Transperitoneal prolapse repair system and method
A prolapse repair system and procedure are provided. The system can include one or more anchor devices and one or more extending members, such as a suture. The system can further include a mesh or like support or suspension structure provided intermediate the one or more anchor devices and the one or more extending members. The anchors can be directed to the coccygeous sacrospinous ligament or complex via a transperitoneal approach, wherein the one or more anchor devices are engaged directly into the target ligament or tissue complex and the one or more sutures extend back through the thickness of the vaginal wall to provide vaginal wall support.
1. A transperitoneal prolapse repair system, comprising:
a first support device and a second support device, each of the first support device and the second support device having an anchor and one or more members extending from the anchor, the anchor having tines to engage target tissue, the anchor being adapted to be deployed through a peritoneum opening and fixated in the coccygeus muscle-sacrospinous ligament complex and the one or more members being adapted to be directed back through a portion of a vaginal wall such that the first support device provides posterior elevation on a first side of the vaginal wall and the second support device provides posterior elevation on a second side of the vaginal wall;
a needle device including a distal tip adapted to selectively engage with the anchor of at least the first support device to selectively push the anchor of at least the first support device through target tissue; and
a retractor having a proximal end portion and a distal end portion, the distal end portion of the retractor having an inflatable member configured to lift a bowel from a procedure pathway, the retractor having a first flexible extension extending from a first side of the distal end portion of the retractor, and a second flexible extension extending from a second side of the distal end portion of the retractor, the first side being opposite the second side, the first flexible extension and the second flexible extension being planar and extending in opposite directions, the first flexible extension and the second flexible extension configured to prevent the bowel from slipping down around the inflatable member during use.
2. The system of claim 1 , wherein the one or more members extending from the anchor are suture members.
3. The system of claim 2 , wherein the suture members are absorbable.
4. The system of claim 3 , wherein the absorbable suture members are continuous delayed absorbable suture members.
5. The system of claim 1 , wherein the one or more members includes two or more suture members.
6. The system of claim 1 , further including a second anchor having one or more members extending from the second anchor.
7. The system of claim 6 , wherein the one or more members of the second anchor includes two or more suture members.
8. The system of claim 1 , wherein at least the first support device further includes a support member provided intermediate the respective anchor and the one or more extending members.
9. The system of claim 8 , wherein the support member is a mesh support member.
10. The system of claim 1 , wherein the retractor further includes an illumination device.
11. A transperitoneal prolapse repair system, comprising:
a first support device having a first anchor and a pair of suspension sutures extending from the first anchor such that the first anchor is adapted to engage a sacrospinous ligament site at a first side of a patient, wherein the pair of sutures of the first support device are adapted to extend back through a portion of a peritoneum to provide vaginal wall support on a first vaginal wall side;
a second support device having a second anchor and a pair of suspension sutures extending from the second anchor such that the second anchor is adapted to engage a sacrospinous ligament site on a second side of the patient, wherein the pair of sutures of the second support device are adapted to extend back through a portion of a peritoneum to provide vaginal wall support on a second vaginal wall side separate from the first vaginal wall side;
a needle device including a distal tip adapted to selectively engage with at least the first anchor to selectively push the first anchor through target tissue; and
a retractor having a proximal end portion and a distal end portion, the distal end portion of the retractor having an inflatable member configured to lift a bowel from a procedure pathway, the retractor having a first flexible extension extending from a first side of the distal end portion of the retractor, and a second flexible extension extending from a second side of the distal end portion of the retractor, the first side being opposite the second side, the first flexible extension and the second flexible extension configured to prevent the bowel from slipping down around the inflatable member during use, the first flexible extension and the second flexible extension being planar and extending in opposite directions.
12. The system of claim 11 , wherein the pair of suspension sutures of the first and second support devices are absorbable.
13. The system of claim 12 , wherein the absorbable suspension sutures are continuous delayed absorbable suspension sutures.
14. The system of claim 11 , wherein the first support device further includes a support member provided intermediate the first anchor and the pair of suspension sutures of the first support device.
15. The system of claim 14 , wherein the support member is a mesh support member.
16. The system of claim 11 , wherein the second support device further includes a support member provided intermediate the second anchor and the pair of suspension sutures of the second support device.
17. The system of claim 16 , wherein the support member is a mesh support member.
18. The system of claim 11 , wherein the retractor further includes an illumination device.