Pubovaginal sling implanter and procedure for the usage

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion and with an aperture on the side of said guide tube at the extreme of the distal end,
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with a shank at the proximal end of said detachable penetrator constructed so it is capable of being inserted inside the distal end of said rigid guide tube, with means to be kept in place in said guide tube by engaging a resilient protrusion on the side of said shank into the aperture on the side of said guide tube and with a penetrating tip at the distal end of said detachable penetrator,
• a stiff but flexible shaft inside said guide tube having a distal end part movable distally relative to the guide tube when the detachable penetrator is not attached to the guide tube,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to the guide tube,
• said shaft, when the detachable penetrator is not connected to the guide tube, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from an retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to a extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally at an angle of not less than about ninety degrees with respect to the stem portion of the guide tube.

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion and with an internal swage groove 360 degrees internally very close to the distal end,
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with a shank at the proximal end of said detachable penetrator constructed so it is capable of being inserted inside the distal end of said rigid guide tube, with means to be kept in place in said guide tube by engaging a resilient protrusion on the side of said shank into the internal swage groove of said guide tube and with a penetrating tip at the distal end of said detachable penetrator,
• a stiff but flexible shaft inside said guide tube having a distal end part movable distally relative to the guide tube when the detachable penetrator is not attached to the guide tube,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to the guide tube,
• said shaft, when the detachable penetrator is not connected to the guide tube, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from a retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to a extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally at an angle of not less than about ninety degrees with respect to the stem portion of the guide tube.

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion;
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with a shank at the proximal end of said detachable penetrator constructed so it is capable of being inserted inside the distal end of said rigid guide tube, with a counterbore threaded hole at the proximal end and with a penetrating tip at the distal end of said detachable penetrator,
• a stiff but flexible shaft inside said guide tube having a external threaded distal end part movable distally relative to the guide tube when the detachable penetrator is not attached to the guide tube, said threaded distal end part for engagement with the internal thread of said counterbore threaded hole at the proximal end of the said detachable penetrator,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to the guide tube,
• said shaft, when the detachable penetrator is not connected to the guide tube, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from an retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to an extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally at an angle of not less than about ninety degrees with respect to the stem portion of the guide tube.

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion and with internal threads at the distal end,
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with external threads at the proximal end of said detachable penetrator constructed so it is capable of being engaged with the internal threads of the distal end of said guide tube and with a penetrating tip at the distal end of said detachable penetrator,
• a stiff but flexible shaft inside said guide tube having a distal end part movable distally relative to the guide tube when the detachable penetrator is not attached to the guide tube,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to the guide tube,
• said shaft, when the detachable penetrator is not connected to the guide tube, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from an retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to a extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally at an angle of not less than about ninety degrees with respect to the stem portion of the guide tube.

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion and with locking engagement means at the proximal end,
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with a shank at the proximal end of said detachable penetrator constructed so it is capable of being inserted inside the distal end of said rigid guide tube and with a penetrating tip at the distal end of said detachable penetrator,
• a stiff but flexible shaft inside said guide tube having a distal end part movable distally relative to the guide tube,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to said guide tube and with locking engagement means at the distal end of said griping means for engaging with the locking engagement means at the proximal end of said guide tube during the instrument insertion during the procedure,
• a dead end cavity at the distal end of said penetrator to make room for the distal end of said flexible shaft when said flexible shaft and said guide tube threads are engaged,
• said shaft, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from a retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to a extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally an angle of not less than about ninety degrees with respect to the stem portion of the guide tube with the bend close to the distal end of said guide tube forcing the side of said flexible shaft to develop a normal force against the internal wall of the dead end cavity as the stiff flexible shaft tends to go in a straight line, said normal force creating enough friction to keep said detachable penetrator from separating from said guide tube.

An instrument which aids inserting a Pubovaginal Sling to correct stress urinary incontinence (SUI) in women, comprising

• a substantially rigid guide tube having opposite open ends which are distal and proximal relative to a person using the instrument, said guide tube having a stem portion and a distal end portion extending generally laterally with respect to the stem portion,
• a handle on the stem portion of the guide tube generally adjacent the proximal end of the guide tube,
• a detachable penetrator having opposite ends with a shank at the proximal end and with a penetrating tip at the distal end, constructed so it is capable of being inserted inside the distal end of said rigid guide tube and with engagement means to keep said penetrator and said rigid guide tube together,
• a stiff but flexible shaft inside said guide tube having a distal end part movable distally relative to the guide tube when the detachable penetrator is not attached to the guide tube,
• a suture thread holder on the distal end part of the shaft and griping means at the proximal end of the flexible shaft externally to the guide tube,
• said shaft, when the detachable penetrator is not connected to the guide tube, being manually movable longitudinally relative to the guide tube to move the distal end part of the shaft from a retracted position in which the suture thread holder is adjacent to the open distal end of the guide tube, to an extended position in which the suture thread holder is farther away from the distal end of the guide tube, the distal end portion of the guide tube being configured to guide the distal end part of the shaft and the suture thread holder thereon along a substantially straight path extending generally laterally at an angle of not less than about ninety degrees with respect to the stem portion of the guide tube.