# US 2013/0158677 A1 · Implantable repair device > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2013/0158677 A1 - Document ID: US20130158677A1 - Status: Published application - Kind: A1 - Application number: 13/766,048 - Filed: 2013-02-13 - Published: 2013-06-20 - Earliest claimed: 2006-10-31 - Assignees: Ethicon, Inc. - Inventors: Robert A. Rousseau; David C. Lindh, SR.; John R. Jacobs; IIya S. Koyfman; Gaoyuan Gavin Chen; Donald G. Hill - Web page: https://patentgrep.com/patent/US20130158677A1 ## CPC - A61F 2/02: Prostheses implantable into the body - A61F 2/0063: {Implantable repair or support meshes, e.g. hernia meshes} - A61F 2002/0068: {having a special mesh pattern} - A61F 2210/0004: bioabsorbable - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract An implantable prosthesis for repairing or reinforcing a tissue or muscle wall defect including a first composite structure including at least one layer of a non-absorbable material, wherein the first composite structure has a central portion sized and shaped to cover at least a portion of the tissue or muscle wall defect, and has an outer periphery. The prosthesis further includes a second structure having a reinforced central region and an outer peripheral edge, a reinforcing element positioned between the first and second structures, and having an outer periphery and a stiffness greater than that of the first and second structures, and at least one pulling element coupled to the reinforced central region of the second structure. The second structure is coupled to the first structure substantially only at their respective peripheries. ## Claims ### Claim 1 An implantable prosthesis for repairing or reinforcing a tissue or muscle wall defect, comprising: a first biocompatible structure having a central portion sized and shaped to cover at least a portion of the tissue or muscle wall defect and having a top side, a bottom side, and first and second extension portions extending laterally outward from opposite sides of the central portion; a reinforcement element positioned adjacent the top side of the patch portion and having a top side, a bottom side, and an outer circumferential edge; and a second biocompatible structure having a top side and a bottom side and at least one opening therethrough, the at least one opening being substantially centrally located; wherein the first and second extension portions of the first structure extend about the outer circumferential edge of the reinforcement element and then inwardly along the top side of the reinforcement element between the reinforcement element and the second structure, to a central portion of the reinforcement element, and then outwardly from the central portion through the at least one opening in the second structure, the first and second structures being secured to one another at least about a peripheral edge of the prosthesis. ### Claim 2 (depends on 1) The prosthesis according to claim 1, wherein the reinforcement element has a stiffness greater than a stiffness of the first and second structures. ### Claim 3 (depends on 1) The prosthesis according to claim 1, wherein the reinforcement element further comprises an outer circumferential ring and an inner circumferential ring and a plurality of spoke elements extending there between. ### Claim 4 (depends on 1) The prosthesis according to claim 1, wherein the reinforcement element has a three-dimensional shape. ### Claim 5 (depends on 4) The prosthesis according to claim 4, wherein the reinforcement element further comprises an outer circumferential ring, an inner circumferential ring, and a plurality of spoke elements extending there between, and wherein the outer circumferential ring lies substantially in a first horizontal plane and the inner circumferential ring lies substantially in a second horizontal plane spaced apart from the first horizontal plane. ### Claim 6 (depends on 5) The prosthesis according to claim 5, further comprising at least one rib-like element extending outwardly from at least one of the plurality of spoke elements, and aligned longitudinally along a length of the at least one spoke element. ### Claim 7 (depends on 6) The prosthesis according to claim 6, wherein the at least one rib-like element is aligned longitudinally along a length of the at least one spoke element. ### Claim 8 (depends on 1) The prosthesis according to claim 1, wherein distal ends of the first and second extension portions are folded over to form first and second looped elements. ### Claim 9 (depends on 8) The prosthesis according to claim 8, further comprising first and second grasping members secured to the first and second looped elements respectively. ### Claim 10 (depends on 1) The prosthesis according to claim 1, wherein the first structure further comprises: a patch member comprised of a non-absorbable mesh; and first and second absorbable film layers positioned adjacent top and bottom sides of the patch member respectively and secured thereto. ### Claim 11 (depends on 