This invention relates to a device suitable for use during deployment of a medical device at a desired treatment location.
It is known to use soft tissue implants to reinforce or replace areas of the human body that have acquired defects. These implants may require invasive means of delivery, which may result in complications and longer recovery periods for the patient.
According to the invention there is provided a device suitable for use during deployment of a medical device at a desired treatment location, the device comprising a support element to support the medical device during deployment.
In one embodiment of the invention the support element comprises a first end mounted to a medical device. Preferably the support element comprises a second end longitudinally spaced-apart from the first end. Ideally the second end of the support element is engagable with a body tissue to maintain the body tissue spaced-apart from a medical device. By maintaining the body tissue spaced-apart from the medical device, this provides the clinician with sufficient working space to attach the medical device at the desired treatment location. Most preferably the support element is configured for location fully within an internal body cavity. The second end of the support element may be insertable into an internal body cavity. Preferably the support element tapers inwardly from the first end towards the second end. Ideally the support element is curved in longitudinal cross-section. Most preferably the concave portion of the curve faces radially outwardly. The support element may be substantially dome-shaped.
In another embodiment the support element comprises an access opening extending at least partially therethrough through which one or more parts may be extended to access a medical device. The part extended through the access opening may be an instrument or a hand/arm of a clinician. Preferably the access opening is located substantially at the second end of the support element. Ideally the access opening is located substantially at the radial centre of the support element.
In one case the device comprises a coupling element to couple a medical device to the support element. Preferably the coupling element is configured to releasably couple a medical device to the support element. By releasing the support element from the medical device, this enables the support element to be removed after the medical device has been attached at the desired treatment location. Ideally the coupling element is extendable through an opening in the support element. Most preferably the coupling element is extendable through an opening in a medical device. The coupling element may be substantially elongate. Preferably the coupling element comprises a drawstring. Ideally the coupling element comprises a low-friction material.
In another case the support element is movable between a delivery configuration for delivery of a medical device to a desired treatment location, and a deployment configuration for deployment of the medical device at the desired treatment location. Preferably the support element is collapsed in the delivery configuration. This low profile provides for ease of delivery. Ideally the support element is expanded in the deployment configuration. Most preferably the support element is biased towards the deployment configuration. The material of the support element may provide the required outward force to deploy the support element and the medical device. The support element may comprise a resilient material. Preferably the support element comprises a shape-memory material. Ideally the support element comprises a thermoplastic material. The support element may comprise a bioabsorbable material.
The invention also provides in another aspect an assembly comprising:
a medical device; and
a device of the invention for use during deployment of the medical device at a desired treatment location.
In one embodiment of the invention the medical device comprises an implant. Preferably the medical device comprises a soft tissue implant.
In another embodiment the medical device is configured to be attached to a body tissue at a desired treatment location. Preferably the medical device comprises one or more openings through which an attachment element may be extended. Ideally the medical device comprises one or more openings through which the coupling element is extendable.
In a further aspect of the invention there is provided a method of deploying a medical device at a desired treatment location, the method comprising the steps of:
using a support element to support the medical device during deployment at the desired treatment location,
attaching the medical device to a first body tissue at the desired treatment location, and
removing the support element from the desired treatment location.
The support element may be removed by withdrawing the support element from the desired treatment location. Alternatively the support element may be provided in the form of a bioabsorbable element, and the support element may be removed by allowing the support element to bioabsorb.
In one embodiment of the invention during deployment of the medical device at the desired treatment location, the support element engages with a second body tissue to maintain the second body tissue spaced-apart from the medical device. By maintaining the second body tissue spaced-apart from the medical device, this provides the clinician with sufficient working space to attach the medical device at the desired treatment location.
In another embodiment one or more parts are used to attach the medical device to the first body tissue. The part used to attach the medical device to the first body tissue may be an instrument or a hand/arm of a clinician. Preferably the method comprises the step of extending the part at least partially through the support element to access the medical device.
In one case the method comprises the step of coupling the medical device to the support element before delivery to the desired treatment location. Preferably the method comprises the step of de-coupling the medical device from the support element after attaching the medical device to the first body tissue. By releasing the support element from the medical device, this enables the support element to be removed after the medical device has been attached at the desired treatment location.
In another case the method comprises the step of collapsing the medical device before delivery to the desired treatment location. This low profile provides for ease of delivery. Preferably the method comprises the step of expanding the medical device before attaching to the first body tissue.
The invention also provides in another aspect a soft tissue implant for repairing a bodily defect comprising:
a first shape memory delivery system component sized and shaped to extend beyond the bodily defect in a patient, the delivery system having a domed configuration and having a selected elasticity,
a biocompatible soft tissue implant; and
an attachment means to the soft tissue implant, the attachment means being reversibly attached to the soft tissue implant.
In one case the invention provides a minimally invasive delivery system for soft tissue implants.
In another case the invention provides a soft tissue implant and method for making the same.
In one case the invention provides an improved delivery system for deploying soft tissue implants for treating bodily defects.
In another case the invention provides improved soft tissue implants and methods of soft tissue implant delivery, specifically implants that treat bodily defects in a minimally invasive fashion.
The invention has a number of advantages over known approaches.
The invention provides an implant and delivery means that results in a procedure with a smaller surgical site incision, with a decrease in pain and shorter recovery periods for the patient.
The invention provides a reduction in postoperative wound healing complications, such as infections and seroma formation, which is correlated with smaller incisions, less trauma and dead space between the prosthesis and the host tissues.
The invention provides an implant and delivery means that results in a procedure that allows for predictable expansion and securement of the implant which may result in decreased recurrence rates and patient discomfort.
The invention provides an implant and delivery means that results in a procedure that allows for shorter procedure times and does not require general anaesthesia which decreases the risk of procedural complications.
