The disclosed embodiments relate generally to medical devices and more particularly to an insertion device for delivery of a mesh carrier into a body of a patient.
The disclosed embodiments have application to a wide variety of surgical procedures. For example, one such procedure is directed to urinary incontinence and includes fixing an implant to tissue within a body of a patient to provide support for the urethra. Another such procedure includes fixing an implant to bodily tissue of a patient to support a bladder of the patient.
Mesh carriers may be placed within a body of a patient to provide anchoring points for medical implants. In some procedures, it is necessary for a practitioner, such as a physician, to insert a mesh carrier into bodily tissue of the patient at a location not easily visible or accessible to the practitioner. For example, some locations are not visible or easily accessible due to internal obstructions, such as the pubic bone. Known insertion devices can be used to position a mesh carrier at a first location within bodily tissue and to fix the mesh carrier to the tissue. However, in such procedures where the location is not easily visible or easily accessible, it may be difficult to maneuver the known insertion device around such obstructions and delivering the mesh carrier to a desired location in bodily tissue. Furthermore, the practitioner may require a larger incision at the incision site in order to allow ample room to rotate and/or pivot the known insertion device within the body in order to reach the desired location. In such an instance, the rotating and/or pivoting of the medical device may cause unintended stretching or tearing of tissue. Additionally, it may become necessary to remove the known insertion device from the body to better position it at the incision site. Unnecessary insertion, over-insertion, or excessive rotation could, therefore, induce trauma to the patient.
Thus, a need exists for an insertion device that has a configuration that facilitates insertion of an implant or a mesh carrier for an implant. For example, a need exists for an insertion device that facilitates insertion around or behind an internal obstruction, such as the pubic bone.
In some embodiments, an insertion device includes an elongate member and a stylet. The elongate member has a proximal end portion, a distal end portion, and defines a lumen therethrough. The elongate member includes a curved portion between the proximal end portion and the distal end portion. In some embodiments, the distal end portion is configured to removably couple a mesh carrier thereto. The proximal end portion includes a handle defining a longitudinal axis. The stylet has a proximal end portion, a distal end portion, and is configured to move from a first position to a second position with respect to the elongate member. The stylet is configured to engage the mesh carrier to remove the mesh carrier from the elongate member such that a longitudinal axis defined by the mesh carrier is substantially orthogonal to the longitudinal axis defined by the handle.
In other embodiments, the elongate member has a proximal end portion, a distal end portion, and defines a lumen therethrough. The proximal end portion of the elongate member defines an axis substantially orthogonal to an axis defined by the distal end portion of the elongate member. The stylet has a proximal end portion and a distal end portion. At least a portion of the stylet is disposed within the lumen of the elongate member. The stylet is coupled to the elongate member such that the stylet is configured to move from a first position to a second position with respect to the elongate member.
The insertion device and mesh carrier described herein can be inserted into a body of a patient, such as into bodily tissue. For example, the insertion device can be configured to deliver a first mesh carrier configured to selectively retain an implant (also referred to herein as a “filament”, “tape”, “implant”, “mesh”, “sling”, or “strap”) with respect to a bodily tissue. A plurality of such mesh carriers can be anchored within the body of a patient at spaced locations while retaining a filament between the plurality of mesh carriers to provide support for other portions of the body (e.g., organs or portions of organs).
The insertion device is configured to place, deposit, or otherwise insert a mesh carrier into a bodily tissue of a patient. The filament is configured to suspend or support a bodily tissue or organ when the filament is retained within the patient by one mesh carrier. Thus, in one embodiment, the insertion device can place the mesh carrier into the obturator externus muscle for incontinence treatment. Specifically, first and second mesh carriers are each placed in opposing obturator externus muscles of a patient and the filament is extended between the first and second mesh carriers to form a sling to provide support to the urethra or bladder neck of the patient. The insertion device can be a variety of different configurations and can have a variety of different components.
As used in this specification, the words “proximal” and “distal” refer to the direction closer to and further away from, respectively, an operator (e.g., surgeon, physician, nurse, technician, etc.) who would use an insertion device or a therapeutic device during a procedure. For example, the end of an insertion device first to contact the patient's body would be the distal end, while the opposite end of the insertion device (e.g., the end of the insertion device being operated by the operator) would be the proximal end of the insertion device. Similarly, the end of a insertion device implanted the furthest within the patient's body would be the distal end, while the opposite end of the insertion device (e.g., the end of the insertion device that is inserted the least amount within the body or the end of the insertion device that is disposed outside of the body) would be the proximal end.
The insertion device 100 has a proximal end portion 102 and a distal end portion 104. The insertion device 100 includes an elongate member 110, a stylet (not shown in
The handle 170 is slidably coupled to the proximal end portion 112 of the elongate member 110 and is fixedly coupled to the proximal end portion of the stylet. The handle 170 is configured to move the stylet relative to the elongate member 110.
