Less traumatic method of delivery of mesh-based devices into human body

Patent metadata

Field	Value
Publication number	US-9504467-B2
Application number	US-97814010-A
Country	US
Kind code	B2
Filing date	Dec 23, 2010
Priority date	Dec 23, 2009
Publication date	Nov 29, 2016
Grant date	Nov 29, 2016

Abstract

In some embodiments, a method includes extending a dilator into a body of a patient in a first direction such that a distal end portion of the dilator extends from the body. The dilator defines a lumen therethrough. At least a portion of the dilator is disposed within the body when the distal end portion extends from the body. At least a portion of an implant is passed through the lumen defined by the dilator. The dilator is removed from the body by moving the dilator in the first direction.

First claim

What is claimed is:

1. A method, comprising:
inserting a needle of a delivery needle into a lumen of a first dilator, wherein, when the needle is inserted into the lumen of the first dilator, a tip of the needle extends outside the lumen from a first opening of the first dilator;
extending the first dilator into a body of a patient via a vaginal incision in a direction until a distal end portion of the first dilator extends from a first supra-pubic incision, the first dilator defining the first opening disposed proximate the distal end portion and a second opening disposed proximate to a proximal end portion of the first dilator, the lumen of the first dilator extending from the first opening to the second opening, at least a portion of the first dilator being disposed within the body when the distal end portion extends from the body, wherein a first suture extends through at least a portion of the lumen of the first dilator, the first suture having a first end portion coupled to an implant;
passing, after the extending, a first portion of the implant through the vaginal incision and then into the lumen defined by the first dilator by pulling on a second end portion of the first suture;
removing the first dilator from the body via the first supra-pubic incision by moving the first dilator in a direction that is the same as the direction used to extend the first dilator into the body of the patient while the portion of the first portion of the implant slides out of the lumen defined by the first dilator and remains in the body, wherein the removing includes removing the needle of the delivery needle from the body of the patient via the vaginal incision and removing the first dilator from the body of the patient via the first supra-pubic incision;
extending a second dilator into the body of the patient via the vaginal incision until a distal end portion of the second dilator extends from a second supra-pubic incision,
wherein a second suture extends through at least a portion of the lumen of the second dilator, the second suture having a first end portion coupled to a second portion of the implant, the first dilator and the second dilator extending into the body of the patient via the same vaginal incision;
passing, after the extending, the second portion of the implant through the vaginal incision and then into the lumen defined by the second dilator.

2. The method of claim 1 , wherein the extending includes pushing the distal end portion of the first dilator through the body.

3. The method of claim 1 , wherein the extending includes pulling the distal end portion of the first dilator through the body.

4. The method of claim 1 , wherein the extending includes extending the first dilator into a portion of the body in a pelvic region of the patient.

5. The method of claim 1 , wherein the extending includes aligning the proximal end portion of the first dilator with a surface of the body such that the proximal end portion is flush with the surface.

6. The method of claim 1 , wherein, during the extending, the distal end portion of the first dilator is configured to contact a portion of the delivery needle.

7. The method of claim 1 , wherein the passing includes pushing the portion of the implant through the lumen of the first dilator in a direction that is the same as the direction used to extend the first dilator into the body of the patient.

8. The method of claim 1 , wherein the passing includes pulling the portion of the implant through the lumen of the first dilator in a direction that is the same as the direction used to extend the first dilator into the body of the patient.

9. The method of claim 1 , wherein the direction used to extend the first dilator into the body of the patient is a distal direction.

10. The method of claim 1 , wherein the proximal end portion of the first dilator includes an enlarged portion in fluid communication with the lumen of the first dilator, the enlarged portion configured to facilitate the passing.

11. A method, comprising:
inserting a needle of a delivery needle into a lumen of a dilator, the delivery needle also including a handle extending the needle, the dilator defining a first opening at a distal end portion of the dilator and a second opening at a proximal end portion of the dilator such that the lumen extends from the first opening to the second opening, wherein, when the needle is inserted into the lumen of the dilator, a tip of the needle extends outside the lumen from the first opening of the dilator;
pushing the needle and the dilator into a body of a patient via a vaginal incision until the distal end portion of the dilator extends from a supra-pubic incision, the distal end portion of the dilator being coupled to a first portion of a suture such that the first portion of the suture is disposed within the body when the distal end portion of the dilator extends from the body via the supra-pubic incision, the suture having a second portion coupled to an end portion of an implant, the distal end portion of the dilator defining an aperture proximate to the first opening, the suture extending through the aperture;
uncoupling the first portion of the suture from the distal end portion of the dilator;
passing, after the extending, at least a portion of the implant through the vaginal incision and then into the lumen defined by the dilator by pulling on the first portion of the suture and moving the suture through the aperture;
removing the needle of the delivery needle from the body of the patient through the vaginal incision; and
removing the dilator from the body of the patient through the supra-pubic incision.

12. The method of claim 11 , further comprising:
coupling the first portion of the suture to the distal end portion of the dilator, the distal end portion of the dilator defining the aperture through which the first portion of the suture is disposed.

13. The method of claim 11 , further comprising:
after the removing, trimming the portion of the implant extending through the bodily tissue such that the suture is detached from the implant.

14. The method of claim 11 , wherein the pushing includes pushing the dilator into a portion of the body in a pelvic region of the patient.

15. The method of claim 11 , wherein the pushing includes pushing the needle and the dilator into the body in a direction towards the supra-pubic incision, and the removing includes removing the dilator from the body via the supra-pubic incision by moving the dilator in a direction substantially the same as the direction used to push the dilator into the body.

16. The method of claim 11 , wherein the pushing includes pushing the dilator into the body and through a portion of an obturator.

Assignees

• Ostrovsky Isaac
• Slanda Jozef
• Li Jianmin
• Palmisano Brent
• Goddard James
• Ostrovsky Daniel
• Boston Scient Scimed Inc

Inventors

• Ostrovsky Isaac
• Slanda Jozef
• Li Jianmin
• Palmisano Brent
• Goddard James
• Ostrovsky Daniel

Classifications

• A61B2017/00805

  Treatment of female stress urinary incontinence · CPC title

• A61F2/0045

  Support slings · CPC title

• A61B17/06109 Primary

  Big needles, either gripped by hand or connectable to a handle · CPC title

• A61B17/0482

  Needle or suture guides (guides for drills, pins or wire A61B17/17; guides for puncturing needles A61B17/3403) · CPC title