Implantable device, particularly for parietal repair

Abstract

The present invention relates to an implantable device, in particular for parietal surgery, comprising a warp-knitted fabric, said fabric comprising:- a first knitted sheet comprising a monofilament yarn A knitted with knitted stitches,- a second knitted sheet comprising a monofilament yarn B knitted with knitted stitches,- a third knitted sheet with a monofilament yarn C knitted with knitted stitches, and- said warp-knitted fabric comprises a knitted base and comprises gripping knitted loops projecting from said knitted base and inclined towards said knitted base. The present invention also relates to a method for manufacturing such a device. Figure for abstract: Fig.1.

Description

Title of the invention: Implantable device, in particular for parietal repair technical field

[0001] The present invention relates to an implantable device, in particular for parietal surgery, especially for the repair of hernias.

[0002] The present invention also relates to a method for manufacturing such an implantable device. State of the art

[0003] It is known that for treating abdominal wall deficiencies (particularly hernias and incisional hernias), a textile prosthesis is used to mechanically reinforce the deficient abdominal or inguinal wall. To secure the textile reinforcement prosthesis to 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 reposition the prosthesis by moving it laterally so that it covers the inguinal openings. The sutures aim to maintain the prosthesis in its final implantation position chosen by the surgeon while it is colonized by native scar tissue, which results from a fibroblastic reaction. However, these fixations cause pain and are uncomfortable for the patient.

[0004] To reduce pain caused by sutures, it has been proposed to incorporate bioadhesives (i.e., adhesives activated by the water contained in human body tissues) into prostheses. These bioadhesives do not allow for satisfactory repositioning of the prosthesis during placement using a TAPP (TransAbdominal PrePeritoneal) or TEP (Totally Extraperitoneal) surgical technique. This is either because they are too adherent, making lateral movement difficult or even impossible (for example, this is the case with the Lifemesh™ prosthesis from Lifebond, which has an adhesive that bonds immediately upon contact with the tissues), or because the adhesion is too weak and does not allow the surgeon's intended position to be maintained long-term, even if lateral movement of the prosthesis is easier.Achieving sufficient adhesion to maintain the prosthesis in its implant position long-term, but not so excessive as to allow lateral repositioning during placement, cannot be accomplished with a bioadhesive.

[0005] An implantable device has thus been proposed comprising a knit from which straight spikes are projected, each spike having a fused head at its free ends with a cross-section larger than the body of the spike. This type of device is Marketed under the brand name ProGrip™ by Medtronic, its manufacturing technique is described in patent EP 1,274,892 Bl. This prosthesis contains small prongs that do not allow for lateral repositioning because the prongs penetrate the muscle tissue during prosthesis insertion. When the prosthesis is repositioned, the prongs tear the muscle tissue and lose their adhesive capacity. This prosthesis also presents a major drawback in addition to the previously mentioned disadvantages. For insertion, the prosthesis is rolled up to be passed through a trocar, but it has the particularity of gripping itself. This drawback forces the surgeon to force its unrolling for insertion, which leads to degradation of the prongs. The operating time for a TAPP or TEP surgical technique is then significantly increased.One proposed solution to this problem has been to coat the gripping spikes with a water-soluble film that dissolves almost immediately after implantation. This solution, described in patent FR2949687B1, has the drawback that the process is more complex and time-consuming, as an additional step of applying the film is required. Once the water-soluble film has dissolved in the body, the spikes penetrate abdominal fat and muscle tissue. Spikes that penetrate the muscle wall can come into contact with nerves and cause pain in the patient. There is therefore a need for an implantable device, particularly for abdominal wall surgery, that allows for immediate adhesion to the abdominal or inguinal wall, is repositionable, does not migrate laterally after implantation, preserves patient comfort (notably by avoiding penetration of the abdominal wall muscle to minimize pain), and can be rolled and unrolled without risk of degradation of its mechanical properties. Finally, there is a need for a simple and reliable manufacturing process for such an implantable device.

[0006] The present invention relates to an implantable device not requiring fixation by means of a suture or synthetic glue, limiting pain without penetrating muscle tissue, easily unrollable after passing through a trocar, easily repositionable laterally without tissue degradation to allow its precise placement on the surgical site by a TAPP or TEP technique in order to cover hernial orifices, and finally which does not migrate laterally in the long term. Description of the invention

[0007] The present invention relates, according to a first aspect, to an implantable device, particularly for abdominal wall surgery, characteristically comprising a knitted fabric, said 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 layer knitted with monofilament yarn C, knitted with knitted stitches, and - said knitted fabric with yarn overs comprises a knitted base and includes hooked knitted loops projecting from said knitted base and inclined towards said knitted base.

[0008] Advantageously, two knitted layers, in particular the first and second knitted layers, form at least in part the knitted background of the yarn over knit, while the remaining knitted layer, in particular the third knitted layer, anchors regularly in the knitted background and forms small knitted loops, closed, and projecting from said knitted background while being inclined relative to the latter.

[0009] Advantageously, the inclined, gripping knitted loops of the yarn over knit according to the invention offer numerous advantages. These gripping loops allow for lateral repositioning of the implantable device because they penetrate adipose tissue but without penetrating, or at least only minimally, muscle tissue. This arrangement considerably improves patient comfort.

[0010] Advantageously, it has been observed that the gripping knitted loops penetrate adipose tissue but do not retain a large amount of fatty tissue when the loops are removed from the fatty tissue, which allows the implantable device to be repositionable.

[0011] Advantageously, the angled gripping loops allow for immediate adhesion without penetrating muscle tissue. The angled gripping loops also prevent the implantable device from migrating laterally, i.e., translating, for example, along the abdominal wall.

[0012] The implantable device can also be wound up for insertion into a trocar and then easily unwound without the angled hook loops catching on the knitted structure and hindering unwinding. The implantable device can therefore be wound and unwound without risk of damaging the knitted fabric.