Although a mesh carrier 190 is used with insertion device 100 as described in the above disclosed embodiment, it should be understood that in some embodiments, a tissue anchor can be used.
The elongate member 210 includes a proximal end portion 212, a distal end portion 213, and defines a lumen 218 (shown, for example in
As shown in
The distal end portion 252 of the coupling member 250 includes a first end portion 251, and second end portion 253 (shown, for example in
The proximal end portion 254 of the coupling member 250 defines a ribbed portion 256 including a first protrusion 256a and a second protrusion 256b (shown in
Although the coupling member 250 is illustrated and described as being disposed about or fixedly coupled to the elongate member 210, other suitable coupling configurations can be used. For example, in some embodiments, the coupling member 250 and elongate member 210 can be monolithically constructed. In other embodiments, for example, the coupling member 250 can be insert-molded to the elongate member 210. Furthermore, the coupling member 250 can be constructed of any suitable material. In one embodiment, the coupling member 250 can be constructed of a polymer. For example, the coupling member 250 can be constructed of acrylonitrile butadiene styrene (ABS).
The distal end portion 213 of the elongate member 210 defines a second axis B-B, as shown, for example in
The elongate member 210 includes a curved portion 211 disposed between the proximal end portion 212 and the distal end portion 213. Specifically, in the illustrated embodiment, the curved portion 211 is configured such that the second axis B-B defined by the distal end portion 213 of the elongate member is substantially orthogonal to the first axis A-A defined by the proximal end portion 212 of the elongate member 210.
The elongate member 210 can be constructed of any material suitable for insertion into a body of a patient. For example, in some embodiments, the elongate member is constructed of stainless steel. In other embodiments, the elongate member is constructed of a polymer.
The handle 270 has a proximal end portion 272 and a distal end portion 274, and is formed by a first portion (first half) 271, and a second portion (second half) 273. The handle defines a longitudinal axis B 1-B (shown in
As shown in
As shown in
The second portion 272 of the handle 270 defines an aperture 279. The aperture 279 is configured to fixedly receive a portion of a proximal end portion 234 of the stylet 230 such that movement of the handle 270 with respect to the elongate member 210, causes the stylet 230 to slidably advance or retract relative to the elongate member 210.
Although the handle 270 is illustrated as defining a contoured shape (shown in
The stylet 230 includes a proximal end portion 234 and a distal end portion 233. The stylet 230 is slidably disposed within the lumen 218 defined by the elongate member 210. The proximal end portion 234 is fixedly coupled to the handle 270. As shown in
The distal end portion 233 of the stylet 230 includes a tip 235. The tip 235 can be a variety of shapes. For example, in one embodiment, the stylet tip can be pointed. In another embodiment, the stylet tip can be blunt or tapered.
The stylet 230 has a first position, (i.e., an extended position) shown, for example, in
As the stylet 230 is moved proximally with respect to the elongate member 210 from its first position to its second position, the distal end portion 233 of the stylet is removed from the lumen 291 defined by the mesh carrier 290. When the stylet 230 is in its second position, the distal end portion 233 of stylet 230 is disposed within the lumen 218 of the elongate member 210. Because the stylet 230 is biased to a linear configuration, when it is in its second position and is no longer engaged with the mesh carrier 290, the distal end portion 233 of the stylet 230 is disposed substantially against the inner surface 219 of the elongate member 210 (shown, for example, in
In some embodiments, when the stylet 230 is moved from its first position to its second position (i.e., when the distal end 233 of the stylet 230 is removed from the lumen 291 of the mesh carrier 290 and contacts the inner surface 219 of the elongate member 210), a user can hear an audible click.
Once in its second position, the stylet 230 is configured to decouple or otherwise disengage the mesh carrier 290 from the elongate member 210. Because the distal end portion 233 of the stylet 230 is configured to contact the proximal end portion 294 of the mesh carrier 290, when the stylet 230 is moved in a distal direction, it can advance the mesh carrier 290 in a distal direction out of the lumen 218 of the elongate member 210, thereby disengaging or decoupling the mesh carrier 290 from elongate member 210 and fixing it into bodily tissue. Specifically, the distal end portion 233 of the stylet 230 is configured to engage the mesh carrier 290 such that an orientation of a longitudinal axis A1-A1 defined by the mesh carrier 290 is substantially orthogonal to the longitudinal axis B 1-B 1 defined by the handle 270 coupled to the elongate member 210 (shown, for example, in
The stylet 230 can be constructed of any material suitable for insertion into a body of a patient. For example, in some embodiment, the stylet can be constructed of stainless steel. In other embodiments, the stylet can be constructed of a polymer.