10) The prosthesis according to claim 10, wherein the patch member is comprised of polypropylene and the first and second film layers are comprised of polydioxanone. ### Claim 12 (depends on 10) The prosthesis according to claim 10, wherein the first structure further comprises a third layer positioned adjacent to a bottom side of the second film layer and secured thereto. ### Claim 13 (depends on 12) The prosthesis according to claim 12, wherein the third layer is comprised of an absorbable material. ### Claim 14 (depends on 13) The prosthesis according to claim 13, wherein the third layer is comprised of oxidized regenerated cellulose. ### Claim 15 (depends on 1) The prosthesis according to claim 1, wherein the second structure further comprises a ring element having an outer diameter less than an outer diameter of the second structure, and wherein the first and second extension portions of the first structure are coupled to the ring element. ### Claim 16 (depends on 15) The prosthesis according to claim 15, wherein the second structure further comprises a mesh layer, and third and fourth film layers positioned adjacent top and bottom sides respectively of the mesh layer and secured thereto. ### Claim 17 (depends on 16) The prosthesis according to claim 16, wherein the mesh layer and third and fourth film layers of the second structure are comprised of absorbable materials. ### Claim 18 (depends on 17) The prosthesis according to claim 17, wherein the mesh layer is comprised of polyglactin and the third and fourth film layers are comprised of polydioxanone. ### Claim 19 An implantable prosthesis for repairing or reinforcing a tissue or muscle wall defect, comprising: a first composite structure including at least one layer of a non-absorbable material, the first composite structure having a central portion sized and shaped to cover at least a portion of the tissue or muscle wall defect, and having an outer periphery; a second structure having a reinforced central region and an outer peripheral edge; a reinforcing element positioned between the first and second structures, and having an outer periphery and a stiffness greater than that of the first and second structures; and at least one pulling element coupled to the reinforced central region of the second structure; wherein the second structure is coupled to the first structure substantially only at their respective peripheries. ### Claim 20 (depends on 19) The prosthesis according to claim 19 having a substantially circular overall shape. ### Claim 21 (depends on 19) The prosthesis according to claim 19, wherein the reinforcing element has a three-dimensional shape. ### Claim 22 (depends on 21) The prosthesis according to claim 21, wherein the reinforcing element has an outer circumferential ring lying in a first horizontal plane and an inner circumferential ring lying in a second horizontal plane spaced apart from the first horizontal plane, and a plurality of spoke element extending between the inner and outer circumferential rings. ### Claim 23 (depends on 19) The prosthesis according to claim 19, wherein the first composite structure further comprises first and second absorbable film layers positioned adjacent top and bottom sides of the non-absorbable layer. ### Claim 24 (depends on 23) The prosthesis according to claim 23, wherein the non-absorbable layer is a mesh layer. ### Claim 25 (depends on 24) The prosthesis according to claim 24, wherein the first composite structure further includes an absorbable layer positioned adjacent a bottom side of the first film layer. ### Claim 26 (depends on 19) The prosthesis according to claim 19, wherein the central region of the second structure is reinforced by a ring element located therein. ### Claim 27 (depends on 19) The prosthesis according to claim 19, wherein the second composite structure is comprised of absorbable materials. ### Claim 28 An implantable prosthesis for repairing or reinforcing a tissue or muscle wall defect, comprising: a first substantially flat, flexible composite structure including at least one layer of non-absorbable material, the first composite structure having a central portion sized and shaped to cover at least a portion of the tissue or muscle wall defect and having an outer periphery; a second substantially flat, flexible, structure having an outer periphery substantially similar to the outer periphery of the first structure, and having a reinforced central region; a three-dimensional reinforcing element positioned between the first and second structures and having an outer periphery substantially similar to the outer periphery of the first and second structures; and at least one pulling element coupled to the central region of the second structure; wherein the first composite structure and the second structure are coupled to one another substantially only around their respective outer peripheries. ### Claim 29 (depends on 28) The prosthesis according to claim 28, wherein the reinforcement element further comprises