Implantable device, in particular for parietal repair

Abstract

The present invention relates to an implantable device, in particular for parietal surgery, comprising a warp knitted fabric, the knitted fabric comprising: - a first knitted layer comprising a monofilament yarn A knitted with knitted stitches; - a second knitted layer comprising a monofilament yarn B knitted with knitted stitches; - a third knitted layer with a monofilament yarn C knitted with knitted stitches; and - the warp knitted fabric comprises a knitted bottom and comprises gripping knitted loops which project from the knitted bottom and are inclined toward the knitted bottom. The present invention also relates to a method for producing such a device.

Description

[0001] IMPLANTABLE DEVICE, IN PARTICULAR FOR PARIETAL RECONSTRUCTION

[0002] Technical Field

[0003] The present invention relates to an implantable device, in particular for parietal surgery, in particular for the repair of hernias.

[0004] The present invention also relates to a method of manufacturing such an implantable device.

[0005] State of the art

[0006] It is known to treat parietal insufficiencies (hernias and eventrations in particular) to use a textile prosthesis to mechanically reinforce the deficient abdominal or inguinal wall. In order to maintain the reinforcing textile prosthesis on the abdominal or inguinal wall, the surgeon uses sutures and / or staples. Before placing the sutures or staples, it is quite common for the surgeon to correctly reposition the prosthesis by moving it laterally so that it can cover the inguinal orifices. The sutures are intended to maintain the prosthesis in its final implantation position chosen by the surgeon, while it is colonized by native scar tissue which is the consequence of a fibroblastic reaction. However, these fixations cause pain and are uncomfortable for the patient.

[0007] To reduce the pain caused by sutures, it has been proposed to integrate bioadhesives into prostheses (i.e., those that can be activated by the water contained in the tissues of the human body). These bioadhesives do not allow satisfactory repositioning of the prosthesis when placed using a TAPP (TransAbdominal PrePeritoneal) or TEP (Totally Extra-peritoneal) surgical technique. Either because they are too adherent and it is difficult, or even impossible, to envisage lateral displacement (for example, this is the case with the LifemeshTM prosthesis from the Lifebond company, which has an adhesive that fixes immediately upon contact with the tissues), or because the adhesion is too weak and does not allow the position given by the surgeon to be maintained in the long term, even if lateral displacement of the prosthesis is easier.Control of sufficient adhesion to allow the prosthesis to be maintained in its implantation position in the long term but not too excessive to allow lateral repositioning during its placement cannot be achieved with a bioadhesive.

[0008] An implantable device has thus been proposed comprising a knitted fabric from which rectilinear spikes project, provided at their free ends with a melted head having a larger cross-section than the body of a spike. This type of device is marketed under the brand name ProGrip TM by the Medtronic company and its manufacturing technique is described in patent EP 1,274,892 Bl. This prosthesis comprises spikes which do not allow lateral repositioning since the spikes penetrate the muscle tissues when the prosthesis is put in place. When the prosthesis is repositioned, the spikes tear the muscle tissues and lose their adhesive capacity. This prosthesis also has a major disadvantage compared to the disadvantages previously mentioned. Indeed, for placement, the prosthesis is rolled up on itself to be passed through a trocar, but it has the particularity of gripping on itself.This drawback forces the surgeon to force its unwinding for its insertion, which causes degradation of the spikes. The operating time using a TAPP or TEP surgical technique is then significantly extended. One solution proposed to this problem was to cover the gripping spikes with a water-soluble film that dissolves almost immediately after implantation. This solution, described in patent FR2949687B1, has the disadvantage that the process is more complex and time-consuming since an additional step of adding a film is necessary. Once the water-soluble film is dissolved in the body, the spikes enter the abdominal fat and muscle tissue. The spikes that penetrate the muscle wall can come into contact with nerves and cause pain in the patient.There is thus a need for an implantable device, particularly for parietal surgery, which allows immediate adhesion to the abdominal or inguinal wall, which is repositionable, does not migrate laterally after implantation, preserves patient comfort (in particular by avoiding penetration into the muscle of the abdominal wall in order to limit pain), and finally can be rolled and unrolled without risk of degradation of its mechanical properties. Finally, there is a need for a manufacturing process for such an implantable device which is simple and reliable.

[0009] The present invention relates to an implantable device which does not require fixation by means of a suture or synthetic glue, which limits pain without penetrating into the muscle tissue, which can be easily unrolled after passing through a trocar, which can be easily repositioned laterally without damaging the tissues to enable it to be precisely positioned on the surgical site using a TAPP or TEP technique in order to cover the hernial orifices, and which finally does not migrate laterally in the long term.

[0010] Statement of the invention

[0011] The present invention relates, according to a first aspect, to an implantable device, in particular for parietal surgery, characteristically comprising a warp-knitted fabric, said fabric comprising:

[0012] - a first knitted sheet comprising a monofilament yarn A knitted with knitted stitches,

[0013] - a second knitted sheet comprising a monofilament yarn B knitted with knitted stitches,

[0014] - a third knitted tablecloth with a monofilament yarn C knitted with knitted stitches, and

[0015] - said warp knit comprises a knitted base and comprises gripping knitted loops projecting from said knitted base and inclined towards said knitted base. Advantageously, two knitted layers, in particular the first and second knitted layers, form at least in part the knitted base of the warp knit, while the remaining knitted layer, in particular the third knitted layer, is regularly anchored in the knitted base and forms small knitted loops, closed, and projecting from said knitted base while being inclined relative to the latter.

[0016] Advantageously, the knitted base comprises, in particular is formed of, the first and second knitted sheets, and optionally comprises, in particular is formed of, at least in part the third knitted sheet.

[0017] Advantageously, the knitted loops comprise, in particular are formed, at least in part from the third knitted sheet, and possibly from the first and / or second knitted sheet(s).

[0018] Advantageously, at least one gripping and inclined knitted loop, in particular the gripping and inclined knitted loops, is (are each) a mesh loop, in particular formed by a needle. Advantageously, at least one gripping and inclined knitted loop, in particular the gripping and inclined knitted loops, is / are not one or more knitted floats.

[0019] Advantageously, the inclined knitted and gripping loops of the warp-knitted fabric according to the invention offer numerous advantages. These gripping loops allow lateral repositioning of the implantable device because they penetrate the fatty tissue but without penetrating, or at least not significantly, the muscle tissue. This arrangement considerably improves patient comfort.

[0020] Advantageously, it has been observed that the gripping knitted loops penetrate fatty tissue but do not retain a large amount of fatty tissue when the loops are removed from the fatty tissue, allowing the implantable device to be repositionable.

[0021] Advantageously, the gripping loops are inclined, allowing immediate adhesion without penetrating the muscle tissue. The inclination of the gripping loops also prevents the implantable device from migrating laterally, i.e. from translating, along the abdominal wall for example.

[0022] The implantable device can also be rolled up on itself for insertion into a trocar and then easily unrolled without the inclined gripping loops catching in the knitted structure and hindering unrolling. The implantable device can therefore be rolled up and unrolled without risk of damaging the warp knit. Finally, the inclined gripping loops are formed by knitting and are therefore obtained inclined at the outlet of the knitting machine. The gripping members are therefore not formed during an additional operation carried out on the warp knit after knitting at the risk of degrading the mechanical strength of the warp knit. The gripping and inclined loops formed by knitting are therefore very reproducible from one loop to another: their rigidity, dimensions, number and distribution are therefore linked to the knitting process with monofilament yarns.This arrangement allows for immediate adhesion, repositionability, and transverse movement without penetrating muscle tissue.

[0023] Preferably, the warp knit comprises a first face and a second face that are substantially opposite.

[0024] Preferably, the knitted bottom extends between said first face and said second face of the warp knit.

[0025] Preferably, the gripping and inclined knitted loops project from the first face of the knitted bottom of the warp knit.

[0026] Preferably, the warp knit does not include inclined gripping loops extending along its second face.

[0027] Preferably, the warp knit comprises a first side edge and a second side edge, in particular substantially parallel to each other.

[0028] A first lateral edge, respectively a second lateral edge, may be straight or not, for example wavy or convex or concave.

[0029] Preferably, the warp knit comprises an upper edge and a lower edge.