Specifically, the mesh carrier 290 is coupled to the elongate member 210 by an interference or frictional fit. Although, the proximal end portion 294 of the mesh carrier 290 defines a substantially smooth outer surface, In other embodiments, the outer surface of the proximal end portion 294 can include a textured surface. For example, in some embodiments, the outer surface of the proximal end of the mesh carrier can include at least one rib or ridge (not shown) configured to help provide an interference or frictional fit with the lumen of the elongate member.
The proximal end portion 294 of the mesh carrier 290 includes protrusions 296, 297 disposed about a periphery of the mesh carrier 290 approximately 180 degrees apart (shown in
The proximal end portion 294 of the mesh carrier 290 further includes a first anchor portion 299 (shown, for example, in
The distal end portion 293 of the mesh carrier 290 includes a second anchor portion 298 (shown, for example, in
The first anchor portion 299 (i.e., projections 299a, 299b) and the second anchor portion 298 (i.e., projections 298a, 298b) are configured to help prevent the mesh carrier 290 from regressing through the bodily tissue in which it is placed. For example, in one application, the first anchor portion 299 and the second anchor portion 298 are configured to retain or anchor the mesh carrier 290 in one of the obturator internus or obturator externus muscles.
As illustrated in
In one embodiment, the aperture 292 is configured to provide a frictional fit with the filament 205 passed through (or received within) the aperture 292. For example, the aperture 292 can be configured to be slightly smaller (or narrower) than the thickness of the filament 205. In such an embodiment, a force must be applied to move the filament 205 through the aperture 292. In yet another embodiment, the aperture 292 provides substantial resistance to movement or adjustment of the filament 205, such that he filament 205 is substantially fixed within the aperture 292.
The aperture 292 can have any suitable size or shape configured to receive the filament 205, for example the shape can be a U-shape (as illustrated in
The mesh carrier 290 can be constructed of any material suitable for implantation into bodily tissue. For example, the mesh carrier 290 can be constructed of implantable grade polypropylene, implantable grade metal, a polymer, a biocompatible material, or any combination thereof. Suitable biocompatible materials include bioabsorbable, cadaveric, and bovine materials.
Although the mesh carrier 290 is illustrated and described as being received by the elongate member 210, it should be understood that other suitable configurations can be used. For example, the mesh carrier can be configured to receive a portion of the elongate member to couple the mesh carrier to the elongate member. Specifically, at least a portion of an outer surface of the elongate member can be configured to provide an interference or slight frictional fit with a mesh carrier when at least a portion of the elongate member is received in a lumen of the mesh carrier. Said another way, a portion of the mesh carrier can be configured to be disposed over a portion of the elongate member. In such an embodiment, the elongate member can include a sheath disposed about an outer surface of the elongate member for disengaging the mesh carrier (discussed in more detail below).
Although the mesh carrier 209 is illustrated and described above as defining a lumen 291 and an opening 291a configured to receive the distal end portion 233 of the stylet 230, other suitable configurations can be used. For example, the proximal end portion of the mesh carrier can define a substantially solid surface configured to contact the distal end portion of the stylet. Specifically, in such embodiments, the style is moved in a distal direction, such that the distal end portion of the stylet moves distally within the lumen of the elongate member and contacts the proximal end portion of the mesh carrier to decouple or otherwise disengage the mesh carrier from the elongate member.
In some embodiments, the insertion device 200 described above, can be used to insert a plurality of mesh carriers within bodily tissue of a patient. As shown in
The filaments and implants as discussed above can be constructed of many different suitable materials and have many different suitable configurations. For example, in some embodiments, a polymer mesh implant is used, which can be used to support the urethra. In other embodiments, a polyform material can be used.
In some embodiments, a portion of the filament can be reinforced, such as with a reinforcing material. The reinforcing material, or reinforced portion of the filament, can be configured to assist in suspending or supporting the bodily tissue or organ. In one embodiment, the filament can be reinforced by a suture.
In some embodiments, at least a portion of the filament can include tangs or a tanged portion to grip or attach to a portion of bodily tissue. The terms “tanged” or “tangs” as used herein mean roughened or jagged edges or areas, such as can result from cutting a woven or knit mesh material or filament. The tangs enhance anchoring of the filament within bodily tissue, such as pubo-urethral tissue. In one embodiment, the filament includes tangs on an edge along an entire length of the filament. In another embodiment, tangs are only on the end portions of the filament.
In other embodiments, the filament is untanged or detanged, such as by heating the tangs on a polymer mesh so that they fuse and bead up to form a smooth finish.
In some embodiments, the filament includes a coating. For example, the filament can include a polymeric coating. In another example, the filament can include a therapeutic agent coating.
In yet other embodiments, the filament can be porous. A porous filament defines openings, or pores, in the filament or between threads of material forming the filament. For example, in one embodiment, the filament is a mesh. The filament can be a micro-porous mesh in which the openings, or pores, are small.