The invention provides an implant and delivery means that results in decreased material content, and that results in a flexible implant with a reduced inflammatory response, and physical properties of the implant that simulate the physical properties of the tissue structures being replaced.
The invention provides an implant and delivery means that permits adequate visualisation of the implant and creates a working space for fixation of the implant during the procedure.
The invention provides a soft tissue implant and delivery means, which has an outstanding combination of ease of delivery and low residual material content.
The invention provides a soft tissue implant and delivery means that provides enhanced placement and biocompatibility in a low profile configuration while maintaining the requisite strength to repair tissue.
In one case the invention provides a minimally invasive delivery system for soft tissue implants for treating bodily defects comprising an elastic and detachable delivery system attached to a soft tissue implant.
In another case, the invention provides a delivery system and soft tissue implant in a biocompatible form. The implant may have a structure characterised by a dome reversibly attached to a soft tissue implant using a drawstring means. The delivery system may be designed to optimise expansion and working space in the subcutaneous tissue space to facilitate soft tissue implant attachment. The implant material may have high flexibility, high strength, high porosity, and a low surface area. The soft tissue implant and delivery means may provide an outstanding combination of ease of delivery and low residual material content.
The invention will be more clearly understood from the following description of some embodiments thereof, given by way of example only, with reference to the accompanying drawings, in which:
Some reference numerals used in the drawings are as follows:
Referring to the drawings, and initially to
In this case the medical device 16 comprises a soft tissue implant. The soft tissue implant 16 may be employed to treat a first portion of body tissue during hernia repair. The soft tissue implant 16 may be attached to the first portion of body tissue at the desired treatment location using an attachment element, such as a suture. The soft tissue implant 16 comprises a plurality of openings 18 through which the attachment element may be extended to attach the soft tissue implant 16 to the first portion of body tissue.
The device 20 comprises a support element 31 to support the soft tissue implant 16 during deployment.
The support element 31 comprises a first end 32 for mounting to the soft tissue implant 16, and a second end 33 longitudinally spaced-apart from the first end 32. The support element 31 tapers inwardly from the first end 32 towards the second end 33. As illustrated in
The device 20 comprises a coupling element 22 to releasably couple the soft tissue implant 16 to the support element 31. The coupling element 22 is extendable through a plurality of openings 35 in the support element 31 (
In this case the coupling element 22 is provided in the form of an elongate drawstring of a low-friction material.
The support element 31 and the soft tissue implant 16 are movable between a collapsed delivery configuration for delivery of the soft tissue implant 16 to the desired treatment location, and an expanded deployment configuration for deployment of the soft tissue implant 16 at the desired treatment location.
The support element 31 is biased towards the deployment configuration. In this manner the support element 31 causes expansion of the soft tissue implant 16 at the desired treatment location. The support element 31 may be provided in the form of a resilient material, and/or a shape-memory material, and/or a thermoplastic material. The support element 31 may comprise a bioabsorbable material.
The support element 31 may be located fully within an internal body cavity, as illustrated in
The support element 31 comprises an access opening 34 extending at least partially therethrough through which one or more parts may be extended to access the soft tissue implant 16. The part extended through the access opening 34 may be an instrument or a hand/arm of a clinician. The access opening 34 is located at the second end 33 of the support element 31 at the radial centre of the support element 31.
In use, the soft tissue implant 16 is coupled to the support element 31 using the coupling element 22 by extending the coupling element 22 through the openings 35 in the support element 31 and the openings in the soft tissue implant 16.
An incision is made in the abdominal wall (
The support element 31 is located fully within the internal body cavity, as illustrated in
An instrument or hand/arm of a clinician is extended through the access opening 34 to access the soft tissue implant 16 (
The support element 31 is then released from the soft tissue implant 16 by removing the coupling element 22 from the openings 35 in the support element 31 and from the openings in the soft tissue implant 16 (
The support element 31 is configured to be sufficiently flexible to enable the support element 31 to be inserted into the opening in the abdominal wall and removed from the opening in the abdominal wall, and is also configured to have sufficient shape memory to expand to the deployment configuration when released which causes expansion of the soft tissue implant 16.
A known non-absorbable mesh implant 10 is illustrated in
Medical implant applications for the soft tissue implant technology described above may include but are not limited to plastic reconstruction, urinary stress incontinence, hernia repair, chest wall reconstruction, and muscular skeletal defects. The delivery system and soft tissue implant may be produced in a variety of shapes and sizes for the particular indication. A non-absorbable soft tissue implant may be selected for indications such as hernia repair that require long-term durability and strength. An absorbable soft tissue implant may be selected for indications such as tissue augmentation during plastic reconstruction when it is desired to avoid the potential complications associated with a permanent implant. Tissue based materials may be best suited for indications such as pelvic slings that require materials less prone to erosion into adjacent tissue structures.
It will be appreciated that the minimally invasive delivery system and soft tissue implant of this invention may be used to treat bodily defects, may be manufactured with an elastic dome, may be designed in configurations to treat different types of bodily defects, may be designed with flexible soft tissue implants, may be designed with detachable means, may be designed with a working space for the application of sutures, tacks, or tissue adhesives, may be designed for placement and expansion through a small incision, and may be manufactured in a cost effective manner.
Although the description above contains many specifics, these should not be construed as limiting the scope of the invention but as merely providing illustrations of some of the presently preferred embodiments of this invention. For example, the delivery system and implant may have other designs, different materials may be utilised, and alternate equipment may be used to produce the structures.
The invention is not limited to the embodiments hereinbefore described, with reference to the accompanying drawings, which may be varied in construction and detail.
Number | Date | Country | Kind |
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2007/0623 | Aug 2007 | IE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP08/61515 | 9/1/2008 | WO | 00 | 1/21/2011 |