis that is angled relative to a longitudinal axis of the handle.
14. The delivery device of claim 1, wherein the shaft includes a second curved section, the first and second curved sections both being sized and shaped for penetrating into the body of the patient.
15. A system for delivering a supportive sling to periurethral tissue of a patient via an obturator foramen of the patient, the system including, a delivery device having;
a handle, a shaft having a first curved portion and terminating in a substantially conical tip at a distal most end, and a transitional portion for affixing a proximal end of the shaft to a distal end of the handle, the transitional portion including a first and second substantially straight sections, the first straight section extending from the distal end of the handle and having an outside diameter greater than an outside diameter of the proximal end of the shaft, and the second substantially straight section having a distal end axially adjacent to the proximal end of the shaft and having a diameter that decreases distally; and a sling assembly including the supportive sling and associatable with a distal end of the shaft.
16. The system of claim 15, wherein the shaft includes a slot located at its distal end and the sling assembly includes a loop for hooking onto the slot.
17. The system of claim 16, wherein the slot is substantially L-shaped.
18. The system of claim 15, wherein the sling assembly includes a tube element located at an end for slidably interfitting over the shaft.
19. The system of claim 15, wherein the sling assembly includes a sleeve for enclosing at least partially the supportive sling, and a tab attached intermediate to first and second ends of the sleeve, the tab requiring cutting to slide the sleeve off the supportive sling.
20. The system of claim 15, wherein the sling assembly includes a sleeve for enclosing at least partially the supportive sling.
21. The system of claim 20, wherein the sleeve is longer than the sling.
22. The system of claim 21, wherein the sleeve is about 10 cm longer than the sling.
23. The system of claim 21, wherein the sleeve is about 20 cm longer than the sling.
24. The system of claim 21, wherein the sleeve is about 30 cm longer than the sling.
25. A delivery device for delivering a supportive sling to periurethral tissue of a patient via an obturator foramen of the patient, the delivery device including, a handle having a longitudinal first axis located in a first plane, and a shaft mechanically coupled to the handle and extending distally relative to a distal end of the handle, the shaft having a single curved section for insertion into a patient, the single curved section being oriented in a second plane angled from the first plane, the shaft also having a distal end for associating with an end of the supportive sling.
26. The delivery device of claim 25, wherein the first and second planes are substantially normal to each other.
27. The delivery device of claim 25 including a transitional portion located intermediate to the handle and the shaft for affixing the shaft to the handle.
28. The delivery device of claim 27, wherein at least part of the transitional portion is formed as part of the shaft.
29. The delivery device of claim 27, wherein the at least part of the transitional portion is formed as part of the handle.
30. The delivery device of claim 27, wherein the transitional portion extends along a second axis angled relative to the first axis.
31. The delivery device of claim 27, wherein at least a part of the transitional portion tapers to be smaller a distal end than at a proximal end.
32. The delivery device of claim 27, wherein at least a section of the transitional portion has a substantially constant outside diameter.
33. The delivery device of claim 25, wherein the shaft includes a slot for associating with the supportive sling at its distal end.
34. The delivery device of claim 33, wherein the slot is substantially L-shaped.
35. A system for delivering a supportive sling to periurethral tissue of a patient via an obturator foramen of the patient, the system comprising, a delivery device including, a handle having a longitudinal first axis located in a first plane, and a shaft mechanically coupled to the handle and extending distally relative to a distal end of the handle, the shaft having a single curved section for insertion into a patient, the single curved section being oriented in a second plane angled from the first plane; the shaft also having a distal end for associating with an end of the supportive sling; and a sling assembly having an end for associating with a distal end of the shaft.
36. The system of claim 35, wherein the shaft includes a slot located at its distal end and the sling assembly includes a loop for hooking onto the slot to perform the associating.
37. The system of claim 36, wherein the slot is substantially L-shaped.
38. The system of claim 35, wherein the sling assembly includes a tube element located at an end for slidably interfttting over the shaft to perform the associating.
39. The system of claim 35, wherein the sling assembly includes a sleeve for at least partially enclosing the supportive sling, and a tab attached intermediate to first and second ends of the sleeve, the tab requiring cutting to slide the sleeve off the supportive sling.
40. The system of claim 35, wherein the sling assembly includes a sleeve for enclosing at least partially the supportive sling.
41. The system of claim 40, wherein the sleeve is longer than the sling.
42. The system of claim 41, wherein the sleeve is about 10 cm longer than the sling.
43. The system of claim 41, wherein the sleeve is about 20 cm longer than the sling.
44. The system of claim 41, wherein the sleeve is about 30 cm longer than the sling.
CA2541069A 2003-10-03 2004-10-04 Systems and methods for delivering a medical implant to an anatomical location in a patient Expired - Fee Related CA2541069C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US50860003P 2003-10-03 2003-10-03
US60/508,600 2003-10-03
US56930004P 2004-05-06 2004-05-06
US60/569,300 2004-05-06
PCT/US2004/032503 WO2005034765A2 (en) 2003-10-03 2004-10-04 Systems for a delivering a medical implant to an anatomical location in a patient

Publications (2)

Publication Number Publication Date
CA2541069A1 true CA2541069A1 (en) 2005-04-21
CA2541069C CA2541069C (en) 2012-08-14

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA2541069A Expired - Fee Related CA2541069C (en) 2003-10-03 2004-10-04 Systems and methods for delivering a medical implant to an anatomical location in a patient

Country Status (5)

Country Link
US (4) US7713187B2 (en)
EP (2) EP2740416B1 (en)
AU (1) AU2004279388B2 (en)
CA (1) CA2541069C (en)
WO (1) WO2005034765A2 (en)

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US7713187B2 (en) 2010-05-11
US9050164B2 (en) 2015-06-09
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US9968429B2 (en) 2018-05-15

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