[0030] In particular, the first lateral edge, respectively the second lateral edge, extends between the upper edge and the lower edge.

[0031] The warp knit can have any shape, for example rectangular or square. Advantageously, since the warp knit is a non-ravel knit, the surgeon can re-cut the warp knit once removed from its sterilized packaging bag to adapt it to the parietal defect to be treated without the risk of the cut portion(s) fraying.

[0032] Advantageously, the warp knit comprises a warp direction, and columns of stitches extending longitudinally in the warp direction.

[0033] Advantageously, the warp knit comprises a weft direction, and rows of stitches extending longitudinally in the weft direction.

[0034] In particular, the weft direction is substantially perpendicular to the warp direction.

[0035] In this text, knitted stitches are understood to mean stitches, in particular closed or open, preferably closed, (i.e. formed by a given yarn) extending over at least two columns of stitches of the warp-knitted fabric or over at least two needles.

[0036] In this text, a knitted sheet comprising a monofilament yarn is understood to mean that said sheet is formed in part or entirely by said knitted monofilament yarn.

[0037] In this text, a knitted tablecloth is understood to mean a knitted network formed by at least one thread extending over the width and height of the warp knit.

[0038] Advantageously, the monofilament yarn knitted into a web is knitted in a repeating pattern that is repeated across the width of the warp knit between the first and second side edges, and across the height of the warp knit between the top and bottom edges.

[0039] In particular, a knitted tablecloth is knitted with at least one yarn supported by a guide bar working on a knitting machine.

[0040] Advantageously, the warp knitting is therefore knitted with at least three different guide bars, in particular each guide bar has a movement (i.e. a stitch pattern) different from the movements (i.e. the stitch patterns) of the at least two other guide bars.

[0041] Warp knitting can be knitted on a warp or rachel knitting machine.

[0042] In particular, warp knitting is knitted with at least three different guide bars, each supporting at least one monofilament yarn.

[0043] Advantageously, the warp knit comprises, in particular is formed of, three monofilament yarns A, B and C each knitted according to different repeat patterns. In particular, a repeat pattern corresponds to the movement of a guide bar on the needles of the knitting machine.

[0044] Monofilament thread(s) A and / or B and / or C

[0045] The monofilament thread(s) is / are in one or more biocompatible materials, i.e. suitable for implantation in a living organism, human or animal, for a period of a few hours to several months or years.

[0046] The monofilament yarn(s) A and / or B and / or C may be in one or more materials chosen from:

[0047] - a list I comprising non-(bio)absorbable materials, preferably non-(bio)absorbable materials include: non-(bio)absorbable polyesters, such as polyethylene terephthalate (PET), and polybutylene terephthalate (PBT); polyamides; polyetheretherketon (PEEK); polyolefins, such as polypropylene and polyethylene; and a mixture thereof; more preferably polyolefins, and non-(bio)absorbable polyesters;- a list II comprising bioresorbable materials, preferably the bioresorbable materials include: polylactic acid (PLA, PDLA, PLLA), polyglycolic acid (PGA), oxidized cellulose, polycaprolactone (PCL), polydioxanone (PDO), polytrimethylenecarbonate (TMC), polyvinyl alcohol (PVA), polyhydroxyalkanoate (PHA), Poly4-Hydroxybutyrate (P4HB), block copolymers of P4HB (poly4-Hydroxybutyrate) and P3HB (poly3-Hydroxybutyrate), copolymers of lactic acid or glycolic acid and caprolactone, copolymers of trimethylenecarbonate and lactic acid, in particular PLA, PLLA, PDLA; copolymers of the latter, or a mixture of the latter, more preferably polylactic acid (PLA, PLLA, PDLA), polyglycolic acid (PGA), and copolymers of trimethylene carbonate and lactic acid (PLA, PLLA, PDLA), or a mixture of the latter.;

[0048] Preferably, yarn A and / or yarn B is / are in one or more materials chosen from list I.

[0049] Preferably, the wire C is in one or more materials chosen from list II.

[0050] Preferably, at least a portion of the inclined gripping loops, more preferably the inclined gripping loops, is / are bioresorbable. When the inclined and gripping loops are bioresorbable, they are formed from one or more bioresorbable material(s). Advantageously, the inclined gripping loops ensure their immediate and repositionable adhesion function for a time allowing the scar fibrosis to take over for the definitive attachment of the implantable device to the abdominal wall to be treated. The gripping loops are therefore resorbed over time and disappear. Only the first and second knitted layers remain as permanent mechanical reinforcement.

[0051] The monofilament yarn(s) A and / or B and / or C each preferably has a diameter of between 50 pm and 300 pm, more preferably between 80 pm and 200 pm, preferably between 80 pm and 150 pm.

[0052] In particular, the monofilament yarn(s) A and / or B each has / have a diameter of between 50 pm and 200 pm, for example of the order of 100 + / -10 pm.

[0053] In particular, the monofilament yarn C has a diameter of between 100 pm and 300 pm, for example of the order of 150 + / - 10 pm. It is understood in this text that a parameter is between x and y, that the values ​​x and y are in the interval from x to y, and therefore that said parameter can be equal to x or y.

[0054] The monofilament yarn(s) A and / or B and / or C may be one or more multifilament yarn(s), in particular in one or more materials chosen from list I and / or II.

[0055] The multifilament yarn(s) preferably has / have a linear mass of between 50 dtex and 400 dtex, more preferably between 60 dtex and 300 dtex, preferably between 60 dtex and 220 dtex.

[0056] In particular, the monofilament yarn(s) A and / or B each has / have a linear density of between 60 dtex and 300 dtex, for example of the order of 70 + / -10 dtex.

[0057] In particular, monofilament yarn C has a linear density of between 60 dtex and 300 dtex, for example of the order of 220 + / -15 dtex.

[0058] In one embodiment, the warp knit consists essentially of the first, second, and third knitted plies.

[0059] It is understood by the warp knit consisting essentially of the first, second, and third knitted layers that said knitted layers represent at least 80% by mass, preferably at least 90% by mass, more preferably at least 95% by mass, preferentially approximately 100% by mass, of the total mass of the warp knit.

[0060] For example, when the three knitted layers represent at least 80% by mass of the warp knit, said warp knit may comprise one or more other yarn(s) but not forming a knitted layer, i.e. repeated over the width and height of the knit.

[0061] In this text, a gripping loop is understood to mean that a loop is configured to grip the abdominal / inguinal wall to be treated, in particular the fatty tissue.

[0062] In this text, an inclined loop is understood to mean that a loop does not extend substantially vertically from the knitted base, but is inclined towards said knitted base, and is in particular oriented in a given direction, for example in a direction F1 or F2 or F3 or F4, more particularly corresponding to the direction of placement of the implantable device in the caudal direction of the patient being treated.

[0063] Advantageously, the inclination of the loops makes it possible to avoid migration of the implantable device in the caudal direction when the patient is in a standing position, i.e. in the direction in which the inclined loops are oriented.

[0064] Preferably, the warp knit comprises a direction F1 and a direction F2 opposite, and substantially parallel to the warp direction or to the direction of the columns of stitches of the warp knit. More preferably, the direction F1 extends from the lower edge of the warp knit to the upper edge of the warp knit, and the direction F2 extends from the upper edge of the warp knit to the lower edge of the warp knit.

[0065] Preferably, the warp knit comprises a direction F3 and a direction F4 opposite, and substantially parallel to the weft direction or to the direction of the rows of stitches. More preferably, the direction F3 extends from the second lateral edge of the warp knit to the first lateral edge of the warp knit, and the direction F4 extends from the first lateral edge of the warp knit to the second lateral edge of the warp knit.

[0066] In one embodiment, a portion (in particular between one third and one half of the total gripping loops) of the gripping and inclined loops of the warp knit are oriented in direction F4, and / or a portion (in particular between one third and one half of the total gripping loops) of the gripping and inclined loops of the warp knit are oriented in direction F3.

[0067] Preferably, a gripping inclined loop, in particular each of the gripping inclined loops, comprises a distal end and a loop foot, more preferably comprises an axis of symmetry S passing through said distal end and separating the loop into first and second lateral portions symmetrical to each other with respect to said axis S.

[0068] Preferably, the gripping knitted loops are knitted loops, i.e. meshed (i.e. each formed by knitting a needle).