[0013] Finally, the inclined gripping loops are formed by knitting and are therefore inclined as they exit the knitting machine. The gripping elements are thus not formed during an additional operation performed on the yarn overstitched fabric after knitting, which would risk degrading its mechanical strength. The inclined gripping loops formed by knitting are therefore highly reproducible from one loop to another: their rigidity, dimensions, number, and distribution are consistent. These are therefore linked to the knitting process with monofilament yarns. This arrangement allows for immediate adhesion, repositionability, and transverse movement without penetrating muscle tissue.

[0014] Preferably, the knitted fabric comprises a first face and a second face that are substantially opposite.

[0015] Preferably, the knitted base extends between said first face and said second face of the knitted yarn.

[0016] Preferably, the hooked and inclined knitted loops project from the first face of the knitted background of the yarn over knitting.

[0017] Preferably, the yarn over knit does not include inclined hook loops extending along its second face.

[0018] Preferably, the yarn over knitting comprises a first lateral edge and a second lateral edge, in particular substantially parallel to each other.

[0019] A first lateral edge, respectively a second lateral edge, may be straight or not, for example wavy or convex or concave.

[0020] Preferably, the knitted yarn includes a top edge and a bottom edge.

[0021] In particular, the first lateral edge, respectively the second lateral edge, extends between the upper edge and the lower edge.

[0022] Knitting with dropped stitches can have any shape, for example rectangular or square.

[0023] Advantageously, since the knitted fabric is a non-running fabric, the surgeon can recut the knitted fabric once it has been removed from its sterilized packaging bag to adapt it to the parietal defect to be treated without risk of the cut portion(s) fraying.

[0024] Advantageously, the knitting with dropped stitches comprises a warp direction, and columns of stitches extending longitudinally in the warp direction.

[0025] Advantageously, the yarn over knitting comprises a weft direction, and rows of stitches extending longitudinally in the weft direction.

[0026] In particular, the weft direction is substantially perpendicular to the warp direction.

[0027] In the present text, knitted stitches are understood to mean stitches, closed or open, preferably closed, (formed by a given yarn) extending over at least two columns of stitches of the yarn over knitting.

[0028] In the present text, it is understood by a knitted sheet comprising a monofilamentary yarn that said sheet is formed in part or entirely by said knitted monofilamentary yarn.

[0029] In the present text, a knitted tablecloth is understood to mean a knitted network formed by at least one yarn extending over the width and height of the knitted fabric.

[0030] Advantageously, the monofilament yarn knitted in a sheet is knitted according to a repeating pattern which is repeated in the width of the yarn over knit between the first and second side edges, and this over the height of the yarn over knit between the top and bottom edges.

[0031] In particular, a knitted tablecloth is knitted with at least one yarn supported by a thread bar working on a knitting machine.

[0032] Advantageously, the yarn over knitting is therefore knitted with at least three different loop bars, in particular each loop bar has a movement (i.e. a stitch pattern) different from the movements (i.e. stitch patterns) of the at least two other loop bars.

[0033] Knitting with dropped stitches can be knitted on a warp or rachel knitting machine.

[0034] In particular, the yarn over knit is knitted with at least three bars at different slots each supporting at least one monofilament wire.

[0035] Advantageously, the yarn over knitting comprises 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 loop bar on the needles of the knitting machine. Monofilamentary wire(s) A and / or B and / or C

[0036] The monofilamentary thread(s) is / are made of one or more bio-compatible materials, i.e. suitable for being implanted in a living organism, human or animal, for a period of a few hours to several months or years.

[0037] The monofilament filament(s) A and / or B and / or C may be made of one or more materials selected from: - a list I comprising non-(bio)resorbable materials, preferably non-(bio)resorbable materials include: non-(bio)resorbable polyesters, such as polyethylene terephthalate (PET), and polybutylene terephthalate (PBT); polyamides; polyetheretherketone (PEEK); polyolefins, such as polypropylene and polyethylene; and a mixture of the latter; again preferably polyolefins, and non-(bio)resorbable polyesters; - a list II comprising bioresorbable materials, preferably bioresorbable materials comprising: polylactic acid (PLA, PDLA, PLLA), polyglycolic acid (PGA), oxidized cellulose, polycaprolactone (PCL), polydioxanone (PDO), polytrimethylene carbonate (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 trimethylene carbonate and lactic acid, in particular PLA, PLLA, PDLA; copolymers of the latter, or a mixture thereof, preferably polylactic acid polylactic acid (PLA, PLLA, PDLA), polyglycolic acid (PGA), and trimethylene carbonate and lactic acid copolymers (PLA, PLLA, PDLA), or a mixture thereof.

[0038] Preferably, wire A and / or wire B is / are in one or more material(s) chosen from list I.

[0039] Preferably, the wire C is made of one or more material(s) chosen from list IL

[0040] Preferably, at least part of the inclined hook-and-loop fasteners, still of Preferably, angled hook-and-loop fasteners are bioresorbable. When angled hook-and-loop fasteners are bioresorbable, they are made of one or more bioresorbable materials. Advantageously, angled hook-and-loop fasteners provide immediate and repositionable adhesion for a period of time that allows scar tissue to take over, ensuring the permanent fixation of the implantable device to the abdominal wall being treated. The hook-and-loop fasteners are therefore absorbed over time and disappear. Only the first and second knitted layers remain as permanent mechanical reinforcement.

[0041] The monofilamentary wire(s) A and / or B and / or C each have preferably a diameter between 50 pm and 300 pm, more preferably between 80 pm and 200 pm, preferably between 80 pm and 150 pm.

[0042] In particular, the monofilamentary wire(s) A and / or B each have a diameter between 50 pm and 200 pm, for example on the order of 100 + / -10 pm.

[0043] In particular, the monofilamentary wire C has a diameter between 100 pm and 300 pm, for example on the order of 150 + / -10 pm. It is understood in the present text that a parameter is between x and y, that the values ​​x and y are within the interval from x to y, and therefore that said parameter can be equal to x or y.

[0044] The monofilamentary yarn(s) A and / or B and / or C may be one or more multifilamentary yarn(s), in particular in one or more material(s) chosen from list I and / or II.

