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Apparatus and method for applying and adjusting an anchoring device
| Details |
Inventors: Green, David T.; Sienkiewicz, Henry R.; Ratcliff, Keith; Castro, Salvatore; Manzo, Scott E.;
Assignee: United States Surgical Corporation (Norwalk, CT)
Primary Examiner: Pellegrino; Stephen C.
Assistant Examiner: Schmidt; Jeffrey A.
Attorney, Agent or Firm:
A method and apparatus for elevating, approximating and/or restraining internal organs or structures, and more particularly for treating female urinary stress incontinence is provided. The invention includes an anchoring device having an elongated suture with an anchor at each end thereof and a cinching member therebetween for adjusting the length of the suture, an apparatus for applying the anchoring device, and an apparatus for drawing the suture relative to the cinching member after it has been emplaced. The method involves securing a first anchor to a first structure, such as the vaginal wall, securing a second anchor to a second structure, such as Cooper's ligament, and drawing the suture relative to the cinching member to approximate the first and second anchors, and thereby move the first structure and the second structure into juxtaposition so as to approximate them. |
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DETAILED DESCRIPTION An apparatus for applying an anchoring device to body tissue preferably comprises a handle portion defining a longitudinal axis, an elongated needle body extending from the handle portion and defining an axial bore configured to retain the anchors of the anchoring device, an elongated housing mounted adjacent the needle body and longitudinally movable with respect thereto between a first position wherein a distal end portion of the needle body is extended from the housing and a second position wherein the distal end portion of the needle body is shielded by the housing.
The apparatus also includes means operatively associated with the handle portion for individually advancing the anchors from the distal end portion of the needle body.
Preferably, the means for individually advancing the anchors from the needle body comprises an axially advanceable ratchet assembly which includes an elongated rack member, engaging means for locking the rack member in a predetermined axial position, a selectively actuable driving arm configured to interact with the rack member to advance the rack member in a distal direction, and a push rod extending within the needle body and from a distal end of the rack member for advancing the anchors therefrom.
In a preferred embodiment of the subject invention, the anchoring device comprises an elongated suture having an anchor positioned at each end thereof, and means provided on the suture and movable with respect thereto for adjusting the operative length of the suture.
Preferably, each anchor is positioned orthogonal to the elongation of the suture.
The operative length of the suture is preferably adjusted by a cinching member positioned proximate a medial portion of the suture and formed by a housing having a passageway extending therethrough for receiving a looped portion of the suture.
Gripping means is operatively associated with the passageway for controlling movement of the cinching member with respect to the suture in a first direction and inhibiting movement of the cinching member with respect to the suture in a second direction
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