CA2094286C - Surgical apparatus and method - Google Patents

Surgical apparatus and method Download PDF

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Publication number
CA2094286C
CA2094286C CA002094286A CA2094286A CA2094286C CA 2094286 C CA2094286 C CA 2094286C CA 002094286 A CA002094286 A CA 002094286A CA 2094286 A CA2094286 A CA 2094286A CA 2094286 C CA2094286 C CA 2094286C
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Prior art keywords
patch
sheath
passageway
prothesis
patient
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CA002094286A
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French (fr)
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CA2094286A1 (en
Inventor
Mark Allen Eberbach
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Cook Inc
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Cook Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0068—Implantable repair or support meshes, e.g. hernia meshes having a special mesh pattern
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0072—Delivery tools therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Transplantation (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)
  • Feeding, Discharge, Calcimining, Fusing, And Gas-Generation Devices (AREA)
  • Saccharide Compounds (AREA)

Abstract

A method and apparatus for use by a surgeon to repair a weakened, deranged portion of the anatomy of a patient compris-ing a sheath (48) having a distal end positionable within a patient and a proximal end positioned exterior thereof for manipula-tion by a surgeon, Ehe sheath being of a Length to extend from exterior of a patient through a laparoscopic opening into a surgical cavity of thepatient; a prothesis (14) movable from interior of the sheath to a location adjacent to the deranged portion to be re-paired; the prokhesis having an elongated passageway located adjacent to the periphery thereof; and art introducer (32) posi-tioned within the sheath and having a distal end coupled to the prothesis, the introducer adapted to effect the movement of the prothesis from intecior of the sheath to exterior thereof and to expand the prothesis to a functionally expanded orientation adja-cent to the part fo be repaired.

Description

SURGICAL APPARATUS AND METHOD
BACKGROUND OF THE INVENTION
Summary of the Invention This invention relates to a surgical apparatus and method and, more particularly, to the repair of hernias with a laparoscopic approach employing patches wherein only the patch remains in the operation site after the operation.
Summary of the Background Art A hernia is one of the most common ailments of mankind. Approximately five percent of the adult male population is affected. Basically, a hernia is a weakness or hole in the abdominal wall through which abdominal contents such as bowels may protrude. Inguinal or groin hernias normally occur at one or more of three locations. The first location is in the weakened wall of inguinal floor of the abdomen in Hesselfbach's triangle.
This type of hernia is called a WO 93/036$5 P~'T/US92/06948 ,., direct hernia. 1~n indirect hernia occurs at the internal ring adjacent to the vas deferens as it exits the abdomen to become part of the spermatic cord. The third is a femoral hernia that occurs adjacent and medial to the femoral blood vessels.
All hernias represent a potentially life threatening condition and once diagnosed they should be repaired unless there is same contraindication.
The surgical repair of an inguinal hernia (ingi:~inal herniorrhaphy) is a common procedure which surgeons often perform on an outpatient basis. It is estimated that 500,000 are performed each year in the United States.
According to the procedure, an anesthetic is first administered to the patient and the surgeon then makes a large incision, about 6 inches, in the patient just above the inguinal ligament. Supporting abdominal muscles and fascia are dissected to reveal the hernia sac. The herniated contents protruding through the opening in the abdominal wall are returned to the abdomen. Thereafter, the surge~n closes the hernia sac. The local tissues are then sutured together from opposite sides of the weakened tissue, hole or hernia. The stretched or otherwise weakened tissue may be cut away. Where appropriate, a patch of artificial Z
sussr~ru~-~ s~~~ a W'O 93/03685 PC.'T/L'S92/U69~8 ,~ ~i ~f '~ '~ ': -t~' material may be sutured to the normal 'tissue to replace the stretched or otherwise weakened tissue or to reenforce over the outside or inside of the repair. The incision is then closed over the repair. Recovery time necessa=°y prior to heavy lifting or strenuous labor is usually s;ix to eight weeks and recurrence rates may approach twenty percent.
Another more difficult approach which is less common, but more physiological, is to make an incision in the abdomen superior or cephalad to the hernia. The surgeon cuts through the abdominal wall to tlae last layer (the peritoneumj. Dissection continues in this preperitoneal approach and exposes the hernia defect from the inside.
Again direct suture repair or patch repair may be perfarmed.
The recurrence rates are low with an inside patch repair because increased intra-abdominal pressure only serves to force the patch more firmly iwto place to plug the Bole similar to a drain plug in~a bathtub.
Although common, the standard operational procedures for regain of a hernia is undesirably leh.gthy and, consequently, costly, requires a large incision with the eaccessive dissection of normal tissue, causes excessive pain and discomfort to the patient, involves unacceptably long S STATE ~H~~T

WO 93/03685 PCT/U~92/06918 v1 l?, '1 tl a .
recovery and work disability time, and results in an unacceptably high recurrence rate.
Accordingly, it is an object of the present invention to provide a method and apparatus for use by a surgeon to repair a weakened, deranged portion of the anatomy of a patient comprising a sheath having a distal e:nd positionable within a patient and a proximal end positioned exterior thereof for manipulation by a surgeon, the sheath being of a length to extend from exterior of a patient through a laparoscopic opening into a surgical cavity of the patient;
a prothesis movable from interior of the sheath to a location adjacent to the deranged portion to be repaired, the prothesis having an, elongated passageway located adjacent to the periphery thereof; and an introducer positioned within the sheath and having a distal end coupled to the prothesis, the introducer adapted to effect the movement o~ the prothesis from interior of the sheath to exterior thereof and to expand the pr~thesis ~to.a functional2y expanded orientation adjacent to the part to be repaired.
It is a further object of the present invention to employ laparoscopic techniques for the repair of hernias S~~ST(TUTE ~~iEET

WO 93/03685 PCT/US92/Ob948 -a n r tV ~l '~
thereby reducing the length ofwthe incision along with the unnecessary dissection of normal tissue.
It is a further abject of the present invention to utilize a new laparoscopic approach via the preperitoneal space in addition to the intraabdominal space.
It is a further object of the present invention to minimize the time and cost of hernia operations.
Tt is a further object of the present invention to xainimize a patient's pain and discomfort associated with a hernia operation.
It is a further object of the present invention to shorten the recovery time normally attendant with a hernia operation.
It is a further object of the present invention to reduce or preclude the recurrence of hernias.
It is a further object of the present invention to provide a delivery system for prosthetic materials.
Further objects of the present invention are to internally patch and restore stretched or weaJcened eras of an abdominal wall or overt hernia defects and to simultaneously patch all primary and secondary abdominal areas which are predisposed to hernias.
~C~~ST~~JT~ ~N~~°

