Adjustable tension incontinence sling assemblies
View Patent ↗Systems for providing support to body tissue to alleviate incontinence are disclosed that comprise an elongated incontinence sling having a central support portion adapted to be positioned to support any one of the urethra or anus and first and second sling end portions extending from the central support portion through body tissue and a tension adjustment mechanism acting on or within one or both of the sling end portions. The sling tension adjustment mechanism is attached to and extends through an adjustment spacing between sling intermediate ends within at least one sling end portion. The adjustment spacing is lengthened to decrease sling tension and shortened to increase sling tension.
1. A system for providing support to body tissue to alleviate incontinence, comprising:
an elongated incontinence sling having a central support portion adapted to be positioned to support any one of the urethra or anus, the elongated incontinence sling having first and second sling end portions extending from the central support portion through body tissue;
a tension adjustment mechanism acting on or within one or both of the sling end portions, wherein the tension adjustment mechanism is attached to and extends through an adjustment spacing intermediate the first sling end portion and the central support portion and includes a drive mechanism provided in a housing and having a rack device, the rack device having a plurality of teeth and a non-rotating catch engageable with the plurality of teeth, with an external portion of the rack extending out of the housing and operatively connected to the first sling end portion;
wherein the non-rotating catch is a pivotable non-rotating catch that engages with the plurality of teeth in response to linear movement of the plurality of teeth; and
an external adjustment actuator that operatively engages with the tension adjustment mechanism and selectively changes the adjustment spacing such that extension of the external portion of the rack out of the housing lengthens the adjustment spacing and withdrawing the external portion of the rack into the housing shortens the adjustment spacing to thereby change tension in the central support portion applied to the urethra or anus.
2. The system of claim 1 , wherein the external adjustment actuator is adapted to extend through the patient's skin for adjustment.
3. The system of claim 1 , further comprising at least one tissue anchor coupled to at least one of the first and second sling end portions and adapted to be passed through body tissue to anchor against the body tissue.
4. The system of claim 1 , wherein:
the external adjustment actuator comprises an elongated instrument having a shaft extending between a handle and an engaging end, the external adjustment actuator shaped to be percutaneously advanced through the skin.
5. The system of claim 1 , wherein the housing includes a generally hexagonal-shaped recess adapted to receive the external adjustment actuator.
6. The system of claim 1 , wherein the mechanism includes a drive shaft operatively connected with the central support portion.
7. The system of claim 1 , wherein at least the central support portion is constructed of a mesh material.
8. The system of claim 1 , wherein the elongated incontinence sling is constructed of a mesh material.
9. The system of claim 1 , wherein the external adjustment actuator is a hex wrench.
10. The system of claim 1 , further including a drive sheath operatively connected with the first sling end portion.