[0045] The multifilamentary yarn(s) preferably has a linear mass between 50 dtex and 400 dtex, more preferably between 60 dtex and 300 dtex, preferably between 60 dtex and 220 dtex.

[0046] In particular, the monofilamentary yarn(s) A and / or B each have a linear mass between 60 dtex and 300 dtex, for example of the order of 70 + / -10 dtex.

[0047] In particular, the monofilamentary yarn C has a linear mass between 60 dtex and 300 dtex, for example on the order of 220 + / -15 dtex.

[0048] In one embodiment, the knitting with yarn overs consists essentially of the first, second, and third knitted layers.

[0049] It is understood that the knitting with dropped stitches consists essentially of the first, second, and third knitted layers, which the said knitted layers represent at less than 80% by mass, preferably at least 90%, even more preferably at least 95% by mass, preferably about 100% by mass, of the total mass of the knitted yarn.

[0050] For example, when the three knitted layers represent at least 80% by mass of the yarn over knit, said yarn over knit may include one or more other yarn(s) but not forming a knitted layer, that is to say repeated over the width and height of the knit.

[0051] In the present text, the term "gripping loop" means that a loop is configured to grip the abdominal / inguinal wall to be treated, in particular the adipose tissue.

[0052] In the present 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, more particularly corresponding to the direction of placement of the implantable device in the caudal direction of the treated patient.

[0053] Advantageously, the inclination of the loops makes it possible to avoid the 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.

[0054] Preferably, the yarn over knit comprises opposite directions Fl and F2, substantially parallel to the warp direction or the direction of the stitch columns of the yarn over knit. Even more preferably, direction Fl extends from the bottom edge of the yarn over knit to the top edge of the yarn over knit, and direction F2 extends from the top edge of the yarn over knit to the bottom edge of the yarn over knit.

[0055] Preferably, the yarn over knit comprises opposite directions F3 and F4, substantially parallel to the weft direction or the direction of the rows of stitches. Even more preferably, direction F3 extends from the second lateral edge of the yarn over knit to the first lateral edge of the yarn over knit, and direction F4 extends from the first lateral edge of the yarn over knit to the second lateral edge of the yarn over knit.

[0056] In one embodiment, a portion (in particular between one-third and one-half of the total number of hook loops) of the hook and inclined loops of the yarn over knit are oriented in the direction F4, and a portion (in particular between one-third and one-half of the total number of hook loops) of the hook and inclined loops of the yarn over knit are oriented in the direction F3.

[0057] Preferably, a hooked inclined loop, in particular each of the hooked inclined loops, comprises a distal end and a loop foot, and even more preferably comprises an axis of symmetry S passing through said distal end and separating the loop into first and second lateral parts symmetrical to each other with respect to said axis S.

[0058] It is understood by an inclined gripping loop is oriented in the direction F4, respectively F3, that the distal end of said loop is oriented opposite the second, respectively the first, lateral edge.

[0059] The knitting with yarn overs can include slanted hook loops all oriented in the same direction (F3 or F4 for example); or slanted hook loops oriented in different directions; or first slanted hook loops oriented in a given direction F (F3 or F4 for example) and second slanted hook loops oriented in a given direction F' opposite to direction F (F3 or F4 for example), said first and second hook loops are repeated between the first and second lateral edges of the knitting and between the upper and lower edges of the knitting in an alternating manner.

[0060] The knitted fabric with yarn overs can be coated on its second side, in particular its second side not comprising inclined hook loops, with a bioresorbable or non-bioresorbable coating.

[0061] In one embodiment, the yarn over knit comprises a first side edge and a second side edge, said first and second side edges extend in the warp direction of the yarn over knit, and said yarn over knit comprises at least one assembly comprising first hook loops oriented towards the first side edge and second hook loops oriented towards the second side edge, preferably said first loops and second loops of said assembly are arranged, in particular alternately, in the warp direction.

[0062] It is understood in the present text by a loop oriented towards the first, respectively second, lateral edge, that the distal end of said loop is oriented towards the first, respectively second, lateral edge of the knitted yarn over.

[0063] Advantageously, the orientation of the inclined loops is alternated towards the first lateral edge and then towards the second lateral edge of the yarn over knit according to a determined sequence extending in the warp direction of the yarn over knit.

[0064] Advantageously, the first and second lateral edges of the knitted garment are positioned according to the cranial / caudal direction of the patient being treated so that the gripping loops are alternately oriented towards one lateral side and then towards a second lateral side of the patient. This alternating orientation of the loops prevents migration in a horizontal direction when the patient is standing.

[0065] Advantageously, the alternating arrangement in the warp direction of the first and second inclined gripping loops prevents migration of the implantable device after implantation in a horizontal direction of the patient, corresponding to the weft direction of the knitted fabric (in particular along one or the other of the directions F3 and F4).

[0066] The first loops can be alternated with the second loops according to a specific sequence, for example, alternating in the chain direction, a first loop with a second loop, or alternating a first loop with two or more second loops, or conversely, alternating a second loop with two first loops. Preferably, the first and second loops are alternated so that a first loop alternates with a second loop, and so on. Regularly alternating the first and second loops improves the stability of the yarn over knit at the implantation site.

[0067] 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°, preferably is between 35° and 55°, for example is on the order of 45° + / - 5°.

[0068] Preferably, said at least one set of (first and second) inclined and alternately oriented loops extends between the upper and lower edges of the yarn over knit, in particular over the entire height of the yarn over knit.

[0069] Said first and second lateral edges may be parallel to each other and / or parallel to the warp direction of the knitted yarn overs.

[0070] Advantageously, since the loops are already inclined, the surgeon can, during implantation, accentuate the inclination of the loops at the surgical site. This arrangement improves the blocking of caudal vertical migration.

[0071] In one embodiment, the yarn over knitting comprises several sets of loops, inclined and oriented, arranged between the first and second lateral edges.

[0072] Advantageously, the yarn over knitting 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 in an alternating manner, in the chain direction.