!~O 93/03b~5 PCT/US92/06948 r~ :, Lastly, it is an object of the present invention to utilize a patch for the repair of a hernia wherein the patch only remains in the repaired area after laparoscopic surgery.
The foregoing has outlined some of the more pertinent objects of the invention. These objects should be construed to be merely illustrative of some of the more prominent features and applications of the intended invention. I~iany other beneficial results can be obtained by applying the disclosed invention in a different manner or modifying the invention within the scope of the disclosure. Accordingly, other objects and a fuller understanding of the invention and the detailed description of the preferred embodiment in addition to the scope of the invention defined by the claims taken in conjunction with the accompanying drawings. v SUM~ZAR3.' OF THE INVENTION
The invention is defined by the appended claasus with specific embodiments shown on bhe attached drawings. For.
the purpose of summarizing this invention, the invention may be incorporated into an improved laparoscopic apparatus for the repair of abdominal hernias by a surgeon through the patching of weakened portions of the abdominal part to be repaired comprising a patch posit:i.onable adjacent to tha SU~ST~~'UTE SHEE s WO 93/03685 PCT/US9~/~6948 6'~r , f ~ ~ l 1 weakened portions of the abdominal part to be repaired, the patch having an elongated passageway located adjacent to the majority of the periphery of the patch, the passageway having an opening at one end thereof; an elongated interior ribbon having a distal end positioned through the opening of the passageway and slidable within the passageway; an elongated intermediate cylindrical plunger having an interior slidably receiving the ribbon, the plunger having a distal end coupled to the patch and a proximal end to be manipulated by the surgeon; and an elongated exter:i.or cylindrical sheath having an interior slidably reoe3.ving the plunger, the ribbon and the patch, the sheath having a distal end adjacent to the distal ends of the patch and a proximal end to be manipulated by the surgeon, the sheath being of a length to extend from'exterior of a patient through a laparoscopic port into a surgical cavity which includes the part to be repaired.
The invention may also be incorporated into apparatus for use by a surgeon to repair a weakened, deranged portion of the anatomy of a patient comprising a sheath having a distal end positionable within a patient and a proximal end positioned exterior thexeof for manipulation by a surgeon, the sheath being of a length to extend from exterior of a SUBSTITtjTE SH~~T

!V0 93/0368 PCT/US92/06948 ;:
patient through a laparoscopic opening into a surgical cavity of the patient; a prothesis movable from interior of the sheath to a location adjacent to the deranged portion to be repaired, the prothesis having an elongated passageway located adjacent to the periphery thereof; and an introducer positioned within the sheath and having a distal end coupled , to the prothesis, the introducer adapted to ef:Eect the movement of the prothesis from interior of the sheath to exterior thereof and to expand the prothesis to a functionally expanded orientation adjacent to the part to be repaired.
The prothesis is a patch. The introducer includes an elongated interior ribbon having a distal end positioned through an opening in a passageway of the patch and slidable within the passageway, the introducer also including an elongated intermediate cylindrical plunger having an interior slidably receiving the ribbon, the plunger having a distal end coupled to the patch and a proximal end to be manipulated by a surgeon. The r5.bbon is slidably reanovable from the patch.
Lastly, the invention may be incorporated into a method for the laparoscopic repair of abdominal hernias by a surgeon through the patching of weakened portions of the vJa~T~ 1 ~~E 5~~~ i ~'O 93/03685 PCT/US92/06948 t~~
abdominal part to be repaired comgrising the steps oy providing a patch positionable adjacent to the weakened portions of the abdominal part to be repaired, the patch having an elongated passageway located adjacent to the majority of the periphery of the patch, the passageway having an opening at one end thereof; providing an elongated interior ribbon having a distal end positioned through the opening of the passageway and slidable within the passageway; providing an elongated intermediate cylindrical plunger having an interior slidably receiving the ribbon, the plunger having a distal end coupled to the patch and a groximal end to be manipulated by the surgeon; providing an elongated exterior cylindrical ,sheath having an interior slidably receiving the plunger, the ribbon and the patch, the sheath having a distal end adjacent to the distal ends of the patch and a proximal end to be manipulated by the surgeon, the sheath being of a length to extend from exterior of a patient through a laparoscopic post into a surgical cavity which includes the part to be repaired;
positioning the patch and the distal ends of the ribbon, plunger and sheath into a.patient adjacent to the area to be repaired; advancing the patch and plunger from the sheath;
advancing the ribbon into the passageway of the patch to ~~~5 T 1TUTE ~H~~T

WO 93/03685 PC d /US92/069~8 ., '~~f,~~~~'I~9 ,.~, :.i ~
expand the patch; coupling the patch to the area to be repaired; withdrawing the ribbon from the patch; separating the patch from the sheath; and withdrawing the ribbon, plunger and sheath from the patient.
The foregoing has outlined rather broadly the more pertinent and important features of the present invention in order that the detailed description of the invention that follows may be better understood so that the present contribution to the art can be more fully appreciated.
Additional features of the invention will be described hereinafter which form the subject of the claims of the invention. It should be appreciated by those skilled in the art that the conception and the~specific embodiments disclosed may be readily utilized as a basis for modifya.ng ' or designing other methods and structures for carrying out the same purposes of the present invention. It should also be realized by those skilled in the art that such equivalent methods and structures do not depart from the spirit and scope of the invention,as set forth in the appended claims.
BRIEF DESCRI~'TION OF TITE D~2AWINGS
For a fuller understanding o:E the nature and objects of the invention, reference should be made to the following S~r~SSTITUTE SHEET

r~
~ii~ ~~'~~,~, N i~
detailed description taken in connection with the accompanying drawings in which:
Figure 1 shows a portion of the abdominal wall from the inside where hernias normally occur and also :illustrating therein a patch for their repair and the precluding of further hernias.
Figure 2 is a perspective view of a patch constructed in accordance with the principles of the present invention similar to that shown in Figure 1, illustrated in association with the patch is an introduces functioning as a delivery assembly and system for the patch.
Figure 3 is a sectional view of a portion of the patch and delivery system which is shown in Figure 2>
Figure 4 is a sectional view of the delivery system of Figure 2 but showing the patch in the sheath prior to deployment.
Figure 5 is a perspective illustration of the patch of the apparatus of the grior Figures and with parts broken away to show certain internal constructions thereof.
similar reference characters refer to similar parts throughout the several views of the drawings.

SI~BSTiT~.'T~ 5~~~~' WO 93/03685 ~ ~ ~, Pf'T/LS9?/06948 v.1 ~ 9 ..
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
Overview Shown in Figure 1 is that po.~tion of the abdomen where hernias normally occur. Whether through old ae;e, accident, personal abuse, congenital problems, or the lib;e, the inguinal floor of the abdomen known as Hesselbach's triangle may become weakened to the point whereby inner abdominal contents such as a bowel may protrude. When the organ extending therethrough is a portion of the bowel, serious illness or even death may occur. This is a direct inguinal hernia. There are two other common types of groin hernias.
These occur adjacent to either the vas deferens (indirect) or the femoral vessels (femoral hernia). When either the internal inguinal ring through which the vas deferens passes or the abdominal wall adjacent to the femoral vessels' becomes enlarged, an opening is created through which abdominal contents such as intestines may protrude thereby constituting a hernia. In the past, surgeons operated upon the hernia area either from above (preperitoneal) or below (anterior) with large incisions which lead to great disability.
The present invention includes an introducer 10 with a prothesis which in the preferred embodiment is a patch 14, S~~ST~TI!T'~ ~~~~i W~ 93/03685 PCT/US9Z/06948 l~ L(~~'f with the patch designed to cover all three areas where groin hernias normally occur and accomplishes a more physiological repair. with a smaller incision utilizing laparoscopic technique by use of a specifically designed introduces and patch and preperitoneal approach presently not used. The prothesis is also adapted to be used on other deranged areas of a patient where repair is needed.
The patch 14 is a preferably fabricated of a mono-.filament thread which is woven, 3cnitted otherwise formed into a fabric which is then cut to a shape. It has a main central portion 16 to cover the inguinal floor area where direct groin hernias normally occur. The shape is generally in the shape of a trapezoid with a major axis and a minor axis.
Extending outwardly from one edge are three asymmetrical portions, formed as three fingers 18, 20 and 22 with the central finger being smaller than the other two.
Formed between the fingers age spaced concave recesses, sized and positioned to be placed in close proximity to the vas deferens and or the femoral vessels. Those portions of the patch located adjacent to the recesses are thus adapted to cover those areas of the abdomen where indirect and femoral hernias a~ormally occur. At the same time, the St~~~~ITUTF 5~~~~°