[0069] Preferably, the gripping knitted loops are each formed from a closed knitted stitch.

[0070] It is understood by a gripping inclined loop oriented in the direction F4, respectively F3, that the distal end of said loop is oriented opposite the second, respectively the first, lateral edge. The warp knit may comprise gripping inclined loops all oriented in the same direction (F3 or F4 for example); or gripping inclined loops oriented in different directions; or even first gripping inclined loops oriented in a given direction F (F3 or F4 for example) and second gripping inclined loops oriented in a given direction F' opposite to the direction F (F3 or F4 for example), said first and second gripping loops are repeated between the first and second lateral edges of the knit and between the upper and lower edges of the knit in an alternating manner.

[0071] The warp knit may be coated on its second side, in particular its second side not comprising inclined gripping loops, with a bioresorbable or non-bioresorbable coating.

[0072] In an alternative embodiment, the warp knit comprises a first side edge and a second side edge, said first and second side edges extend in the warp direction of the warp knit, and said warp knit comprises at least one set comprising first gripping loops oriented towards the first side edge and second gripping loops oriented towards the second side edge, preferably said first loops and second loops of said set are arranged, in particular alternately, in the warp direction.

[0073] In this text, a loop oriented towards the first, respectively second, lateral edge is understood to mean that the distal end of said loop is oriented opposite the first, respectively second, lateral edge of the warp knit.

[0074] Advantageously, the orientation of the inclined loops is alternated towards the first lateral edge then towards the second lateral edge of the warp knit according to a determined sequence extending in the warp direction of the warp knit.

[0075] Advantageously, the first and second lateral edges of the warp-knitted fabric are positioned in the cranial / caudal direction of the patient being treated so that the gripping loops are oriented alternately towards a first lateral side and then towards a second lateral side of the patient. This alternating orientation of the loops makes it possible to avoid migration in a horizontal direction when the patient is in a standing position.

[0076] Advantageously, the alternating arrangement in the warp direction of the first and second inclined gripping loops makes it possible to avoid migration of the implantable device after implantation in a horizontal direction of the patient, corresponding to the weft direction of the warp knit (in particular according to one or other of the directions F3 and F4).

[0077] The first loops may be alternated with the second loops in a determined sequence, for example by alternating in the warp direction, a first loop with a second loop, or by alternating a first loop with two or more second loops or conversely by alternating a second loop with two first loops. Preferably, the first and second loops are alternated so that a first loop is alternated with a second loop and so on. The regular alternation of the first and second loops makes it possible to improve the stabilization of the warp knit at the implantation site.

[0078] Advantageously, the angle formed between the axis of symmetry S of a gripping inclined loop and the direction of the first, respectively second, lateral edge is between 20° and 80°, preferably is between 30° and 60°, preferentially is between 35° and 55°, for example is of the order of 45° + / - 5°. Preferably, said at least one set of (first and second) inclined and alternately oriented loops extends between the upper and lower edges of the warp knit, in particular over the entire height of the warp knit.

[0079] Said first and second side edges may be parallel to each other and / or parallel to the warp direction of the warp knitting.

[0080] Advantageously, since the loops are already inclined, the surgeon can accentuate the inclination of the loops at the surgical site during implantation. This arrangement improves the blocking of caudal vertical migration.

[0081] In an alternative embodiment, the warp knit comprises a plurality of sets of loops, inclined and oriented, disposed between the first and second side edges.

[0082] Advantageously, the warp knit comprises several sets of inclined and oriented loops, each set comprising first loops inclined and oriented towards the first lateral edge and second loops inclined and oriented towards the second lateral edge, preferably said first loops and second loops of said set are arranged, in particular alternately, in the warp direction.

[0083] Advantageously, the sets of inclined and oriented loops are arranged side by side between the first and second side edges.

[0084] In an alternative embodiment, the first knitted sheet comprises first portions of knitted stitches, in particular each knitted according to a knitted pattern M1, each extending over at least three columns of stitches, and second portions of knitted stitches, in particular each knitted according to a knitted pattern M2, each extending over at least three columns of stitches, the first portions of knitted stitches are alternated with the second portions of knitted stitches, and the second portions of knitted stitches are knitted in an inverted manner with respect to the first portions of knitted stitches or the second knitted pattern M2 is inverted with respect to the first knitted pattern M1.

[0085] Preferably, the first, respectively second, portions of knitted stitches each extend over three rows of stitches.

[0086] In an alternative embodiment, the first knitted sheet comprises first portions of knitted stitches, in particular each knitted according to a knitted pattern M1, each extending over at least three columns of stitches, and second portions of knitted stitches, in particular each knitted according to a knitted pattern M2, each extending over at least three columns of stitches, the first portions are alternated with the second portions. The first portions of knitted stitches are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the first knitted pattern M1, while the second portions of knitted stitches are each in the form of an elongated V open towards the first lateral edge (“>”), in particular corresponding to the second knitted pattern M2.

[0087] In a variant, the first portions of knitted stitches are alternated with the second portions of knitted stitches in the warp direction of the warp knitting, in particular the first yarn forms first portions of knitted stitches and second portions of knitted stitches which are alternated in the warp direction.

[0088] In an alternative embodiment, the second knitted sheet comprises third portions of knitted stitches, in particular each knitted according to a knitted pattern M3, each extending over at least three columns of stitches, and fourth portions of knitted stitches, in particular each knitted according to a knitted pattern M4, each extending over at least three columns of stitches, the third portions of knitted stitches are alternated with the fourth portions of knitted stitches, and the fourth portions of knitted stitches are knitted in an inverted manner with respect to the third portions of knitted stitches, or the third knitted pattern M3 is inverted with respect to the fourth knitted pattern M4.

[0089] In a variant, the third portions of knitted stitches are alternated with the fourth portions of knitted stitches in the warp direction of the yarn-over knitting, in particular the second yarn forms third portions of knitted stitches and fourth portions of knitted stitches which are alternated in the warp direction.

[0090] In a variant, the third, respectively fourth, portions of knitted stitches each extend over three rows of stitches.

[0091] In an alternative embodiment, the second knitted sheet comprises third portions of knitted stitches, in particular each knitted according to a knitted pattern M3, each extending over at least three columns of stitches, and fourth portions of knitted stitches, in particular each knitted according to a knitted pattern M4, each extending over at least three columns of stitches, the third portions of knitted stitches are alternated with the fourth portions of knitted stitches, and the third portions of knitted stitches are each in the form of an elongated V open towards the first lateral edge (“>”), in particular corresponding to the third knitted pattern M3, while the fourth portions of knitted stitches are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the fourth knitted pattern M4.

[0092] In an alternative embodiment, the third knitted sheet comprises fifth portions of knitted stitches, in particular each knitted according to a knitted pattern M5, each extending over at least two columns of stitches, and sixth portions of knitted stitches, in particular each knitted according to a knitted pattern M6, each extending over at least two columns of stitches, the fifth portions of knitted stitches and the sixth portions of knitted stitches are alternated, and the fifth portions of knitted stitches are each in the form of an elongated V open towards the first lateral edge (“>”), in particular corresponding to the third knitted pattern M5, while the sixth portions of knitted stitches are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the sixth knitted pattern M6.

[0093] In one variant, the fifth portions of knitted stitches are offset by at least one column of stitches from the sixth portions of knitted stitches.

[0094] In a variant, the third knitted sheet comprises fifth portions of knitted stitches, in particular each knitted according to a knitted pattern M5, each extending over at least two columns of stitches, and sixth portions of knitted stitches, in particular each knitted according to a knitted pattern M6, each extending over at least two columns of stitches, the fifth portions of knitted stitches and the sixth portions of knitted stitches are alternated, and the fifth portions of knitted stitches are each in the form of an elongated V open towards the first lateral edge (“>”), in particular corresponding to the knitted pattern M5, while the sixth portions of knitted stitches are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the knitted pattern M6.

[0095] Preferably, the fifth knitted stitch portions are offset from the sixth knitted stitch portions by at least one stitch column. Preferably, the fifth and sixth knitted sections are arranged one above the other between the upper and lower edges of the warp-knit fabric.