[0073] Advantageously, the sets of inclined and oriented loops are arranged side by side between the first and second lateral edges.

[0074] In one embodiment, the first knitted layer 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 reverse relative to the first portions of knitted stitches or the second knitted pattern M2 is reversed relative to the first knitted pattern Ml.

[0075] Preferably, the first, respectively second, portions of knitted stitches each extend over three rows of stitches.

[0076] In one embodiment, the first knitted layer 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 alternating 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.

[0077] In one variant, the first portions of knitted stitches are alternated with the second portions of knitted stitches in the chain direction of the yarn over knitting, in particular the first yarn forms first portions of knitted stitches and second portions of knitted stitches which are alternated in the chain direction.

[0078] In one embodiment, the second knitted layer 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 reverse with respect to the third portions of knitted stitches, or the third knitted pattern M3 is reversed with respect to the fourth knitted pattern M4.

[0079] In one variant, the third portions of knitted stitches are alternated with the fourth portions of knitted stitches in the chain 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 chain direction.

[0080] In one variant, the third, respectively fourth, portions of knitted stitches each extend over three rows of stitches.

[0081] In one embodiment, the second knitted layer 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, extending each on 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 each appear in the form of an elongated V open towards the first lateral edge (“>”), in particular corresponding to the third knitted motif M3, while the fourth portions of knitted stitches each appear in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the fourth knitted motif M4.

[0082] In one embodiment, the third knitted layer comprises fifth knitted stitch portions, in particular each knitted according to a knitted pattern M5, each extending over at least two columns of stitches, and sixth knitted stitch portions, in particular each knitted according to a knitted pattern M6, each extending over at least two columns of stitches, the fifth knitted stitch portions and the sixth knitted stitch portions are alternated, and the fifth knitted stitch portions 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 knitted stitch portions are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the sixth knitted pattern M6.

[0083] In one variant, the fifth knitted stitch portions are offset by at least one column of stitches from the sixth knitted stitch portions.

[0084] In one variant, the third knitted layer comprises fifth knitted stitch portions, in particular each knitted according to a knitted pattern M5, each extending over at least two columns of stitches, and sixth knitted stitch portions, in particular each knitted according to a knitted pattern M6, each extending over at least two columns of stitches, the fifth knitted stitch portions and the sixth knitted stitch portions are alternated, and the fifth knitted stitch portions 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 knitted stitch portions are each in the form of an elongated V open towards the second lateral edge (“<”), in particular corresponding to the knitted pattern M6.

[0085] Preferably, the fifth knitted stitch portions are offset from the sixth knitted stitch portions by at least one stitch column.

[0086] Preferably, the fifth and sixth knitted sections are arranged one above the other between the upper and lower edges of the knitted yarn overs.

[0087] Preferably, the yarn over knit comprises several alternating fifths and sixths knitted in the chain direction, in particular between the upper and lower edges of the yarn over knit.

[0088] Preferably, the yarn over knit comprises several alternating fifths and sixths knitted in the chain direction, in particular the alternation being repeated between the upper and lower edges of the yarn over knit.

[0089] In an alternative embodiment, a first portion of knitted stitches, and a third portion of knitted stitches, are knitted over three columns of common stitches, and in particular over three rows of common stitches.

[0090] 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.

[0091] In one embodiment, the yarn over knitting comprises: - a first knitted section comprising knitted stitches, said first knitted section extending 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 - a second knitted section comprising knitted stitches, said second knitted section extending 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 - the second knitted section is separated from the first knitted section by a through hole having at least a dimension greater than or equal to 3 mm.

[0092] The first section is formed by a portion of the first knitted layer, a portion of the second knitted layer, and finally a portion of the third knitted layer.

[0093] The first knitted section extends between the first and second faces of the knitted yarn overs.

[0094] Preferably, the first knitted section and the second knitted section are arranged side by side in the weft direction of the yarn over knit.

[0095] Preferably, the first knitted section and the second knitted section are knitted over at least three rows of common stitches.

[0096] Preferably, the first knitted section and the second knitted section are separated by at least one column of stitches.

[0097] Preferably, the yarn over knitting comprises several first knitted sections and several second knitted sections, said first and second knitted sections being alternated in the weft direction of the row knitting, in particular are arranged repeatedly between the first and second lateral edges.

[0098] In one embodiment, the first knitted section is knitted together with the second knitted section, preferably via a third knitted section, said third knitted section comprising knitted stitches, said third knitted section extending 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.

[0099] Preferably, the first knitted section is knitted together with the second knitted section also through 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 yarns A and B, and optionally yarn C.

[0100] Preferably, the yarn over knit comprises several through openings, each having at least one dimension greater than or equal to 3 mm.

[0101] Preferably, a through opening is delimited, at least in part, by the first, second, third and fourth knitted sections.

[0102] Preferably, the third and fourth knitted sections are arranged one above the other between the upper and lower edges of the knitted yarn overs.

[0103] Preferably, the yarn over knit comprises several alternating third and fourth knitted sections in the chain direction, in particular between the upper and lower edges of the yarn over knit.

[0104] Preferably, the yarn over 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.

[0105] In one embodiment, the yarn over knitting comprises a slanted gripping loop formed at least in part by a portion of a monofilament yarn selected from yarns A, B or C, said portion of monofilament yarn is knitted into at least one of the first, second, third and fourth knitted sections.

[0106] Advantageously, said at least one inclined gripping loop is formed by a portion of the monofilamentary yarn, C,

[0107] In one embodiment, at least two, preferably at least three, and even more preferably each, of the first, second, third and fourth knitted sections comprise a hook-and-loop angled loop formed by a portion of a monofilament yarn selected from yarns A, B or C, in particular yarn C.

