Urethral Sling Plicating Lines for Tensioning
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Solution Overview
Problem
Current urethral sling procedures for treating stress urinary incontinence are time-consuming and challenging due to the complexity of tensioning and securing the sling to bone anchors, often requiring repeated knotting and untightening, which complicates achieving adequate urethral resistance.
Innovation Solution
A urethral sling with pre-positioned plicating lines that can be drawn to create a fold or crease in the central portion, allowing for easier tensioning and fixation to bone anchors, reducing the need for extensive knotting and simplifying the surgical process.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional urethral sling procedures are used with manual tensioning and knotting, then adequate urethral support can be achieved, but the surgical time is excessive and the procedure is complex
Solution Approach 1:
The sling is pre-formed with plicating lines and creases during manufacturing, allowing the surgeon to simply draw and secure the pre-configured structure rather than manually creating folds and tensioning points during surgery. This preliminary preparation of the sling geometry resolves the contradiction by enabling adequate urethral support through a simplified, faster surgical process.
Solution Approach 2:
The plicating lines act as intermediaries that translate the simple action of drawing ends together into the complex result of creating controlled folds and tensioning the sling uniformly. These pre-positioned lines mediate between the surgeon's simple pulling action and the desired complex deformation pattern, reducing surgical time while maintaining support adequacy.
2Reliability
If traditional manual tensioning methods are used, then the sling can be secured to bone anchors, but the procedure requires extensive knotting and untightening which increases complexity
Solution Approach 1:
The complex steps of manual knotting, untightening, and re-knotting are extracted from the surgical procedure. Instead, the pre-formed plicating lines allow the surgeon to simply draw the ends together and secure, eliminating the need for extensive knotting while maintaining reliable fixation to bone anchors.
Solution Approach 2:
The sling structure serves itself by being pre-configured with the necessary folds and tensioning geometry. The plicating lines are self-contained features that automatically create the required deformation pattern when drawn together, eliminating the need for complex manual manipulation and multiple knotting cycles.
3Reliability
If the sling is tensioned to achieve adequate urethral resistance, then incontinence treatment is effective, but the procedure becomes more difficult and time-consuming
Solution Approach 1:
The optimal tensioning geometry is pre-established through the plicating lines and creases formed during manufacturing. This preliminary configuration ensures that when the sling ends are drawn together, the correct amount of tension is automatically applied to achieve adequate urethral resistance, making the procedure easier while maintaining treatment effectiveness.
Solution Approach 2:
The physical state of the sling is changed during manufacturing by pre-forming specific folds and creases that encode the required tension parameters. This parameter preparation allows the surgeon to achieve the correct urethral resistance with simple drawing motions, improving ease of operation while ensuring effective treatment.
Data Source
AI summary
Improved methods and apparatus to secure a urethral sling to pubic bone in a sub-urethral location to support the urethra and alleviate incontinence are disclosed. The urethral sling is preferably formed of a flexible sheet material extending between opposed first and second sling ends and bounded by opposed first and second sling sides. The urethral sling is selectively tensioned in a central portion intermediate the first and second sling ends and/or in one or both of end portions bracketing the central portion. In one embodiment, pre-positioned plicating lines in the central portion are selectively drawn and tied to slacken the central portion and tension the end portions. In further embodiments, bone anchor lines passed through locations displaced from the sling ends are drawn and fixed to tension the central portion between the displaced locations and slacken the end portions.