[0096] Preferably, the warp knit comprises a plurality of fifth and sixth sections knitted alternately in the warp direction, particularly between the upper and lower edges of the warp knit.

[0097] Preferably, the warp knit comprises a plurality of fifth and sixth sections knitted alternating in the warp direction, in particular the alternation repeating between the upper and lower edges of the warp knit.

[0098] In an alternative embodiment, a first portion of knitted stitches, and a third portion of knitted stitches, are knitted on three columns of common stitches, and in particular on three rows of common stitches.

[0099] In an alternative embodiment, a second portion of knitted stitches and a fourth portion of knitted stitches are spaced at least one column of stitches apart. In an alternative embodiment, the warp-knitted fabric comprises:

[0100] - a first knitted section comprising knitted stitches, said first knitted section extends over at least three columns of stitches, in particular and extending over at least three rows of stitches, and is knitted with at least yarns A and B, and possibly yarn C, and

[0101] - a second knitted section comprising knitted stitches, said second knitted section extends over at least three columns of stitches, in particular and extending over at least three rows of stitches, and is knitted at least with yarns A and B, and possibly yarn C, and

[0102] - the second knitted section is spaced from the first knitted section by a through hole, in particular having at least one dimension greater than or equal to 3 mm.

[0103] The first section is formed by a portion of the first knitted sheet, a portion of the second knitted sheet, and finally a portion of the third knitted sheet.

[0104] The first knitted section extends between the first and second faces of the warp knit.

[0105] Preferably, the first knitted section and the second knitted section are arranged side by side in the weft direction of the warp knit.

[0106] Preferably, the first knitted section and the second knitted section are knitted over at least three rows of common stitches.

[0107] Said at least one dimension of an orifice is preferably measured on the warp-knitted fabric at rest, i.e. without exerting any tension on the latter, using a microscope or a graduated ruler.

[0108] Said at least one dimension is preferably any dimension of an orifice, and in particular may be the width, the length, the diameter, or even the distance between the two most distant points taken on the periphery of the orifice.

[0109] Preferably, the first knitted section and the second knitted section are spaced at least one column of stitches apart.

[0110] Preferably, the warp knit comprises a plurality of first knitted sections and a plurality of second knitted sections, said first and second knitted sections being alternated in the weft direction of the warp knit, in particular are arranged repeatedly between the first and second side edges.

[0111] In an alternative embodiment, the first knitted section is in knitted connection with the second knitted section, preferably via a third knitted section, said third knitted section comprising knitted stitches, said third knitted section extends over at least three columns of stitches, in particular and extending over at least three rows of stitches, and is knitted with at least yarns A and B, and optionally yarn C.

[0112] Preferably, the first knitted section is in knitted connection with the second knitted section also via a fourth knitted section, said fourth knitted section comprising knitted stitches extending over at least three columns of stitches, in particular and extending over at least three rows of stitches, and knitted with at least the yarns A and B, and possibly the yarn C.

[0113] Preferably, the warp knit comprises several through openings each having at least one dimension greater than or equal to 3 mm.

[0114] Preferably, a through opening is delimited, at least in part, by the first, second, third and fourth knitted sections.

[0115] Preferably, the third and fourth knitted sections are arranged one above the other between the upper and lower edges of the warp knit.

[0116] Preferably, the warp knit comprises a plurality of third and fourth sections knitted alternately in the warp direction, particularly between the upper and lower edges of the warp knit.

[0117] Preferably, the warp knit comprises several through openings each having at least one dimension greater than or equal to 3 mm, each of the through openings being delimited at least in part by first, second, third and fourth knitted sections.

[0118] In an alternative embodiment, the warp knit comprises a gripping inclined loop formed at least in part by a portion of a monofilament yarn chosen from yarns A, B or C, said portion of monofilament yarn is knitted in at least one of the first, second, third and fourth knitted sections.

[0119] Advantageously, said at least one gripping and inclined loop is formed by a portion of the monofilament thread C.

[0120] In an alternative embodiment, at least two, preferably at least three, more preferably each, of the first, second, third and fourth knitted sections comprises / comprise a gripping and inclined loop formed by a portion of a monofilament yarn chosen from yarns A, B or C, in particular yarn C.

[0121] In a variant, the warp knit comprises several through openings of which at least one through opening, in particular each of said through openings, has a dimension greater than or equal to 3 mm, said through opening is surrounded at least in part by at least two, preferably at least four, gripping and inclined loops, each gripping and inclined loop being formed by a portion of monofilament yarn, in particular a monofilament yarn C, more particularly said through opening is surrounded by:

[0122] - a gripping and inclined loop 01 arranged in the first knitted section, and in particular oriented towards the second lateral edge, more particularly in the direction F4; and / or

[0123] - a gripping and inclined loop 02 arranged in the second knitted section, and in particular oriented towards the second lateral edge, more particularly in the direction F4; and / or

[0124] - a gripping and inclined loop 03 arranged in the third knitted section, and in particular oriented towards the first lateral edge, more particularly in the direction F3; and / or - a gripping and inclined loop 04 arranged in the fourth knitted section, and in particular oriented towards the first lateral edge, more particularly in the direction F3.In an alternative embodiment, at least one loop selected from said gripping inclined loops, in particular several or each of the gripping inclined loops, is / are knitted with the monofilament yarn C, and said, or each of said gripping inclined loop(s) is arranged between a first base stitch and a second base stitch knitted with said monofilament yarn C, and the warp knit comprises a first blocking stitch knitted with yarn A or B, preferably yarn B, and superimposed with the first base stitch, and optionally a second blocking stitch knitted with yarn A or B, preferably yarn B, and superimposed with the second base stitch.

[0125] Advantageously, the first basic stitch and the first blocking stitch, possibly the second basic stitch and the second blocking stitch, are in the knitted section (in particular first or second or third or fourth) comprising the gripping inclined knitted loop.

[0126] Advantageously, when the warp knit is relaxed as it leaves the knitting machine, the portions of yarn forming the inclined, oriented and gripping loops retract and each form a loop.

[0127] Advantageously, at the outlet of the knitting machine, for a given gripping inclined loop, a stitch is formed between the first and second basic stitches blocked by the first and second blocking stitches, said stitch unravels (i.e. it is released from the needle on which said stitch was knitted) and then forms a portion of looped monofilament yarn extending between the first and second basic stitches, said portion forming the gripping and inclined loop.

[0128] Advantageously, the blocking stitches allow the gripping and inclined knitted loops to maintain their loop shape when leaving the knitting machine and prevent them from forming floats when untwisting.

[0129] Preferably, the first, or second, blocking stitch and the first, or second, foundation stitch are knitted on the same needle and / or interlaced.

[0130] Preferably, a gripping inclined loop, or each of said gripping inclined loop(s), is arranged between a first foundation stitch and a second foundation stitch knitted with said monofilament yarn C, and the warp knit comprises a first blocking stitch knitted with yarn A or B, preferably yarn B, and superimposed with the first foundation stitch, and optionally a second blocking stitch knitted with yarn A or B, preferably yarn B, and superimposed with the second foundation stitch, and the first foundation stitch and / or the first blocking stitch, and / or the second foundation stitch and / or the second blocking stitch, is / are arranged on a column of stitches adjacent to the column of stitches comprising said gripping knitted loop. This arrangement helps to prevent the gripping knitted loop from untwisting and forming a float.

[0131] In an alternative embodiment, the knitting diagram of the first sheet is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 H.

[0132] This knitting diagram corresponds advantageously to the movement of the guide bar supporting at least yarn A, and knitting the first knitted tablecloth.

[0133] In this text, any knitting diagram is written in accordance with ISO 11676:2014 entitled "Textile machinery - Armature discs and warps for warp knitting machines - Vocabulary and symbols". In an alternative embodiment, the knitting diagram of the second sheet is: 1- 0 / 2- 3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 H.

[0134] This knitting diagram corresponds advantageously to the movement of the guide bar supporting at least yarn B, and knitting the second knitted sheet.

[0135] In an alternative embodiment, the knitting diagram of the third layer is: 4- 5 / 3- 2 / 4- 5 / 1- 0 / 2- 3 / 1- 0 H.

[0136] This knitting diagram corresponds advantageously to the movement of the guide bar supporting at least yarn C, and knitting the third knitted sheet.

