This invention relates to a medical device and more particularly to methods and devices for delivering a suture including tissue anchors.
Sutures including tissue anchors have application to a wide variety of surgical procedures including those that require high anchoring strength. For example, one such procedure is directed to female urinary incontinence and involves insertion of a suture to be fixed to bodily tissue under and/or lateral to the urethra to reconstitute the ligamentary support for the urethra. Generally, the suture is inserted into two or more body tissues to couple the body tissues tightly together without knotting the suture.
In other procedures a suture having tissue anchors is coupled to an implant that is configured to support a portion of a body of a patient. In such a procedure, the tissue anchor must be able to support the implant without tearing through the tissue within which it is disposed.
Tissue anchors that are large or have many barbs are often difficult to insert into a tissue. When inserting such tissue anchors, a large incision is often necessary and bulky delivery tools are often used. Using a large incision or bulky delivery tools causes unwanted trauma to the tissue and can weaken the tissue within which the tissue anchor is disposed. Thus, a need exists for devices and methods that can be used to effectively deliver a suture having tissue anchors to a tissue of a patient.
An apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis. The distal end portion of the elongate member defines a notch having a face defining an axis. The axis of the face and the longitudinal axis define an acute angle with respect to a first direction along the longitudinal axis. The notch is configured to retain a loop of a suture when the elongate member is moved through a tissue of a patient in the first direction along the longitudinal axis. The notch is configured to release the loop of the suture when the elongate member is moved through the tissue of the patient in a second direction different than the first direction. The suture has at least one tissue anchor configured to be disposed within the tissue of the patient.
In some embodiments, an apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis. The distal end portion of the elongate member defines a notch having a face defining an axis. The axis of the face and the longitudinal axis define an acute angle with respect to a first direction along the longitudinal axis. The notch is configured to retain a loop of a suture when the elongate member is moved through a tissue of a patient in the first direction along the longitudinal axis. The notch is configured to release the loop of the suture when the elongate member is moved through the tissue of the patient in a second direction different than the first direction. The suture has at least one tissue anchor configured to be disposed within the tissue of the patient.
In some embodiments, an apparatus includes an elongate member and an adjustable stop. The elongate member has a distal end portion and a proximal end portion. The distal end portion of the elongate member defines a notch configured to releasably retain a loop of a suture when the elongate member is inserted into a tissue of a patient a distance. The adjustable stop is movably coupled to the elongate member. The adjustable stop is configured to allow a user to determine the distance the elongate member is inserted into the tissue.
In some embodiments, an apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis and an outer perimeter. The distal end portion of the elongate member has a tissue piercing tip and an oblique shoulder facing toward the tissue piercing tip. The oblique shoulder is disposed proximal to the tissue piercing tip along the longitudinal axis and is within the outer perimeter defined by the elongate member.
In some embodiments, a medical device includes an elongate member, a suture and an anchor. The elongate member has a distal end portion and a proximal end portion. The distal end portion of the elongate member defines a notch. The suture has a distal end portion and a proximal end portion. The distal end portion of the suture has a loop configured to be inserted into the notch. The notch is configured to retain the loop of the suture when the elongate member is inserted into a tissue of a patient. The anchor is coupled to the suture and configured to retain the suture within the tissue of the patient when the suture is disposed within the tissue of the patient and the elongate member is removed from the tissue of the patient.
In some embodiments, a method of inserting a suture within a body of a patient includes sliding an adjustable stop along an elongate member. A loop of a suture is attached to a distal end portion of the elongate member. A tissue anchor is coupled to the suture. The tissue anchor is inserted into a tissue of a patient by moving the elongate member through the tissue of the patient until the adjustable stop contacts an outer surface of the tissue of the patient. The distal end portion of the elongate member is disposed within the tissue a distance from the outer surface of the tissue. The distance from the outer surface of the tissue is substantially equal to a distance between the distal end portion of the elongate member and the adjustable stop. The loop of the suture is the released from the distal end portion of the elongate member and the elongate member is removed from the body of the patient.
As used herein, the terms proximal portion or proximal end refer to the portion or end, respectively, of a device that is closest to a medical practitioner (e.g., a physician) when performing a medical procedure, and the terms distal portion or distal end refer to the portion or end, respectively, of the device that is furthest from the physician during a medical procedure. For example, the end of a medical device first inserted inside the patient's body would be the distal end of the medical device, while the end of the medical device handled by the medical practitioner would be the proximal end of the medical device.
The proximal end portion 124 of the suture 120 is configured to be attached to any device configured to be retained within a body of a patient, such as an implant (not shown in
The implant can be formed with a mesh material to allow tissue in-growth to the implant after implantation. For example, some or all of the implant can be formed with a mesh material as described in U.S. Patent Pub. 2005/0038452 A1 to Chu, the disclosure of which is hereby incorporated by reference in its entirety. In some embodiments, some or all of the implant can be formed with the Advantage® Mesh or the Polyform™ Synthetic Mesh material each provided by Boston Scientific Corporation.
The distal end portion 122 of the suture 120 includes an attachment portion 123 configured to be releasably attached to the delivery device 110, described in further detail herein. In some embodiments, the attachment portion 123 of the distal end portion 122 of the suture 120 can be, for example, a loop configured to be inserted into a notch 115 of the delivery device 110. In other embodiments, the attachment portion can be a clip, an adhesive portion, and/or any other attachment mechanism known in the art.
The tissue anchor 130 can be any device configured to retain the suture 120 within a tissue of a patient. In some embodiments, for example, the tissue anchor 130 is similar to the tissue anchors shown and described in U.S. Provisional Patent Application No. 61/071,726 entitled “Surgical Composite Barbed Suture,” filed on May 14, 2008, which is hereby incorporated by reference in its entirety.
The tissue anchor 130 is configured to retain its position with respect to bodily tissue when inserted into bodily tissue. In some embodiments, the tissue anchor 130 includes a retaining member, for example, a barb, a prong, a tab, and/or any other retaining member known in the art. In other embodiments, the tissue anchor includes multiple retaining members extending from the elongate member. In some embodiments, the retaining members can flex or bend to facilitate insertion into bodily tissue. In other embodiments, the retaining members are rigid and are not configured to bend or flex during insertion.
The tissue anchor 130 is constructed of any suitable material. In some embodiments, for example, the tissue anchor 130 is constructed of a biocompatible polymer, a metal, and/or any other material known in the art. In some embodiments, the tissue anchor 130 includes an opaque material to increase the visibility of the medical practitioner during insertion of the suture 120.
The tissue anchor 130 is coupled to the suture 120 by any suitable means. In some embodiments, for example, the tissue anchor 130 is coupled to the suture 120 via a knot, an adhesive, such as, for example, glue, and/or any other attachment mechanism known in the art. In other embodiments, the tissue anchor is monolithically formed with the suture and/or molded to the suture. In some embodiments, the tissue anchor 130 is coupled near the distal end portion 122 of the suture 120. In such embodiments, the distal end portion 112 of the delivery device 110 need not be inserted as far into the body of the patient for the tissue anchor 130 to be disposed within the tissue of the patient. This decreases the trauma caused to the tissue of the patient beyond the portion of the tissue where the tissue anchor 130 is disposed.