WO 93/0368 PCT/L'S92f06948 ,J ,rsj,;~'C.i central portion of the patch is adapted to cover the area of the inguinal floor where direct hernias normally occur.
The threads from which the patch is fabricated are of a surgically clean material which is durable, flexible, essentially inextensible and resistant to corrosion from bodily fluids. By way of example, one acceptable material is polypropylene such as Marlex mesh. Marlex is a trademark of the Johnson & Johnson Company of Sommerville N.J. .
Further, by way of example, one acceptable material thread is Nylon polymer. Nylon is a registered trademark of the E.I. DuPont deNemours Company of ~lilmington, Delaware.
Foamed into the patch is an ellipse shaped passageway 30 for receiving the far or distal end of an interior ribbon 32. Tn the passageway, the ribbon forms a generally ellipse shaped loop which constitutes the distal part of the patch delivery assembly or introdueer 10. The passagewag is shorn in the preferred embodiment as a supplemental piece of patch material of a tubular fabric generally attached to the patch in the shape of an ellipse. The supplemental piece is preferably a tube coupled to the patch by stitches 34, or by glue or the like or may be fabricated in continuity in the patch. The coupling is at a location adjacent to the periphery of the patch and the periphery of the supplemental S~STITUTE S~CET

WO 93/03b85 P~'T/US92/06948 ,: ~.. ;;
'nlV il r~/~5,~
piece except at one end through which the ribbon extends.
The ribbon preferably has a flat cross sectional configuration to promote its handling. Specifically, the longer flat face of the ribbon always extends parallel with the axis of the loop which it forms. Stability of the loop shape is enhanced which allows rotation of ~t.he ribbon during operation and use while maintaining such loop shape.
When distended, the loop 32 is in the form of an ellipse which has a major axis and a minor axis coextensive with the major axis and minor axis of the patch. :Cn the alternative, the loop and its passageway may take ane of 'the many other forms such as that of a teardrop, circle, oval or the like. Other smoothly shaped, curved configurations could be utilized. The periphery of the patch is at varying distances from the passageway and loop. fence the peripheral portions of the patch may not necessarily immediately reach all the areas of direct as well as indirect hernias. Consequently, conventional laparoscopic techniques may be necessary by 'the surgeon to provide final positioning of the patch after initial expansion of the loop.
Located within the passageway is the loop of the ribbon 32, constructed of surgically antiseptic material and shaped S~T1TUTE ~H~ET

'WO 93/03b85 IPtT/1J592/06948 ;y ';'~3 a .,,~ (~ c.,:
>S~ ; J ..J ,..
in a smoothly curved configuration such as an ellipse when expanded and canstrained by the passageway. The ribbon 32 is of a size and configuration to be received within the passageway of the patch 14. The loop exits at the distal end 38 of the intermediate plunger 42. As shown in the Figures, the loop of the ribbon holds the xuajority of the ' patch in an extended orientation for initial placement adjacent to the abdominal wall over the hernia to be repaired. The distal end of the ribbon is of a bullet shape, generally hemispherical, so as to facilitate smooth movement within the passageway. In the alternative, the endmost part of the ribbon could be simply bent inwardly toward the center of the patch to effect the same result.
The near or proximal end of the loop is a ribbon extension of the Loop which, like the Ioop, is flexible, but sufficiently rigid to function in association with the plunger 42 so that a surgeon may remotely push, pull, or rotate the loop and, consequently, the patch, during an operation. The plunger ~2 is a hollow cylinder through the ribban passes. The introducer 10 includes the plunger 42 and a cylindrical exterior sheath 48.
The proximal end of the patch Z4 includes an extension of the tubular component, the passageway 30, attaching to SU~STITUTF SHEFT

Wp 93/~3b85 P~.'T/US92/06948 x~~~,A~~ ~a the distal end of the plunger so that the ribbon is at all time enclosed by the passageway. Coupling is preferably through a C-shaped spring clamp 52 installed at fabrication in a circular recess 54 on the plungFr. Other coupling techniques include thread, glue, tape, or the like.
Further, the attached tubular component could be coupled to the interior or end of the plunger. This coupling of patch and plunger assists the surgeon in the proper positioning of the patch on the area to be repaired.
The patch 14 as well as its supporting ribbon 32 and plunger and sheath are preferably prepackaged together as the delivery assembly 10, prior to use by insertion through a sleeve, channel or part which is conventionally placed in a patient by a trochar. The entire delivery assembly 10 is easily seen in Figures 3 and 4, sectional views.
In operation and use, the introducer 10, patch, sheath, plunger and ribbon, is inserted through the channel in the patient with its distal end adjacent to the area of the abdominal wall to be patched. The patch 14 are pre-positioned with in the sheath 48 as shown in Figure 4.
The introduces 10 then is moved forwardly by the surgeon waving the introduces with respect to the channel. The ribbon, laop and patch move with the introduces when Sl~~~ T ~ T UT~ S~F~T

1~V~ 93/03b8~ PC.'f/US92/~1G948 :~ U
relative movement occurs between the channel and introduces.
The plunger is then moved forward from the sheath by either pushing the plunger forwardly with respect to the sheath or withdrawing the sheath with respect to the plunger. With the patch disposed out of the sheath, the ribbon is advanced with respect to the plunger to effect the positioning and orientation of the patch.
The passageway may be formed of a material which is ignpervious to the flow of air therethrough. In such embodiment, the expansion of the patch when exterior of the plunger is effected by a flow of air into the passageway o:E
the patch prior to final positioning and attaching of the patch to the area to be repaired.
Using a secand laparoscopic opening, the surgeon will position the edges of the patch into final position.
Staples, sutures or clips are employed to secure the patch in its final position. The ribbon is then withdrawn from the passageway into the plunger. Thereafter, the passageway of the patch is cut adjacent to the distal end of the plunger to effect removal of the plunger and,ribbon from the patient.
~tar~Cings in a grid pattern are preferably formed on the patch to ensure proper positioning and attachment to the is J~~T6TUT~ SHEET

1~~10 93/03b85 PCT/tJS92/06948 ~J pi ~,~ ,~ S~ ~J
patient. Additional markings are also preferably formed on the sleeve and ribbon to indicate the linear and rotational orientation of the sleeve and, hence, the patch. To that extent an axial marking on the sleeve extends proximally from the distal end to a location for indicat:Lng the proximal end of the patch. Any one or more or alternate markings could be utilized for these purposes. Such markings could be visually observable.
the present disclosure includes that contained in the appended claims, as well as that of the foregoing description.. Although this invention has been described in its rareferred form with a certain degree of particularity, it is understood that the present disclosure of the preferred form has bean made only by way of example and that numerous changes in the details of construction and the combination and arrangement of parts may be resorted to without departing from the spirit and scope of the invention.
Now that the invention has been described, SI~ESTiTUTE SHcET