[0137] In an alternative embodiment, at least one loop selected from said gripping inclined loops, in particular several or each of the gripping inclined loops, is / are knitted with the monofilament yarn C, and said, or each of said gripping inclined loop(s) is knitted on a row of stitches n and on a column of stitches p, and the knitted yarns A and B are knitted so as to cross on either side of the gripping knitted loop: on said column of stitches p and on a row of stitches n+1 adjacent to the row of stitches n, and on said column of stitches p and on a row of stitches n-1 adjacent to the row of stitches n, p and n being whole numbers greater than or equal to 1.

[0138] Advantageously, the crossings of the knitted yarns A and B on either side of the gripping knitted loops promote their blocking and prevent the gripping knitted loops from untwisting and forming floats without gripping function.

[0139] In an alternative embodiment, the warp-knitted fabric comprises at least 40% by mass of one or more bioresorbable (co)polymer(s), in particular said bioresorbable (co)polymer(s) is / are chosen from: polylactic acid (PLA), polyglycolic acid (PGA), oxidized cellulose, polycaprolactone (PCL), polydioxanone (PDO), polytrimethylenecarbonate (TMC), a copolymer of trimethylene carbonate (PTMC) and L-form lactic acid, polyvinyl alcohol (PVA), polyhydroxyalkanoate (PHA), Poly4-Hydroxybutyrate (P4HB), block copolymers of P4HB and P3HB, a mixture of the latter, in particular chosen from list II defined in the present text.

[0140] In one embodiment, the warp knit comprises between 40% and 75%, in particular between 55% and 65%, of bioresorbable (co)polymer(s), in particular chosen from list II defined in the present text.

[0141] In particular, the warp knit comprises one or more monofilament yarn(s), in particular chosen from yarns A, B and C, comprising one or more bioresorbable (co)polymer(s), in particular chosen from list II cited above, said bioresorbable (co)polymer(s) representing at least 40% by mass of the total mass of the warp knit.

[0142] In one variant, the warp knit comprises at least one yarn, in particular yarn C, comprising a copolymer of polytrimethylene carbonate (PTMC) and lactic acid, in particular of L form (PLLA).

[0143] Preferably, the mass fraction of lactic acid, in particular of L form, in said copolymer is greater than or equal to 60%, more preferably greater than or equal to 70%, in particular approximately 80% to within + / -5%.

[0144] Preferably, the mass fraction of trimethylene carbonate in said copolymer is less than or equal to 40%, more preferably less than or equal to 30%, in particular approximately 20% to within + / -5%.

[0145] Preferably, the copolymer of polytrimethylene carbonate (PTMC) and lactic acid is a block copolymer, in particular a triblock copolymer whose repeating unit comprises a central block and two side blocks arranged on either side of the central block, the central block comprises a trimethylene carbonate unit, and each side block comprises a lactic acid unit, in particular of L form.

[0146] In an alternative embodiment, the warp-knitted fabric comprises less than 60% by mass of one or more non-(bio)absorbable (co)polymer(s), in particular said non-(bio)absorbable (co)polymer(s) is / are chosen from: co)polymers of at least one olefin (for example polypropylene, polyethylene, a copolymer of propylene and ethylene), polyesters such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT), more particularly chosen from list I defined in the present text.

[0147] In particular, the warp knit comprises one or more monofilament yarn(s), in particular chosen from yarns A, B and C, comprising one or more non-(bio)absorbable (co)polymer(s), in particular chosen from list I cited above, said non-absorbable (co)polymer(s) represent(s) less than 45% by mass of the total mass of the warp knit, in particular said non-absorbable (co)polymer(s) is / are chosen from: co)polymers of at least one olefin (for example polypropylene, polyethylene, a copolymer of propylene and ethylene), polyesters such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT).

[0148] In one embodiment, the warp knit comprises between 20% and 40%, in particular between 30% and 40%, of non-(bio)absorbable (co)polymer(s).

[0149] In an alternative embodiment, the warp knit has a surface mass greater than or equal to 50 g / m 2 and less than or equal to 150 g / m 2 .

[0150] In a preferred embodiment, the warp knit has a basis weight of between 80 g / m 2 and 120 g / m 2 , in particular of the order of 100 g / m 2 at + / - 5 g / m 2 In an alternative embodiment, at least one of the wires chosen from wires A, B and C has a diameter greater than or equal to 0.02 mm and less than or equal to 0.30 mm.

[0151] Preferably, the warp knit comprises at least one monofilament yarn A having a diameter between 0.08 mm and 0.30 mm, at least one monofilament yarn B having a diameter between 0.08 mm and 0.30 mm, at least one monofilament yarn C having a diameter between 0.08 mm and 0.30 mm.

[0152] In an alternative embodiment, the warp knit comprises a number of stitches in the warp direction less than or equal to 6 per cm, and a number of stitches in the weft direction less than or equal to 6 per cm.

[0153] In a preferred embodiment, the warp knit comprises a number of stitches in the warp direction of between 1 and 6 per cm, preferably between 2 and 5 per cm.

[0154] In a preferred embodiment, the warp knit comprises a number of stitches in the weft direction of between 1 and 6 per cm, preferably between 2 and 5 per cm.

[0155] The subject of the present invention, according to a second aspect, is a method of manufacturing an implantable device according to any one of the variant embodiments with reference to the first aspect, comprising a step of knitting a warp knit on a knitting machine comprising:

[0156] - knitting a first knitted tablecloth with a first guide bar supporting at least one monofilament yarn A and forming knitted stitches,

[0157] - knitting a second knitted sheet with a second guide bar supporting at least one monofilament yarn B and forming knitted stitches, - knitting a third knitted sheet with a third guide bar supporting at least one monofilament yarn C and forming knitted stitches, and

[0158] - the movement of said first, second, and third guide bars is determined so as to obtain a warp stitch knit comprising a knitted base and comprising gripping knitted loops projecting from said knitted base and inclined towards said knitted base.

[0159] The manufacturing process advantageously makes it possible to obtain a warp-knitted fabric with inclined and gripping loops obtained by knitting, and therefore arranged spatially and in number in a manner determined by the stitch pattern and reproducible.

[0160] Advantageously, warp knitting includes gripping loops without the need for an additional step after knitting to melt portions of yarn and form gripping picots.

[0161] Preferably, the knitting loom is a warp or Rachel loom.

[0162] Preferably, the first and second guide bars are each threaded one full and three empty.

[0163] Preferably, the third guide bars are threaded two empty, one solid, and one empty.

[0164] The schematic representation ...I means, for example, three empty threads and one full thread. A dot (.) represents an empty thread, and (I) represents a full thread.

[0165] In a variant, at least one loop, chosen from said gripping inclined loops, is knitted with the monofilament yarn C, and said loop is arranged between a first base stitch and a second base stitch, and the warp stitch knitting comprises a first blocking stitch knitted with the yarn A or B and superimposed with the first base stitch, and optionally a second blocking stitch knitted with the yarn A or B and superimposed with the second base stitch.

[0166] In an alternative embodiment, the movement of the first guide bar, in particular the front bar, is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 / / , in particular with repetitive threading of three empty guides followed by one full guide (schematic representation

[0167] In an alternative embodiment, the movement of the second guide bar, in particular of the intermediate bar, is: 1- 0 / 2- 3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 H in particular with repetitive threading of three empty guides followed by a full guide (schematic representation: ...I).

[0168] In an alternative embodiment, the movement of the third guide bar, in particular the rear bar, is: 4- 5 / 3- 2 / 4- 5 / 1- 0 / 2- 3 / 1- 0 H in particular with repetitive threading of two empty guides followed by a full guide and followed by an empty guide (schematic representation: : (..I.)-

[0169] The embodiment variants described with reference to the first aspect of the invention may be combined with the embodiment variants with reference to the second aspect of the invention, independently of one another.

[0170] Description of the drawings

[0171] The invention will be better understood on reading the following description of an exemplary embodiment of the invention given without limitation, with reference to the appended drawings, in which:

[0172] - figure 1 schematically represents, seen from the front, a first example of an implantable device according to the invention, - figure 2 schematically represents, seen from the side, the first example of an implantable device shown in figure 1;

[0173] - figure 3 schematically represents a top view of the warp knit with an inclined gripping loop oriented towards the first lateral edge and an inclined gripping loop oriented towards the second lateral edge;

[0174] - Figure 4 represents the knitting diagram of the warp knitting of the first example of an implantable device according to Figures 1 to 3.

