Method of treating anal incontinence
View Patent ↗A method for treating anal incontinence is provided, in which a support member is implanted in a tissue pathway extending from a first location posterior to and adjacent the anus, through the perineum anterior to the anus and terminating at a location posterior to and adjacent the anus opposite the first location.
1. A method of treating anal incontinence in a patient comprising:
establishing a pathway in tissue of the patient extending about the anal sphincter, wherein said pathway extends from a left pathway end laterally left and posterior to the anus, through the perineum, to a right pathway end laterally right and posterior to the anus, and wherein the step of establishing said pathway comprises:
making a left buttock incision in the patient's left buttock at said left pathway end;
making a right buttock incision in the patient's right buttock at said right pathway end;
making an incision in the posterior vaginal wall that extends into the perineum;
establishing a left passage of said pathway extending between said left buttock incision and said vaginal incision; and
establishing a right passage of said pathway extending between said right buttock incision and said vaginal incision;
implanting an elongate flexible support member in and extending along said pathway to support the anal sphincter,
wherein the elongate flexible support member comprises a central portion and exactly two elongate extension portions extending from the central portion.
2. The method of claim 1 , wherein:
the step of establishing said left passage comprises passing an elongate surgical instrument between said left buttock incision and said vaginal incision; and
the step of establishing said right passage comprises passing an elongate surgical instrument between said right buttock incision and said vaginal incision.
3. The method of claim 2 , wherein the step of locating said support member comprises:
securing a first end of said support member to an elongate surgical instrument;
drawing said elongate surgical instrument and said first end of said support member through said left passage; and
securing a second end of said support member to an elongate surgical instrument; and
drawing said elongate surgical instrument and said second end of said support member through said right passage.
4. The method of claim 1 further comprising the step of suturing said support member to the perineal body.
5. A method of treating anal incontinence in a patient comprising:
forming a first incision in the buttock of the patient posterior to the anus;
forming a second incision in the opposite buttock posterior to the anus;
forming a tissue pathway between the first and second incisions by passing a surgical instrument between the first incision and the perineum anterior to the anus, and between the second incision and the perineum anterior to the anus; and
implanting a support member in the tissue pathway such that the support member is positioned around a substantial portion of the circumference of the anal sphincter, wherein the support member comprises a central portion and exactly two elongate extension portions extending from the central portion.
6. The method of claim 5 comprising forming a vaginal incision in the posterior vaginal wall, wherein the tissue pathway is formed by passing the surgical instrument from the first incision to the vaginal incision and from the second incision to the vaginal incision.
7. The method of claim 5 wherein said support member extends about the anal sphincter through an included angle of at least about 180° , measured about an axis extending centrally and perpendicularly through the anus.
8. The method of claim 5 comprising placing the support member in a supporting relationship with the anal sphincter to provide support for the external anal sphincter.
9. The method of claim 5 comprising placing a finger in the patient's anal canal and palpating a tip of the elongate surgical instrument.
10. The method of claim 5 comprising adjusting the support member with tension to draw the support member to a periphery of the anal sphincter.
11. The method of claim 5 wherein the support member comprises a mesh sling consisting of an elongate mesh strip.
12. The method of claim 11 wherein the support member comprises a connector at a distal end.
13. The method of claim 11 wherein the support member comprises a protective sheath.