Methods and apparatus for deploying sheet-like materials
Implant delivery systems for delivering sheet-like implants include a delivery shaft, an implant expander, a sheath, and a sheet-like implant. In some embodiments, the delivery shaft has a proximal end and a distal end. The implant expander is mounted to the distal end of the delivery shaft. The implant expander includes a central portion and a plurality of leg portions radiating from the central portion. The implant expander is evertable between an unstressed configuration in which a distal surface of the implant expander defines a concave surface, and a first compact configuration in which the distal surface of the implant expander defines a convex surface. The implant expander has a first lateral extent when the implant expander is free to assume the unstressed configuration. The sheath defines a lumen having a lumen diameter. At least a portion of the delivery shaft is slidably disposed in the lumen. The lumen diameter is smaller than the first lateral extent of the implant expander so that the sheath holds the implant expander in the first compact configuration when slidably disposed therein. The sheet-like implant overlays at least a portion of the distal surface of the implant expander with portions of the sheet-like implant extending between the leg portions of the implant expander and the sheath. Methods of treating a rotator cuff of a shoulder are also disclosed.
1. An implant delivery system adapted to deliver a sheet-like implant to a target tissue, the implant delivery system comprising:
a delivery shaft extending along a longitudinal axis, the delivery shaft including a proximal end and a distal end;
an implant expander including a body portion and a plurality of flexible legs extending from the body portion, the body portion coupled to the distal end of the delivery shaft, wherein the plurality of flexible legs are configured to move between a compact configuration and an expanded configuration;
a sheet-like implant having an upper surface facing the implant expander, a lower surface configured to be positioned against the target tissue, and a thickness measured from the upper surface to the lower surface;
wherein the plurality of flexible legs define a concave surface extending across the upper surface of the sheet-like implant in the expanded configuration; and
a plurality of retainers extending from the flexible legs and penetrating into the sheet-like implant to retain the sheet-like implant thereto.
2. The implant delivery system of claim 1 , further comprising a projection extending distally from the body portion of the implant expander along the longitudinal axis.
3. The implant delivery system of claim 2 , wherein the projection comprises a pointed distal tip pointing in a distal direction along the longitudinal axis.
4. The implant delivery system of claim 3 , wherein the pointed distal tip is configured to penetrate into the target tissue.
5. The implant delivery system of claim 3 , wherein the pointed distal tip penetrates through the sheet-like implant in the expanded configuration.
6. The implant delivery system of claim 1 , wherein the plurality of flexible legs are elastically deformed in the compact configuration.
7. An implant delivery system adapted to deliver a sheet-like implant to a target tissue, the implant delivery system comprising:
a delivery sheath having a lumen therein;
a delivery shaft movably disposed in the lumen of the delivery sheath along a longitudinal axis of the delivery shaft, the delivery shaft including a proximal end and a distal end;
an implant expander including a body portion and a plurality of flexible legs extending from the body portion, the body portion coupled to the distal end of the delivery shaft, wherein the plurality of flexible legs are configured to move between a compact configuration when constrained within the delivery sheath and an expanded configuration when deployed from the delivery sheath;
a sheet-like implant having an upper surface facing the implant expander, a lower surface configured to be positioned against the target tissue, and a thickness measured from the upper surface to the lower surface;
wherein the plurality of flexible legs define a concave surface extending along the upper surface of the sheet-like implant in the expanded configuration; and
a plurality of retainers extending from the flexible legs and penetrating into the sheet-like from the upper surface of the sheet-like implant to retain the sheet-like implant thereto.
8. The implant delivery system of claim 7 , further comprising a projection extending distally from the body portion of the implant expander along the longitudinal axis.
9. The implant delivery system of claim 8 , wherein the projection comprises a pointed distal tip pointing in a distal direction along the longitudinal axis.
10. The implant delivery system of claim 9 , wherein the pointed distal tip is configured to penetrate into the target tissue.
11. The implant delivery system of claim 9 , wherein the pointed distal tip penetrates through the sheet-like implant in the expanded configuration.
12. The implant delivery system of claim 8 , wherein the projection is configured to temporarily hold the sheet-like implant in position against the target tissue.
13. The implant delivery system of claim 7 , wherein the plurality of flexible legs are elastically deformed in the compact configuration.
14. The implant delivery system of claim 7 , wherein the plurality of retainers are located near free ends of the plurality of legs.
15. The implant delivery system of claim 14 , wherein the plurality of retainers curve toward the free ends of the plurality of legs.
16. The implant delivery system of claim 7 , wherein the plurality of retainers have a hook shape.
17. A method of deploying a sheet-like implant comprising:
positioning an implant delivery device proximate a target tissue site, the implant delivery device comprising:
a delivery shaft having a proximal end and a distal end;
an implant expander, mounted to the distal end of the delivery shaft, the implant expander including a body portion, a plurality of leg portions extending from the body portion, and a plurality of retainers extending from the flexible legs;
a sheath having a proximal end and a distal end and defining a lumen, wherein at least a portion of the delivery shaft is slidably disposed in the lumen; and
a sheet-like implant disposed at least partially within the sheath in a compact configuration covering at least a portion of the implant expander, with the plurality of retainers penetrating into the sheet-like implant;
advancing the delivery shaft relative to the sheath to cause the implant expander to advance through a distal opening of the sheath, wherein after advancing through the distal opening of the sheath, the implant expander causes the sheet-like implant to transition from the compact configuration to an expanded configuration, the plurality of flexible legs defining a concave surface extending along an upper surface of the sheet-like implant in the expanded configuration.
18. The method of claim 17 , wherein the implant expander further comprises a distal tip extending distally from a distal surface of the body portion of the implant expander, and the method further comprises:
causing the distal tip to penetrate the target tissue in order to temporarily hold the sheet-like implant in position relative to the target tissue; and
attaching the sheet-like implant to the target tissue.
19. The method of claim 17 , further comprising inserting one or more sutures through the sheet-like implant.
20. The method of claim 19 , further comprising withdrawing the implant expander subsequent to insertion of the one or more sutures.