an outer circumferential ring in a first horizontal plane, an inner circumferential ring in a second horizontal plane, and a plurality of spoke elements extending therebetween. ### Claim 30 (depends on 28) The prosthesis according to claim 28, wherein the at least one pulling element is a separate element coupled directly to the reinforced central region of the second structure. ### Claim 31 (depends on 28) The prosthesis according to claim 28, wherein the at least one pulling element is integrally formed with the first composite structure. ### Claim 32 (depends on 28) The prosthesis according to claim 28, wherein the non-absorbable layer of the first laminate structure is a mesh, and wherein the first structure further comprises first and second absorbable film layers positioned adjacent the top and bottom sides of the mesh. ### Claim 33 (depends on 32) The prosthesis according to claim 32, wherein the mesh is comprised of polypropylene and the first and second film layers are comprised of polydioxanone. ### Claim 34 (depends on 33) The prosthesis according to claim 33, wherein the second structure is further comprised of a mesh layer and third and fourth film layers positioned adjacent top and bottom sides of the mesh layer. ### Claim 35 (depends on 34) The prosthesis according to claim 34, wherein the mesh layer and third and fourth film layers of the second structure are comprised of absorbable materials. ### Claim 36 (depends on 28) The prosthesis according to claim 28, wherein the reinforcing element is comprised of an absorbable material. ### Claim 37 An implantable prosthesis for repairing or reinforcing a tissue or muscle wall defect, comprising: a first biocompatible structure having a central portion sized and shaped to cover at least a portion of the tissue or muscle wall defect and having a top side, a bottom side, and first and second extension portions extending laterally outward from opposite sides of the central portion; a reinforcement element positioned adjacent the top side of the first structure and having a top side, a bottom side, and an outer circumferential edge wherein the reinforcement element further comprises rings and a plurality of spoke elements extending therebetween; and, a second biocompatible structure having a top side and a bottom side and at least one opening therethrough, the at least one opening being substantially centrally located; wherein the first and second extension portions of the first structure extend about the outer circumferential edge of the reinforcement element and then inwardly along the top side of the reinforcement element between the reinforcement element and the second structure, to a central portion of the reinforcement element, and then outwardly from the central portion through the at least one opening in the second structure, the first and second structures being secured to one another at least about a peripheral edge of the prosthesis. ### Claim 38 (depends on 37) The prosthesis according to claim 37, wherein the reinforcement element has a stiffness greater than a stiffness of the first and second structures. ### Claim 39 (depends on 37) The prosthesis according to claim 37, wherein the reinforcement element has a three-dimensional shape. ### Claim 40 (depends on 37) The prosthesis according to claim 37, wherein distal ends of the first and second extension portions are folded over to form first and second looped elements, and further comprising first and second grasping members secured to the first and second looped elements respectively. ### Claim 41 (depends on 37) The prosthesis according to claim 37, wherein the first structure further comprises: a patch member comprised of a non-absorbable mesh; and first and second absorbable film layers positioned adjacent top and bottom sides of the patch member respectively and secured thereto. ### Claim 42 (depends on 41) The prosthesis according to claim 41, wherein the patch member is comprised of polypropylene and the first and second film layers are comprised of polydioxanone. ### Claim 43 (depends on 41) The prosthesis according to claim 41, wherein the first structure further comprises a third layer of an absorbable material positioned adjacent to a bottom side of the second film layer and secured thereto. ### Claim 44 (depends on 37) The prosthesis according to claim 37, wherein the second structure further comprises a ring element having an outer diameter less than an outer diameter of the second structure, and wherein the first and second extension portions of the first structure are coupled to the ring element. ### Claim 45 (depends on 44) The prosthesis according to claim 44, wherein the second structure further comprises a mesh layer, and third and fourth film layers positioned adjacent top and bottom sides respectively of the mesh layer and secured thereto, and wherein the mesh layer and third and fourth film layers of the second structure are comprised of an absorbable material. ### Claim at position 46 46-88. (canceled)