U.S. patent application number 10/436812 was filed with the patent office on 2004-11-18 for article for positioning mesh over tissue.
Invention is credited to Shayani, Vafa.
Application Number | 20040230208 10/436812 |
Document ID | / |
Family ID | 33417254 |
Filed Date | 2004-11-18 |
United States Patent
Application |
20040230208 |
Kind Code |
A1 |
Shayani, Vafa |
November 18, 2004 |
Article for positioning mesh over tissue
Abstract
An article of manufacture suitable for positioning a sheet of
mesh material over tissue is described. In one embodiment, the
article comprises a surgical tack having a hook-type material such
as Velcro.RTM. material carried by the tack, e.g., secured to the
top of the head thereof. A plurality of such tacks are positioned
around the site of a hernia or the like and the mesh is positioned
over the site and the tacks. The mesh is made of a loop-type
Velcro.RTM. material or the like which allows the mesh to be
releasably engaged and disengaged from the hook-type material
carried by the tacks so that the mesh can be appropriately
positioned over the tissue.
Inventors: |
Shayani, Vafa; (Hinsdale,
IL) |
Correspondence
Address: |
OLSON & HIERL, LTD.
20 North Wacker Drive, 36th Floor
Chicago
IL
60606
US
|
Family ID: |
33417254 |
Appl. No.: |
10/436812 |
Filed: |
May 13, 2003 |
Current U.S.
Class: |
606/151 |
Current CPC
Class: |
A61B 2017/0649 20130101;
A61F 2/0063 20130101; A61B 17/064 20130101 |
Class at
Publication: |
606/151 |
International
Class: |
A61B 017/08 |
Claims
I claim:
1. An article of manufacture suitable for positioning a sheet of
mesh over tissue comprising a tack adapted to be fastened to the
tissue and mesh engaging material carried by the tack for
releasable engagement of the mesh.
2. The article of manufacture in accordance with claim 1 wherein
the tack has a base for fastening the tack to the tissue and a head
which supports the mesh engaging material.
3. The article of manufacture in accordance with claim 2 wherein
the mesh engaging material is a hook-type fiber material adhesively
attached on the top of the head of the tack and the mesh is a
loop-type fiber material adapted for releasable engagement with the
hook-type fiber material.
4. The article of manufacture in accordance with claim 1 wherein
the mesh engaging material is carried by a Q-ring type tack.
5. The article of manufacture in accordance with claim 4 wherein
the engaging material is a hook-type fiber material and the mesh is
a loop-type fiber material adapted for releasable engagement with
the hook-type material.
6. A surgical tack for use in positioning and repositioning a sheet
of mesh material over tissue, the tack comprising: a head having
hook-type fiber material disposed thereon; and a tissue piercing
and engaging member extending away from a bottom face of the head,
whereby the tack is adapted to be secured to the tissue and the
mesh material is releasably engageable with the hook-type
material.
7. The surgical tack of claim 6 wherein the tissue piercing and
engaging member comprises a spiral coil member terminating in a
piercing tip.
8. The surgical tack of claim 6 wherein the head defines a cavity
adapted to accept a driver for fastening the tack into the
tissue.
9. The surgical tack of claim 6 wherein the strip of hook-type
fiber material is adhesively secured to the head.
10. A method of positioning and securing a sheet of mesh material
over tissue comprising the steps of: (a) securing a plurality of
tacks to the tissue, each of the tacks having a mesh engagement
element associated therewith; (b) positioning the sheet of mesh
material over the tissue and the tacks; (c) pressing the sheet of
mesh material against the tacks and the mesh engagement elements
thereon; and (d) adjusting the position of sheet of mesh material
over the tissue by releasably engaging and disengaging the sheet of
mesh material from the mesh engagement elements.
11. The method of claim 10 wherein step (a) includes positioning a
plurality of the mesh engagement elements to the tissue and then
driving a plurality of the tacks through the mesh engagement
elements and into the tissue.
12. The method of claim 10 further comprising the step (e) of
fastening the sheet of mesh material to the tissue following step
(d).
Description
FIELD OF THE INVENTION
[0001] This invention relates to surgical devices and, more
particularly, to surgical articles used to position and fix mesh
over tissue for repair of abdominal wall defects.
BACKGROUND OF THE INVENTION
[0002] Abdominal wall defects or hernias are commonly repaired
using a physiologically compatible synthetic mesh such as a
polytetrafluoroethylene mesh, polypropylene mesh, and the like.