Although the stylet 230 as illustrated in
The proximal end portion 494 of the mesh carrier 490, in such embodiments, defines a cavity C configured to receive at least a portion the distal end portion 313 of the elongate member 310. Specifically, an inner surface 494a of the proximal end portion 494 of the mesh carrier 490, which defines the cavity C is configured to provide an interference or slight frictional fit with an outer surface 319 of the elongate member 310 received in the cavity C. In such embodiments, when the stylet 330 (and elongate member 310) is in its first configuration, the stylet 230 is configured such that a portion of the distal end portion 333 the stylet 330 extends through the lumen 491 of the mesh carrier 490 and out the opening 491b, as shown in
In some embodiments, an inner surface of the proximal end 494 of the mesh carrier 490 can include at least one rib or ridge configured to help provide the interference or frictional fit with the outer surface 319 of the elongate member 310.
Although the insertion devices are illustrated and described above as including an elongate member having a radius of curvature such that the proximal end portion of the elongate member defines an axis substantially orthogonal to an axis defined by the distal end portion of the elongate member, other suitable configurations can be used. For example, the axis defined by the proximal end portion of the elongate member and the axis defined by the distal end portion of the elongate member can define an angle greater than or less than 90 degrees relative to one another.
At 510, the mesh carrier is coupled to the stylet of the insertion device. For example, the proximal end portion of the mesh carrier is engaged with the distal end portion of the elongate member. For example, in some embodiments, a portion of the proximal end portion of the mesh carrier is received within the lumen defined by the distal end portion of the elongate member. In other embodiments, the portion of the proximal end portion of the mesh carrier is configured to receive a portion of the distal end portion of the elongate member.
In some embodiments at least a portion of the filament is inserted into the aperture defined by the mesh carrier prior to the coupling of the mesh carrier to the elongate member. For example, at least a portion of the filament is inserted into the aperture such that at least a portion of the filament is substantially orthogonal to the lumen defined by the mesh carrier.
In some embodiments, the mesh carrier is coupled to or engaged with the elongate member when the stylet is in its first position. In such embodiments, the stylet passes through the filament inserted into the aperture defined by the mesh carrier and retains the filament within the aperture of the mesh carrier.
At 520, the insertion device is inserted into a body of a patient. For example, in one embodiment, the insertion device is inserted into the body of the patient through an incision made in bodily tissue. In a procedure for urinary incontinence, one approach for inserting the insertion device into the body of the patient includes making an incision in the vaginal wall and inserting a portion of the insertion device through the vaginal incision. The portion of the insertion device is then directed towards the desired bodily tissue. The curved elongate member is useful in navigating around certain bodily structures to reach the desired bodily tissue.
At 530, the mesh carrier is positioned proximate to a desired portion of bodily tissue, and the mesh carrier is inserted into the bodily tissue. For example, in a procedure for female urinary incontinence, the mesh carrier is inserted into one of the obturator intern us or obturator externus muscles.
At 540, the mesh carrier is removed from the lumen at the distal end portion of the elongate member. Specifically, the stylet is moved from its first position to its second position, and then from its second position to its first position. For example, in one embodiment, as shown in
To remove the mesh carrier, the stylet is moved in a distal direction from its first position to its second position such that the distal end portion of the stylet concurrently moves the mesh carrier in a distal direction thereby removing the mesh carrier from the lumen at the distal end portion of the elongate member. Thus, the mesh carrier is decoupled from the elongate member, and the mesh carrier and filament are fixed within the bodily tissue.
At 550, the filament is moved, or adjusted, through the aperture of the mesh carrier. In one embodiment, the filament is moved or adjusted through the aperture in a first direction. For example, the filament is moved in the first direction to increase tension in the filament. In another example, the filament is moved in the first direction to decrease the length of the filament, for example, to shorten the length of the filament that will support or suspend a target organ or tissue.
In some embodiments, the filament is moved, or adjusted, through the aperture in a second direction different than the first direction. For example, the filament is moved in the second direction to decrease the tension in the filament. In one embodiment, the filament is moved in the second direction to increase the length of the filament suspended between a first mesh carrier and a second mesh carrier. For example, the filament is moved in the second direction to alter the position of the organ or tissue being supported or suspended, such as by increasing the length of filament between a first mesh carrier and a second mesh carrier and lowering the organ or tissue to a more anatomically correct position.
In another example, the filament is moved in the second direction to create or increase a space between the filament and the organ or tissue to be supported or suspended. For example, in a treatment for urinary incontinence, the filament can be adjusted to leave a space between the filament and the urethra (the organ to be supported). The space exists between the filament and the urethra when the patient is in one position. When the patient moves to another position, such as an upright position, the urethra shifts to occupy the space and is then supported by the filament.
In one embodiment, the filament is manually moved by a practitioner. In another embodiment, the practitioner grips at least a portion of the filament with a medical instrument, such as forceps, to move the filament.