Claims (5)

CLAIMS:
1. Laparoscopic apparatus for the repair of abdominal hernias by a surgeon through the patching of weakened portions of the abdominal part to be repaired comprising:
a patch formed of a flexible material positionable substantially in a plane adjacent to the weakened portions of the abdominal part to be repaired, the patch having an elongated passageway located in the plane of the patch adjacent to the majority of the periphery of the patch, the passageway having an opening at one end thereof;
an elongated interior ribbon having a distal end positioned through the opening of the passageway and freely slidable forwardly and rearwardly within the passageway, the ribbon being sufficiently rigid whereby it may be remotely pushed into the passageway;
an elongated intermediate cylindrical plunger having an interior slidably receiving the ribbon, the plunger having a distal end coupled to the patch and a proximal end to be manipulated by the surgeon; and an elongated exterior cylindrical sheath having an interior slidably receiving the plunger, the ribbon and the patch, the sheath having a distal end adjacent to the patch and a proximal end to be manipulated by the surgeon, the sheath being of a length to extend from exterior of a patient through a laparoscopic port into a surgical cavity which includes the part to be repaired.
2. Apparatus for use by a surgeon to repair a weakened, deranged portion of the anatomy of a patient comprising:
a sheath having a distal end positionable within a patient and a proximal end positioned exterior of the patient for manipulation by a surgeon, the sheath being of a length to extend from exterior of a patient through a laparoscopic opening into a surgical cavity of the patient;
a prothesis formed of flexible, essentially inextensible material movable from interior of the sheath to a generally planar orientation at a location adjacent to the deranged portion to be repaired, the prothesis having an elongated passageway located in the plane of the prothesis adjacent to the periphery thereof; and an introducer positioned within the sheath and having a distal end coupled to the prothesis, the introducer adapted to effect the movement of the prothesis from interior of the sheath to exterior thereof, said introducer including means therein, to expand the prothesis to a functionally expanded planar orientation adjacent to the portion to be repaired.
3. The apparatus as set forth in claim 2 wherein the prothesis is a patch.
4. The apparatus as set forth in claim 3 wherein the introducer means includes an elongated interior member having a distal end positioned through an opening in the passageway of the patch and freely slidable within the passageway, the interior member being sufficiently rigid whereby it may be remotely pushed into the passageway, the introducer also including an elongated intermediate cylindrical plunger having an interior slidably receiving the interior member, the plunger having a distal end coupled to the patch and a proximal end to be manipulated by a surgeon.
5. The apparatus as set forth in claim 4 wherein the interior member is a ribbon slidably removable from the patch.
CA002094286A 1991-08-19 1992-08-18 Surgical apparatus and method Expired - Lifetime CA2094286C (en)

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US746,707 1991-08-19
US07/746,707 US5122155A (en) 1990-10-11 1991-08-19 Hernia repair apparatus and method of use
PCT/US1992/006948 WO1993003685A1 (en) 1991-08-19 1992-08-18 Surgical apparatus and method

