Claims
- 1. A method of treating incontinence in a patient comprising the steps of:
providing an implantable material capable of eliciting a foreign body response, the implantable material being sized and shaped to be placed in the patient's retropubic space without extending through the patient's rectus fascia, placing the implantable material in the retropubic space without securing the implant to substantially fixed anatomical structures such as the patient's pubic bone, periosteum of the pubic bone, Cooper's ligament and rectus fascia; and eliciting a foreign body response with the implantable material.
- 2. A method according to claim 1 wherein the step of eliciting a foreign body response with the implantable material causes the patient's retropubic space to more closely mimic the retropubic space of a continent individual.
- 3. A method according to claim 1 wherein the step of placing the implantable material in the retropubic space includes the step of anchoring the implantable material to endopelvic fascia with a mechanical fastener.
- 4. A method of treating incontinence in a patient comprising the steps of:
providing an implantable material that is sized and shaped be implanted in the patient's retropubic space and that is capable of eliciting a foreign body response; placing the implantable material in the retropubic space in a therapeutically effective position relative to the patient's urethra without extending the implantable material to the patient's rectus fascia, without suturing the implant to the patient's Cooper's ligament, and without using bone anchors.
- 5. A method according to claim 4 wherein the step of providing an implantable material includes the step of providing an implantable material with first and second ends, and
the step of placing the implantable material includes the step of associating the first end of the implantable material with endopelvic fascia on one side of the patient's urethra and associating the second end of the implantable material with endopelvic fascia on the other side of the patient's urethra.
- 6. A method according to claim 4 wherein the step of placing the implantable material includes the step of placing the implant mid-urethra.
- 7. A method according to claim 4 wherein the step of placing the implantable material includes the steps of:
passing a deployable anchoring member with an associated suture through endopelvic fascia; deploying the anchoring member after the anchoring member has substantially passed through endopelvic fascia, and securing the implantable material to the suture associated with the anchoring member.
- 8. A method according to claim 4 wherein the step of placing the implantable material includes the step of extending the implantable material from the endopelvic fascia on one side of the patient's urethra, underneath approximately the mid-urethra, and to the endopelvic fascia on the other side of the patient's urethra.
- 9. A method according to claim 4 wherein the step of placing the implantable material includes the step of at least temporarily adhering the implantable material to endopelvic fascia with a tissue adhesive.
- 10. A method according to claim 9 further including the step of using a foam material.
- 11. An assembly for placing an implant in a patient's retropubic space during a surgical procedure for treating incontinence, the assembly comprising:
at least one deployable member for associating the implant with endopelvic fascia of a retropubic space; and an inserter that is sized and shaped to associate the deployable member with endopelvic fascia.
- 12. An assembly according to claim 11 wherein the inserter includes a sheath with a distal end, and a movable member within the sheath,
the movable member being operatively associated with the deployable member to move the deployable member between i) a retracted position with the deployable member at least partially received within the sheath of the inserter, and ii) an extended position spaced more distally to the distal end of the sheath than in the retracted position, and wherein movement of the movable member causes the deployable member to move from the retracted position toward the extended position.
- 13. An assembly according to claim 11 wherein the deployable member is capable of assuming a first orientation that affords at least partial receipt of the deployable member within a sheath of the inserter, and a second orientation that affords secure association between the deployable member and endopelvic fascia.
- 14. An assembly according to claim 13 wherein the deployable member has a first profile in the first orientation and a second profile in the second orientation, and
wherein the first profile is less than the second profile.
- 15. An assembly according to claim 11 wherein the deployable member comprises a flexible, substantially disc shape.
- 16. An assembly according to claim 11 wherein the inserter comprises a tissue adhesive dispenser and the deployable members comprises components of a tissue adhesive.
- 17. An assembly according to claim 13 wherein the deployable member comprises a substantially clover shaped top portion substantially situated in a first plane, and a stem substantially adapted to be situated in a second plane, and
in the first orientation, the first plane is nearly parallel to the second plane, and in the second orientation, the first plane is substantially perpendicular to the second plane.
- 18. An assembly according to claim 11 wherein the inserter includes a tissue stop for blocking insertion of a distal end of the inserter past preselected endopelvic fascia.
- 19. An assembly according to claim 13 wherein the movable member is rotatable.
- 20. An assembly according to claim 13 wherein the movable member is linearly movable relative to the sheath.
- 21. An assembly according to claim 11 wherein the deployable member comprises a conical spring.
- 22. An assembly according to claim 11 wherein the deployable member comprises a plurality of anchoring fingers.
- 23. An assembly according to claim 11 wherein the deployable member comprises an expandable tube that affords movement into tissue in one direction, but that resists movement though tissue in an opposite direction.
- 24. A kit for a surgical procedure to treat incontinence comprising:
an implant that is sized and shaped to be implanted in a patient's retropubic space; at least two deployable members for associating the implant with endopelvic fascia of a retropubic space; and an inserter that is sized and shaped to associate the deployable members with endopelvic fascia.
- 25. An implant for treating incontinence in a patient comprising:
a substantially thin, flexible sheet that has a geometry, size and shape suitable for implanting in the patient's retropubic space without extending through the patient's rectus fascia and without requiring the implant to be secured to substantially fixed anatomical structures such as the patient's pubic bone, periosteum of the pubic bone, Cooper's ligament and rectus fascia.
- 26. An implant according to claim 25 wherein the sheet is capable of eliciting a foreign body response.
- 27. An implant according to claim 26 wherein the sheet comprises a synthetic mesh material having a plurality of holes, the holes being sized and shaped to afford tissue ingrowth to anchor the implant in the retropubic space.
- 28. An implant according to claim 25 wherein the implant is sized and shaped to anchor in the patient's endopelvic fascia.
- 29. A method of treating fecal incontinence comprising the steps of:
providing an implantable material capable of eliciting a foreign body response, the implantable material being sized and shaped to be placed in the patient's retropubic space without extending through the patient's rectus fascia, placing the implantable material in the retropubic space without securing the implant to substantially fixed anatomical structures such as the patient's pubic bone, periosteum of the pubic bone, Cooper's ligament and rectus fascia; and looping the implantable material underneath the rectum to correct the patient's ano-rectal angle.
- 30. A method of treating incontinence in a patient comprising the steps of:
providing an implantable material capable of eliciting a foreign body response, the implantable material being sized and shaped to be placed in the patient's retropubic space without extending through the patient's rectus fascia, and securing the implantable material in the retropubic space with a sponge-like substance without securing the implant to substantially fixed anatomical structures such as the patient's pubic bone, periosteum of the pubic bone, Cooper's ligament and rectus fascia.
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] The present application claims priority to U.S. Provisional Application Serial No. 60/279,794, filed Mar. 29, 2001; and U.S. Provisional Application Serial No. 60/302,929, filed Jul. 3, 2001; and U.S. Provisional Application Serial No. 60/307,836, filed Jul. 25, 2001, and U.S. Provisional Application Serial No. 60/322,309, filed Sep. 14, 2001.
Provisional Applications (4)
|
Number |
Date |
Country |
|
60279794 |
Feb 2002 |
US |
|
60302929 |
Jul 2001 |
US |
|
60307836 |
Jul 2001 |
US |
|
60322309 |
Sep 2001 |
US |