Surgical articles and methods for treating pelvic conditions
According to an aspect, pelvic implants optionally including the ability to engage a spreader tool for spreading the implant within the patient, also optionally including a frame, exemplary implants being capable of being used to treat pelvic floor disorders, for example by supporting of levator tissue, and methods of surgically placing pelvic implants.
1. A method of supporting tissue of the pelvic region, the method comprising
creating an incision that allows access to a pelvic region,
providing a pelvic implant comprising a tissue support portion and an extension portion extending from the tissue support portion,
providing a spreader tool comprising a handle, an elongate shaft having a distal end, a first jaw hingedly coupled to the elongate shaft at a connection location, a second jaw hingedly coupled to the elongate shaft, and a bias member operatively coupled to and extending between the first jaw and the second jaw, the bias member being disposed distally of the connection location,
passing the implant through the incision and placing the tissue support portion to support tissue of the pelvic region,
inserting the spreader through the incision to locate the spreader at a location of the implant, and
using the spreader to spread material of the implant.
2. The method of claim 1 wherein the spreader comprises two jaws that can engage the implant and that can be selectively spread and unspread to spread or unspread the implant.
3. The method of claim 1 wherein the spreader comprises a hollow shaft, and the spreader can be extended from the shaft to take on a spread configuration, and retracted into the shaft to take on an unspread configuration.
4. The method of claim 1 comprising
engaging the spreader and implant,
placing the spreader in an unspread configuration and causing the implant to be placed in an unspread configuration,
passing the spreader in its unspread configuration and the implant in its unspread configuration through the incision, and
spreading the spreader to spread the implant.
5. The method of claim 1 comprising
inserting the implant with an insertion tool and placing the implant at a position in the pelvic region,
removing the insertion tool,
inserting the spreader through an incision and engaging the spreader and implant while at the position in the pelvic region,
spreading the spreader to spread the implant at the position in the pelvic region.
6. The method of claim 1 wherein the implant comprises a bearing for engaging a spreader.
7. A method according to claim 1 comprising placing the support portion inferior to a superficial transverse perineal muscle.
8. A method according to claim 1 comprising extending the extension portion to contact tissue of the pelvic region to cause the extension portion to support the tissue support portion and the tissue support portion to support levator tissue.
9. A method according to claim 1 comprising securing a distal end of the extension portion to periostium of a pubic bone in a region of an ischial tuberosity.
10. A method according to claim 1 comprising extending a portion of the implant through a tissue path between levator ani muscle and obturator internus muscle and attaching the extension portion at an arcus tendineus.
11. A kit comprising an implant and a spreader tool,
the spreader tool comprising a handle, an elongate shaft having a distal end, and a spreader at the distal end of the shaft, the spreader including a first jaw hingedly coupled to the elongate shaft at a connection location, a second jaw hingedly coupled to the elongate shaft, and a bias member operatively coupled to and extending between the first jaw and to the second jaw, the bias member being located distally of the connection location,
the implant comprising a tissue support portion and an extension portion.
12. The kit of claim 11 wherein the implant comprises a bearing for engaging the spreader.
13. A kit according to claim 11 comprising two bearings for engaging the spreader.