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JP (1) JP3313112B2 (en)
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AU (1) AU651493B2 (en)
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Families Citing this family (225)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5441508A (en) * 1989-04-27 1995-08-15 Gazielly; Dominique Reinforcement and supporting device for the rotator cuff of a shoulder joint of a person
US5141515A (en) * 1990-10-11 1992-08-25 Eberbach Mark A Apparatus and methods for repairing hernias
US5254133A (en) * 1991-04-24 1993-10-19 Seid Arnold S Surgical implantation device and related method of use
US5716327A (en) * 1991-05-29 1998-02-10 Origin Medsystems, Inc. Body wall retraction system for wide cavity retraction
US5803901A (en) * 1991-05-29 1998-09-08 Origin Medsystems, Inc. Inflatable devices for separating layers of tissue and methods of using
US5728119A (en) * 1991-05-29 1998-03-17 Origin Medsystems, Inc. Method and inflatable chamber apparatus for separating layers of tissue
US5468248A (en) * 1991-05-29 1995-11-21 Origin Medsystems, Inc. Endoscopic inflatable retraction devices for separating layers of tissue
US5704372A (en) * 1991-05-29 1998-01-06 Origin Medsystems, Inc. Endoscopic inflatable retraction devices for separating layers of tissue, and methods of using
US5501653A (en) * 1991-05-29 1996-03-26 Origin Medsystems, Inc. Abdominal wall lifting retractor with hinged cross-member
US7744617B2 (en) * 1991-05-29 2010-06-29 Covidien Ag Method and inflatable chamber apparatus for separating layers of tissue
US5836871A (en) * 1991-05-29 1998-11-17 Origin Medsystems, Inc. Method for lifting a body wall using an inflatable lifting apparatus
US6361543B1 (en) 1991-05-29 2002-03-26 Sherwood Services Ag Inflatable devices for separating layers of tissue, and methods of using
US5779728A (en) * 1991-05-29 1998-07-14 Origin Medsystems, Inc. Method and inflatable chamber apparatus for separating layers of tissue
US5632761A (en) * 1991-05-29 1997-05-27 Origin Medsystems, Inc. Inflatable devices for separating layers of tissue, and methods of using
US5361752A (en) * 1991-05-29 1994-11-08 Origin Medsystems, Inc. Retraction apparatus and methods for endoscopic surgery
CA2075080A1 (en) * 1991-08-02 1993-02-03 Ralph A. Dematteis Method and apparatus for laparoscopic repair of hernias
US5290217A (en) * 1991-10-10 1994-03-01 Earl K. Sipes Method and apparatus for hernia repair
US5258000A (en) * 1991-11-25 1993-11-02 Cook Incorporated Tissue aperture repair device
US5333624A (en) * 1992-02-24 1994-08-02 United States Surgical Corporation Surgical attaching apparatus
CA2090000A1 (en) * 1992-02-24 1993-08-25 H. Jonathan Tovey Articulating mesh deployment apparatus
CA2089999A1 (en) * 1992-02-24 1993-08-25 H. Jonathan Tovey Resilient arm mesh deployer
US5263969A (en) * 1992-04-17 1993-11-23 Phillips Edward H Tool for the laparoscopic introduction of a mesh prosthesis
WO1994027535A1 (en) * 1992-05-20 1994-12-08 C.R. Bard, Inc. Implantable prosthesis and method and apparatus for loading and delivering an implantable prosthesis
US5766246A (en) * 1992-05-20 1998-06-16 C. R. Bard, Inc. Implantable prosthesis and method and apparatus for loading and delivering an implantable prothesis
US6312442B1 (en) * 1992-06-02 2001-11-06 General Surgical Innovations, Inc. Method for developing an anatomic space for laparoscopic hernia repair
US6540764B1 (en) 1992-06-02 2003-04-01 General Surgical Innovations, Inc. Apparatus and method for dissecting tissue layers
US5540711A (en) * 1992-06-02 1996-07-30 General Surgical Innovations, Inc. Apparatus and method for developing an anatomic space for laparoscopic procedures with laparoscopic visualization
US6364892B1 (en) 1992-06-02 2002-04-02 General Surgical Innovations, Inc. Ballon dissector with improved visualization
US5607443A (en) * 1992-06-02 1997-03-04 General Surgical Innovations, Inc. Expansible tunneling apparatus for creating an anatomic working space with laparoscopic observation
US6432121B1 (en) 1992-06-02 2002-08-13 General Surgical Innovations, Inc. Apparatus and method for guiding placement of a minimally invasive surgical instrument
US6565589B1 (en) 1992-06-02 2003-05-20 General Surgical Innovations, Inc. Balloon device for use in surgery and method of use
US5304187A (en) * 1992-06-30 1994-04-19 United States Surgical Corporation Surgical element deployment apparatus
US5379754A (en) * 1992-07-30 1995-01-10 United States Surgical Corporation Method using approximating apparatus for hernia repair
US5356432B1 (en) * 1993-02-05 1997-02-04 Bard Inc C R Implantable mesh prosthesis and method for repairing muscle or tissue wall defects
US5368602A (en) * 1993-02-11 1994-11-29 De La Torre; Roger A. Surgical mesh with semi-rigid border members
US5370109A (en) * 1993-02-19 1994-12-06 United States Surgical Corporation Deformable endoscopic surgical retractor
US5450842A (en) * 1993-02-19 1995-09-19 United States Surgical Corporation Endoscopic surgical retractor
US5354292A (en) * 1993-03-02 1994-10-11 Braeuer Harry L Surgical mesh introduce with bone screw applicator for the repair of an inguinal hernia
US5445140A (en) * 1993-06-07 1995-08-29 United States Surgical Corporation Endoscopic surgical device
US5397332A (en) * 1993-09-02 1995-03-14 Ethicon, Inc. Surgical mesh applicator
SE506164C2 (en) * 1995-10-09 1997-11-17 Medscand Medical Ab Instruments for the treatment of urinary incontinence in women
US5769864A (en) * 1994-09-29 1998-06-23 Surgical Sense, Inc. Hernia mesh patch
US5916225A (en) * 1994-09-29 1999-06-29 Surgical Sense, Inc. Hernia mesh patch
US6171318B1 (en) 1994-09-29 2001-01-09 Bard Asdi Inc. Hernia mesh patch with stiffening layer
US6290708B1 (en) 1994-09-29 2001-09-18 Bard Asdi Inc. Hernia mesh patch with seal stiffener
US6174320B1 (en) 1994-09-29 2001-01-16 Bard Asdi Inc. Hernia mesh patch with slit
US6280453B1 (en) 1994-09-29 2001-08-28 Bard Asdi Inc. Hernia mesh patch with stiffener line segment
US6176863B1 (en) 1994-09-29 2001-01-23 Bard Asdi Inc. Hernia mesh patch with I-shaped filament
US5634931A (en) * 1994-09-29 1997-06-03 Surgical Sense, Inc. Hernia mesh patches and methods of their use
US5653726A (en) * 1994-11-03 1997-08-05 Archimedes Surgical, Inc. Retrograde dissector and method for facilitating a TRAM flap
US5681341A (en) * 1995-03-14 1997-10-28 Origin Medsystems, Inc. Flexible lifting apparatus
US5810846A (en) * 1995-08-03 1998-09-22 United States Surgical Corporation Vascular hole closure
DE19535993C1 (en) * 1995-09-27 1997-05-15 Fraunhofer Ges Forschung Widening device for surgical purposes
WO1997035533A1 (en) 1996-03-25 1997-10-02 Enrico Nicolo Surgical mesh prosthetic material and methods of use
US5716409A (en) * 1996-10-16 1998-02-10 Debbas; Elie Reinforcement sheet for use in surgical repair
AU6171798A (en) 1997-02-13 1998-09-08 Boston Scientific Ireland Limited, Barbados Head Office Method and apparatus for minimally invasive pelvic surgery
JP2001511685A (en) * 1997-02-13 2001-08-14 ボストン サイエンティフィック リミテッド Stabilized sling for use in minimally invasive pelvic surgery
US6015421A (en) * 1997-05-15 2000-01-18 General Surgical Innovations, Inc. Apparatus and method for developing an anatomic space for laparoscopic procedures
US6042592A (en) 1997-08-04 2000-03-28 Meadox Medicals, Inc. Thin soft tissue support mesh
FR2767671B1 (en) 1997-08-27 1999-11-26 Ethnor PROSTHETIC SHUTTER DEVICE FOR SHUTTERING HERNARY CHANNELS
FR2767672B1 (en) * 1997-08-27 1999-11-26 Ethnor PROSTHESES FOR SEALING HERNIA CANALS
US6241768B1 (en) 1997-08-27 2001-06-05 Ethicon, Inc. Prosthetic device for the repair of a hernia
US6080168A (en) * 1997-08-28 2000-06-27 Levin; John M. Compression pad for laparoscopic/thorascopic surgery
CA2304296C (en) 1997-10-01 2005-02-15 Boston Scientific Limited Pelvic floor reconstruction
KR100430099B1 (en) * 1999-03-02 2004-05-03 엘지.필립스 엘시디 주식회사 Shift Register Circuit
US6258124B1 (en) 1999-05-10 2001-07-10 C. R. Bard, Inc. Prosthetic repair fabric
US20060247665A1 (en) * 1999-05-28 2006-11-02 Ferree Bret A Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft
US7273497B2 (en) * 1999-05-28 2007-09-25 Anova Corp. Methods for treating a defect in the annulus fibrosis
US20070038231A1 (en) * 1999-05-28 2007-02-15 Ferree Bret A Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft
US6497650B1 (en) 1999-07-28 2002-12-24 C. R. Bard, Inc. Hernia prosthesis
WO2004100841A1 (en) 1999-08-18 2004-11-25 Intrinsic Therapeutics, Inc. Devices and method for augmenting a vertebral disc nucleus
US7717961B2 (en) 1999-08-18 2010-05-18 Intrinsic Therapeutics, Inc. Apparatus delivery in an intervertebral disc