Adjustment of the filament through the aperture in the first direction or in the second direction different than the first direction can be repeated until the desired tension or length of filament is achieved. For example, a practitioner can alternatively move the filament in the first direction to increase tension and move the filament in the second direction to decrease tension until the desired tension is achieved.
In some embodiments, the filament can be trimmed to a preferred length once the desired tension is achieved or once the mesh carrier is disengaged from the elongate member and delivered into bodily tissue.
At 560, the insertion device is withdrawn from the body of the patient.
Although activities of a method of delivering a mesh carrier into bodily tissue have been illustrated and described in one order, each activity is not required for delivery of a mesh carrier into bodily tissue. For example, in some embodiments, the filament can be adjusted in only one direction through the aperture of the mesh carrier. In another example, the filament is not adjusted through the aperture of the mesh carrier at all.
A method for delivering a mesh carrier (and filament or implant) into bodily tissue of a patient can include delivering more than one mesh carrier for securing a filament to bodily tissue. For example, in one embodiment, as illustrated in
Although the “U” shaped implant is achieved when placed within the body through the obturator membrane and into the externus muscle, the “U” shaped implant configuration, however, can also be achieved via a retro-pubic approach by placing the mesh carriers at the locations marked R1 and R2.
When fixing the implant to tissue, an insertion device (for example, insertion device 200, including stylet 230 and mesh carrier 290, as discussed above with respect to
In one embodiment, as shown in
In one embodiment, an insertion device includes an elongate member having a proximal end portion, a distal end portion, and defining a lumen therethrough. The elongate member includes a curved portion between the proximal end portion and the distal end portion. The distal end portion is configured to be removably coupled to a mesh carrier. The proximal end portion includes a handle defining a longitudinal axis. The insertion device also includes a stylet that has a proximal end portion, a distal end portion and is configured to move from a first position to a second position with respect to the elongate member. The stylet is configured to engage the mesh carrier to remove the mesh carrier from the elongate member such that a longitudinal axis defined by the mesh carrier is substantially orthogonal to the longitudinal axis defined by the handle.
In one embodiment, the distal end portion of the stylet is configured to extend outside of the distal end portion of the elongate member when the stylet is in its first position. In another embodiment, the distal end portion of the stylet is configured to contact a proximal end portion of a mesh carrier when the stylet is moved from its second position to its first position.
In one embodiment, a longitudinal axis defined by the proximal end portion of the elongate member is substantially orthogonal to a longitudinal axis defined by the distal end portion of the elongate member. In another embodiment, the curved portion of the elongate member has a radius of curvature of approximately 1.1 inches.
In one embodiment, the lumen of distal end portion of elongate member is configured receive a portion of the mesh carrier and to provide an interference fit with the mesh carrier.
In one embodiment, the elongate member includes stainless steel. In another embodiment, the handle is slidably coupled to the proximal end portion of the elongate member and the handle has at least one groove. The proximal end of the elongate member includes a coupling member that has at least one protrusion configured to engage the at least one groove.
In one embodiment, the insertion device includes a coupling member coupled to the proximal end portion of the elongate member. The coupling portion defines at least one protrusion.
In another embodiment, the insertion device includes a coupling member coupled to the proximal end portion of the elongate member. The coupling member includes a coupling portion extending proximally therefrom. The coupling portion defining at least one protrusion. The handle is configured to engage the at least one protrusion of the coupling portion.
In another embodiment, an insertion device includes an elongate member having a proximal end portion, a distal end portion, and defining a lumen therethrough. An axis defined by the proximal end portion of the elongate member is substantially orthogonal to an axis defined by the distal end portion of the elongate member. The insertion devise also includes a stylet having a proximal end portion and a distal end portion. At least a portion of the stylet is disposed within the lumen of the elongate member. The stylet is slidably coupled to the elongate member such that the stylet is configured to move from a first position to a second position with respect to the elongate member.
In one embodiment, the elongate member includes a curved portion that has a radius of curvature of 1.1 inches.
In another embodiment, the distal end portion of the elongate member is configured to be removably coupled to a mesh carrier. In yet another embodiment, the lumen defined by the elongate member is configured to receive a portion of a mesh carrier and to provide an interference fit with the mesh carrier.
In one embodiment, the stylet is biased to a linear configuration.
In another embodiment, the insertion device also includes a coupling member disposed about the proximal end portion of the elongate member. The coupling member has at least one protrusion. The handle has at least one groove to engage the at least one protrusion of the coupling member.
In one embodiment, the elongate member includes stainless steel.
In one embodiment, the distal end portion of the stylet is configured to pierce a filament received in a mesh carrier when the insertion device is in its first configuration. In another embodiment, the distal end portion of the stylet is configured to decouple a mesh carrier from the elongate member when the stylet is moved from its second position to its first position.