The delivery device 110 includes a distal end portion 112 and a proximal end portion 114 and defines a longitudinal axis AL. The delivery device 110 is configured to be moved through a tissue of a patient in a direction substantially parallel to the longitudinal axis AL. In some embodiments, the delivery device 110 is substantially rigid and/or solid. In other embodiments, the delivery device defines a lumen. The proximal end portion 114 of the delivery device 110 is controlled by the medical practitioner directly by holding the proximal end portion 114 or indirectly by controlling another device coupled to the proximal end portion 114 when the distal end portion 112 of the delivery device 110 is inserted into the tissue of the patient.
The distal end portion 112 of the delivery device 110 defines a notch 115 or a shoulder configured to releasably retain the attachment portion 123 of the distal end portion 122 of the suture 120. The notch 115 includes a first face 117 and a second face 116. The first face 117 defines an axis AF1. In other embodiments, the notch only includes a first face. In some embodiments, the notch 115 or shoulder is within an outer parameter defined by the delivery device 110. In other embodiments, the notch or shoulder extends outside the outer parameter defined by the delivery device.
The axis AF1 of the first face 117 defines an angle SF1 with the longitudinal axis AL. The angle SF1 defined by the axis AF1 of the first face 117 and the longitudinal axis AL is acute with respect to a first direction shown by the arrow AA in
Similarly, the second face 116 defines an axis AF2. The axis AF2 of the second face 116 defines an angle 0F2 with the longitudinal axis AL. The angle 0F2 defined by the axis AF2 of the second face 116 and the longitudinal axis AL is obtuse with respect to a second direction shown by the arrow BB in
The distal end portion 112 of the delivery device 110 is configured to be inserted into the body of the patient to assist in delivering the suture 120 within a tissue of the patient. In some embodiments, the distal end portion includes a tapered portion configured to pierce and/or dilate tissue as the delivery device is inserted into the tissue of the patient.
In use, the suture 120 is attached to the delivery device 110 by attaching the attachment portion 123 of the distal end portion 122 of the suture 120 to the notch 115 defined by the delivery device 110. In some embodiments, this includes inserting a loop of the suture 120 into the notch 115 of the delivery device 110. The proximal end portion 124 of the suture 120 is aligned substantially parallel to the longitudinal axis AL defined by the delivery device 110. Said another way, a longitudinal axis defined by the suture is aligned such that it is substantially parallel to the longitudinal axis AL defined by the delivery device 110. Positioning the suture 120 along the longitudinal axis AL allows the suture 120 to be inserted into the tissue of the patient through a lumen created by the delivery device 110 as the delivery device 110 moves through the tissue of the patient.
Once the tissue anchor 130 reaches a depth within the tissue where it is to be disposed, the medical practitioner can release the attachment portion 123 of the suture 120 from the notch 115 of the delivery device 110 by moving the delivery device 110 in a second direction along the longitudinal axis AL shown by the arrow BB in
Said another way, when the delivery device 110 is moved in the second direction BB, the second face 116 of the notch 115 exerts a force on the attachment portion 123 of the suture 120 that is normal to the second face 116. This force pushes the attachment portion 123 of the suture 120 out of the notch 115. Once the attachment portion 123 of the suture 120 is released from the notch 115, the medical practitioner can remove the delivery device 110 from the tissue of the patient by continuing to move the delivery device 110 in the second direction BB.
The distal end portion 222 of the suture 220 includes an attachment portion 223 configured to be releasably attached to the delivery device 210. In some embodiments, the attachment portion 223 of the distal end portion 222 of the suture 220 can be, for example, a loop configured to be inserted into a notch 215 of the delivery device 210. In other embodiments, the attachment portion 223 can be a clip, an adhesive portion, and/or any other attachment mechanism known in the art.
In some embodiments, the suture 220 includes a tissue anchor (not shown in
The delivery device 210 includes a distal end portion 212 and a proximal end portion 214 and defines a longitudinal axis AL. The delivery device 210 is configured to be moved through a tissue of a patient in a direction substantially parallel to the longitudinal axis AL. In some embodiments, the delivery device 210 is substantially rigid and/or solid. In other embodiments, the delivery device defines a lumen. The proximal end portion 214 of the delivery device 210 is controlled by the medical practitioner directly by holding the proximal end portion 214 or indirectly by controlling another device coupled to the proximal end portion 214 when the distal end portion 212 of the delivery device 210 is inserted into the tissue of the patient.
The distal end portion 212 of the delivery device 210 defines a notch 215 or a shoulder configured to releasably retain the attachment portion 223 of the distal end portion 222 of the suture 220. The distal end portion 212 of the delivery device 210 is configured to be inserted into the body of the patient to assist in delivering the suture 220 within a tissue of the patient. In some embodiments, the distal end portion includes a tapered portion configured to pierce and/or dilate tissue as the delivery device is inserted into the tissue of the patient.
An adjustable stop 218 is movably coupled to the delivery device 210. The adjustable stop 218 is configured to be disposed in at least two positions with respect to the delivery device 210. In some embodiments, for example, the adjustable stop 218 has a first configuration and a second configuration. When the adjustable stop 218 is in its first configuration, the location of the adjustable stop 218 with respect to the delivery device 210 is fixed. Said another way, when the adjustable stop 218 is in its first configuration it cannot slide with respect to the delivery device 210. Accordingly, when the adjustable stop 218 is in its first configuration, the distance D shown in
In other embodiments, the adjustable stop does not slide with respect to the delivery device but instead is coupled to the delivery device in a desired location with respect to the delivery device. In such embodiments, in order to move the adjustable stop with respect to the delivery device the adjustable stop is uncoupled from the delivery device and recoupled to the delivery device in another location.
The adjustable stop 218 is configured to help limit the distance that the distal end portion 212 of the delivery device 210 can be inserted into the tissue of the patient. The distance that the distal end portion 212 of the delivery device 210 can be inserted into the patient is substantially equal to the distance between the distal end portion 212 of the delivery device 210 and the adjustable stop 218 shown as distance D in
In use, the medical practitioner moves the adjustable stop 218, in its second configuration, with respect to the delivery device 210 to adjust the distance D between the distal end portion 212 of the delivery device 210 and the adjustable stop 218. As discussed above, the distance D corresponds to the depth the distal end portion 212 of the delivery device can be inserted into the tissue of the patient. Once the adjustable stop 218 is in the position along the delivery device 210 that corresponds to the desired depth, the adjustable stop 218 is moved from its second configuration to its first configuration. As discussed above, when the adjustable stop 218 is in its first configuration, the location of the adjustable stop 218 with respect to the delivery device 210 is fixed. Accordingly, the desired depth cannot be inadvertently changed prior to and/or during the insertion process.
The suture 220 is attached to the delivery device 210 by attaching the attachment portion 223 of the distal end portion 222 of the suture 220 to the notch 215 defined by the delivery device 210. In some embodiments, this includes inserting a loop of the suture 220 into the notch 215 of the delivery device 210. The proximal end portion 224 of the suture 220 is aligned substantially parallel to the longitudinal axis AL defined by the delivery device 210. Once the adjustable stop 218 has been adjusted and moved to its first configuration and the suture 220 has been attached to the delivery device 210, the suture 220 can be inserted into the tissue of the patient similar to suture 120.