[0108] In one variant, the yarn over knit comprises several through-openings, at least one of which, in particular each of said through-openings, has a dimension greater than or equal to 3 mm, said through-opening being surrounded at least in part by at least two, preferably at least four, hook-and-loop slants, each hook-and-loop slant being formed by a portion of monofilament yarn, in particular a monofilament yarn C, more particularly said through-opening being surrounded by: - a hooked 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

[0109] - a hooked and inclined loop 02 arranged in the second knitted section, and in particularly oriented towards the second lateral edge, more particularly in the direction F4; and / or

[0110] - a hooked 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

[0111] - a hooked and inclined loop 04 arranged in the fourth knitted section, and in particular oriented towards first side edge, more particularly in direction F3. In one embodiment, at least one loop chosen from said slanted gripping loops, in particular several or each of the slanted gripping loops, is knitted with monofilament yarn C, and said slanted gripping loop is placed between a first base stitch and a second base stitch knitted with said monofilament yarn C, and the yarn over knitting includes 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.

[0112] Advantageously, the first base stitch and the first blocking stitch, optionally the second base stitch and the second blocking stitch, are in the knitted section (in particular first or second or third or fourth) comprising the slanted gripping knitted loop.

[0113] Advantageously, during the relaxation of the knitted fabric as it exits the knitting machine, the portions of yarn forming the inclined, oriented and gripping loops retract and each form a loop.

[0114] Advantageously, at the exit of the knitting machine, for a given inclined gripping loop, a stitch is formed between the first and second base stitches blocked by the first and second blocking stitches, said stitch then unravels and forms a portion of monofilament yarn extending between the first and second base stitches, said portion forming the inclined loop.

[0115] In an alternative embodiment, the knitting diagram of the first layer is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 / / .

[0116] This knitting diagram advantageously corresponds to the movement of the loop bar supporting at least yarn A, and knitting the first knitted layer.

[0117] In this text, all knitting diagrams are written in accordance with ISO 11676:2014, entitled "Materials for the textile industry - Reinforcement discs and "Reinforcement chains for drop-stitch knitting machines - Vocabulary and symbols."

[0118] In an alternative embodiment, the knitting diagram of the second layer is: 1- 0 / 2- 3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 / / .

[0119] This knitting diagram advantageously corresponds to the movement of the loop bar supporting at least yarn B, and knitting the second knitted layer.

[0120] In an alternative embodiment, the knitting diagram of the third layer is: 4-5 / 3-2 / 4-5 / 1-0 / 2-3 / 1-0 / / .

[0121] This knitting diagram advantageously corresponds to the movement of the loop bar supporting at least yarn C, and knitting the third knitted layer.

[0122] In one embodiment, the yarn over knit comprises at least 40% by mass of one or more bioresorbable (co)polymer(s), in particular the said bioresorbable (co)polymer(s) is / are selected from: polylactic acid (PLA), polyglycolic acid (PGA), oxidized cellulose, polycaprolactone (PCL), polydioxanone (PDO), polytrimethylene carbonate (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 selected from List II defined in this text.

[0123] In one embodiment, the yarn over 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 this text.

[0124] In particular, the knitted fabric comprises one or more monofilament yarn(s), in particular selected from yarns A, B and C, comprising one or more bioresorbable (co)polymer(s), in particular selected from list II cited above, the said bioresorbable (co)polymer(s) representing(s) at least 40% by mass of the total mass of the knitted fabric.

[0125] In one variant, the yarn over knitting comprises at least one yarn, in particular yarn C, comprising a copolymer of polytrimethylene carbonate (PTMC) and lactic acid, in particular of form L (PLLA).

[0126] 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 about 80% within + / -5%.

[0127] 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 about 20% to within + / -5%.

[0128] Preferably, the polytrimethylene carbonate (PTMC) and lactic acid copolymer is a block copolymer, in particular a triblock copolymer whose motif of repetition includes a central block and two lateral blocks arranged on either side of the central block, the central block includes a unit of trimethylene carbonate, and each lateral block includes a unit of lactic acid, in particular of form L.

[0129] In one embodiment, the yarn over knit comprises less than 60% by mass of one or more non-(bio)resorbable (co)polymer(s), in particular the said non-(bio)resorbable (co)polymer(s) is / are chosen from: (co)polymers of at least one oleofin (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 this text.

[0130] In particular, the yarn-knitted fabric comprises one or more monofilament yarn(s), in particular selected from yarns A, B and C, comprising one or more non-(bio)absorbable (co)polymer(s), in particular selected from List I cited above, said non-absorbable (co)polymer(s) represent(s) less than 45% by mass of the total mass of the yarn-knitted fabric, in particular said non-absorbable (co)polymer(s) is / are selected from: (co)polymers of at least one oleofin (for example polypropylene, polyethylene, a copolymer of propylene and ethylene), polyesters such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT).

[0131] In one embodiment, the yarn over knit comprises between 20% and 40%, in particular between 30% and 40%, of non-(bio)resorbable (co)polymer(s).

[0132] In one embodiment, the yarn over knit has a surface mass greater than or equal to 50 g / m2 and less than or equal to 150 g / m2.

[0133] In a preferred embodiment, the yarn over knit has a surface mass between 80 g / m2 and 120 g / m2, in particular in the order of 100 g / m2 at + / - 5 g / m2.

[0134] In one 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.

[0135] Preferably, the yarn over 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.

[0136] In one embodiment, the yarn over knitting 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.

[0137] In a preferred embodiment, the yarn over knitting comprises a number of stitches in the chain direction of between 1 and 6 per cm, preferably between 2 and 5 per cm.

[0138] In a preferred embodiment, the yarn over knitting comprises a number of stitches in the weft direction between 1 and 6 per cm, preferably between 2 and 5 per cm.

[0139] The present invention relates, according to a second aspect, to a method for manufacturing an implantable device according to any one of the embodiments referred to in the first aspect, comprising a step of knitting a knitted fabric with dropped stitches on a knitting machine comprising: - the knitting of a first knitted layer with a first bar with loops supporting at least one monofilament yarn A and forming knitted stitches, - the knitting of a second knitted layer with a second loop bar supporting at least one monofilament yarn B and forming knitted stitches, - the knitting of a third knitted layer with a third loop bar supporting at least one monofilament yarn C and forming knitted stitches, and - the movement of said first, second, and third loop bars is determined so as to obtain a knitted fabric comprising a knitted base and comprising hooked knitted loops projecting from said knitted base and inclined towards said knitted base.