A method of inserting a mesh carrier into a body of a patient includes (1) coupling the mesh carrier to a distal end portion of an elongate member of an insertion device; (2) inserting the insertion device into the body; (3) decoupling the mesh carrier such that a longitudinal axis defined by the mesh carrier is substantially orthogonal to an axis defined by the proximal end portion of the elongate member; and (3) removing the insertion device from the body.
In one embodiment, the coupling of the mesh carrier includes moving the stylet to its first position such that a distal end portion of a stylet extends beyond the distal end portion of the elongate member. In another embodiment, the decoupling of the mesh carrier includes moving the stylet from its first position to a second position. In yet another embodiment, the moving of the stylet to its second position includes moving the stylet in a proximal direction.
In one embodiment, the method includes inserting a filament into an aperture defined by the mesh carrier prior to coupling the mesh carrier to the stylet. In another embodiment, the method includes inserting a filament into an aperture defined by the mesh carrier prior to coupling the mesh carrier to the stylet.
In one embodiment, the decoupling of the mesh carrier includes moving the stylet from its second position to its first position such that the distal end of the stylet contacts a proximal end portion of the mesh carrier. In another embodiment, the moving of the stylet to its first position includes moving the stylet in a distal direction.
In one embodiment, the method includes coupling a second mesh carrier to the distal end portion of the elongate member when the stylet is in its first position and inserting the insertion device into the body of the patient. In another embodiment, the method includes moving the stylet from its second position to its first position to decouple the second mesh carrier at a second location, wherein an orientation of the second mesh carrier is orthogonal to the axis defined by the proximal end of the elongate member, and removing the insertion device from the body.
While various embodiments of the invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. Thus, the breadth and scope of the invention should not be limited by any of the above-described embodiments, but should be defined only in accordance with the following claims and their equivalents. While the invention has been particularly shown and described with reference to specific embodiments thereof, it will be understood that various changes in form and details may be made.
The previous description of the embodiments is provided to enable any person skilled in the art to make or use the invention. While the invention has been particularly shown and described with reference to embodiments thereof, it will be understood by those skilled in art that various changes in form and details may be made. For example, a delivery instrument can include various combinations and sub-combinations of the various embodiments described herein.
This application is a continuation of, and claims priority to, U.S. patent application Ser. No. 15/069,499, filed on Mar. 14, 2016, entitled “INSERTION DEVICE AND METHOD FOR DELIVERY OF A MESH CARRIER”, now U.S. Pat. No. 10,271,937, which, is a continuation of U.S. patent application Ser. No. 13/888,892, filed on May 7, 2013, entitled “INSERTION DEVICE AND METHOD FOR DELIVERY OF A MESH CARRIER”, now U.S. Pat. No. 9,289,204, which claims priority to U.S. patent application Ser. No. 12/549,704, filed on Aug. 28, 2009, entitled “INSERTION DEVICE AND METHOD FOR DELIVERY OF A MESH CARRIER”, now U.S. Pat. No. 8,449,573, which claims priority to U.S. Provisional Patent Application No. 61/120,105, filed on Dec. 5, 2008, entitled “INSERTION DEVICE AND METHOD FOR DELIVERY OF A MESH CARRIER”, the disclosures of which are incorporated by reference herein in their entirety.
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 |
4840185 | Hernandez | Jun 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 |
5059206 | Winters | Oct 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 |
5217486 | Rice 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 |
5433722 | Sharpe et al. | Jul 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 |
5478353 | Yoon | Dec 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, Jr. 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, Jr. 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 |