The proximal end portion 314 of the delivery device 310 is configured to be held by a medical practitioner and/or indirectly controlled by a medical practitioner when the distal end portion 312 of the delivery device is inserted into the tissue of the patient.
The distal end portion 312 of the delivery device 310 includes a tapered portion 313 and defines a notch 315 or a shoulder. The distal end portion 312 of the delivery device 310 is configured to be inserted into the tissue of the patient to assist in delivering a suture within the tissue of the patient. The tapered portion 313 of the distal end portion 312 has a sharp tip configured to pierce the tissue and is tapered. This allows the tapered portion 313 to dilate tissue as the delivery device 310 is inserted into the tissue of the patient. Accordingly, the tapered portion 313 pierces and dilates a tissue in which a suture will be disposed.
The notch 315 defined by the distal end portion 312 of the delivery device 310 is configured to releasably retain an attachment portion of a suture. The attachment portion of the suture can be, for example, a loop on the distal end portion of the suture and/or any other attachment mechanism known in the art. The notch 315 includes a first face 317 and a second face 316. In other embodiments, the notch includes only a first face. In some embodiments, the notch 315 or shoulder is within an outer parameter defined by the delivery device 310. In other embodiments, the notch or shoulder extends outside the outer parameter defined by the delivery device.
The first face 317 defines an axis AF1. The axis AF1 of the first face 317 defines an angle 8F1 with the longitudinal axis AL. The angle 8F1 defined by the axis AF1 of the first face 317 and the longitudinal axis AL is acute with respect to a first direction shown by the arrow CC in
Similarly, the second face 316 defines an axis AF2. The axis AF2 of the second face 316 defines an angle OF2 with the longitudinal axis AL. The angle OF2 defined by the axis AF2 of the second face 316 and the longitudinal axis AL is obtuse with respect to a second direction shown by the arrow DD in
The distal end portion 414 of the suture 410 includes a loop 412. The loop 410 is configured to be releasably coupled to a delivery device, as described in further detail herein. In some embodiments, for example, the loop 412 is configured to be releasably coupled to a notch of a delivery device such as the notch 315 of delivery device 310. In other embodiments, the suture can include other attachment mechanisms, such as, for example, a clip, an adhesive portion, and/or any other attachment mechanism known in the art.
The tissue anchor 420 has a first end portion 421 and a second end portion 423 opposite the first end portion 421. As shown in
As shown in
The tissue anchor 420 includes multiple retaining members 434, 435, 436, 437. The retaining members 434, 435, 436, 437 are configured to allow movement of the suture 410 with respect to the tissue through the tissue of the patient in a first direction shown by the arrow EE in
The delivery device 310 and the suture 410 are inserted into the tissue of the patient by moving the delivery device 310 with respect to the tissue in a first direction along the longitudinal axis AL shown by the arrow GG in
Once the tissue anchor 420 reaches a depth within the tissue where it is to be disposed, the medical practitioner can release the loop 412 of the suture 410 from the notch 315 of the delivery device 310 by moving the delivery device 310 in a second direction along the longitudinal axis AL shown by the arrow HH in
The body portion 510 defines a lumen 514 and a slit 520. The lumen 514 extends the entire length of the body portion 510 of the adjustable stop 500. Said another way, the lumen extends from the first face 512 of the body portion 510 to the second face (not shown) of the body portion 510.
The first leg portion 530 of the adjustable stop 500 and the second leg portion 540 of the adjustable stop 540 extend from the body portion 510 of the adjustable stop 500. The first leg portion 530 and the second leg 540 portion cross each other as shown in
The adjustable stop 500 has a first configuration and a second configuration, as shown in
When the adjustable stop 500 is in its second configuration (
The width of the slit 520 in the second configuration is greater than the width of the slit 520 in the first configuration. The width of the slit 520 in the second configuration, however, is smaller than the width of the delivery device. As such, similar to the first configuration, the delivery device cannot pass through the slit 520. This prevents the delivery device from inadvertently being removed from the lumen 514 when the adjustable stop 500 is in its second configuration.
The adjustable stop 500 can be moved from its first configuration (
The adjustable stop 500 is biased in its first configuration. Thus, to return the adjustable stop 500 to its first configuration, the force exerted on the first leg portion 530 and the force exerted on the second leg portion 540 are released. This causes the lumen 514 and the slit 520 to contract back to the first configuration.
The adjustable stop 500 is configured to help limit the distance that a distal end portion of the delivery device can be inserted into the tissue of the patient. The distance that the distal end portion of the delivery device can be inserted into the patient is substantially equal to the distance between the distal end portion of the delivery device and the adjustable stop 500. Having an adjustable stop 500 prevents a medical practitioner from inserting the distal end portion of the delivery device into the tissue of the patient further than expected, causing unwanted harm. The adjustable stop 500 also provides the medical practitioner with the ability to determine a depth within the tissue of the patient where a distal end portion of a suture and/or a tissue anchor of the suture is to be disposed, and, using the adjustable stop 500, setting the delivery device to deliver the distal end portion of the suture 500 and/or the tissue anchor of the suture to this depth, as further described in detail herein.
In use, the adjustable stop 500 is moved into its second configuration and coupled to the delivery device.
A suture 410 is releasably coupled to the distal end portion 312 of the delivery device 310. This can be accomplished by any of the methods described above. The distal end portion 312 of the delivery device 310 is inserted into the tissue of the patient in a first direction until the second face (not shown) of the adjustable stop contacts the outer surface of the tissue. Once the second face of the adjustable stop contacts the outer surface of the tissue, the distal end portion 312 of the delivery device 310 cannot be inserted deeper into the tissue (i.e., the skin near the insertion site). The suture is released from the distal end portion of the delivery device and the distal end portion of the delivery device removed from the tissue of the patient by moving the delivery device in a second direction, substantially opposite the first direction.
A loop of a suture is attached to a distal end portion of the elongate member, at 604. A tissue anchor is coupled to the suture. The suture can be attached to the distal end portion of the elongate member by any suitable method. In some embodiments, for example, the suture has a loop configured to attach to a notch defined by the elongate member as shown and described herein. In other embodiments, the suture can be attached to the distal end portion of the elongate member using a clip, an adhesive, glue and/or any other attachment mechanism known in the art.
The tissue anchor is inserted into a tissue of a patient by moving the elongate member through the tissue of the patient until the adjustable stop contacts an outer surface of the tissue of the patient, at 606. The distal end portion of the elongate member is disposed within the tissue a distance from the outer surface of the tissue. The distance is substantially equal to a distance between the distal end portion of the elongate member and the adjustable stop.
The loop of the suture is released from the distal end portion of the elongate member. This can be done by any suitable method. In some embodiments, for example, the elongate member is moved in a direction substantially opposite the direction in which the elongate member was moved to insert the tissue anchor, as shown and described herein. In such embodiments, the movement in the opposite direction causes the loop of the suture to release from the distal end portion of the elongate member. In other embodiments, the loop of the suture can be released from the distal end portion of the elongate member by releasing a clip, waiting for an adhesive to dissolve, moving a switch on a handle, and/or the like.
