Methods for Inserting and Affixing an Implant in an Abdominal Wall Cavity by Using Laparoscopy

1 . A method of inserting and affixing an implant, the method comprising the steps of:

making a first incision in an abdominal wall;

forming a subcutaneous pocket between a first layer of the abdominal wall and a second layer of the abdominal wall, such that the pocket is at least 2 centimeters from the costal margin, and such that the first incision defines an opening into the pocket;

inserting an implant through the opening and into the pocket;

positioning the implant into the pocket;

affixing the implant within the subcutaneous pocket; and

closing the opening such that the implant is secured within the pocket.

2 . The method of claim 1 , further comprising creating a second incision for a first introduction tool.

3 . The method of claim 1 , the method further comprising creating additional incisions for one or more introduction tools.

4 . The method of claim 3 , wherein the method further comprises forming a first incision and four additional incisions for one or more introduction tools.

5 . (canceled)

6 . The method of claim 3 , wherein each of the incisions for the one or more introduction tools accommodates at least a 10 mm trocar.

7 . The method of claim 6 , wherein the one or more introduction tools comprises an umbilical introduction tool, wherein the umbilical introduction tool is a 15 millimeter trocar.

8 . The method of claim 3 , wherein an introduction tool in the one or more introduction tools creates a port to accommodate a lead.

9 . (canceled)

10 . The method of claim 1 , wherein the subcutaneous pocket is between subcutaneous tissue and the rectus sheath

11 . The method of any one of claim 1 , wherein the subcutaneous pocket is 7.5 centimeters to 8.5 centimeters in length.

12 . A method of creating a pocket for securing a surgical implant between subcutaneous tissue and rectus abdominus muscle, the method comprising the steps of:

making a first incision in an abdominal wall;

inserting a surgical instrument into the first incision; and

using the surgical instrument to extend the pocket from the first incision, wherein the pocket is at least 2 centimeters from the costal margin.

13 . The method of claim 12 , wherein inserting the surgical instrument further comprises developing the pocket using blunt dissection.

14 . The method of claim 12 , wherein the pocket is 7.5 centimeters to 8.5 centimeters in length.

15 . The method of claim 12 , wherein the pocket is 2.5 centimeters to 3.5 centimeters in width.

16 . The method of claim 12 , further comprising inserting and affixing an implant in the pocket.

17 . A method of inserting an implant, the method comprising the steps of:

making a first incision in an abdominal wall;

forming a pocket between subcutaneous tissue and the rectus sheath by using a surgical instrument to extend the pocket from the first incision, such that the first incision defines an opening into the pocket;

inserting an implant through the opening and into the pocket;

positioning the implant into the pocket; and

closing the opening such that the implant is secured by at least one suture within the pocket.

18 . The method of claim 17 , wherein the pocket is at least 2 centimeters from the costal margin.

19 . (canceled)

20 . The method of claim 17 , wherein the closing further comprises grasping the suture with a suture passer through one of the introduction tools, wherein the suture passer is visualized under laparoscopic visualization.

21 . The method of claim 17 , wherein the closing further comprises advancing the suture passer through the fascia in an upper distal corner of the pocket.

22 . The method of claim 17 , further comprising clamping the suture to maintain proper cranial to caudal alignment.

23 . The method of claim 17 , wherein the suture is selected from the group of: a U-stitch and a staple.

24 . (canceled)