5830220 | Wan | Nov 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 |
5968078 | Grotz | Oct 1999 | A |
5984933 | Yoon | Nov 1999 | A |
5997554 | Thompson | Dec 1999 | A |
6010447 | Kardjian et al. | 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 |
6066146 | Carroll et al. | May 2000 | A |
6096041 | Gellman et al. | Aug 2000 | A |
6099547 | Gellman et al. | Aug 2000 | A |
6099552 | Adams | Aug 2000 | A |
6110101 | Tihon et al. | Aug 2000 | A |
6117067 | Gil-Vernet | Sep 2000 | A |
6200330 | Benderev et al. | 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 |
6319252 | McDevitt | Nov 2001 | B1 |
6334446 | Beyar | Jan 2002 | B1 |
6382214 | Raz et al. | May 2002 | B1 |
6387041 | Harari 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 et al. | 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 |
7056333 | Walshe | Jun 2006 | B2 |
7377926 | Topper et al. | May 2008 | B2 |
7381212 | Topper et al. | Jun 2008 | B2 |
7387634 | Benderev et al. | Jun 2008 | B2 |
7524281 | Chu et al. | Apr 2009 | B2 |
7527588 | Zaddem et al. | May 2009 | B2 |
8043205 | MacLean | Oct 2011 | B2 |
8192458 | Hart et al. | Jun 2012 | B2 |
8449573 | Michael | May 2013 | B2 |
8591545 | Lunn et al. | Nov 2013 | B2 |
8944990 | Mujwid et al. | Feb 2015 | B2 |
8951185 | Binkowski et al. | Feb 2015 | B2 |
8968334 | Ostrovsky et al. | Mar 2015 | B2 |
9011489 | Ostrovsky et al. | Apr 2015 | B2 |
9028509 | Chu et al. | May 2015 | B2 |
9107659 | MacLean | Aug 2015 | B2 |
9289204 | Chu et al. | Mar 2016 | B2 |
9301750 | Ostrovsky et al. | Apr 2016 | B2 |
9974637 | Chu et al. | May 2018 | B2 |
10271937 | Chu | Apr 2019 | B2 |
10716556 | Elattrache et al. | Jul 2020 | B2 |
10856959 | Chu et al. | Dec 2020 | B2 |
20010018549 | Scetbon | Aug 2001 | A1 |
20010037119 | Schmieding | Nov 2001 | A1 |
20010049467 | Lehe et al. | Dec 2001 | A1 |
20020013608 | Elattrache et al. | Jan 2002 | A1 |
20020028980 | Thierfelder et al. | Mar 2002 | A1 |
20020058959 | Gellman et al. | May 2002 | A1 |
20020072694 | Snitkin et al. | Jun 2002 | A1 |
20020077526 | Kammerer et al. | Jun 2002 | A1 |
20020091373 | Berger | Jul 2002 | A1 |
20020116025 | Haab et al. | Aug 2002 | A1 |
20020120277 | Hauschild et al. | 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 |
20020193830 | Bonutti | 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 |
20030105489 | Eichhorn et al. | Jun 2003 | A1 |
20030120309 | Colleran et al. | 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 et al. | Jan 2004 | A1 |
20040039453 | Anderson et al. | Feb 2004 | A1 |
20040087970 | Chu et al. | May 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 |
20060089524 | Chu | Apr 2006 | A1 |
20060089525 | Mamo et al. | Apr 2006 | A1 |
20060167481 | Baker et al. | Jul 2006 | A1 |
20060173468 | Simmon et al. | Aug 2006 | 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 |
20070015953 | MacLean | Jan 2007 | A1 |
20070016135 | Kanner et al. | Jan 2007 | A1 |
20070038249 | Kolster | Feb 2007 | A1 |
20070112384 | Conlon et al. | 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 |
20100145368 | Chu et al. | Jun 2010 | A1 |
20100268255 | Ostrovsky et al. | Oct 2010 | A1 |
20100324357 | Chu et al. | Dec 2010 | A1 |
20110106108 | Ostrovsky et al. | May 2011 | A1 |
20130253259 | Chu | Sep 2013 | A1 |
20150148820 | Ostrovsky et al. | May 2015 | A1 |
20150238298 | Chu et al. | Aug 2015 | A1 |
20160193025 | Chu | Jul 2016 | A1 |
20180243066 | Chu et al. | Aug 2018 | A1 |
20190229375 | Chu | Jul 2019 | A1 |
Number | Date | Country |
---|---|---|
3223153 | Aug 1983 | DE |
4220283 | Dec 1993 | DE |
4334419 | Apr 1995 | DE |
10103179 | Jul 2001 | DE |
202007015955 | Mar 2009 | DE |
0598976 | Jun 1994 | EP |
0599772 | Jun 1994 | EP |
0686373 | Dec 1995 | EP |
0688056 | Dec 1995 | EP |
0774240 | May 1997 | EP |
0941712 | Sep 1999 | EP |
1025811 | Aug 2000 | EP |
1234544 | Aug 2002 | EP |
2422386 | Nov 1979 | FR |
2001511684 | Aug 2001 | JP |
2004500763 | Jan 2004 | JP |
2005532848 | Nov 2005 | JP |
20060502754 | Jan 2006 | JP |
2006515204 | May 2006 | JP |
2007532174 | Nov 2007 | JP |
2007535335 | Dec 2007 | JP |
2010540020 | Dec 2010 | JP |
2002028312 | Apr 2002 | NO |
503271 | Apr 1996 | SE |
1225547 | Apr 1986 | SU |
1443873 | Dec 1988 | SU |
1990003766 | Apr 1990 | WO |
1996006597 | Mar 1996 | WO |
9606567 | Mar 1996 | WO |
1997013465 | Apr 1997 | WO |
1998031301 | Jul 1998 | WO |
1998034545 | Aug 1998 | WO |
2000074594 | Dec 2000 | WO |
2001006951 | Feb 2001 | WO |
200178609 | Oct 2001 | WO |
2002026108 | Apr 2002 | WO |
2002038079 | May 2002 | WO |
