US3384073A - Surgical device for correction of urinary incontinence - Google Patents

Surgical device for correction of urinary incontinence Download PDF

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Publication number
US3384073A
US3384073A US361383A US36138364A US3384073A US 3384073 A US3384073 A US 3384073A US 361383 A US361383 A US 361383A US 36138364 A US36138364 A US 36138364A US 3384073 A US3384073 A US 3384073A
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United States
Prior art keywords
fabric
collagen
tapes
urinary incontinence
openings
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Expired - Lifetime
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US361383A
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Jr Walton Van Winkle
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Ethicon Inc
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Ethicon Inc
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Priority to US361383A priority Critical patent/US3384073A/en
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    • 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
    • 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
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0078—Gender-specific, e.g. different for male and female patients
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00—Surgery
    • Y10S128/25—Artificial sphincters and devices for controlling urinary incontinence

Definitions

  • the present invention relates to: collagen prosthesis, and more particularly to a device useful in correcting urinary incontinence.
  • Urinary incontinence in the male frequently results from a prostatectomy and has always been a most diflicult problem to handle.
  • the bladder is devoid of sphincter action and the retention of urine with overflow incontinence is present in most instances.
  • FIGURE 1 is a plan view of the prosthesis of the present invention.
  • FIG. 2 is a sectional view of the prosthesis taken on the line 22 of FIG. 1.
  • the prosthesis illustrated in FIG. 1 is a woven collagen fabric.
  • the warp yarns may be an extruded collagen multifilament or monofilament strands obtained by the procedure described U.S. Patent No. 3,114,593.
  • the weft yarns are also collagen multifilament or monofilament.
  • a number of cuts 3 may be made in the fabric parallel either to the warp yarns or to the weft yarns. These cuts are in alignment to permit the collagen tape 4 having a width slightly less than the width of the cut 3 to be laced therethrough. When the collagen tapes are in position they may be moved in a longitudinal direction with respect to the fabric but are restrained from lateral movement.
  • the collagen tape may be an extruded tape of the type described in U.S. Patent No. 3,114,372.
  • the fabric may be Woven around the collagen tapes 4 or alternatively the fabric may be patternly woven to provide the openings 3 aligned in rank and file to permit lacing therethrough sections of collagen tape 4.
  • the fabric of the present invention has an open weave (about 15 threads to the inch) and may be generally square in shape.
  • the dimension b may conveniently be 3 centimeters.
  • the dimension a may be 0.7 centimeter and the dimension c may be about 1 centimeter. Since the openings 3 are made wider in the tape 4 the surgeon may remove the tape from the fabric and cut the fabric to any desired size and shape. The tapes may then be reinserted in the openings 3.
  • the collagen fabric and tapes may be tanned to decrease "ice the rate of absorption in the human body.
  • Suitable tar ning bath for this purpose may contain 1.2% Cr O 0.37 pyrogallol, 0.2% formaldehyde, and have a pH of 3.2
  • the fabric with the tape in place is immersed in this bat for 3 minutes, and dried for 3 minutes in a current of ai heated to F. It is then sterilized and packaged in sterile condition.
  • the surgical technique for using the device of th present invention has been developed by Drs. R. Veeneni and A. Girgis at Columbia University.
  • the co lagen prosthesis is passed anterior to the bulbar urethr through a perineal approach, the collagen fabric is wrappe around the membranous urethra throughout its enti1 length and the terminal ends of the collagen tapes a1 sutured through the levator ani muscles which then fun tion as a new urinary sphincter to the angulated uret'hr
  • the open weave collagen fabric will encourage and pe mit the growth of connective tissue around the urethi and will gradually be absorbed and replaced by this co] nective tissue.
  • the multiplicity of tapes are for the pu pose of fixing the device in place and to exert tensi-o: backwards and downwards, on the urethra by their a tachment to the lateral extensions of the levator a muscles. These tapes are absorbed at approximately tl same rate as the collagen fabric and will disappear whe no longer needed.
  • a surgical prosthesis useful in the surgical corre tion of urinary incontinence comprising a woven collage fabric having several rows of slit-like openings extendir across said fabric, the openings in each row being in alig: ment with each other and parallel to one set of threat forming the fabric; a plurality of collagen tapes, each ha ing a length substantially greater than the distance acro said fabric, each of said tapes being laced through tl openings in one of said rows, whereby the tapes are para lel to each other and may be moved in a direction para lel to said rows but are restrained from lateral movemer References Cited UNITED STATES PATENTS 3,066,667 12/1962 Berry 128 2,143,910 1/1939 Diclusch 128335 2,551,044 5/1951 Ottinger et al. 128389 3,270,742 9/1966 Costa 128-2'.

