Expandable mesh with locking feature

1. A method for treating a perforation in tissue of a patient, the method comprising:

delivering a mesh material received in a delivery state within a lumen of an insertion tool into the patient, the mesh material in the delivery state having first and second coupling elements disposed at separate locations and an intermediate portion disposed between the first coupling element and the second coupling element and including an everted portion of the mesh;

deploying the mesh material from the lumen of the insertion tool;

proximally retracting the first coupling element relative to the second coupling element to cause the intermediate portion to flare out to an enlarged width for covering the perforation, wherein the proximally retracting causes an interference fit between the first and second coupling elements, and wherein, during the interference fit, a distal end of the first coupling element is located distal to a proximal end of the second coupling element; and

covering the perforation with the mesh having the intermediate portion flared out to the enlarged width.

2. The method of claim 1 , wherein, during the interference fit, a proximal end of the first coupling element also is located distal to the proximal end of the second coupling element.

3. The method of claim 1 , wherein in the delivery state the first and second coupling elements lack an axial overlap.

4. The method of claim 1 , wherein a first tether is secured to the first coupling element, and wherein the proximally retracting the first coupling element includes proximally retracting the first tether.

5. The method of claim 4 , further comprising advancing a graft material having a first bore formed therein over the first tether to permit the graft material to be advanced relative to the first coupling element.

6. The method of claim 5 , wherein a proximal end of the first tether is disposed through the first bore of the graft material and extends outside of the patient.

7. The method of claim 5 , wherein the graft material comprises a second bore, wherein the second bore is advanced over a second tether at a time when the first bore is simultaneously advanced over the first tether, and wherein the method further includes tying first and second tethers together in a manner that secures the graft material adjacent to the patient tissue and the mesh material.

8. A method for treating a perforation in tissue of a patient, the method comprising:

delivering a mesh material received in a delivery state within a lumen of an insertion tool into the patient, the mesh material in the delivery state having first and second coupling elements disposed at separate locations and an intermediate portion disposed between the first coupling element and the second coupling element and including an everted portion of the mesh;

deploying the mesh material from the lumen of the insertion tool;

proximally retracting the first coupling element relative to the second coupling element to cause the intermediate portion to flare out to an enlarged width, wherein the proximally retracting the first coupling element comprises retracting a first tether secured to the first coupling element; and

covering the perforation with the mesh having the intermediate portion flared out to the enlarged width.

9. The method of claim 8 , wherein a proximal end of the first tether is disposed outside of the patient.

10. The method of claim 8 , wherein the mesh material is an absorbable mesh material.

11. The method of claim 8 , wherein the proximally retracting causes an interference fit between the first and second coupling elements, and

wherein, during the interference fit, a distal end of the first coupling element is located distal to a proximal end of the second coupling element.

12. The method of claim 11 , wherein, during the interference fit, a proximal end of the first coupling element also is located distal to the proximal end of the second coupling element.

13. The method of claim 8 , comprising:

advancing a graft material having a first bore formed therein over the first tether to permit the graft material to be advanced relative to the first coupling element.

14. The method of claim 1 , wherein the enlarged width of the intermediate portion is greater than an inner diameter of the perforation.

15. The method of claim 14 , wherein the perforation comprises a perforation in a body wall, wherein the delivering comprises delivering the mesh material to the perforation from a proximal side of the body wall, and wherein during the proximally retracting the intermediate portion is positioned on a distal side of the body wall.

16. The method of claim 15 , wherein the perforation in a body wall comprises an abdominal hernia.

17. The method of claim 8 , wherein the enlarged width of the intermediate portion is greater than an inner diameter of the perforation.

18. The method of claim 17 , wherein the perforation comprises a perforation in a body wall, and wherein the delivering comprises delivering the mesh material to the perforation from a proximal side of the body wall, and wherein during the proximally retracting the intermediate portion is positioned on a distal side of the body wall.

19. The method of claim 18 , wherein the perforation in a body wall comprises an abdominal hernia.

20. A method for using an expandable mesh, the method comprising:

delivering a mesh material having first and second coupling elements disposed at separate locations, wherein an intermediate portion is disposed between the first coupling element and the second coupling element;

proximally retracting the first coupling element relative to the second coupling element to cause the intermediate portion to flare out to an enlarged width, wherein there is an interference fit between the first and second coupling elements upon proximal retraction of the first coupling element relative to the second coupling element, and wherein, during the interference fit, a distal end of the first coupling element is located distal to a proximal end of the second coupling element;

advancing a graft material having a first bore formed therein over the first tether to permit the graft material to be advanced relative to the first coupling element; and

wherein the graft material comprises a second bore, wherein the second bore is advanced over a second tether at a time when the first bore is simultaneously advanced over the first tether, and wherein the first and second tethers are tied together in a manner that secures the graft material adjacent to tissue and the mesh material.