The elongate member is then removed from the body of the patient. This can be done by moving the elongate member in a direction substantially opposite the direction in which the elongate member was moved to insert the tissue anchor.
While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where methods described above indicate certain events occurring in certain order, the ordering of certain events may be modified. Additionally, certain of the events may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above.
For example, while a single type of adjustable stop is described, any adjustable stop capable of limiting the depth a distal end portion of a delivery device can be inserted into a tissue can be used. For example, the adjustable stop might have a different shape, size, and/or method of moving between its first configuration and its second configuration. In some embodiments, for example, the adjustable stop is moved between its first configuration and its second configuration by use of a switch, a dial, a screw, and/or any other mechanism known in the art.
Although various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having a combination of any features and/or components from any of embodiments where appropriate.
An apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis. The distal end portion of the elongate member defines a notch having a face defining an axis. The axis of the face and the longitudinal axis define an acute angle with respect to a first direction along the longitudinal axis. The notch is configured to retain a loop of a suture when the elongate member is moved through a tissue of a patient in the first direction along the longitudinal axis. The notch is configured to release the loop of the suture when the elongate member is moved through the tissue of the patient in a second direction different than the first direction. The suture has at least one tissue anchor configured to be disposed within the tissue of the patient.
In some embodiments, the loop of the suture remains within the tissue of the patient when the elongate member is moved in the second direction.
In some embodiments, the apparatus further includes an adjustable stop coupled to the elongate member. The adjustable has a first configuration and a second configuration. The adjustable stop is configured to move with respect to the elongate member when in the first configuration and is configured to maintain its position with respect to the elongate member when in the second configuration. The adjustable stop is configured to limit the distance between an outer surface of the tissue and the distal end portion of the elongate member when the adjustable stop is in its second configuration and the elongate member is inserted into the tissue of the patient such that the adjustable stop contacts the outer surface of the tissue.
In some embodiments, the tissue anchor is configured to allow movement of the suture through the tissue of the patient in the first direction and configured to limit movement of the suture through the tissue of the patient in the second direction. In some embodiments, the distal end portion of the elongate member includes a tissue piercing portion configured to penetrate the tissue of the patient.
In some embodiments, the elongate member is substantially solid. In some embodiments, the elongate member is substantially rigid. In some embodiments, the face of the notch is a first face of the notch and the notch has a second face defining an axis. The axis of the second face and the longitudinal axis define an obtuse angle with respect to the second direction.
In some embodiments, a method includes sliding an adjustable stop along an elongate member. A loop of a suture is attached to a distal end portion of the elongate member. A tissue anchor is coupled to the suture. The tissue anchor is inserted into a tissue of a patient by moving the elongate member through the tissue of the patient until the adjustable stop contacts an outer surface of the tissue of the patient. The distal end portion of the elongate member is disposed within the tissue a distance from the outer surface of the tissue. The distance is substantially equal to a distance between the distal end portion of the elongate member and the adjustable stop. The loop of the suture is released from the distal end portion of the elongate member and the elongate member is removed from the body of the patient.
In some embodiments, the inserting includes penetrating the tissue of the patient with the distal end portion of the elongate member. In some embodiments, the inserting includes moving the elongate member through the tissue of the patient in a first direction and the releasing includes moving the elongate member in a second direction substantially opposite the first direction.
In some embodiments, the releasing the loop of the suture from the distal end portion of the elongate member includes moving the elongate member with respect to the tissue of the patient. In some embodiments, the attaching includes inserting the loop of the distal end portion of the suture into a notch defined by the distal end portion of the elongate member.
In some embodiments, the apparatus includes an elongate member having a distal end portion and a proximal end portion and an adjustable stop movably coupled to the elongate member. The distal end portion of the elongate member defines a notch configured to releasably retain a loop of a suture when the elongate member is inserted into a tissue of a patient a distance. The adjustable stop is configured to allow a user to determine the distance the elongate member is inserted into the tissue.
In some embodiments, the adjustable stop defines a face configured to contact an outer portion of the tissue when the elongate member is inserted into the tissue the distance. In some embodiments, the distance is a first distance and the adjustable stop has a first position with respect to the elongate member and a second position with respect to the elongate member. The elongate member is configured to be inserted into the tissue of the patient the first distance when the adjustable stop is in the first position. The elongate member is configured to be inserted into the tissue of the patient a second distance when the adjustable stop is in the second position. The second distance is greater than the first distance.
In some embodiments, the elongate member defines a longitudinal axis and is configured to be inserted into the tissue of the patient in a direction substantially along the longitudinal axis. In some embodiments, the adjustable stop is configured to move with respect to the elongate member. In some embodiments, the notch is configured to retain the loop of the suture when the elongate member is moved in a first direction through the tissue of the patient. The notch is configured to release the loop of the suture when the elongate member is moved in a second direction substantially opposite the first direction.
In some embodiments, the elongate member is substantially solid. In some embodiments, the elongate member is substantially rigid. In some embodiments, at least one tissue anchor configured to be disposed within the tissue of the patient is coupled to the suture.
In some embodiments, an apparatus includes an elongate member having a distal end portion and a proximal end portion. The elongate member defines a longitudinal axis and an outer perimeter. The distal end portion of the elongate member has a tissue piercing tip and an oblique shoulder facing toward the tissue piercing tip. The oblique shoulder is disposed proximal to the tissue piercing tip along the longitudinal axis and is within the outer perimeter defined by the elongate member.
In some embodiments, the oblique shoulder is configured to retain a loop of a suture when the elongate member is moved through a tissue of a patient in the first direction along the longitudinal axis. The oblique shoulder is configured to release the loop of the suture when the elongate member is moved through the tissue of the patient in a second direction different than the first direction. The suture has at least one tissue anchor configured to be disposed within the tissue of the patient.
In some embodiments, the elongate member is substantially solid. In some embodiments, the elongate member is substantially rigid. In some embodiments the apparatus further includes an adjustable stop coupled to the elongate member. The adjustable stop has a first configuration and a second configuration. The adjustable stop is configured to move with respect to the elongate member when in the first configuration and is configured to maintain its position with respect to the elongate member when in the second configuration. The adjustable stop is configured to limit the distance between an outer surface of the tissue and the distal end portion of the elongate member when the adjustable stop is in its second configuration and the elongate member is inserted into the tissue of the patient such that the adjustable stop contacts the outer surface of the tissue.
In some embodiments, a medical device includes an elongate member having a distal end portion and a proximal end portion, a suture having a distal end portion and a proximal end portion and an anchor coupled to the suture. The distal end portion of the elongate member defines a notch. The distal end portion of the suture has a loop configured to be inserted into the notch. The notch is configured to retain the loop of the suture when the elongate member is inserted into a tissue of a patient. The anchor is configured to retain the suture within the tissue of the patient when the suture is disposed within the tissue of the patient and the elongate member is removed from the tissue of the patient.
In some embodiments, the anchor is configured to allow movement of the suture through the tissue of the patient in a first direction and is configured to help prevent movement of the suture through the tissue of the patient in a second direction substantially opposite the first direction.