US7553329B2 (en) 1999-08-18 2009-06-30 Intrinsic Therapeutics, Inc. Stabilized intervertebral disc barrier
US7220281B2 (en) * 1999-08-18 2007-05-22 Intrinsic Therapeutics, Inc. Implant for reinforcing and annulus fibrosis
US7998213B2 (en) 1999-08-18 2011-08-16 Intrinsic Therapeutics, Inc. Intervertebral disc herniation repair
US8323341B2 (en) 2007-09-07 2012-12-04 Intrinsic Therapeutics, Inc. Impaction grafting for vertebral fusion
US7972337B2 (en) 2005-12-28 2011-07-05 Intrinsic Therapeutics, Inc. Devices and methods for bone anchoring
US6425919B1 (en) 1999-08-18 2002-07-30 Intrinsic Orthopedics, Inc. Devices and methods of vertebral disc augmentation
CA2425951C (en) 1999-08-18 2008-09-16 Intrinsic Therapeutics, Inc. Devices and method for nucleus pulposus augmentation and retention
US7507243B2 (en) 1999-08-18 2009-03-24 Gregory Lambrecht Devices and method for augmenting a vertebral disc
WO2009033100A1 (en) 2007-09-07 2009-03-12 Intrinsic Therapeutics, Inc. Bone anchoring systems
US6592602B1 (en) 1999-10-08 2003-07-15 General Surgical Innovations, Inc. Balloon dissection apparatus
US7935147B2 (en) 1999-10-20 2011-05-03 Anulex Technologies, Inc. Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus
US8632590B2 (en) 1999-10-20 2014-01-21 Anulex Technologies, Inc. Apparatus and methods for the treatment of the intervertebral disc
US7615076B2 (en) 1999-10-20 2009-11-10 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US7951201B2 (en) 1999-10-20 2011-05-31 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US8128698B2 (en) 1999-10-20 2012-03-06 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
US6592625B2 (en) 1999-10-20 2003-07-15 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and spinal disc annulus stent
US7004970B2 (en) 1999-10-20 2006-02-28 Anulex Technologies, Inc. Methods and devices for spinal disc annulus reconstruction and repair
US7052516B2 (en) 1999-10-20 2006-05-30 Anulex Technologies, Inc. Spinal disc annulus reconstruction method and deformable spinal disc annulus stent
US6383511B1 (en) * 1999-10-25 2002-05-07 Epicept Corporation Local prevention or amelioration of pain from surgically closed wounds
US6425924B1 (en) 2000-03-31 2002-07-30 Ethicon, Inc. Hernia repair prosthesis
US6805695B2 (en) 2000-04-04 2004-10-19 Spinalabs, Llc Devices and methods for annular repair of intervertebral discs
US6425856B1 (en) 2000-05-10 2002-07-30 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
US7404819B1 (en) 2000-09-14 2008-07-29 C.R. Bard, Inc. Implantable prosthesis
US6296607B1 (en) * 2000-10-20 2001-10-02 Praxis, Llc. In situ bulking device
AU2002217880A1 (en) 2000-11-15 2002-05-27 Scimed Life Systems, Inc. Device and method for treating female urinary incontinence
US6755779B2 (en) 2000-12-01 2004-06-29 Acorn Cardiovascular, Inc. Apparatus and method for delivery of cardiac constraint jacket
JP2004515306A (en) * 2000-12-16 2004-05-27 トーディ コーネル Implant, reinforcement element introduction procedure and implant manufacturing process
US20040049289A1 (en) * 2000-12-16 2004-03-11 Kornel Tordy Implant, method for inserting a reinforcing element, and method for producing an implant
US8033983B2 (en) 2001-03-09 2011-10-11 Boston Scientific Scimed, Inc. Medical implant
US6991597B2 (en) * 2001-03-09 2006-01-31 Boston Scientific Scimed, Inc. System for implanting an implant and method thereof
US6551356B2 (en) 2001-03-19 2003-04-22 Ethicon, Inc. Pocketed hernia repair
US6575988B2 (en) 2001-05-15 2003-06-10 Ethicon, Inc. Deployment apparatus for supple surgical materials
US6712859B2 (en) 2001-06-28 2004-03-30 Ethicon, Inc. Hernia repair prosthesis and methods for making same
US6755781B2 (en) 2001-07-27 2004-06-29 Scimed Life Systems, Inc. Medical slings
PT1423066E (en) 2001-09-07 2008-09-29 Mardil Inc Method and apparatus for external heart stabilization
US6666817B2 (en) 2001-10-05 2003-12-23 Scimed Life Systems, Inc. Expandable surgical implants and methods of using them
DE10153334B4 (en) * 2001-10-29 2004-04-29 Ethicon Gmbh Flat implant
US6790213B2 (en) 2002-01-07 2004-09-14 C.R. Bard, Inc. Implantable prosthesis
FR2835737B1 (en) * 2002-02-13 2004-12-10 Cousin Biotech HERMAL PLATE WITH NON-PERMANENT DEPLOYMENT MEMBER
US6755868B2 (en) 2002-03-22 2004-06-29 Ethicon, Inc. Hernia repair device
DE60330860D1 (en) * 2002-06-12 2010-02-25 Boston Scient Ltd The Corporat MEDICAL SLING
US20040019360A1 (en) * 2002-07-25 2004-01-29 Farnsworth Ted R. Tissue repair device with a removable support member
US7101381B2 (en) * 2002-08-02 2006-09-05 C.R. Bard, Inc. Implantable prosthesis
US7300448B2 (en) * 2002-10-04 2007-11-27 Tyco Healthcare Group Lp Balloon dissector with cannula
ES2389919T3 (en) 2002-10-04 2012-11-05 Tyco Healthcare Group Lp Cannula balloon dissector
US7402133B2 (en) 2002-12-17 2008-07-22 Boston Scientific Scimed, Inc. Spacer for sling delivery system
GB0300784D0 (en) * 2003-01-14 2003-02-12 Barker Stephen G E Inguinal hernia repair prosthesis
EP1592361A2 (en) * 2003-02-11 2005-11-09 C.R. Bard, Inc. Implantable hernia repair system
WO2004100799A2 (en) * 2003-05-08 2004-11-25 Tyco Healthcare Group Lp Balloon dissector with balloon anchor cannula
KR100828144B1 (en) 2003-06-20 2008-05-14 인트린식 쎄라퓨틱스 인코포레이티드 Implant for intervertebral disc annular defect
US20040260300A1 (en) 2003-06-20 2004-12-23 Bogomir Gorensek Method of delivering an implant through an annular defect in an intervertebral disc
US7361138B2 (en) 2003-07-31 2008-04-22 Scimed Life Systems, Inc. Bioabsorbable casing for surgical sling assembly
US7235042B2 (en) 2003-09-16 2007-06-26 Acorn Cardiovascular, Inc. Apparatus and method for applying cardiac support device
US8262694B2 (en) * 2004-01-30 2012-09-11 W.L. Gore & Associates, Inc. Devices, systems, and methods for closure of cardiac openings
US20050192600A1 (en) * 2004-02-24 2005-09-01 Enrico Nicolo Inguinal hernia repair prosthetic
ES1057646Y (en) * 2004-05-19 2004-12-16 Ayet Felix Checa PERFECTED PROTESIS FOR THE SURGICAL TREATMENT OF HERNIAS DE LA INGLE.
US7846171B2 (en) 2004-05-27 2010-12-07 C.R. Bard, Inc. Method and apparatus for delivering a prosthetic fabric into a patient
US8562633B2 (en) * 2004-08-02 2013-10-22 W. L. Gore & Associates, Inc. Tissue repair device with a bioabsorbable support member
US20060029633A1 (en) * 2004-08-03 2006-02-09 Arthrotek, Inc Biological patch for use in medical procedures
US8298290B2 (en) * 2004-09-20 2012-10-30 Davol, Inc. Implantable prosthesis for soft tissue repair
US20060079922A1 (en) * 2004-10-12 2006-04-13 Brian Creston Balloon anchored surgical apparatus, its use and manufacture
FR2884134B1 (en) * 2005-04-07 2008-03-28 Safradim Production Soc Par Ac SYSTEM FOR ESTABLISHING MEANS FORMING REINFORCEMENT OF A SUTURE
US20070038299A1 (en) * 2005-08-12 2007-02-15 Arthrotek, Inc Multilayer microperforated implant
WO2007059199A2 (en) 2005-11-14 2007-05-24 C.R. Bard, Inc. Sling anchor system
US7922648B1 (en) * 2006-02-14 2011-04-12 Pacesetter, Inc. Myocardial infarction patch for minimally invasive implant
US20070208217A1 (en) 2006-03-03 2007-09-06 Acorn Cardiovascular, Inc. Self-adjusting attachment structure for a cardiac support device
US8764835B2 (en) * 2006-06-13 2014-07-01 Bret A. Ferree Intervertebral disc treatment methods and apparatus
US8834496B2 (en) 2006-06-13 2014-09-16 Bret A. Ferree Soft tissue repair methods and apparatus
US9232938B2 (en) 2006-06-13 2016-01-12 Anova Corp. Method and apparatus for closing fissures in the annulus fibrosus
US8821549B2 (en) 2006-06-13 2014-09-02 Anova Corporation Methods and apparatus for anulus repair
US7651462B2 (en) 2006-07-17 2010-01-26 Acorn Cardiovascular, Inc. Cardiac support device delivery tool with release mechanism
WO2008033950A2 (en) * 2006-09-13 2008-03-20 C. R. Bard, Inc. Urethral support system
US8206280B2 (en) 2007-11-13 2012-06-26 C. R. Bard, Inc. Adjustable tissue support member
US9034002B2 (en) 2008-02-18 2015-05-19 Covidien Lp Lock bar spring and clip for implant deployment device
US9393093B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9393002B2 (en) 2008-02-18 2016-07-19 Covidien Lp Clip for implant deployment device
US9044235B2 (en) 2008-02-18 2015-06-02 Covidien Lp Magnetic clip for implant deployment device
US8808314B2 (en) * 2008-02-18 2014-08-19 Covidien Lp Device and method for deploying and attaching an implant to a biological tissue
US9398944B2 (en) 2008-02-18 2016-07-26 Covidien Lp Lock bar spring and clip for implant deployment device
WO2009104182A2 (en) 2008-02-18 2009-08-27 Polytouch Medical Ltd A device and method for deploying and attaching a patch to a biological tissue