Description

y 1968 w. VAN WINKLE, JR 3,384,073
SURGICAL DEVICE FOR CORRECTION OF URINARY INCONTINENCE Filed April 21. 1964 INVENTOR.
BY a).
ATTOR Y United States Patent 3,384,073 SURGICAL DEVICE FOR CORRECTION OF URINARY INCONTINENCE Walton Van Winkle, Jr., Princeton, N.J., assignor to Ethicon, Inc., a corporation of New Jersey Filed Apr. 21, 1964, Ser. No. 361,383 1 Claim. (Cl. 128--1) The present invention relates to: collagen prosthesis, and more particularly to a device useful in correcting urinary incontinence.
Urinary incontinence in the male frequently results from a prostatectomy and has always been a most diflicult problem to handle. The bladder is devoid of sphincter action and the retention of urine with overflow incontinence is present in most instances.
It is an object of the present invention therefore to provide a prosthesis that may be used to correct urinary incontinence.
The prosthesis of the present invention will appear more clearly from the following descriptions when taken in connection with the accompanying drawings which show by way of example a preferred embodiment of the inventive idea. I
Referring now to the" drawings:
FIGURE 1 is a plan view of the prosthesis of the present invention.
FIG. 2 is a sectional view of the prosthesis taken on the line 22 of FIG. 1.
The prosthesis illustrated in FIG. 1 is a woven collagen fabric. The warp yarns may be an extruded collagen multifilament or monofilament strands obtained by the procedure described U.S. Patent No. 3,114,593. The weft yarns are also collagen multifilament or monofilament. A number of cuts 3 may be made in the fabric parallel either to the warp yarns or to the weft yarns. These cuts are in alignment to permit the collagen tape 4 having a width slightly less than the width of the cut 3 to be laced therethrough. When the collagen tapes are in position they may be moved in a longitudinal direction with respect to the fabric but are restrained from lateral movement.
The collagen tape may be an extruded tape of the type described in U.S. Patent No. 3,114,372.
To avoid cutting the collagen fabric the fabric may be Woven around the collagen tapes 4 or alternatively the fabric may be patternly woven to provide the openings 3 aligned in rank and file to permit lacing therethrough sections of collagen tape 4.
The fabric of the present invention has an open weave (about 15 threads to the inch) and may be generally square in shape. The dimension b may conveniently be 3 centimeters. The dimension a may be 0.7 centimeter and the dimension c may be about 1 centimeter. Since the openings 3 are made wider in the tape 4 the surgeon may remove the tape from the fabric and cut the fabric to any desired size and shape. The tapes may then be reinserted in the openings 3.
The collagen fabric and tapes may be tanned to decrease "ice the rate of absorption in the human body. Suitable tar ning bath for this purpose may contain 1.2% Cr O 0.37 pyrogallol, 0.2% formaldehyde, and have a pH of 3.2 The fabric with the tape in place is immersed in this bat for 3 minutes, and dried for 3 minutes in a current of ai heated to F. It is then sterilized and packaged in sterile condition.
It is an advantage of the collagen prosthesis describe above that it is absorbed and yet will provide wide strengt and support for the membranous urethra. Other advar tages of this device are that it encourages the growt of connective tissue around the membranous urethra an maintains a fixed position during the growth of this cor nective tissue.
The surgical technique for using the device of th present invention has been developed by Drs. R. Veeneni and A. Girgis at Columbia University. In use, the co lagen prosthesis is passed anterior to the bulbar urethr through a perineal approach, the collagen fabric is wrappe around the membranous urethra throughout its enti1 length and the terminal ends of the collagen tapes a1 sutured through the levator ani muscles which then fun tion as a new urinary sphincter to the angulated uret'hr The open weave collagen fabric will encourage and pe mit the growth of connective tissue around the urethi and will gradually be absorbed and replaced by this co] nective tissue. The multiplicity of tapes are for the pu pose of fixing the device in place and to exert tensi-o: backwards and downwards, on the urethra by their a tachment to the lateral extensions of the levator a muscles. These tapes are absorbed at approximately tl same rate as the collagen fabric and will disappear whe no longer needed.
What is claimed is:
1. A surgical prosthesis useful in the surgical corre tion of urinary incontinence comprising a woven collage fabric having several rows of slit-like openings extendir across said fabric, the openings in each row being in alig: ment with each other and parallel to one set of threat forming the fabric; a plurality of collagen tapes, each ha ing a length substantially greater than the distance acro said fabric, each of said tapes being laced through tl openings in one of said rows, whereby the tapes are para lel to each other and may be moved in a direction para lel to said rows but are restrained from lateral movemer References Cited UNITED STATES PATENTS 3,066,667 12/1962 Berry 128 2,143,910 1/1939 Diclusch 128335 2,551,044 5/1951 Ottinger et al. 128389 3,270,742 9/1966 Costa 128-2'.
FOREIGN PATENTS 851,720 10/ 1960 Great Britain.
DALTON L. TRULUCK, Primary Examiner.
3,384,072 Patented May 21, 196E

