Laparoscopic Mesh Graft Delivery Device for Sacrocolpexy

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Solution Overview

Problem

Current methods for treating vaginal wall prolapse, such as abdominal sacrocolopexy and transvaginal mesh insertion, face challenges like high failure rates, complications, and require specialized skills, with difficulties in applying the correct tension and risk of bowel complications.

Innovation Solution

A system and method using a modified graft delivery device with a precut mesh graft and a suture-capturing mechanism that allows for independent adjustment of anterior and posterior vaginal wall support without suturing to the sacrum, utilizing a dilator to adjustably couple the mesh to the sacrum, reducing the need for skilled knot tying and minimizing mesh overlap.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If abdominal sacrocolopexy is performed through open incision with peritoneum opening and retroperitoneal suturing, then graft attachment to sacrum is achieved, but surgical skill requirement increases and bleeding risk increases

Engineering Contradiction:

Improvegraft attachment reliabilityVSAvoidsurgical operation ease

Core Design Contradiction:

ReliabilityVSEase of operation

Solution Approach 1:

The patent introduces a delivery device as an intermediary tool that facilitates graft placement and sacral attachment without requiring direct retroperitoneal access. The device includes a needle guide and suture passing mechanism that enables secure graft-to-sacrum attachment through a safer, more accessible surgical pathway, reducing the need for complex peritoneal dissection and retroperitoneal suturing skills

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The surgical procedure is segmented into distinct steps facilitated by the delivery device: graft preparation, device insertion, needle passage through sacrum, suture tying, and device removal. This segmentation allows each step to be performed with standardized techniques rather than requiring mastery of complex continuous retroperitoneal dissection and suturing

Inventive Principle:

Principle #1Segmentation

2Reliability

If abdominal sacrocolopexy is performed with peritoneum opening and retroperitoneal suturing, then graft can be attached to sacrum, but bowel complication risk increases

Engineering Contradiction:

Improvegraft attachment reliabilityVSAvoidbowel complication risk

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The delivery device serves as an intermediary that enables sacral attachment while avoiding direct manipulation in the retroperitoneal space where bowel structures reside. The device's needle guide and suture passing mechanism allow precise attachment without the need for extensive peritoneal opening and retroperitoneal dissection, thereby reducing the risk of bowel injury, obstruction, and other serious complications

Inventive Principle:

Principle #24Intermediary (Mediator)

3Object-affected harmful factors

If laparoscopic approach is used for sacrocolopexy, then bowel complication risk is reduced, but knot tying skill requirement increases

Engineering Contradiction:

Improvebowel complication riskVSAvoidknot tying accessibility

Core Design Contradiction:

Object-affected harmful factorsVSEase of operation

Solution Approach 1:

The delivery device incorporates a self-service mechanism where the suture is pre-threaded through the needle guide and attached to the graft. The surgeon simply needs to pass the needle through the sacrum and tie the knot at the abdominal wall, without requiring complex laparoscopic knot-tying skills. The device performs the complex threading and positioning functions automatically

Inventive Principle:

Principle #25Self-service

Solution Approach 2:

The delivery device acts as an intermediary that translates the simple external knot-tying action into precise internal graft attachment. The needle guide and suture mechanism mediate between the surgeon's external manipulation and the internal surgical requirements, making the procedure accessible to surgeons without advanced laparoscopic knot-tying skills while maintaining safety

Inventive Principle:

Principle #24Intermediary (Mediator)

4Ease of operation

If transvaginal mesh insertion is used, then surgical accessibility is improved, but infectious and sexual complication risk increases

Engineering Contradiction:

Improvesurgical accessibilityVSAvoidinfectious and sexual complication risk

Core Design Contradiction:

Ease of operationVSObject-affected harmful factors

Solution Approach 1:

The patent segments the surgical approach into an abdominal access route for graft placement and sacral attachment, separated from the vaginal canal. This segmentation allows the mesh to be introduced and secured through the abdominal wall, avoiding direct transvaginal manipulation and thereby reducing the risk of introducing infection and causing sexual dysfunction while maintaining surgical accessibility

Inventive Principle:

Principle #1Segmentation

Data Source

PatentUS11051924B2System and method for treating prolapse and incontinence

Publication Date: 2021.07.06 BOSTON SCIENTIFIC SCIMED INC

AI summary

A system and method of treating vaginal prolapse and incontinence comprises a kit. The kit includes a mesh graft configured for attachment to the anterior and posterior vaginal walls to thereby treat the vaginal prolapse. A graft delivery device is also provided for introducing and placing the mesh graft to a location deep within the peritoneal cavity and for attaching the graft thereto. A leg assembly is provided and coupled to an end of the mesh graft and cooperates with the graft delivery device to anchor and affix the mesh graft to the desired anatomical structures. The method according to the present invention contemplates a laparoscopic graft placement utilizing the components of the kit.