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:
providing an elongate flexible support member having two opposed ends, a flexible tape extending between the two opposed ends, the flexible tape forming a central portion and two elongate extension portions between the two ends;
establishing a pathway in tissue of the patient extending about the patient's anal sphincter and extending into the patient's perineum, comprising the steps of making a left buttock incision in the patient's left buttock at a left pathway end, making a right buttock incision in the patient's right buttock at a right pathway end, making an incision in a 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, wherein said pathway extends from the left pathway end, through the perineum, to the right pathway end; and
implanting the elongate flexible support member in and extending along said pathway to support the anal sphincter.
2. The method of claim 1 wherein said support member extends about the anal sphincter through an included angle of at least 180°, measured about an axis extending centrally through the anus.
3. The method of claim 1 wherein said support member extends about the anal sphincter through an included angle of at least 270°, measured about an axis extending centrally through the anus.
4. 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.
5. The method of claim 4 , wherein the step of implanting 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.
6. The method of claim 5 further comprising the step of suturing said support member to the perineal body.
7. The method of claim 1 further comprising the step of tensioning said support member so as to locate said support member in a desired position relative to the anal sphincter.
8. The method of claim 1 wherein said support member is formed of a flexible mesh material.
9. The method of claim 1 further comprising the step of implanting a pelvic organ prolapse device in the patient.
10. The method of claim 1 comprising the step of suturing said support member to the perineal body.
11. The method of claim 1 wherein the central portion extends between an anterior side of the anal sphincter and the posterior vaginal wall.
12. The method of claim 1 wherein the central portion is not positioned to contact vaginal tissue as part of a procedure to treat vaginal prolapse.
13. The method of claim 1 wherein the support member consists of the flexible tape forming a central portion and two elongate extension portions between the two ends.
14. A method of treating anal incontinence in a patient comprising:
forming a first incision in a buttock of the patient posterior to the anus;
forming a second incision in an opposite buttock posterior to the anus;
forming a vaginal incision in the posterior vaginal wall;
forming a tissue pathway between the first and second incisions by passing a surgical instrument between the first incision and the vaginal incision, and between the second incision and the vaginal incision; and
implanting a support member in the tissue pathway such that the support member is positioned around at least 180 of the circumference of the anal sphincter;
wherein the support member comprises two opposed ends, a flexible tape extending between the two opposed ends, the flexible tape forming a central portion and two elongate extension portions between the two ends.
15. The method of claim 14 further comprising the step of suturing said support member to the perineal body.
16. The method of claim 14 wherein the support member consists of the flexible tape forming a central portion and two elongate extension portions between the two ends.