Claims (1)

1. A SURGICAL PROSTHESIS USEFUL IN THE SURGICAL CORRECTION OF URINARY INCONTINENCE COMPRISING A WOVEN COLLAGEN FABRIC HAVING SEVERAL ROWS OF SLIT-LIKE OPENINGS EXTENDING ACROSS SAID FABRIC, THE OPENINGS IN EACH ROW BEING IN ALIGNMENT WITH EACH OTHER AND PARALLEL TO ONE SET OF THREADS FORMING THE FABRIC; A PLURALITY OF COLLAGEN TAPES, EACH HAVING A LENGTH SUBSTANTIALLY GREATER THAN THE DISTANCE ACROSS SAID FABRIC, EACH OF SAID TAPES BEING LACED THROUGH THE OPENINGS IN ONE OF SAID ROWS, WHEREBY THE TAPES ARE PARALLEL TO EACH OTHER AND MAY BE MOVED IN A DIRECTION PARALLEL TO SAID ROWS BUT ARE RESTAINED FROM LATERAL MOVEMENT.
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US3496940A (en) * 1966-09-19 1970-02-24 Charles Steinman Surgical suture and sling device
US4209010A (en) * 1978-07-26 1980-06-24 The Kendall Company Artificial sphincter
US4210131A (en) * 1978-07-26 1980-07-01 The Kendall Company Artificial sphincter with collection bag
US4210132A (en) * 1978-07-26 1980-07-01 The Kendall Company Artificial sphincter
US6306079B1 (en) 1999-12-07 2001-10-23 Arnaldo F. Trabucco Mesh pubovaginal sling
US20020161382A1 (en) * 2001-03-29 2002-10-31 Neisz Johann J. Implant inserted without bone anchors
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
US20030089586A1 (en) * 2001-11-15 2003-05-15 Abroy Hamid S. Switch mechanism housing
US6582443B2 (en) 2000-12-27 2003-06-24 Ams Research Corporation Apparatus and methods for enhancing the functional longevity and for facilitating the implantation of medical devices
US20030130670A1 (en) * 2001-01-23 2003-07-10 Anderson Kimberly A. Pelvic floor implant system and method of assembly
US6599235B2 (en) 1997-03-18 2003-07-29 American Medical Systems Inc. Transvaginal bone anchor implantation device
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
US6641524B2 (en) 1997-03-18 2003-11-04 Ams Research Corporation Sling system for treating 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
US20040039453A1 (en) * 2001-07-27 2004-02-26 Anderson Kimberly A. Pelvic health implants and methods
US20050004427A1 (en) * 2003-04-30 2005-01-06 Mauro Cervigni Prosthesis for use in the surgical treatment of urogenital prolapse and female urinary incontinence
US20050065395A1 (en) * 2003-09-22 2005-03-24 Ams Research Corporation Prolapse repair
US6911003B2 (en) 2002-03-07 2005-06-28 Ams Research Corporation Transobturator surgical articles and methods
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
US20060173468A1 (en) * 2005-01-28 2006-08-03 Marc Simmon Obturator introducer with snare
US7357773B2 (en) 2002-03-07 2008-04-15 Ams Research Corporation Handle and surgical article
US20080195120A1 (en) * 2004-10-06 2008-08-14 Jesus ROMERO MAROTO Mesh for the Surgical Treatment of Urinary Incontinence
US20080200751A1 (en) * 2000-10-12 2008-08-21 James Browning Urethral support system
US20080196729A1 (en) * 2004-05-21 2008-08-21 Mpathy Medical Devices Limited Implant for Treatment of Vaginal and/or Uterine Prolapse