[0140] The manufacturing process advantageously makes it possible to obtain a knit with dropped stitches with inclined and gripping loops obtained by knitting, and therefore arranged spatially and in number in a way determined by the stitch pattern and reproducible.

[0141] Advantageously, the yarn over knitting includes gripping loops without it being necessary to carry out an additional step after knitting to melt portions of yarn and form gripping picots.

[0142] Preferably, the knitting machine is a warp or Rachel machine.

[0143] Preferably, the first and second slotted bars are each threaded with one full and three empty ones.

[0144] Preferably, the third slotted bar is threaded with two empty slots, one full slot, and one empty slot.

[0145] The schematic representation ...I means, for example, three empty spaces and one full space. A point (.) represents an empty thread, and (I) represents a full thread.

[0146] In one variant, at least one loop, chosen from said slanted gripping loops, is knitted with monofilament yarn C, and said loop is arranged between a first base stitch and a second base stitch, and the yarn over knitting comprises a first blocking stitch knitted with yarn A or B and superimposed with the first base stitch, and optionally a second blocking stitch knitted with yarn A or B and superimposed with the second base stitch.

[0147] In one embodiment, the movement of the first pass-through bar, in particular the front bar, is: 5-4 / 5-6 / 5-4 / 8-9 / 8-7 / 8-9 / / , in particular with a repetitive threading of three empty loops followed by one full loop (schematic representation: ...1),

[0148] In one embodiment, the movement of the second loop bar, in particular the intermediate bar, is: 1- 0 / 2-3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 / / in particular with a repetitive threading of three empty loops followed by a full loop (schematic representation: ...I),

[0149] In one embodiment, the movement of the third loop bar, in particular the rear bar, is: 4-5 / 3-2 / 4-5 / 1-0 / 2-3 / 1-0 / / in particular with a repetitive threading of two empty loops followed by a full loop and followed by an empty loop (schematic representation: (..1.),

[0150] The embodiment variants described with reference to the first aspect of the invention can be combined with the embodiment variants with reference to the second aspect of the invention, independently of each other. Description of the drawings

[0151] The invention will be better understood upon reading the following description of an example embodiment of the invention given by way of non-limiting example, with reference to the accompanying drawings, in which:

[0152] - Fig. 1 schematically represents, from the front, a first example of implantable device according to the invention,

[0153] - [Fig.2] schematically represents, in profile view, the first example of implantable device shown in [Fig.1];

[0154] - [Fig.3] schematically represents, viewed from above, the knitting with yarn overs with an angled hook loop oriented towards the first lateral edge and an angled hook loop oriented towards the second lateral edge;

[0155] - [Fig. 4] represents the knitting diagram of the yarn over stitch knitting of the first example of an implantable device according to figures 1 to 3. Description of the implementation methods

[0156] The implantable device 10 shown in Figures 1 and 2 comprises a yarn over knit 20, said yarn over knit 20 comprising a knitted base 30 having substantially opposite first and second faces 32, 34, and comprising gripping knitted loops 40 projecting from the first face 32 of the knitted base 30 and inclined towards said knitted base 30. The yarn over 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 chain direction C of the yarn over knit. The yarn over knit 20 comprises several sets 50 of inclined gripping loops 40, in particular with an alternating orientation in the chain direction C towards the first lateral edge 22 and towards the second lateral edge 24. Advantageously, each set 50 includes first angled hook loops 40A which are oriented towards the first lateral edge 22, and second angled hook 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 chain direction C of the knitting 20.

[0157] The knitting with yarn overs 20 thus comprises several sets 50 of inclined loops 40, and in particular oriented in a determined way, arranged between the first and second lateral edges 22,24.

[0158] 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 chain 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 for two or more second loops 40B to be 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, allowing the lateral displacement of the knitted fabric 20 to be stabilized when placed in contact with adipose tissue.

[0159] Preferably, the sets 50 of inclined loops 40, and in particular oriented, extend between the upper and lower edges 23,25 of the yarn over knit 20, in particular over the entire height H of the yarn over knit 20, and over the entire width 1 of the knit 20.

[0160] Preferably, the first and second lateral edges 22,24 are parallel to each other and parallel to the chain direction C of the knitting with yarn overs 20.

[0161] Figure 2 shows the inclination of the hook loops 40 towards the knitted base 30. The knitted base 30 has a thickness e less than the total thickness E. The thickness e of the knitted base 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 hook loops 40.

[0162] Figure 3 schematically represents the knitting with 20 yarn overs, viewed from the front and slightly in perspective. Only a first hook loop 40A and a second hook loop 40B are shown for the sake of simplification.

[0163] In particular, each inclined gripping 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.

[0164] The inclined gripping loop 40A includes an axis of symmetry Sa passing through said distal end 41A and substantially perpendicular to the axis Pa tangent to the foot of loop 42A. The axis of symmetry Sa separates the loop 40A into first and second lateral parts (43A,44A) symmetrical.

[0165] The inclined gripping loop 40B includes 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 symmetrical first and second lateral parts (43B, 44B).

[0166] Fig. 4 represents the stitch patterns of the different yarns knitted in the yarn over knitting 20 using a stitch grid (each row of stitches representing the position of the knitting needles when working the corresponding row of stitches) comprising from ml to ml2 rows of stitches and from n1 to n23 columns of stitches.

[0167] Zone 1 of [Fig. 3] represents the preferred stitch patterns of the three yarn types A, B, and C implemented in yarn over knitting, with two repetitions per yarn to understand the knitted arrangement of yarn over knitting 20. Zone 3 represents in particular the stitch patterns of yarns A and B. Zone 2 represents in particular the stitch pattern of yarn C.