In some embodiments, the medical device further includes an adjustable stop coupled to the elongate member. The adjustable stop has a first configuration and a second configuration. The adjustable stop is configured to move with respect to the elongate member when in the first configuration. The adjustable stop is configured to maintain its position with respect to the elongate member when in the second configuration. The adjustable stop configured to limit the distance between an outer surface of the tissue and the distal end portion of the elongate member when the adjustable stop is in its second configuration and the elongate member is inserted into the tissue of the patient such that the adjustable stop contacts the outer surface of the tissue.
In some embodiments, the notch of the distal end portion of the elongate member has a face defining an axis. The axis and a longitudinal axis defined by the elongate member define an acute angle with respect to a distal direction.
In some embodiments, the distal end portion of the elongate member includes a tissue piercing portion configured to penetrate the tissue of the patient. In some embodiments, the elongate member is substantially solid. In some embodiments, the elongate member is substantially rigid.
This application is a Continuation of, and claims priority to, U.S. patent application Ser. No. 12/760,049, filed on Apr. 14, 2010, entitled “APPARATUS FOR DELIVERING AND ANCHORING IMPLANTABLE MEDICAL DEVICES”, which, in turn, claims the benefit of and priority to U.S. Patent Application No. 61/170,312, filed on Apr. 17, 2009, entitled “APPARATUS FOR AND METHOD OF DELIVERING AND ANCHORING IMPLANTABLE MEDICAL DEVICES”, both of which are incorporated by reference herein their entireties.
Number | Name | Date | Kind |
---|---|---|---|
527263 | Blanchard | Oct 1894 | A |
3182662 | Shirodkar | May 1965 | A |
3212502 | Myers | Oct 1965 | A |
3311110 | Singerman et al. | Mar 1967 | A |
3372695 | Beliveau et al. | Mar 1968 | A |
3472232 | Earl | Oct 1969 | A |
3565073 | Giesy | Feb 1971 | A |
3608095 | Barry | Sep 1971 | A |
3704712 | Giesy et al. | Dec 1972 | A |
3763860 | Clarke | Oct 1973 | A |
3858783 | Kapitanov et al. | Jan 1975 | A |
3924633 | Cook et al. | Dec 1975 | A |
4037603 | Wendroff | Jul 1977 | A |
4128100 | Wendroff | Dec 1978 | A |
4221212 | Miller | Sep 1980 | A |
4235238 | Ogiu et al. | Nov 1980 | A |
4392495 | Bayers | Jul 1983 | A |
4441497 | Paudler | Apr 1984 | A |
4509516 | Richmond | Apr 1985 | A |
4549545 | Levy | Oct 1985 | A |
4583540 | Malmin | Apr 1986 | A |
4735615 | Uddo, Jr. et al. | Apr 1988 | A |
4798193 | Geisy et al. | Jan 1989 | A |
4824435 | Giesy et al. | Apr 1989 | A |
4872451 | Moore et al. | Oct 1989 | A |
4946467 | Ohi et al. | Aug 1990 | A |
4946468 | Li | Aug 1990 | A |
4976717 | Boyle | Dec 1990 | A |
5002550 | Li | Mar 1991 | A |
5013292 | Lemay | May 1991 | A |
5032508 | Naughton et al. | Jul 1991 | A |
5064435 | Porter | Nov 1991 | A |
5078730 | Li et al. | Jan 1992 | A |
5080667 | Chen et al. | Jan 1992 | A |
5084058 | Li | Jan 1992 | A |
5085661 | Moss | Feb 1992 | A |
5087263 | Li | Feb 1992 | A |
5112344 | Petros | May 1992 | A |
5149329 | Richardson | Sep 1992 | A |
5152749 | Giesy et al. | Oct 1992 | A |
5180385 | Sontag | Jan 1993 | A |
5207679 | Li | May 1993 | A |
5217438 | Richard et al. | Jun 1993 | A |
5250033 | Evans et al. | Oct 1993 | A |
5256150 | Quiachon et al. | Oct 1993 | A |
5281237 | Gimpelson | Jan 1994 | A |
5292327 | Dodd et al. | Mar 1994 | A |
5312422 | Trott | May 1994 | A |
5334185 | Giesy et al. | Aug 1994 | A |
5337736 | Reddy | Aug 1994 | A |
5362294 | Seitzinger | Nov 1994 | A |
5368595 | Lewis | Nov 1994 | A |
5368756 | Vogel et al. | Nov 1994 | A |
5382257 | Lewis et al. | Jan 1995 | A |
5383904 | Totakura et al. | Jan 1995 | A |
5395349 | Quiachon et al. | Mar 1995 | A |
5403328 | Shallman | Apr 1995 | A |
5439467 | Benderev et al. | Aug 1995 | A |
5441508 | Gazielly et al. | Aug 1995 | A |
5450860 | O'Connor | Sep 1995 | A |
5456722 | McLeod et al. | Oct 1995 | A |
5499991 | Garman et al. | Mar 1996 | A |
5505735 | Li | Apr 1996 | A |
5507796 | Hasson | Apr 1996 | A |
5520700 | Beyar et al. | May 1996 | A |
5527342 | Pietrzak et al. | Jun 1996 | A |
5540703 | Barker et al. | Jun 1996 | A |
5571119 | Atala | Nov 1996 | A |
5582188 | Benderev et al. | Dec 1996 | A |
5611515 | Benderev et al. | Mar 1997 | A |
5628756 | Barker et al. | May 1997 | A |
5645568 | Chervitz et al. | Jul 1997 | A |
5645589 | Li | Jul 1997 | A |
5683418 | Luscombe et al. | Nov 1997 | A |
5690649 | Li | Nov 1997 | A |
5702215 | Li | Dec 1997 | A |
5741299 | Rudt | Apr 1998 | A |
5742943 | Chen | Apr 1998 | A |
5749884 | Benderev et al. | May 1998 | A |
5816258 | Jervis | Oct 1998 | A |
5836315 | Benderev et al. | Nov 1998 | A |
5840011 | Landgrebe et al. | Nov 1998 | A |
5855549 | Newman | Jan 1999 | A |
5860425 | Benderev et al. | Jan 1999 | A |
5860993 | Thompson et al. | Jan 1999 | A |
5891168 | Thal | Apr 1999 | A |
5899906 | Schenk | May 1999 | A |
5899909 | Claren et al. | May 1999 | A |
5899999 | De Bonet | May 1999 | A |
5931855 | Buncke | Aug 1999 | A |
5934283 | Willem et al. | Aug 1999 | A |
5935122 | Fourkas et al. | Aug 1999 | A |
5945122 | Abra et al. | Aug 1999 | A |
5954057 | Li | Sep 1999 | A |
5984933 | Yoon | Nov 1999 | A |
5997554 | Thompson | Dec 1999 | A |
6010447 | Kardjian | Jan 2000 | A |
6030393 | Corlew | Feb 2000 | A |
