Surgical articles and methods for treating pelvic conditions
View Patent ↗Described are pelvic implants and methods of surgically placing pelvic implants, that provide treatment for pelvic floor disorders by support of the levator. A pelvic implant ( 100, 102 ) may comprise a tissue support portion ( 104 ) to be placed in contact with tissue to be supported, extension portions ( 106, 110 ) that extend from the tissue support portion to provide additional support, and tissue fasteners ( 108, 112 ) to attach extension portions to supportive tissue.
1. A pelvic implant for supporting levator tissue, the implant comprising a first tissue support portion bounded by:
an anterior side capable of extending on a first side of a patient from an anterior region of the pelvic region to a region of medial levator tissue on the first side of the patient, the anterior region selected from a region of the obturator foramen, a region of the arcus tendineus, and a region of puborectalis muscle,
a posterior side capable of extending on the first side of the patient from a posterior region of the pelvic region to a region of medial levator tissue, the posterior region selected from a region of the ischial spine, an ischial tuberosity, a sacrospinous ligament, a sacrotuberous ligament, and a sacrum,
a lateral end capable of extending from the anterior region to the posterior region on the first side of the patient, and
a medial end capable of being located at a medial position below levator tissue selected from a rectum, an external anal sphincter, a perineal body, and an anococygeal body, when the first tissue support portion is located at a region of levator tissue and inferior to the levator tissue on the first side of the patient; and
a second tissue support portion bounded by:
an anterior side capable of extending on a second side of the patient from an anterior region of the pelvic region to a region of medial levator tissue, the anterior region selected from a region of the obturator foramen, a region of the arcus tendineus, and a region of puborectalis muscle,
a posterior side capable of extending on the second side of the anent from a posterior region of the pelvic region to a region of medial levator tissue, the posterior region selected from a region of the ischial spine, an ischial tuberosity, a sacrospinous ligament, a sacrotuberous ligament, and a sacrum,
a lateral end capable of extending from the anterior region to the posterior region on the second side of the patient, and
a medial end capable of being located at a medial position below levator tissue selected from a rectum, an external anal sphincter, a perineal body, and an anococygeal body, when the second tissue support portion is located at a region of levator tissue inferior to the levator tissue, on the second side of the patient,
wherein the first and second tissue support portions have a width of the medial end less than a width of the lateral end.
2. The implant of claim 1 wherein the first tissue support portion and the second tissue support portion each independently have a shape substantially of a figure selected from a symmetric trapezoid, and a non-symmetric trapezoid.
3. The implant of claim 1 comprising one or two extension portions located at corners of the first tissue support portion along the lateral end.
4. The implant of claim 3 comprising a tissue fastener located at a lateral end of the one or two extension portions.
5. The implant of claim 3 wherein the extension portions are about 1 to about 1.5 centimeters wide.
6. The implant of claim 1 comprising a tissue fastener located at a corner of the first tissue support portion.
7. The implant of claim 1 comprising two tissue fasteners located at each corner of the first and second tissue support portions.
8. The implant of claim 1 wherein the medial end of the first tissue support portion is attached to the medial end of the second tissue support portion.
9. The implant of claim 1 comprising one or two extension portions located at corners of the first and second tissue support portions along the lateral ends.
10. The implant of claim 1 wherein a length of the implant is about 14 to about 18 centimeters.
11. The implant of claim 1 wherein the width of the lateral end of the first tissue support portion is about 4 to about 5 centimeters.
12. The implant of claim 1 wherein the width of the medial ends of the tissue support portions is about 2 to about 3 centimeters.
13. The implant of claim 1 having a length in a range from about 14 to about 18 centimeters.
14. The implant of claim 1 wherein the width of the lateral end of the second tissue support portion is about 4 to about 5 centimeters.
15. The implant of claim 1 , having a width of the medial end of the second tissue support portion is in a range from about 2 to about 3 centimeters.
16. The implant of claim 1 wherein the first tissue support portion and the second tissue support portion each have a shape substantially of a figure selected from a symmetric trapezoid and a non-symmetric trapezoid.
17. The implant of claim 1 wherein the first tissue support portion has a trapezoid shape and the second tissue support portion has a trapezoid shape.
18. The implant of claim 1 wherein the first tissue support portion has a symmetric trapezoid shape and the second tissue support portion has a symmetric trapezoid shape.
19. The implant of claim 1 wherein the widths of the lateral ends of the first and second tissue support portions are about 3 to about 7 centimeters and the widths of the medial ends of the first and second tissue support portions are about 2 to about 3 centimeters.
20. The implant of claim 1 , comprising one piece comprising the first tissue support portion and the second tissue support portion.