US8317808B2 (en) 2008-02-18 2012-11-27 Covidien Lp Device and method for rolling and inserting a prosthetic patch into a body cavity
US9301826B2 (en) 2008-02-18 2016-04-05 Covidien Lp Lock bar spring and clip for implant deployment device
US9833240B2 (en) 2008-02-18 2017-12-05 Covidien Lp Lock bar spring and clip for implant deployment device
US8758373B2 (en) 2008-02-18 2014-06-24 Covidien Lp Means and method for reversibly connecting a patch to a patch deployment device
AU2009239670B2 (en) * 2008-04-21 2013-11-14 Quickring Medical Technologies Ltd. Surgical stapling systems
AU2009288268A1 (en) * 2008-09-03 2010-03-11 Cook Incorporated Hernia patch with removable resilient element
WO2010033189A1 (en) * 2008-09-16 2010-03-25 VentralFix, Inc. Method and apparatus for minimally invasive delivery, tensioned deployment and fixation of secondary material prosthetic devices in patient body tissue, including hernia repair within the patient's herniation site
US9072586B2 (en) 2008-10-03 2015-07-07 C.R. Bard, Inc. Implantable prosthesis
US8163022B2 (en) 2008-10-14 2012-04-24 Anulex Technologies, Inc. Method and apparatus for the treatment of the intervertebral disc annulus
CA2730547C (en) * 2008-10-20 2013-08-06 Polytouch Medical Ltd. A device for attaching a patch to a biological tissue
WO2010081029A1 (en) 2009-01-08 2010-07-15 Rotation Medical, Inc. Implantable tendon protection systems and related kits and methods
US9179910B2 (en) 2009-03-20 2015-11-10 Rotation Medical, Inc. Medical device delivery system and method
EP2437686B1 (en) 2009-06-04 2017-12-13 Rotation Medical, Inc. Apparatus for deploying sheet-like materials
CA2763794C (en) 2009-06-04 2017-01-17 Rotation Medical, Inc. Apparatus having bowstring-like staple delivery to a target tissue
US20110034941A1 (en) * 2009-08-10 2011-02-10 Joseph Iraci Surgical Instrument for Hernia Repair and Method
WO2011021083A1 (en) * 2009-08-17 2011-02-24 PolyTouch Medical, Inc. Articulating patch deployment device and method of use
US9999424B2 (en) * 2009-08-17 2018-06-19 Covidien Lp Means and method for reversibly connecting an implant to a deployment device
US20110082479A1 (en) * 2009-10-07 2011-04-07 Jack Friedlander Apparatus, method and system for the deployment of surgical mesh
US8652153B2 (en) 2010-01-11 2014-02-18 Anulex Technologies, Inc. Intervertebral disc annulus repair system and bone anchor delivery tool
US10028814B2 (en) 2010-02-03 2018-07-24 Covidien Lp X-shaped device and method for deployment and placement of a patch
US9198750B2 (en) 2010-03-11 2015-12-01 Rotation Medical, Inc. Tendon repair implant and method of arthroscopic implantation
US10568628B2 (en) 2017-05-23 2020-02-25 Muffin Incorporated Closing device for tissue openings
EP2563231A1 (en) 2010-04-29 2013-03-06 Cook Medical Technologies LLC Systems and methods for facilitating closure of bodily openings
WO2012145059A1 (en) 2011-02-15 2012-10-26 Rotation Medical, Inc. Methods and apparatus for fixing sheet-like materials to a target tissue
CA2825918C (en) 2011-02-15 2018-08-07 Rotation Medical, Inc. Methods and apparatus for delivering and positioning sheet-like materials
US10952783B2 (en) 2011-12-29 2021-03-23 Rotation Medical, Inc. Guidewire having a distal fixation member for delivering and positioning sheet-like materials in surgery
US9198751B2 (en) 2011-02-15 2015-12-01 Rotation Medical, Inc. Methods and apparatus for delivering and positioning sheet-like materials in surgery
US9314314B2 (en) 2011-02-15 2016-04-19 Rotation Medical, Inc. Anatomical location markers and methods of use in positioning sheet-like materials during surgery
CN103841900B (en) * 2011-09-30 2016-08-17 柯惠Lp公司 Hernia prosthetic device and method
EP3403601A1 (en) 2011-12-19 2018-11-21 Rotation Medical, Inc. Apparatus for forming pilot holes in bone and delivering fasteners therein for retaining an implant
US9107661B2 (en) 2011-12-19 2015-08-18 Rotation Medical, Inc. Fasteners and fastener delivery devices for affixing sheet-like materials to bone or tissue
US9271726B2 (en) 2011-12-19 2016-03-01 Rotation Medical, Inc. Fasteners and fastener delivery devices for affixing sheet-like materials to bone or tissue
EP2793712B1 (en) 2011-12-19 2018-03-28 Rotation Medical, Inc. Fasteners for affixing sheet -like materials to bone or tissue
US8945235B2 (en) 2012-03-27 2015-02-03 Atrium Medical Corporation Removable deployment device, system, and method for implantable prostheses
AU2013328871B2 (en) 2012-10-12 2018-08-16 Diaxamed, Llc Cardiac treatment system and method
US9737294B2 (en) 2013-01-28 2017-08-22 Cartiva, Inc. Method and system for orthopedic repair
US10179012B2 (en) 2013-01-28 2019-01-15 Cartiva, Inc. Systems and methods for orthopedic repair
FR3006581B1 (en) 2013-06-07 2016-07-22 Sofradim Production PROSTHESIS BASED ON TEXTILE FOR LAPAROSCOPIC PATHWAY
US10166376B2 (en) 2013-06-11 2019-01-01 Covidien Lp Restricted expansion dissector
US10070853B2 (en) 2013-08-14 2018-09-11 Covidien Lp Expandable balloon desufflation assembly
USD717954S1 (en) 2013-10-14 2014-11-18 Mardil, Inc. Heart treatment device
WO2015172052A1 (en) 2014-05-09 2015-11-12 Rotation Medical, Inc. Medical implant delivery system for sheet-like implant
AU2015343273B2 (en) 2014-11-04 2017-12-14 Rotation Medical, Inc. Medical implant delivery system and related methods
EP3215025B1 (en) 2014-11-04 2020-12-23 Rotation Medical, Inc. Medical implant delivery system
US10123796B2 (en) 2014-11-04 2018-11-13 Rotation Medical, Inc. Medical implant delivery system and related methods
US10478281B2 (en) 2014-12-24 2019-11-19 C.R. Bard, Inc. Implantable prosthesis for soft tissue repair
US10898228B2 (en) 2015-05-06 2021-01-26 Rotation Medical, Inc. Medical implant delivery system and related methods
WO2016205186A1 (en) 2015-06-15 2016-12-22 Rotation Medical, Inc. Tendon repair implant and method of implantation
US10675016B2 (en) * 2015-10-30 2020-06-09 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Suture sleeve patch and methods of delivery within an existing arthroscopic workflow
WO2017117437A1 (en) 2015-12-31 2017-07-06 Rotation Medical, Inc. Fastener delivery system and related methods
AU2016381936B2 (en) 2015-12-31 2019-02-28 Rotation Medical, Inc. Medical implant delivery system and related methods
CN110225726A (en) 2017-12-07 2019-09-10 罗特迅医疗有限公司 Medical implant transportation system and correlation technique
US11369400B2 (en) 2019-03-20 2022-06-28 Covidien Lp Balloon dissector
US11484337B2 (en) 2020-02-06 2022-11-01 Covidien Lp Surgical access device including anchor with rachet mechanism
US11672563B2 (en) 2020-02-07 2023-06-13 Covidien Lp Surgical access device with rotatably actuated fixation mechanism
US11547441B2 (en) 2020-02-20 2023-01-10 Covidien Lp Retention anchor for surgical access devices
US11786233B2 (en) 2020-03-27 2023-10-17 Covidien Lp Retention anchor with suture tie down for surgical access devices
US11432846B2 (en) 2020-05-05 2022-09-06 Covidien Lp Surgical access device including alternating cutout fluid flow pathway for anchor inflation and deflation
US11376037B2 (en) 2020-05-08 2022-07-05 Covidien Lp Surgical access device including dual lumen cannula for anchor inflation and deflation
US11439430B2 (en) 2020-05-11 2022-09-13 Covidien Lp Surgical access device with air release mechanism
US11896263B2 (en) 2020-05-11 2024-02-13 Covidien Lp Surgical access device with fixation mechanism
US11564708B2 (en) 2020-06-15 2023-01-31 Covidien Lp Cannula assembly including an adjustable elongate shaft assembly
US11896473B2 (en) 2020-07-13 2024-02-13 Covidien Lp Surgical mesh deployment device
US11839404B2 (en) 2020-07-28 2023-12-12 Covidien Lp Surgical access assembly having pre-filled air chamber
US11717322B2 (en) 2020-08-17 2023-08-08 Covidien Lp Flexible cannula having selective rigidity
US11844549B2 (en) 2020-10-15 2023-12-19 Covidien Lp Surgical access device including a universal fluid flow valve
US11471189B2 (en) 2020-10-29 2022-10-18 Covidien Lp Surgical access device with fixation mechanism and illumination mechanism
US11751906B2 (en) 2020-10-29 2023-09-12 Covidien Lp Adapter for use with surgical access device for evacuation of smoke
US11583315B2 (en) 2020-11-09 2023-02-21 Covidien Lp Surgical access device including variable length cannula
US11849969B2 (en) 2020-12-04 2023-12-26 Covidien Lp Cannula with smoke evacuation housing
US11944348B2 (en) 2021-04-07 2024-04-02 Covidien Lp Surgical access device including an anchor having a suture retention mechanism
US11751907B2 (en) 2021-04-13 2023-09-12 Covidien Lp Surgical access device with self-inflating balloon
US11864761B2 (en) 2021-09-14 2024-01-09 Covidien Lp Surgical instrument with illumination mechanism