6039686 | Kovac | Mar 2000 | A |
6042534 | Gellman et al. | Mar 2000 | A |
6050937 | Benderev | Apr 2000 | A |
6053935 | Brenneman et al. | Apr 2000 | A |
6096041 | Gellman et al. | Aug 2000 | A |
6099547 | Gellman et al. | Aug 2000 | A |
6110101 | Tihon et al. | Aug 2000 | A |
6117067 | Gil-Vernet | Sep 2000 | A |
6200330 | Benderev | Mar 2001 | B1 |
6221005 | Bruckner et al. | Apr 2001 | B1 |
6221084 | Fleenor | Apr 2001 | B1 |
6264676 | Gellman et al. | Jul 2001 | B1 |
6273852 | Lehe et al. | Aug 2001 | B1 |
6306079 | Trabucco | Oct 2001 | B1 |
6306156 | Clark | Oct 2001 | B1 |
6334446 | Beyar | Jan 2002 | B1 |
6382214 | Raz et al. | May 2002 | B1 |
6398787 | Itoman | Jun 2002 | B1 |
6406423 | Scetbon | Jun 2002 | B1 |
6423072 | Zappala | Jul 2002 | B1 |
6423080 | Gellman et al. | Jul 2002 | B1 |
6475139 | Miller | Nov 2002 | B1 |
6478727 | Scetbon | Nov 2002 | B2 |
6491703 | Ulmsten | Dec 2002 | B1 |
6494887 | Kaladelfos | Dec 2002 | B1 |
6530943 | Hoepffner et al. | Mar 2003 | B1 |
6582443 | Cabak et al. | Jun 2003 | B2 |
6596001 | Stormby et al. | Jul 2003 | B2 |
6596002 | Therin et al. | Jul 2003 | B2 |
6599235 | Kovac | Jul 2003 | B2 |
6605097 | Lehe et al. | Aug 2003 | B1 |
6612977 | Staskin et al. | Sep 2003 | B2 |
6635058 | Beyar | Oct 2003 | B2 |
6638209 | Landgrebe | Oct 2003 | B2 |
6638210 | Berger | Oct 2003 | B2 |
6638211 | Suslian et al. | Oct 2003 | B2 |
6641525 | Rocheleau et al. | Nov 2003 | B2 |
6648921 | Anderson et al. | Nov 2003 | B2 |
6652450 | Neisz et al. | Nov 2003 | B2 |
6652561 | Tran | Nov 2003 | B1 |
6685629 | Therin | Feb 2004 | B2 |
6691711 | Raz et al. | Feb 2004 | B2 |
6730110 | Harari et al. | May 2004 | B1 |
6755781 | Gellman | Jun 2004 | B2 |
6802807 | Anderson et al. | Oct 2004 | B2 |
6830052 | Carter et al. | Dec 2004 | B2 |
6848152 | Genova | Feb 2005 | B2 |
6932759 | Kammerer et al. | Aug 2005 | B2 |
7377926 | Topper et al. | May 2008 | B2 |
7381212 | Topper et al. | Jun 2008 | B2 |
7387634 | Benderev | Jun 2008 | B2 |
7524281 | Chu et al. | Apr 2009 | B2 |
8449573 | Chu | May 2013 | B2 |
8591545 | Lunn et al. | Nov 2013 | B2 |
8968334 | Ostrovsky | Mar 2015 | B2 |
9011489 | Ostrovsky et al. | Apr 2015 | B2 |
9289204 | Chu | Mar 2016 | B2 |
20010018549 | Scetbon | Aug 2001 | A1 |
20010037119 | Schmieding | Nov 2001 | A1 |
20010049467 | Lehe et al. | Dec 2001 | A1 |
20020028980 | Thierfelder et al. | Mar 2002 | A1 |
20020058959 | Gellman | May 2002 | A1 |
20020072694 | Snitkin et al. | Jun 2002 | A1 |
20020077526 | Kammerer et al. | Jun 2002 | A1 |
20020091373 | Berger | Jul 2002 | A1 |
20020116025 | Haab | Aug 2002 | A1 |
20020128670 | Ulmsten et al. | Sep 2002 | A1 |
20020138025 | Gellman et al. | Sep 2002 | A1 |
20020147382 | Neisz et al. | Oct 2002 | A1 |
20020151910 | Gellman et al. | Oct 2002 | A1 |
20020161382 | Neisz et al. | Oct 2002 | A1 |
20020188169 | Kammerer et al. | Dec 2002 | A1 |
20020188301 | Dallara et al. | Dec 2002 | A1 |
20030004395 | Therin | Jan 2003 | A1 |
20030004580 | Sump et al. | Jan 2003 | A1 |
20030009181 | Gellman et al. | Jan 2003 | A1 |
20030010929 | Priewe et al. | Jan 2003 | A1 |
20030023135 | Ulmsten et al. | Jan 2003 | A1 |
20030023138 | Luscombe | Jan 2003 | A1 |
20030028075 | Ulmsten et al. | Feb 2003 | A1 |
20030050530 | Neisz et al. | Mar 2003 | A1 |
20030065336 | Xiao | Apr 2003 | A1 |
20030088272 | Smith | May 2003 | A1 |
20030100954 | Schuldt-Hempe et al. | May 2003 | A1 |
20030120309 | Colleran | Jun 2003 | A1 |
20030130670 | Anderson et al. | Jul 2003 | A1 |
20030149440 | Kammerer et al. | Aug 2003 | A1 |
20030171644 | Anderson et al. | Sep 2003 | A1 |
20030171778 | Lizardi | Sep 2003 | A1 |
20030176762 | Kammerer | Sep 2003 | A1 |
20030195386 | Thierfelder et al. | Oct 2003 | A1 |
20030220538 | Jacquetin | Nov 2003 | A1 |
20040002734 | Fallin | Jan 2004 | A1 |
20040039453 | Anderson et al. | Feb 2004 | A1 |
20040087978 | Velez et al. | May 2004 | A1 |
20040098053 | Tran | May 2004 | A1 |
20040106847 | Benderev | Jun 2004 | A1 |
20040237736 | Genova et al. | Dec 2004 | A1 |
20050203576 | Sulamanidze et al. | Sep 2005 | A1 |
20050228406 | Bose | Oct 2005 | A1 |
20060173491 | Meade et al. | Aug 2006 | A1 |
20060217589 | Wan et al. | Sep 2006 | A1 |
20060229596 | Weiser et al. | Oct 2006 | A1 |
20060282161 | Huynh et al. | Dec 2006 | A1 |
20070016135 | Kanner | Jan 2007 | A1 |
20070038249 | Kolster | Feb 2007 | A1 |
20070112384 | Conlon | May 2007 | A1 |
20070129758 | Saadat | Jun 2007 | A1 |
20080103527 | Martin et al. | May 2008 | A1 |
20080132931 | Mueller | Jun 2008 | A1 |
20090076529 | Ganti | Mar 2009 | A1 |
20090287245 | Ostrovsky et al. | Nov 2009 | A1 |
20100268255 | Ostrovsky et al. | Oct 2010 | A1 |
20100324357 | Chu | Dec 2010 | A1 |
20110106108 | Ostrovsky et al. | May 2011 | A1 |
20130253259 | Chu | Sep 2013 | A1 |
20160193025 | Chu | Jul 2016 | A1 |
Number | Date | Country |
---|---|---|
3223153 | Aug 1983 | DE |
4220283 | Dec 1993 | DE |
4334419 | Apr 1995 | DE |
10103179 | Jul 2001 | DE |
2007015955 | Apr 2009 | DE |
0598976 | Jun 1994 | EP |
0599772 | Jun 1994 | EP |
0688056 | Dec 1995 | EP |
0774240 | May 1997 | EP |
0941712 | Sep 1999 | EP |
1025811 | Aug 2000 | EP |
2422386 | Nov 1979 | FR |
2005-532848 | Nov 2005 | JP |
2006-515204 | May 2006 | JP |
2007-532174 | Nov 2007 | JP |
2007-535335 | Dec 2007 | JP |
1225547 | Apr 1986 | RU |
1443873 | Dec 1988 | RU |
503271 | Apr 1996 | SE |
1990003766 | Apr 1990 | WO |
1996006567 | Mar 1996 | WO |
1996006597 | Mar 1996 | WO |
