Systems and methods for delivering a medical implant to an anatomical location in a patient
View Patent ↗A surgical device for use in a minimally invasive procedure to treat urinary incontinence can include a dilator coupled to a curved needle at one end and a sling at the opposite end. Urinary incontinence can be treated minimally invasively. One treatment includes positioning the sling on an anterior portion of the urethra to provide proper coaptation to the urethra.
1. A method of treating urinary incontinence in a patient, the method comprising:
inserting a curved needle through a first portion of an anterior portion of a vaginal wall of the patient;
advancing the curved needle around a urethra of the patient;
passing the curved needle through a second portion of the anterior portion of the vaginal wall of the patient;
passing a dilator coupled to the curved needle through the first portion of the anterior portion of the vaginal wall;
introducing an implantable surgical sling coupled with the dilator through the first portion of the anterior portion of the vaginal wall; and
withdrawing the dilator from the second portion of the anterior portion of the vaginal wall.
2. The method of claim 1 , wherein the dilator is coupled to the curved needle using a tether and the passing the dilator through the first portion of the anterior portion of the vaginal wall includes pulling the dilator through the the first portion of the anterior portion of the vaginal wall by withdrawing, at least partially, the tether from the second portion of the anterior portion of the vaginal wall.
3. The method of claim 1 , wherein passing the dilator through the first portion of the anterior portion of the vaginal wall includes enlarging an incision or puncture in the vaginal wall using a tapered leading edge of the dilator.
4. The method of claim 1 , wherein the dilator is substantially cylindrical and tapered at one end.
5. The method of claim 1 , wherein an outer circumference of the dilator increases from a first end of the dilator towards a second end of the dilator.
6. The method of claim 1 , wherein a width of the dilator is larger than a width of the curved needle.
7. The method of claim 1 , wherein the sling comprises a material selected from the group consisting of a natural material, a synthetic material, and a combination of a natural material and a synthetic material.
8. The method of claim 1 , wherein the sling is about 1 centimeter to about 3 centimeters in width.
9. The method of claim 1 , wherein a distal end of the sling is coupled with the dilator, the method further comprising:
securing a first tether coupled with a proximal end of the sling to the vaginal wall;
tensioning the sling, using a second tether coupled with the distal end of the sling, to pull the urethra against the vaginal wall;
securing the second tether to the vaginal wall.
10. The method of claim 9 , wherein:
securing the first tether to the vaginal wall includes suturing the first tether to the anterior portion of the vaginal wall at a first location; and
securing the second tether to the vaginal wall includes suturing the second tether to the anterior portion of the vaginal wall at a second location.
11. A method of treating urinary incontinence in a patient, the method comprising:
inserting a curved needle through a first portion of an anterior portion of a vaginal wall of the patient;
advancing the curved needle around a urethra of the patient;
passing the curved needle through a second portion of the anterior portion of the vaginal wall of the patient;
passing a dilator coupled to the curved needle through the first portion of the anterior portion of the vaginal wall;
introducing a pouch coupled with the dilator through the first portion of the anterior portion of the vaginal wall, the pouch having an implantable surgical sling disposed at least partially therein; and
withdrawing the dilator from the second portion of the anterior portion of the vaginal wall.
12. The method of claim 11 , further comprising, prior to introducing the pouch through the first portion of the anterior portion of the vaginal wall, hydrating the implantable surgical sling through one or more pores disposed in the pouch.
13. The method of claim 12 , wherein the hydrating the implantable surgical sling includes hydrating the sling with at least one of an antibiotic and saline.
14. The method of claim 11 , wherein the pouch fully encapsulates the sling.
15. The method of claim 11 , wherein the pouch is made of a low friction material.
16. The method of claim 11 , wherein the pouch is substantially flat.
17. The method of claim 11 , wherein the pouch is translucent.
18. The method of claim 12 , further comprising:
removing the pouch from the implantable surgical sling;
securing the sling to a first location of the anterior portion of the vaginal wall with a first tether coupled with a first end of the implantable surgical sling;
tensioning the sling using a second tether coupled with a second end of the implantable surgical sling to pull the urethra against the vaginal wall; and
securing the sling to a second location of the anterior portion of the vaginal wall with the second tether.