Tension-free mesh repair of hernias is preferred over conventional
suture closure, which often results in the creation of significant
tension and subsequent recurrence of the hernia. More recently,
video-assisted (laparoscopic) technology has been utilized to
repair the abdominal wall defects from a posterior (from inside the
abdomen) position, thus offering the potential for a lower
incidence of subsequent recurrence of the hernia. Where the
laparoscopic technique is utilized, the synthetic mesh is typically
secured against the abdominal wall using surgical tacks of various
types, for example of the type disclosed in U.S. Pat. Nos.
5,728,116 and 6,036,701, and also of the Q-ring type commercially
available from Onux Medical, Inc. of Hampton, NH.
[0003] One of the challenges encountered during laparoscopic hernia
repair is the placement of the mesh and the tacks in the precisely
intended location to provide adequate overlap of the mesh with the
surrounding abdominal wall tissue. With each application of an
additional surgical tack, repositioning of the mesh (when
necessary) becomes more and more difficult, if not impossible. In
addition, during the early process of tacking the mesh to the
abdominal wall, the field of view is often significantly hindered
by the partially dangling piece of mesh. This limitation may reach
unsafe levels in cases of large abdominal wall defects requiring
large pieces of mesh, with significant potential for inadvertent
injury to abdominal organs.
[0004] There is, therefore, a need for improving the existing
technique of laparoscopic hernia repair through the use of a tack
or the like that would allow placement of the tacks before
obliteration of the view by the mesh, and subsequent near-perfect
positioning and repositioning of the mesh as needed.
SUMMARY OF THE INVENTION
[0005] The present invention provides a safe and efficient means or
article for the application and subsequent repositioning of
synthetic mesh to the abdominal wall with minimal risk of injury to
abdominal tissue and organs.
[0006] Accordingly, the invention is an article suitable for
positioning a sheet of surgical mesh over tissue and comprising a
mesh engaging material associated with a tack adapted to be
fastened to the tissue. The mesh is releasably engaged and
disengaged from the mesh engaging material associated with the tack
so as to allow the positioning and subsequent repositioning and
stretching of the mesh over the tissue.
[0007] In one embodiment, the tack includes a head bearing a
hook-type fiber material and a tissue anchoring member which
depends from the head. The tack is secured to the tissue and the
mesh material is releasably engageable with the hook-type material
carried by the tack. In this manner the mesh material can be
positioned and repositioned over tissue as desired by the
surgeon.
[0008] In another embodiment, the tack secures a piece of the mesh
engaging material to the tissue. The mesh can then be pressed
against the mesh engaging material secured to the tissue and is
releasably held in place by the mesh engaging material.
[0009] Other advantages and features of the present invention will
be more readily apparent from the following detailed description of
the preferred embodiments of the invention, the accompanying
drawings, and the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] In the accompanying drawings forming part of the
specification and in which like numerals are employed to designate
like parts throughout the same,
[0011] FIG. 1 is an enlarged, partial front elevational view of a
surgical tack provided with releasable mesh engagement element;
[0012] FIG. 2 is a top plan view of a patch of surgical mesh
suitable for releasable engagement to the mesh engagement element
shown in FIG. 1;
[0013] FIG. 3 is a front elevational view of the entire surgical
tack of FIG. 1;
[0014] FIG. 4 is a perspective view of the surgical tack of FIG. 3
provided with a slotted head;
[0015] FIG. 5 is a perspective view of a tack similar to that of
FIG. 3 and provided with a head configured to receive a Torx
driver;
[0016] FIG. 6 is a perspective view of a tack similar to that of
FIG. 3 and configured to receive a Phillips driver;
[0017] FIG. 7 is a perspective view of a tack similar to that of
FIG. 3 and configured to receive an Allen driver; and
[0018] FIG. 8 is an enlarged, fragmentary front elevational view
depicting the releasable mesh engagement element held in place with
a Q-ring type of tack.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0019] The invention disclosed herein is susceptible of embodiment
in many different forms. Shown in the drawings and described
hereinbelow in detail are preferred embodiments of the invention.
It is to be understood, however, that the present disclosure is an
exemplification of the principles of the invention and does not
limit the invention to the illustrated embodiments.
[0020] Moreover, it is understood that the specification herein
does not necessarily describe the details of the surgical tack or
the releasable mesh engagement element that are known in the art
and that will be recognized as such by those skilled in the art.