1997013465 | Apr 1997 | WO |
1998031301 | Jul 1998 | WO |
1998034545 | Aug 1998 | WO |
2000074594 | Dec 2000 | WO |
2001006951 | Feb 2001 | WO |
2001078609 | Oct 2001 | WO |
2002026108 | Apr 2002 | WO |
2002028312 | Apr 2002 | WO |
2002038079 | May 2002 | WO |
2004012626 | Feb 2004 | WO |
2004112585 | Dec 2004 | WO |
2005122954 | Dec 2005 | WO |
2006108145 | Oct 2006 | WO |
2007098212 | Aug 2007 | WO |
2008020937 | Feb 2008 | WO |
2008087635 | Jul 2008 | WO |
2009140012 | Nov 2009 | WO |
2010065274 | Jun 2010 | WO |
2010121052 | Oct 2010 | WO |
2010121052 | Jan 2011 | WO |
Entry |
---|
International Search Report and Written Opinion for PCT Application No. PCT/US2009/040587, dated Oct. 21, 2009, 13 pages. |
International Search Report and written Opinion for PCT Application No. PCT/US2009/064564, dated Feb. 23, 2010, 13 pages. |
International Preliminary Report on Patentability for PCT Patent Application No. PCT/US2009/040587, dated Nov. 25, 2010, 10 pages. |
International Search Report and Written opinion for PCT Patent Application No. PCT/US2010/031273, dated Dec. 1, 2010, 17 Pages. |
International Preliminary Report on Patentability for PCT Application No. PCT/US2009/064564, dated Jun. 16, 2011, 9 pages. |
Restriction Requirement for U.S. Appl. No. 12/760,049, dated Mar. 29, 2012, 9 pages. |
Response to Restriction Requirement for U.S. Appl. No. 12/760,049, filed Apr. 27, 2012, 2 pages. |
Non-Final Office Action for U.S. Appl. No. 12/760,049, dated Jun. 1, 2012, 10 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/760,049, filed Aug. 29, 2012, 8 pages. |
Final Office Action for U.S. Appl. No. 12/760,049, dated Nov. 8, 2012, 17 pages. |
Response to Final Office Action for U.S. Appl. No. 12/760,049, filed Feb. 8, 2013, 8 pages. |
Non-Final Office Action for U.S. Appl. No. 12/760,049, dated Oct. 3, 2013, 18 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/760,049, filed Dec. 23, 2013, 10 pages. |
Final Office Action for U.S. Appl. No. 12/760,049, dated Apr. 4, 2014, 37 pages. |
Response to Final Office Action for U.S. Appl. No. 12/760,049, filed May 28, 2014, 9 pages. |
Non-Final Office Action for U.S. Appl. No. 12/760,049, dated Jun. 19, 2014, 22 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/760,049, filed Sep. 17, 2014, 9 pages. |
Notice of Allowance for U.S. Appl. No. 12/760,049, dated Oct. 24, 2014, 7 pages. |
Restriction Requirement for U.S. Appl. No. 12/394,965, dated May 18, 2011, 6 pages. |
Restriction Requirement Response for U.S. Appl. No. 12/394,965, filed Jun. 15, 2011, 1 page. |
Non-Final Office Action for U.S. Appl. No. 12/394,965, dated Aug. 8, 2011, 8 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/394,965, filed Nov. 3, 2011, 10 pages. |
Non-Final Office Action for U.S. Appl. No. 12/394,965, dated Mar. 2, 2012, 13 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/394,965, filed Jun. 4, 2012, 09 pages. |
Final Office Action for U.S. Appl. No. 12/394,965, dated Dec. 7, 2012, 15 pages. |
Response to Final Office Action for U.S. Appl. No. 12/394,965, filed Mar. 5, 2013, 9 pages. |
Non-Final Office Action for U.S. Appl. No. 12/394,965, dated Mar. 21, 2013, 14 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/394,965, filed Jul. 17, 2013, 10 pages. |
Final Office Action for U.S. Appl. No. 12/394,965, dated Oct. 31, 2013, 13 pages. |
Response to Final Office Action for U.S. Appl. No. 12/394,965, filed Jan. 31, 2014, 11 pages. |
Notice of Allowance for U.S. Appl. No. 12/394,965, dated Dec. 17, 2014, 8 pages. |
Non-Final Office Action for U.S. Appl. No. 12/549,704, dated Sep. 26, 2011, 9 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/549,704, filed Dec. 23, 2011, 7 pages. |
Final Office Action for U.S. Appl. No. 12/549,704, dated Jan. 30, 2012, 10 pages. |
Response to Final Office Action for U.S. Appl. No. 12/549,704, filed Apr. 27, 2012, 8 pages. |
Non-Final Office Action for U.S. Appl. No. 12/549,704, dated Jul. 25, 2012, 10 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/549,704, filed Oct. 25, 2012, 8 pages. |
Final Office Action for U.S. Appl. No. 12/549,704, dated Nov. 20, 2012, 12 pages. |
Response to Final Office Action for U.S. Appl. No. 12/549,704, filed Jan. 18, 2013, 8 pages. |
Notice of Allowance for U.S. Appl. No. 12/549,704, dated Feb. 1, 2013, 9 pages. |
Restriction Requirement for U.S. Appl. No. 12/938,553, dated Dec. 28, 2012, 9 pages. |
Response to Restriction Requirement for U.S. Appl. No. 12/938,553, filed Jan. 25, 2013, 2 pages. |
Non-Final Office Action for U.S. Appl. No. 12/938,553, dated Jun. 7, 2013, 7 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/938,553, filed Sep. 3, 2013, 8 pages. |
Non-Final Office Action for U.S. Appl. No. 12/938,553, dated Dec. 19, 2013, 8 pages. |
Response to Non-Final Office Action for U.S. Appl. No. 12/938,553, filed Mar. 17, 2014, 8 pages. |
Final Office Action for U.S. Appl. No. 12/938,553, dated Aug. 6, 2014, 8 pages. |
Response to Final Office Action for U.S. Appl. No. 12/938,553, filed Sep. 30, 2014, 7 pages. |
Advisory Action for U.S. Appl. No. 12/938,553, dated Oct. 21, 2014, 2 pages. |
Office Action for Japanese Patent Application No. 2011-509522, dated May 22, 2013, 4 pages. (Official Communication Only). |
Office Action for Japanese Patent Application No. 2011-509522, dated Sep. 13, 2013, 2 pages. (Official Communication Only). |
Office Action for Japanese Patent Application No. 2011-509522, dated Jun. 12, 2014, 7 pages. (3 Pages Office Action + 4 Pages English translation). |