[0168] Advantageously, zone 1 comprises, represented twice, and knitted repeatedly over the entire width 1 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 edge 23 and lower edge 25: - a monofilamentary yarn A 62 so as to form a first knitted layer 60 comprising knitted stitches; - a monofilament yarn B 72 so as to form a second knitted layer 70 comprising knitted stitches; and - a monofilamentary yarn C 82 so as to form a third knitted layer 80 comprising knitted stitches.

[0169] Zones 2 and 3 are each represented with fewer yarns to better understand the stitch patterns for each yarn type. Zone 2 thus focuses on knitted yarn C 82, and zone 3 focuses on knitted yarns A and B (62,72) without yarn C 82.

[0170] Advantageously, the first knitted tablecloth 60 comprises: - the first 64 portions of knitted stitches, each extending over three columns of stitches and three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 24, and - second portions of 65 knitted stitches, each extending over three columns of stitches and 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 reverse by in relation to the first portions of knitted stitches 64 (the direction of the elongated V of the first portions is reversed in relation to the direction of the elongated V of the second portions), and in particular are offset in relation to the first portions of knitted stitches 64 by two columns of stitches.

[0171] The first portions of knitted stitches 64 correspond to first knitted motifs Ml (<), a first motif Ml extends for example between the stitch (ml,n20), then the stitch (m2,nl8), and finally the stitch (m3,n20).

[0172] The second portions of knitted stitches 65 correspond to second knitted motifs M2 (>), a second motif M2 extends for example between the stitch (m4,nl6), then the stitch (m5,nl8), and finally the stitch (m6,nl6).

[0173] Advantageously, the second portions of knitted stitches 65 and the first portions of knitted stitches 64 are knitted by alternating in the direction of the chain or the height of the knitting 20.

[0174] For example, a first portion of knitted stitches 64 extends over three columns of stitches nl8 to nl20 and over three rows of stitches ch 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 nl20, relative to the first portion of knitted stitches 64.

[0175] Advantageously, the second knitted tablecloth 70 comprises: - third portions 74 of knitted stitches, each extending over three columns of stitches and three rows of stitches, each in the shape of an elongated V (“>”) open towards the first lateral edge 22, and - fourth portions, 75 pieces of knitted stitches, each extending over three columns of stitches and three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 22, - the fourth portions of knit stitches 75 are knitted in reverse relative to the third portions of knit stitches 74, and in particular are offset relative to the third portions of knit stitches 74 by two columns of stitches.

[0176] The third portions of knitted stitches 74 correspond to third knitted motifs M3 (>), a third motif M3 extends for example between the stitch (ml,nl8), then the stitch (m2,n20), and finally the stitch (m3,nl8).

[0177] The fourth portions of knitted stitches 75 correspond to fourth knitted motifs M4 (<), a fourth motif M4 extends for example between the stitch (m4,n22), then the stitch (m5,n20), and finally the stitch (m6,nl8).

[0178] In addition, the fourth portions of knitted stitches 75 and the third portions of knitted stitches 74 are knitted by alternating in the direction of the chain or the height of the knitting 20.

[0179] For example, a third portion of knitted stitches 74 extends over three columns of stitches nl8 to nl20 and over three rows of stitches ch to m3; and a fourth portion of knitted stitches 75 extends over three columns of stitches nl20 to nl22 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.

[0180] Advantageously, the first knitted layer 60 is knitted in a direction opposite to the direction of knitting of the second knitted layer 70, that is to say that the first loop bar supporting yarn A 62 knits for example from left to right while the second loop bar supporting yarn B 72 knits from right to left.

[0181] Advantageously, the third knitted tablecloth 80 comprises: - fifth portions 84 of knitted stitches, each extending over two columns of stitches and three rows of stitches, each in the shape of an elongated V (“>”) open towards the first lateral edge 22, and - sixth portions of 85 knitted stitches, each extending over two columns of stitches and three rows of stitches, each in the shape of an elongated V (“<”) open towards the second lateral edge 24, - the sixth portions of knit stitches 85 are knitted in reverse to the fifth portions of knit stitches 84 (the direction of the elongated V of the fifth portions is reversed to the direction of the elongated V of the sixth portions), and in particular are offset from the fifth portions of knit stitches 84 by two columns of stitches.

[0182] In addition, the sixth portions of knitted stitches 85 and the fifth portions of knitted stitches 84 are knitted by alternating in the direction of the chain or the height of the knitting 20.

[0183] The fifth portions of knitted stitches 84 correspond to fifth knitted motifs M5 (>) open towards the first lateral edge 22, a fifth motif M5 extends for example between the stitch (ml,n2), then the stitch (m2,n3), and finally the stitch (m3,n2).

[0184] The sixth portions of knitted stitches 85 correspond to sixth knitted motifs M6 (<), a sixth motif M6 extends for example between the stitch (m4,n6), then the stitch (m5,n5), and finally the stitch (m6,n6).

[0185] For example, a fifth portion of knitted stitches 84 extends over two columns of stitches n2 to n3 and over three rows of stitches ch 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.

[0186] Advantageously, the arrangement of the first, second, and third knitted layers (60, 70, 80) allows knitted sections to be arranged around through openings 90.

[0187] In particular, the yarn over knit 20 comprises a first knitted section 100 comprising knitted stitches, said first section 100 extending over three columns of stitches and three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82. The yarn over knit 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 separated from the first knitted section 100 by a through hole 90 having at least a dimension greater than or equal to 3 mm.

[0188] In particular, the first knitted section 100 is knitted into the second knitted section 120 by means of 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.

[0189] In particular, the second knitted section 120 is knitted in connection with the first knitted section 100 also by means of a fourth knitted section 160, said fourth knitted section 160 comprising knitted stitches, said fourth section extends over three columns and over three rows of stitches, and is knitted with yarn A 62, yarn B 72, and yarn C 82.

[0190] 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.

[0191] Advantageously, each knitted section (100,120,140,160) includes a hooked inclined loop formed by a portion of the monofilament yarn C 82 of the third knitted layer 80.

