Multi-piece urethral sling with adjustable extension portions

Solution Overview

Problem

Conventional surgical methods for treating urinary incontinence in males require invasive abdominal incisions, which are time-consuming and uncomfortable, and there is a need for more efficient and less traumatic procedures.

Innovation Solution

The development of a surgical assembly and method involving a multi-piece implant with adjustable extension portions and a small-diameter insertion tool that allows for the placement of a tissue support portion below the urethra, with extension portions extending through the obturator foramen, reducing the need for lateral incisions and minimizing tissue trauma.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If conventional abdominal incision method is used to place sling, then complete access to abdominal cavity is achieved, but surgical time increases and patient discomfort increases

Engineering Contradiction:

Improveease of sling placementVSAvoidsurgical time

Core Design Contradiction:

Ease of operationVSLoss of time

Solution Approach 1:

The sling implant is divided into multiple segments: a proximal portion inserted through the obturator foramen and a distal portion inserted through the perineal incision. This segmentation allows each portion to be placed through separate, smaller access points rather than requiring a large abdominal incision, thereby reducing surgical time and patient discomfort while maintaining complete access to the bladder neck for effective sling placement.

Inventive Principle:

Principle #1Segmentation

2Ease of operation

If conventional abdominal incision method is used to place sling, then complete access to abdominal cavity is achieved, but patient trauma increases

Engineering Contradiction:

Improveease of sling placementVSAvoidtissue trauma

Core Design Contradiction:

Ease of operationVSObject-affected harmful factors

Solution Approach 1:

The sling implant is divided into multiple segments: a proximal portion inserted through the obturator foramen and a distal portion inserted through the perineal incision. This segmentation allows each portion to be placed through separate, smaller access points rather than requiring a large abdominal incision, thereby reducing surgical time and patient discomfort while maintaining complete access to the bladder neck for effective sling placement.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The obturator foramen serves as an intermediary access pathway, allowing the proximal sling portion to be inserted through the pelvic bone opening rather than through abdominal muscles. This intermediary route avoids direct trauma to abdominal tissues while still providing access to the bladder neck, thereby reducing overall tissue trauma compared to conventional abdominal incision methods.

Inventive Principle:

Principle #24Intermediary (Mediator)

3Object-affected harmful factors

If transobturator method is used to place sling, then abdominal muscles are avoided, but access to bladder neck is limited

Engineering Contradiction:

Improveabdominal muscle traumaVSAvoidaccess to bladder neck

Core Design Contradiction:

Object-affected harmful factorsVSEase of operation

Solution Approach 1:

The sling implant is divided into multiple segments: a proximal portion inserted through the obturator foramen and a distal portion inserted through the perineal incision. This segmentation allows each portion to be placed through separate, smaller access points rather than requiring a large abdominal incision, thereby reducing surgical time and patient discomfort while maintaining complete access to the bladder neck for effective sling placement.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The invention merges the transobturator approach (avoiding abdominal muscles) with the perineal approach (direct access to bladder neck) by combining two insertion routes into a single multi-segment sling system. The proximal portion uses the obturator route to avoid abdominal trauma, while the distal portion uses the perineal route to ensure direct access to the bladder neck, thereby achieving both benefits simultaneously.

Inventive Principle:

Principle #5Merging (Combining)

Data Source

PatentUS20230190437A1Surgical articles and methods for treating urinary incontinence

Publication Date: 2023.06.22 BOSTON SCIENTIFIC SCIMED INC

AI summary

Described are devices, implants and kits for treating incontinence in a male or female. In particular an assembly comprising a multi-piece implant comprising a support portion piece (82) and two extension portion pieces (84) adjustably connected to the support portion piece, and an adjusting tool (92) to allow adjustment of extension portion pieces relative to the support portion piece, is described.