The detailed descriptions of these elements are not necessary to an
understanding of the article of the present invention. Accordingly,
such elements are herein represented and described only to the
degree necessary to aid in an understanding of the features of the
present invention.
[0021] FIGS. 1, 3 and 4 depict a preferred embodiment of the
present invention in which article 10 comprises a surgical tack 11
having a releasable mesh engagement element or member 20 attached
to the top of head 12.
[0022] Head 12 has a circular, disk like figuration and includes a
body 14 and top and bottom radial faces 16 and 18, respectively.
The top face 16 of the head 12 is covered with a circular, disk
shaped releasable mesh engagement member, such as patch 20, which
is preferably made of and includes hook-type Velcro.RTM. or the
like latching fiber material 21. The mesh engagement member such as
patch 20 may be secured to the top face 16 of the head 12 by any
known means including, but not limited to, adhesive applied either
directly to the top of the head 12, to the lower surface of the
mesh engagement member 20, or both. A tack driver cavity, such as
slot or straight slit 22, extends across top face 16 and into the
body 14 of head 12. The slot 22 is configured to receive a
complementary driver.
[0023] The tack 11 additionally comprises an elongate spiral screw
member or base 24 which extends generally away from the bottom
radial face 18 of the head 12. The spiral screw member 24
terminates in a distal tissue piercing tip 26.
[0024] FIGS. 5-7 depict alternate respective article embodiments
100, 200 and 300 similar in structure to the article 10 except that
the respective heads 112, 212 and 312 of the tacks 111, 211 and 311
respectively incorporate cavities 122, 222 and 322 structured and
shaped to accept Torx, Phillips or Allen drivers for driving and
securing the tacks into tissue for the purposes described in more
detail below.
[0025] The article 10 of the present invention is suitable for use
in a variety of surgical procedures including, but not limited to,
the repair of ventral hernias. In connection with the repair of
ventral hernias, an incision is first made into a patient's
abdominal cavity in order to access the site of the hernia (i.e.,
abdominal wall defect) using conventional surgical techniques.
After the site has been prepared using conventional surgical
techniques, several tacks capable of releasably holding a surgical
mesh are secured around the perimeter of the abdominal wall defect
using conventional tacking devices such as, for example, a surgical
grasper, a tack driver, or alternatively, a tacking gun which has
been pre-loaded with a predetermined number of the surgical
tacks.
[0026] The tacks 11 are advantageously secured to the tissue around
the abdominal wall defect sought to be repaired prior to the
insertion of any mesh material into the abdominal cavity, and with
the full view of the abdominal wall defect and surrounding internal
organs. Thereafter, an appropriately sized sheet or patch of the
biocompatible surgical mesh, for example, such as the sheet of mesh
material 28 depicted in FIG. 2, is inserted through the incision
and positioned over the site of the hernia with the peripheral
edges thereof overlying the tacks. The mesh material is then
pressed into abutting contact against the tacks 11 and, more
specifically, against the heads 12 thereof so as to cause the
loop-type material comprising the fabric of the mesh 28 to become
releasably intertwined, latched and engaged with the hook-type
material 21 of tack 11 as shown in FIG. 1. The mesh 28 may then be
selectively disengaged or released from tack 11, and then
subsequently selectively stretched and re-attached or re-engaged
with the latching fiber material until the optimal positioning and
stretching of the mesh 28 over the tissue site has been
achieved.
[0027] Once the desired mesh placement has been accomplished, any
one of a number of conventional tacking devices may be used to
apply conventional surgical tacks to further secure and maintain
the mesh 28 over the site of the hernia. The hernia repair
procedure is then completed in a conventional manner and the
incision in the wall of the abdominal cavity is closed using
conventional surgical sutures.
[0028] The foregoing description is to be taken as illustrative,
but not limiting of the scope of the present invention. Still other
variants within the spirit and scope of the present invention will
readily present themselves to those skilled in the art such as, for
example, the alternate article 500 shown in FIG. 8 where a patch or
strip 520 including Velcro.RTM. type hook material 521 is
positioned against the tissue 522 and a Q-ring type tack 511 of the
type manufactured by Onux Medical, Inc. of Hampton, NH is driven
through the patch 520 and into the tissue 522 to fasten the patch
520 to the tissue. It is understood, of course, that a plurality of
patches such as patch 520 are positioned around the hernia site,
and that a plurality of the tacks 511 are driven through the
patches 520 respectively. The mesh 528 is then releasably securable
to the aforesaid plurality of patches in the same manner as that
described above with respect to the tacks 11.
* * * * *