[0192] The inclined gripping loops 40A towards the first lateral edge 22 are formed by the sixth elongated V-shaped knitted motifs (<), and the inclined gripping loops 40B towards the second lateral edge 24 are formed by the fifth elongated V-shaped knitted motifs (>).

[0193] Advantageously, the slanted gripping loops 40 (40A, 40B) knitted with monofilament yarn C 82 are each arranged between a first foundation stitch, for example stitch 82a, and a second foundation stitch, for example stitch 82b. Furthermore, each slanted gripping loop also includes a first blocking stitch, for example stitch 72a, knitted with yarn B 70 and superimposed on the first foundation stitch, and a second blocking stitch, for example stitch 72b, knitted with yarn B 70 and superimposed on the second foundation stitch. These first and second blocking stitches are superimposed on first and second foundation stitches respectively and allow the gripping loops to be held firmly in place. The 30-stitch base is knitted without risk of the loops stretching lengthwise. The feet of a gripping loop, formed by the base and locking stitches, are thus secured with the 30-stitch base. This arrangement helps maintain the shape of the loops and therefore improves their gripping power.

[0194] A hook loop 40A extending between the first and second base stitches is referenced in [Fig. 3]. After knitting, the central stitch 82c unravels and forms the hook loop 40A. Similarly, a hook loop 40B includes a central stitch 82c which unravels once the knitting 20 is relaxed.

[0195] In a specific preferred example, the knitting diagram: - of the first bar with slots supporting said monofilamentary wire A 62 for the formation of the first layer 60 is: 5- 4 / 5- 6 / 5- 4 / 8- 9 / 8- 7 / 8- 9 / / with a threading: ...I; - of the second bar with slots supporting said monofilamentary wire B 72 for the formation of the first layer 70 is: 1- 0 / 2-3 / 1- 0 / 4- 5 / 3- 2 / 4- 5 / / with a threading: ...I; - of the third bar with slots supporting said monofilament C 82 yarn for the formation of the first layer 70 is: 4- 5 / 3- 2 / 4- 5 / 1- 0 / 2- 3 / 1- 0 / / with a threading: ..I.,

[0196] Monofilament yarn A 62 is a polypropylene monofilament yarn with a diameter of 0.10 mm. Monofilament yarn B 72 is a polypropylene monofilament yarn with a diameter of 0.10 mm. Monofilament yarn C 82 is a polylactic acid L-form (PLLA) monofilament yarn with a diameter of 0.15 mm. In this specific example, the mass fraction of PLLA monofilament yarns, and therefore of PLLA, in the 20-stitch knit is approximately 66%, and the mass fraction of PP monofilament yarns, and therefore of PP, in the 20-stitch knit is approximately 34%. The surface mass of the 20-threaded knit is approximately 105 g / m2 at + / - 10 g / m2, the number of stitches in the warp direction per cm is approximately 3, and the number of stitches in the weft direction per cm is approximately 3.

[0197] In this specific example, the thickness E of the knitted fabric, including the 40 hook loops, is approximately 1.5 mm ± 0.5 mm. The tensile strength in the warp direction is greater than 80 N, the elongation in the warp direction under a load of 80 N is a maximum of 110%, the tensile strength in the weft direction is greater than 80 N, and the elongation in the weft direction under a load of 80 N is a maximum of 90%. The mechanical tests in this specific example are carried out according to ISO 13934-1 and Annex 1, with the following parameters: 5 kN load cell, fabric clamping jaw, 4.5 Nm torque wrench setting, initial sample length 200 mm and width approximately 50 mm, speed 100 mm / min.

[0198] The monofilament C 82 wire can advantageously be replaced by a monofilament wire lamentary of substantially the same diameter also bioresorbable, but in a copolymer trimethylene carbonate (PTMC) and lactic acid of L form.

[0199] The resulting yarn over knit comprises gripping, angled loops formed regularly and reproducibly by knitting without the need to fuse portions of the knit afterward. The loops thus formed allow for immediate adhesion to adipose tissue, enabling the knit to be repositioned while maintaining satisfactory immediate adhesion. The arrangement of the gripping, angled loops also prevents migration of the yarn over knit in both the warp and weft directions once it is placed against adipose tissue. Furthermore, the yarn over knit can be rolled up and placed inside another knit without the loops catching on the knit's structure, preventing it from unwinding and potentially damaging it.

[0200] Finally, the angled, gripping loops 40 are formed from portions of bioresorbable monofilament yarns whose ends are locked into the mesh structure so that they are securely anchored and non-deformable. Furthermore, the loops will dissolve over time, and only the knitted base will remain in place to provide stable mechanical reinforcement.

[0201] It is also possible to provide that the threads A and B are bioresorbable but in bioresorbable materials which are absorbed less quickly than the material forming the 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 desired duration 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 monofilament 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-knitted fabric (20) comprises a knitted base (30) and comprises gripping knitted loops (40, 40A, 40B)) projecting from said knitted base (30) and inclined towards said knitted base (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 with respect 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-knitted fabric (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 optionally 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 optionally the yarn C (82), and - the second knitted section (120) is spaced from the first knitted section (100) by a through-hole (90) having at least one dimension greater than or equal to 3 mm.

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 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 (82a), basic (82b).

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

10. Implantable device (10) according to any one of claims 1 to 9, characterized in that the knitting pattern of the second sheet (70) is: 1-0 / 2-3 / 1-0 / 4-5 / 3-2 / 4-5 / / .

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

12. Implantable device (10) according to any one of claims 1 to 11, 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 of these.

13. Implantable device (10) according to any one of claims 1 to 12, 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.

14. Implantable device (10) according to any one of claims 1 to 13, characterized in that the warp-knitted fabric (20) has a surface mass greater than or equal to 50 g / m2 and less than or equal to 150 g / m2

15. ili . Implantable device (10) according to any one of claims 1 to 14, 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.

16. Implantable device (10) according to any one of claims 1 to 15, 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.

17. A method of manufacturing an implantable device (10) according to one of any of claims 1 to 16, 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 sheet (80) with a third guide bar 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).

18. Manufacturing method according to claim 17, 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).