[0175] Description of the embodiments

[0176] The implantable device 10 shown in Figures 1 and 2 comprises a warp knit 20, said warp knit 20 comprising a knitted bottom 30 having substantially opposite first and second faces 32, 34, and comprises gripping knitted loops 40 projecting from the first face 32 of the knitted bottom 30 and inclined towards said knitted bottom 30. The warp knit 20 comprises a first side edge 22 and a second side edge 24, said first and second side edges 22, 24 extending in the warp direction C of the warp knit. The warp knit 20 comprises several sets 50 of inclined gripping loops 40, in particular with an alternating orientation in the warp direction C towards the first side edge 22 and towards the second side edge 24.Advantageously, each set 50 comprises first inclined gripping loops 40A which are oriented towards the first lateral edge 22, and second inclined gripping loops 40B which are oriented towards the second lateral edge 24. Advantageously, the first loops 40A and the second loops 40B of each set 50 extend so as to have an alternating orientation in the warp direction C of the knit 20.

[0177] The warp knit 20 thus comprises several sets 50 of inclined loops 40, and in particular oriented in a determined manner, arranged between the first and second lateral edges 22, 24.

[0178] Preferably, the first and second loops 40A, 40B have an alternating orientation such that a first loop 40A has an orientation that alternates with a second loop 40B and so on in the warp direction C. The alternation of the orientations of the first and second loops 40A, 40B could be different, for example a first loop 40A is oriented towards the first lateral edge 22 while two or more second loops 40B are oriented towards the second lateral edge 24, or two or more first loops 40A are oriented towards the first lateral edge 22 for a second loop 40B that is oriented towards the second lateral edge 24. The advantage is to obtain a regular alternation of the orientations of the first and second loops making it possible to stabilize the lateral movements of the warp-knitted fabric 20 placed in contact with the adipose tissues.

[0179] Preferably, the sets 50 of inclined loops 40, and in particular oriented, extend between the upper and lower edges 23, 25 of the warp knit 20, in particular over the entire height H of the warp knit 20, and over the entire width I of the knit 20.

[0180] Preferably, the first and second side edges 22, 24 are parallel to each other and parallel to the warp direction C of the warp knit 20.

[0181] Figure 2 shows the inclination towards the knitted bottom 30 of the gripping loops 40. The knitted bottom 30 has a thickness e less than the total thickness E. The thickness e of the knitted bottom 30 corresponds to the distance separating the first and second faces 34 and 32. The thickness E corresponds to the distance separating the first face 34 from the distal ends of the gripping loops 40.

[0182] Figure 3 schematically represents the warp knit 20 seen from the front and slightly in perspective. Only a first gripping loop 40A and a second gripping loop 40B are shown for reasons of simplification.

[0183] In particular, each gripping inclined loop (40A, 40B) comprises a distal end (41A, 41B) and a loop foot (42A, 42B). The distal end 41A is oriented towards the first edge 22, and therefore in the direction F3, while the distal end 41B is oriented towards the second edge 24, and therefore in the direction F4.

[0184] The gripping inclined loop 40A comprises an axis of symmetry Sa passing through said distal end 41A and substantially perpendicular to the axis Pa tangent to the loop foot 42A. The axis of symmetry Sa separates the loop 40A into first and second symmetrical lateral parts (43A, 44A).

[0185] The gripping inclined loop 40B comprises an axis of symmetry Sb passing through said distal end 41B and substantially perpendicular to the axis Pb tangent to the loop foot 42A. The axis of symmetry Sb separates the loop 40B into first and second symmetrical lateral parts (43B, 44B).

[0186] Figure 4 shows the stitch patterns of the different yarns knitted in the 20 warp knitting using a stitch grid (each row of stitches representing the position of the knitting needles when making the corresponding row of stitches) comprising from ml to ml2 rows of stitches and from n1 to n23 columns of stitches.

[0187] Area 1 of Figure 3 represents the preferred stitch patterns of the three types of yarns A, B and C implemented in the warp knitting, with two repeats per yarn to understand the knitted arrangement of the warp knitting 20. Area 3 represents in particular the stitch patterns of yarns A and B. Area 2 represents in particular the stitch pattern of yarn C.

[0188] Advantageously, zone 1 comprises, represented twice, and knitted repeatedly over the entire width I of the knit 20 between its first and second lateral edges 22, 24 and over the entire height H of the knit 20 between its upper 23 and lower 25 edges:

[0189] - a monofilament yarn A 62 so as to form a first knitted sheet 60 comprising knitted stitches;

[0190] - a monofilament yarn B 72 so as to form a second knitted sheet 70 comprising knitted stitches; and

[0191] - a monofilament yarn C 82 so as to form a third knitted sheet 80 comprising knitted stitches.

[0192] Zones 2 and 3 are each shown with fewer yarns to better understand the stitch patterns for each yarn type. Zone 2 is thus focused on the C 82 yarn knitted, and Zone 3 is focused on the A and B yarns knitted (62,72) without the C 82 yarn.

[0193] Advantageously, the first knitted tablecloth 60 comprises:

[0194] - first portions 64 of knitted stitches each extending over three columns of stitches and over three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 24, and

[0195] - second portions 65 of knitted stitches each extending over three columns of stitches and over three rows of stitches, each in the shape of an elongated V (“>”) open towards the first lateral edge 22, - the second portions of knitted stitches 65 are knitted in an inverted manner relative to the first portions of knitted stitches 64 (the direction of the elongated V of the first portions is inverted relative to the direction of the elongated V of the second portions), and in particular are offset relative to the first portions of knitted stitches 64 by two columns of stitches.

[0196] The first portions of knitted stitches 64 correspond to first knitted patterns Ml (<), a first pattern Ml extends for example between stitch (ml,n20), then stitch (m2,nl8), and finally stitch (m3,n20).

[0197] The second portions of knitted stitches 65 correspond to second knitted patterns M2 (>), a second pattern M2 extends for example between stitch (m4,nl6), then stitch (m5,nl8), and finally stitch (m6,nl6).

[0198] Advantageously, the second portions of knitted stitches 65 and the first portions of knitted stitches 64 are knitted by alternating in the warp direction or the height of the knitting 20.

[0199] For example, a first portion of knitted stitches 64 extends over three columns of stitches nl8 to n20 and over three rows of stitches ml to m3; and a second portion of knitted stitches 65 extends over three columns of stitches nl6 to nl8 and over three rows of stitches m4 to m6. In particular, this second portion of knitted stitches 65 is offset by two columns of stitches, namely columns of stitches nl9 and n20, relative to the first portion of knitted stitches 64.

[0200] Advantageously, the second knitted sheet 70 comprises:

[0201] - third portions 74 of knitted stitches each extending over three columns of stitches and over three rows of stitches, each in the shape of an elongated V (“>”) open towards the first lateral edge 22, and

[0202] - fourth portions 75 of knitted stitches each extending over three columns of stitches and over three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 22,

[0203] - the fourth portions of knitted stitches 75 are knitted in reverse with respect to the third portions of knitted stitches 74, and in particular are offset with respect to the third portions of knitted stitches 74 by two columns of stitches.

[0204] The third portions of knitted stitches 74 correspond to third knitted patterns M3 (>), a third pattern M3 extends for example between stitch (ml,nl8), then stitch (m2,n20), and finally stitch (m3,nl8).

[0205] The fourth portions of knitted stitches 75 correspond to fourth knitted patterns M4 (<), a fourth pattern M4 extends for example between stitch (m4,n22), then stitch (m5,n20), and finally stitch (m6,nl8).

[0206] Furthermore, the fourth portions of knitted stitches 75 and the third portions of knitted stitches 74 are knitted by being alternated in the warp direction or the height of the knitting 20.

[0207] For example, a third portion of knitted stitches 74 extends over three columns of stitches nl8 to n20 and over three rows of stitches ml to m3; and a fourth portion of knitted stitches 75 extends over three columns of stitches n20 to n22 and over three rows of stitches m4 to m6. In particular, this fourth portion of knitted stitches 75 is offset by two columns of stitches, namely columns of stitches nl8 and nl9, relative to said third portion of knitted stitches 74.