2004012626 | Feb 2004 | WO |
2004112585 | Dec 2004 | WO |
2005122954 | Dec 2005 | WO |
2006108145 | Oct 2006 | WO |
2006108145 | Oct 2006 | WO |
2007016698 | Feb 2007 | WO |
2007098212 | Aug 2007 | WO |
2007149348 | Dec 2007 | WO |
2008020937 | Feb 2008 | WO |
2008087635 | Jul 2008 | WO |
2009038781 | Mar 2009 | WO |
2009140012 | Nov 2009 | WO |
2010065274 | Jun 2010 | WO |
2010065504 | Jun 2010 | WO |
2010121052 | Oct 2010 | WO |
2010121052 | Oct 2010 | WO |
Entry |
---|
“Suture”, retrieved on May 21, 2012 from http://www.thefreedictionary.com/suture, 3 pages. |
Bayer, et al., “A New Approach to Primary Strengthening of Colostomy with Marlex Mesh to Prevent Paracolostomy Hernia”, Dec. 1986, 1 page. |
Delorme, “La Bandelette Trans-Obturatrice: Un Procede Mini-Invasif Pour Traiter l'incontinence Urinaire D'effort De La Femme”, vol. 11, No. 6, 2001, pp. 1306-1313. |
Fianu et al., “Absorbable Polyglactin Mesh for Retropubic Sling Operation in Female Urinary Stress Incontinence”, vol. 16, No. 1, 1983, 1 page. |
Giberti, “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, 1 page. |
Haab, et al., “Feasibility of Outpatient Percutaneous Bladder Neck Suspension Under Local Anesthesia”, vol. 50, No. 4, Oct. 1997, 1 page. |
Kovac, et al., “Pubic Bone Suburethral Stabilization Sling for Recurrent Urinary Incontinence”, Obstetrics & Gynecology, vol. 89, No. 4, Apr. 1997, 1 page. |
Norris, et al., “Use of Synthetic Material in Sling Surgery: A Minimally Invasive Approach”, Journal of Endourology, vol. 10, No. 3, Jun. 1996, 4 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/US2009/040587, dated Oct. 21, 2009, 13 pages. |
International Search Report and Written Opinion for PCT Patent Application No. PCT/US2009/064564, dated Feb. 23, 2010, 13 pages. |
International Preliminary Report on Patentability for PCT Patent Application No. PCT/US2009/064564, dated Jun. 16, 2011, 9 pages. |
International Search Report and Written opinion for PCT Patent Application No. PCT/US2010/031273, dated Dec. 1, 2010, 17 pages. |
Petros, et al., “Ambulatory Surgery for Urinary Incontinence and Vaginal Prolapse”, The Medical Journal of Australia, vol. 161, Jul. 18, 1994, pp. 171-172. |
Petros, et al., “An Integral Theory and Its Method for the Diagnosis and Management of Female Urinary Incontinence”, Scandinavian Journal of Urology and Nephrology, Supplement 153, 1993, 93 pages. |
Petros, “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. |
Petros, “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, “The Intravaginal Slingplasty Operation, a Minimally Invasive Technique for Cure of Urinary Incontinence in the Female”, Australian and New Zealand Journal of Obstetrics and Gynaecology vol. 36, Issue 4, Nov. 1996, pp. 453-461. |
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, “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, “Modified Bladder Neck Suspension for Female Stress Incontinence”, Urology, vol. 17 No. 1, Jan. 1981, pp. 82-85. |
Stamey, “Endoscopic Suspension of the Vesical Neck for Urinary Incontinence in Females”, Annals of Surgery, vol. 192, No. 4, Oct. 1980, pp. 465-471. |
Starney, “Endoscopic Suspension of the Vesical Neck for Urinary Incontinence. Surgery”, Gynecology & Obstetrics, vol. 136, No. 4, 1973, pp. 547-554. |
Staskin, “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, et al., “An Ambulatory Surgical Procedure Under Local Anesthesia for Treatment of Female Urinary Incontinence”, International Urogynecology Journal, vol. 7, No. 2, 1996, pp. 81-86. |
Ulmsten, “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, “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, “The basic understanding and clinical results of tension-free vaginal tape for stress urinary incontinence”, Urologe A., Jul. 2001, pp. 269-273. |
Extended European Search Report for European Application No. 20202729.8, dated Mar. 11, 2021, 11 pages. |
Communication pursuant to Article 94(3) EPC for European Application No. 09764365.4, dated Dec. 5, 2019, 7 pages. |
Extended European Search Report for European Application No. 22205660.8, dated Feb. 17, 2023, 14 pages. |
Number | Date | Country | |
---|---|---|---|
20190229375 A1 | Jul 2019 | US | |
20220200055 A9 | Jun 2022 | US |
Number | Date | Country | |
---|---|---|---|
61120105 | Dec 2008 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15069499 | Mar 2016 | US |
Child | 16369853 | US | |
Parent | 13888892 | May 2013 | US |
Child | 15069499 | US | |
Parent | 12549704 | Aug 2009 | US |
Child | 13888892 | US |