First Examiner Report for Australian Patent Application No. 2009322835, dated May 21, 2014, 3 pages. |
Bayer et al., “A New Approach to Primary Strengthening of Colostomy With Marlex Mesh to Prevent Paracolostomy Hernia”, Surg Gynecol Obstet, vol. 163, No. 6 ,Dec. 1986 ,1 page. (Abstract Only). |
Delorme, Emmanuel, “La Bandelette Trans-Obturatrice: Un Procede Mini-Invasif Pour Traiter L'incontinence Urinaire D'effort De La Femme”, Progres en Urologie with English translated Abstract ,2001 ,pp. 1306-1313 and 1 page of translation. |
Fianu et al., “Absorbable Polyglactin Mesh for Retropubic Sling Operation in Female Urinary Stress Incontinence”, Gynecol. Obstet. Invest., vol. 16, 1983, pp. 45-50 , 1983 , 1 page. |
Giberti, C. , “TVT Tension-free Vaginal Tape, Minimally Invasive Highly Effective Treatment for Female Stress Unrinary Incontinence”, Urology vol. 57 No. 4 ,2001 ,pp. 666-669. |
Gittes et al., “No-Incision Pubovaginal Suspension for Stress Incontinence”, Journal of Urology, vol. 138 No. 3 , Sep. 1987 , pp. 568-570.(Abstract Only). |
Haab et al., “Feasibility of Outpatient Percutaneous Bladder Neck Suspension Under Local Anesthesia”, Urology vol. 50 No. 4 ,Oct. 1997 ,pp. 585-587.(Abstract Only). |
Kovac et al., “Pubic Bone Suburethral Stabilization Sling for Recurrent Urinary Incontinence”, Obstetrics & Gynecology, vol. 89, No. 4, Apr. 1997, pp. 624-627.(Abstract Only). |
Norris et al., “Use of Synthetic Material in Sling Surgery: A Minimally Invasive Approach”, Journal of Endourology, vol. 10, Issue 3 ,Jun. 1996 ,pp. 227-230.(Abstract Only). |
Petros et al., “An Integral Theory and Its Method for the Diagnosis and Management of Female Urinary Incontinence”, Scandinavian Journal of Urology and Nephrology, An Integral Theory and its Method for the Diagnosis ,1993, pp. 1-93. |
Petros, P., “An Integral Theory of Bladder Neck Opening, Closure and Urinary incontinence in the Female”, International Journal of Gynecology & Obstetrics. XXIII World Congress of Gynaecology and Obstetrics (FIGO) ,1991. |
Petro, P. P., “Medium-term Follow-up of the Intravaginal Slingplasty Operation Indicates Minimal Deterioration of Urinary Continence with Time”, Aust NZ J Obstet Gynaecol vol. 39 No. 3 ,Aug. 1999,pp. 354-356. |
Petros, P., “The Intravaginal Slingplasty Operation, a Minimally Invasive Technique for Cure of Urinary Incontinence in the Female”, Aust. NZ J Obstet Gynaecol, vol. 36, No. 4 ,1996, pp. 453-461. (Abstract Only). |
Petros et al., “Urethral Pressure Increase on Effort Originates from Within the Urethra, and Continence From Musculovaginal Closure”, Neurourology and Urodynamics vol. 14 No. 4 ,1995 ,pp. 337-346. |
Petros, P E., “Vault Prolapse I: Dynamic Supports of the Vagina”, Int Urogynecol J Pelvic Floor Dysfunct vol. 12 No. 5 ,2001 ,pp. 292-295. |
Raz et al., “Fascial Sling to Correct Male Neurogenic Sphincter Incompetence: The McGuire/RAZ Approach”, Journal of Urology vol. 139 No. 3 ,Mar. 1988 ,pp. 528-531. |
Raz, S., “Modified Bladder Neck Suspension for Female Stress Incontinence”, Urology vol. 17 No. 1 ,Jan. 1981 , pp. 82-85. |
Raz et al., “Vaginal Wall Sling”, The Journal of Urology vol. 141, 1989, pp. 43-46. |
Richardson, P A., “Ambulatory Surgery for Urinary Incontinence and Vaginal Prolapse”, Medical Journal of Australia vol. 161 No. 8,1994, pp. 171-172. |
Stamey, Thomas A., “Endoscopic Suspension of the Vesical Neck for Urinary Incontinence in Females”, Annals of Surgery vol. 192 No. 4 ,Oct. 1980 ,pp. 465-471. |
Starney, T. A., “Endoscopic Suspension of the Vesical Neck for Urinary Incontinence Surgery”, Gynecology & Obstetrics vol. 136 No. 4 ,1973 ,pp. 547-554. |
Staskin, D. R., “Sling Surgery for the Treatment of Female”, Stress Incontinence vol. 5 No. 1 ,1991 ,pp. 106-122. |
Staskin et al., “The Gore-Tex Sling Procedure for Female Sphincteric Incontinence: Indications, Technique, and Results”, World J of Urol. vol. 15 No. 5 ,1997, pp. 295-299. |
Ulmsten, U., “An Ambulatory Surgical Procedure Under Local Anesthesia for Treatment of Female Urinary Incontinence”, The International Urogynecology Journal vol. 7 No. 2 ,1996 ,pp. 81-86. |
Ulmsten, U., “An Introduction to Tension-Free Vaginal Tape (TVT)—A New Surgical Procedure for Treatment of Female Urinary Incontinence”, Int Urogynecol J. Pelvic Floor Dysfunct. (Suppl 2) ,2001,pp. S3-S4. |
Ulmsten, U., “Connective Tissue Factors in the Aetiology of Female Pelvic Disorders”, Ann. Med vol. 22 No. 6 , Dec. 1990 ,pp. 403. |
Ulmsten et al., “Intravaginal Slingplasty”, Zentralbl Gynakol vol. 116 ,1994 ,pp. 398-404. |
Ulmsten et al., “Intravaginal Slingplasty (IVS): An Ambulatory Surgical Procedure for Treatment of Female Urinary Incontinence”, Scand J Urol Nephrol vol. 29 No. 1 ,Mar. 1995 ,pp. 75-82. |
Ulmsten et al., “Surgery for Female Urinary Incontinence”, Current Opinion in Obstetrics & Gynecology vol. 4 No. 3 ,1992 ,pp. 456-462. |
Ulmsten, U., “The Basic Understanding and Clinical Results of Tension-Free Vaginal Tape for Stress Urinary Incontinence”, Urologe A., Jul. 2001 ,pp. 269-273. |
freedictionary.com, “Suture”, available online at <http://www.thefreedictionary.com/suture>, Retrieved on May 21, 2012, 3 pages. |
Number | Date | Country | |
---|---|---|---|
20150148820 A1 | May 2015 | US |
Number | Date | Country | |
---|---|---|---|
61170312 | Apr 2009 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 12760049 | Apr 2010 | US |
Child | 14610861 | US |