[0208] Advantageously, the first knitted sheet 60 is knitted in a direction opposite to the knitting direction of the second knitted sheet 70, that is to say that the first guide bar supporting the yarn A 62 knits for example from left to right while the second guide bar supporting the yarn B 72 knits from right to left. Advantageously, the third knitted sheet 80 comprises:

[0209] - fifth portions 84 of knitted stitches each extending over two columns of stitches and over three rows of stitches, each in the shape of an elongated V (“>”) open towards the first lateral edge 22, and

[0210] - sixth portions 85 of knitted stitches each extending over two columns of stitches and over three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 24,

[0211] - the sixth portions of knitted stitches 85 are knitted in an inverted manner relative to the fifth portions of knitted stitches 84 (the direction of the elongated V of the fifth portions is inverted relative to the direction of the elongated V of the sixth portions), and in particular are offset relative to the fifth portions of knitted stitches 84 by two columns of stitches.

[0212] Furthermore, the sixth portions of knitted stitches 85 and the fifth portions of knitted stitches 84 are knitted by being alternated in the warp direction or the height of the knitting 20.

[0213] The fifth portions of knitted stitches 84 correspond to fifth knitted patterns M5 (>) open towards the first lateral edge 22, a fifth pattern M5 extends for example between the stitch (ml,n2), then the stitch (m2,n3), and finally the stitch (m3,n2). The sixth portions of knitted stitches 85 correspond to sixth knitted patterns M6 (<), a sixth pattern M6 extends for example between the stitch (m4,n6), then the stitch (m5,n5), and finally the stitch (m6,n6).

[0214] For example, a fifth portion of knitted stitches 84 extends over two columns of stitches n2 to n3 and over three rows of stitches ml to m3; and a sixth portion of knitted stitches 85 extends over two columns of stitches n5 to n6 and over three rows of stitches m4 to m6. In particular, this sixth portion of knitted stitches 85 is offset by two columns of stitches, namely columns of stitches n3 and n4, relative to the fifth portion of knitted stitches 84.

[0215] Advantageously, the arrangement of the first, second, and third knitted layers (60, 70, 80) makes it possible to arrange knitted sections around through openings 90. In particular, the warp-knitted fabric 20 comprises a first knitted section 100 comprising knitted stitches, said first section 100 extends over three columns of stitches and over three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82. The warp-knitted fabric comprises a second knitted section 120 comprising knitted stitches, said second section extends over three columns of stitches and over three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82. The second knitted section 120 is spaced from the first knitted section 100 by a through opening 90 having at least one dimension greater than or equal to 3 mm.

[0216] In particular, the first knitted section 100 is in knitted connection with the second knitted section 120 via a third knitted section 140, said third knitted section 140 comprising knitted stitches, said third section extends over three columns of stitches and over three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82.

[0217] In particular, the second knitted section 120 is in knitted connection with the first knitted section 100 also via a fourth knitted section 160, said fourth knitted section 160 comprising knitted stitches, said fourth section extends over three columns and three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82.

[0218] The first, second, third and fourth knitted sections (100, 120, 140, 160) are advantageously arranged in a circle so as to delimit a through opening 90. Advantageously, each knitted section (100, 120, 140, 160) comprises an inclined gripping loop formed by a portion of the monofilament yarn C 82 of the third knitted sheet 80.

[0219] The inclined gripping loops 40A towards the first side edge 22 are formed by the sixth elongated V knitted patterns (<), and the inclined gripping loops 40B towards the second side edge 24 are formed by the fifth elongated V knitted patterns (>).

[0220] Advantageously, the gripping inclined loops 40 (40A, 40B) knitted with the monofilament yarn C 82 are each arranged between a first base stitch, for example the stitch 82a, and a second base stitch, for example the stitch 82b. In addition, each gripping inclined loop further comprises a first blocking stitch, for example the stitch 72a, knitted with the yarn B 70 and superimposed with the first base stitch, and a second blocking stitch, for example the stitch 72b, knitted with the yarn B 70 and superimposed with the second base stitch. These first and second blocking stitches are superimposed with first and second base stitches respectively and make it possible to hold the gripping loops firmly to the knitted base 30 without the risk of the loops relaxing in length. The feet of a gripping loop being formed by the base and blocking stitches are thus blocked with the knitted base 30.This arrangement allows the shape of the loops to be preserved and therefore improves their gripping power.

[0221] A gripping loop 40A extending between the first and second foundation stitches is referenced in Figure 3. After knitting, the center stitch 82c unravels, i.e., it is released from its needle, and forms the gripping loop 40A. Similarly, a gripping loop 40B includes a center stitch 82c that unravels once the knit 20 is relaxed.

[0222] Advantageously, a gripping inclined loop, for example a gripping inclined loop 82c, is knitted on a row of stitches n and a column of stitches p, for example the column of stitches n9 and the row of stitches m5, and the knitted yarns A (62) and B (72) are knitted so as to cross on either side of the gripping knitted loop: on said column of stitches p, for example n9, and on a row of stitches n+1, for example m6, adjacent to the row of stitches n (e.g. m5), and on said row of stitches p, for example n9, and on a row of stitches n-1, for example m4, adjacent to the row of stitches n, p and n being whole numbers greater than or equal to 1.

[0223] In a preferred specific example, the knitting diagram:

[0224] - of the first guide bar supporting said monofilament yarn A 62 for the formation of the first sheet 60 is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 H with a threading: ...I;

[0225] - of the second guide bar supporting said monofilament yarn B 72 for the formation of the first sheet 70 is: 1- 0 / 2- 3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 H with a threading: ...I;

[0226] - of the third guide bar supporting said monofilament yarn C 82 for the formation of the first layer 70 is: 4- 5 / 3- 2 / 4- 5 / 1- 0 / 2- 3 / 1- 0 H with a threading: The monofilament yarn A 62 is a polypropylene monofilament yarn with a diameter of 0.10 mm. The monofilament yarn B 72 is a polypropylene monofilament yarn with a diameter of 0.10 mm. The monofilament yarn C 82 is a polylactic acid monofilament yarn of L form (PLLA) with a diameter of 0.15 mm. In this specific example, the mass fraction of PLLA monofilament yarns, and therefore PLLA, in the warp knit 20 is approximately 66%, and the mass fraction of PP monofilament yarns, and therefore PP, in the warp knit is approximately 34%. The surface mass of the warp knit 20 is approximately 105 g / m 2 at + / - 10 g / m 2, the number of stitches in the warp direction per cm is about 3, and the number of stitches in the weft direction per cm is about 3.

[0227] In this specific example, the thickness E of the warp knit, including the 40 gripping loops, is approximately 1.5 mm to within + / - 0.5 mm. The breaking strength in the warp direction is greater than 80N, the elongation in the warp direction under a load of 80N is 110% maximum, the strength in the weft direction is greater than 80N, and the elongation in the weft direction under a load of 80N is 90% maximum. The mechanical tests are carried out in this specific example according to ISO 13934-1 and Annex 1, with the following parameters: 5 kN sensor, dedicated fabric jaw, tightening with the 4.5 Nm torque wrench, initial length of the sample 200mm and width of approximately 50 mm, speed of 100 mm / min.

[0228] The C 82 monofilament thread can be advantageously replaced by a monofilament thread of substantially the same diameter, also bioresorbable, but in a copolymer of trimethylene carbonate (PTMC) and lactic acid in L form.

[0229] The warp knit 20 obtained comprises gripping and inclined loops formed in a regular and reproducible manner by knitting without it being necessary to merge portions of the knit after knitting. The loops thus formed allow immediate adhesion in the adipose tissues, allow the knit to be repositionable while maintaining satisfactory immediate adhesion. The arrangement of the gripping and inclined loops also makes it possible to block migration in the weft and warp directions of the warp knit once placed against the adipose tissues. In addition, it is possible to roll the warp knit on itself to arrange it in a knit without the loops becoming snagged in the structure of the knit, preventing its proper unwinding thereafter, and risking damaging it.