US20080207989A1 (en) * 2005-08-29 2008-08-28 Ams Research Corporation System For Positioning Support Mesh in a Patient
US7494495B2 (en) 2003-03-28 2009-02-24 Coloplast A/S Method and implant for curing cystocele
US20090123522A1 (en) * 2003-03-27 2009-05-14 James Browning Medicament Delivery Device and a Method of Medicament Delivery
US20090221867A1 (en) * 2005-11-11 2009-09-03 Ams Research Corporation Integral Sling Connection System and Method
US7588598B2 (en) 2003-03-28 2009-09-15 Coloplast A/S Implant for treating rectocele and a device for putting said implant into place
US20090259092A1 (en) * 2006-06-22 2009-10-15 Ogdahl Jason W Adjustable Sling and Method of Treating Pelvic Conditions
US20100030016A1 (en) * 2008-07-31 2010-02-04 Knoll L Dean Methods and Implants for Treating Urinary Incontinence
US20100056856A1 (en) * 2000-07-05 2010-03-04 Coloplast A/S Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
US20100234681A1 (en) * 2006-09-13 2010-09-16 C.R. Bard Inc. Urethral support system
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
US20110124956A1 (en) * 2009-11-23 2011-05-26 Ams Research Corporation Patterned Sling Implant and Method
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US8007430B2 (en) 2000-10-12 2011-08-30 Coloplast A/S Apparatus and method for treating female urinary incontinence
US20110237879A1 (en) * 2000-10-12 2011-09-29 Coloplast A/S Pelvic implant with fibrous anchor
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US8574149B2 (en) 2007-11-13 2013-11-05 C. R. Bard, Inc. Adjustable tissue support member
US8808162B2 (en) 2011-03-28 2014-08-19 Ams Research Corporation Implants, tools, and methods for treatment of pelvic conditions
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Cited By (213)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3496940A (en) * 1966-09-19 1970-02-24 Charles Steinman Surgical suture and sling device
US4209010A (en) * 1978-07-26 1980-06-24 The Kendall Company Artificial sphincter
US4210131A (en) * 1978-07-26 1980-07-01 The Kendall Company Artificial sphincter with collection bag
US4210132A (en) * 1978-07-26 1980-07-01 The Kendall Company Artificial sphincter
US6599235B2 (en) 1997-03-18 2003-07-29 American Medical Systems Inc. Transvaginal bone anchor implantation device
US6641524B2 (en) 1997-03-18 2003-11-04 Ams Research Corporation Sling system for treating incontinence
US6306079B1 (en) 1999-12-07 2001-10-23 Arnaldo F. Trabucco Mesh pubovaginal sling
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
US8920304B2 (en) 2000-07-05 2014-12-30 Coloplast A/S Method and device for treating urinary incontinence
US8469875B2 (en) 2000-07-05 2013-06-25 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
US7621864B2 (en) 2000-07-05 2009-11-24 Coloplast A/S Method for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
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