Family Cites Families (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US460940A (en) * 1891-10-13 Surgical instrument
US1275520A (en) * 1917-06-14 1918-08-13 William L Bell Gauze-dam surgical instrument.
US3152466A (en) * 1962-10-15 1964-10-13 Catherine B Williams Diaper rinsing device
US3706311A (en) * 1970-11-27 1972-12-19 Procter & Gamble Self-spreading catamenial tampon
US3874388A (en) * 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US4007743A (en) * 1975-10-20 1977-02-15 American Hospital Supply Corporation Opening mechanism for umbrella-like intravascular shunt defect closure device
JPS5394481A (en) * 1977-01-31 1978-08-18 Olympus Optical Co Operating string for percutaneous endoscope instrument
US4347847A (en) * 1980-06-06 1982-09-07 Usher Francis C Method of hernia repair
US4557255A (en) * 1983-08-22 1985-12-10 Goodman Tobias M Ureteroscope
US4519643A (en) * 1984-03-09 1985-05-28 Harris Warren R Handle for extending the reach of a rope
GB8520999D0 (en) * 1985-08-22 1985-09-25 Clinical Product Dev Ltd Wound closure device
US4779616A (en) * 1986-02-04 1988-10-25 Johnson Lanny L Surgical suture-snagging method
US4769038A (en) * 1986-03-18 1988-09-06 C. R. Bard, Inc. Prostheses and techniques and repair of inguinal and femoral hernias
US4909789A (en) * 1986-03-28 1990-03-20 Olympus Optical Co., Ltd. Observation assisting forceps
EP0274037A1 (en) * 1986-12-10 1988-07-13 BBC Brown Boveri AG Process and device for the separation of particles
US4744364A (en) * 1987-02-17 1988-05-17 Intravascular Surgical Instruments, Inc. Device for sealing percutaneous puncture in a vessel
US5021059A (en) * 1990-05-07 1991-06-04 Kensey Nash Corporation Plug device with pulley for sealing punctures in tissue and methods of use

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DE69227097D1 (en) 1998-10-29
ATE171363T1 (en) 1998-10-15
US5122155A (en) 1992-06-16
ES2121865T3 (en) 1998-12-16
EP0553344A1 (en) 1993-08-04
DK0553344T3 (en) 1999-02-08
DE69227097T2 (en) 1999-04-01
WO1993003685A1 (en) 1993-03-04
AU2516592A (en) 1993-03-16
JPH06508787A (en) 1994-10-06
JP3313112B2 (en) 2002-08-12
CA2094286A1 (en) 1993-02-20
AU651493B2 (en) 1994-07-21
EP0553344B1 (en) 1998-09-23

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