[0230] Finally, the gripping and inclined loops 40 are formed by portions of bioresorbable monofilament threads whose feet are blocked in the mesh structure so that they are firmly anchored and non-deformable. In addition, the loops will resorb over time, and only the knitted bottom will remain in place to ensure stable mechanical reinforcement.

[0231] It is also possible to provide that threads A and B are bioresorbable but in bioresorbable materials that are resorbed less quickly than the material forming thread C of the gripping loops depending on the pathology to be treated, the compromise to be found between immediate and repositionable adhesion, and finally the duration sought for the mechanical reinforcement.

Claims

CLAIMS 1. Implantable device (10), in particular for parietal surgery, characterized in that it comprises a warp-knitted fabric (20), said fabric (20) comprising: - a first knitted sheet (60) comprising a monofilamentary yarn A (62) knitted with knitted stitches, - a second knitted sheet (70) comprising a monofilament yarn B (72) knitted with knitted stitches, - a third knitted sheet (80) with a monofilament yarn C (82) knitted with knitted stitches, and - said warp knit (20) comprises a knitted bottom (30) and comprises gripping knitted loops (40, 40A, 40B) projecting from said knitted bottom (30) and inclined towards said knitted bottom (30).

2. Implantable device (10) according to claim 1, characterized in that the warp knit (20) comprises a first lateral edge (22) and a second lateral edge (24), said first and second lateral edges (22, 24) extending in the warp direction of the warp knit, and in that said warp knit (20) comprises at least one assembly (50) comprising first gripping loops (40A) oriented towards the first lateral edge (22) and second gripping loops (40B) oriented towards the second lateral edge (24), preferably said first gripping loops (40A) and said second gripping loops (40B) of said assembly (50) extend, in particular alternately, in the warp direction.

3. Implantable device (10) according to claim 2, characterized in that the warp knit (20) comprises several sets (50) of gripping loops (40, 40A, 40B) and oriented, said sets (50) being arranged between the first and second lateral edges (22, 24).

4. Implantable device (10) according to any one of claims 1 to 3, characterized in that the first knitted sheet (60) comprises first portions of knitted stitches (64) each extending over at least three columns of stitches, and second portions of knitted stitches (65) each extending over at least three columns of stitches, the first portions of knitted stitches (64) are alternated with the second portions of knitted stitches (65), and the second portions of knitted stitches (65) are knitted in an inverse manner relative to the first portions of knitted stitches (64).

5. Implantable device (10) according to any one of claims 1 to 4, characterized in that the warp knit (20) comprises: - a first knitted section (100) comprising knitted stitches, said first knitted section (100) extends over at least three columns of stitches and is knitted with at least the yarns A (62) and B (72), and possibly the yarn C (82), and - a second knitted section (120) comprising knitted stitches, said second knitted section (120) extends over at least three columns of stitches and is knitted with at least the yarns A (62) and B (72), and possibly the yarn C (82), and - the second knitted section (120) is spaced from the first knitted section (100) by a through hole (90).

6. Implantable device according to claim 5, characterized in that the first knitted section (100) is in knitted connection with the second knitted section (120), preferably via a third knitted section (140), said third knitted section (140) comprising knitted stitches, said third knitted section (140) extends over at least three columns of stitches and is knitted with at least the yarns A (62) and B (72), and possibly the yarn C (82).

7. Implantable device (10) according to either of the claims 5 and 6, characterized in that at least one of the first and second knitted sections (100, 120) comprises an inclined gripping loop (40, 40A, 40B), said inclined gripping loop (40, 40A, 40B) comprising a portion of a monofilament yarn C (82).

8. Implantable device (10) according to any one of claims 1 to 7, characterized in that at least one loop (40, 40A, 40B) chosen from said gripping inclined loops (40, 40A, 40B) is knitted with the monofilament yarn C (82), and in that said gripping inclined loop (40, 40A, 40B) is arranged between a first base stitch (82a) and a second base stitch (82b) knitted with the monofilament yarn C (82), and in that the warp-knitted fabric (20) comprises a first blocking stitch (72a) knitted with the yarn A (62) or B (72) and superimposed with the first base stitch (82a), and optionally a second blocking stitch (72b) knitted with the yarn A (62) or B (72) and superimposed with the second base stitch (82b).

9. Implantable device (10) according to any one of claims 1 to 8, characterized in that at least one loop chosen from said inclined gripping loops is knitted with the monofilament yarn C, and said inclined gripping loop is knitted on a row of stitches n and a column of stitches p, and the knitted yarns A and B are knitted so as to cross on either side of the knitted gripping loop: on said column of stitches p and on a row of stitches n+1 adjacent to the row of stitches n, and on said column of stitches p and on a row of stitches n-1 adjacent to the row of stitches n, p and n being whole numbers greater than or equal to 1.

10. Implantable device (10) according to any one of claims 1 to 9, characterized in that the knitting diagram of the first sheet (60) is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 / / .

11. Implantable device (10) according to any one of claims 1 to 10, characterized in that the knitting pattern of the second sheet (70) is: 1- 0 / 2- 3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 H.

12. Implantable device (10) according to any one of claims 1 to 11, characterized in that the knitting diagram of the third sheet (80) is: 4- 5 / 3- 2 / 4- 5 / 1- 0 / 2- 3 / 1- 0 / / .

13. Implantable device (10) according to any one of claims 1 to 12, characterized in that the warp-knitted fabric (20) comprises at least 55% by mass of one or more bioresorbable (co)polymer(s), in particular said bioresorbable (co)polymer(s) is / are chosen from: polylactic acid (PLA), polyglycolic acid (PGA), oxidized cellulose, polycaprolactone (PCL), polydioxanone (PDO), polytrimethylenecarbonate (TMC), a copolymer of trimethylene carbonate (PTMC) and L-form lactic acid, polyvinyl alcohol (PVA), polyhydroxyalkanoate (PHA), Poly4-Hydroxybutyrate (P4HB), block copolymers of P4HB and P3HB, a mixture thereof.

14. Implantable device (10) according to any one of claims 1 to 13, characterized in that the warp-knitted fabric (20) comprises less than 45% by mass of one or more non-resorbable (co)polymer(s), in particular said non-resorbable (co)polymer(s) is / are chosen from: co-polymers of at least one olefin, polyesters such as polyethylene terephthalate and polybutylene terephthalate.

15. Implantable device (10) according to any one of claims 1 to 14, characterized in that the warp-knitted fabric (20) has a surface mass greater than or equal to 50 g / m 2 and less than or equal to 150 g / m 2 .

16. Implantable device (10) according to any one of claims 1 to 15, characterized in that at least one of the wires chosen by the wires A (62), B (72) and C (82), has a diameter greater than or equal to 0.02 mm and less than or equal to 0.30 mm.

17. Implantable device (10) according to any one of claims 1 to 16, characterized in that the warp knit (20) comprises a number of stitches in the warp direction less than or equal to 6 per cm, and a number of stitches in the weft direction less than or equal to 6 per cm.

18. Method for manufacturing an implantable device (10) according to any one of claims 1 to 17, characterized in that it comprises a step of knitting a warp knit (20) on a knitting machine comprising: - knitting a first knitted sheet (60) with a first guide bar supporting at least one monofilament yarn A (62) and forming knitted stitches, - knitting a second knitted sheet (70) with a second guide bar supporting at least one monofilament yarn B (72) and forming knitted stitches, - knitting a third knitted tablecloth (80) with a third bar at guides supporting at least one monofilament yarn C (82) and forming knitted stitches, and -in that the movement of said first, second, and third guide bars is determined so as to obtain a warp stitch knit (20) comprising a knitted bottom (30) and comprising gripping knitted loops (40, 40A, 40B) projecting from said knitted bottom (30) and inclined towards said knitted bottom (30).

19. Manufacturing method according to claim 18, characterized in that at least one loop (40, 40A, 40B), chosen from said gripping inclined loops (40, 40A, 40B), is knitted with the monofilament yarn C (82), and in that said loop (40, 40A, 40B) is arranged between a first base stitch (82a) and a second base stitch (82b), and in that the warp stitch knit comprises a first blocking stitch (72a) knitted with the yarn A (62) or B (72) and superimposed with the first base stitch (82a), and optionally a second blocking stitch (72b) knitted with the yarn A (62) or B (72) and superimposed with the second base stitch (82b).

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