Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Reexamination Certificate
1999-08-02
2001-01-16
Jackson, Gary (Department: 3731)
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
Reexamination Certificate
active
06174320
ABSTRACT:
TECHNICAL FIELD
The present invention generally relates to a surgically implantable patch for use in repairing a hernia of other wound. More particularly, the present invention relates to a hernia repair patch having a slit for receiving a patient's chord structure when placing a patch in a patient for hernia repair.
BACKGROUND
Surgically implantable mesh patches for the repair of inguinal and other abdominal wall hernias, which are intended for permanent placement within a patient's body space, have been provided and used previously. Tension free surgical repairs of hernias have been developed using synthetic mesh materials to bridge and to patch hernia defects. These repairs resulted in both a decrease in the recurrence rate as well as a decrease in the amount of a patient's post operative discomfort. Patients undergoing these more advanced procedures were able and are able to resume their normal activities sooner.
Some of these earlier techniques are somewhat complicated. Several use a plug or a locating member to fit within the hernia defect itself. Also, many of these earlier techniques were designed specifically for use in laparoscopic repair of hernias. Moreover, many of the prior inventions required suturing to the patient's body tissue. Although these medical advances are acknowledged for their usefulness and success, there remains a need or needs for more improvements in the surgical repair of hernias. In particular, a need exists for an improved implantable patch having a slit for receiving a patient's chord structure to facilitate a Lichtenstein repair.
DISCLOSURE OF INVENTION
A hernia mesh patch for use in the surgical repair of a patient's inguinal or other abdominal wall hernias, or other tissue apertures, is disclosed for permanent placement within a patient's body space. The hernia mesh patch of the invention has a top and a bottom layer of an inert, synthetic mesh, preferably polypropylene mesh, secured to each other with a seam. The seam has an opening for allowing a slit to pass from an edge of the patch to an opening in the interior of the patch.
To serve a spring function, an implantable inert monofilament fiber, arranged in a partial oval, ovoid, loop having a circumference slightly greater than the circumference of the interior pocket volume of this patch, is inserted into this pocket to keep the hernia mesh patch expanded under tension in a planar configuration. A border on at least one of the layers extends outward past the seam. The border preferably has slits to fill uneven voids in the patient's tissue and fit more tightly. The monofilament fiber has ends that terminate at the slit. An access opening is provided at the center of a layer so that a surgeon can insert his finger into an interior pouch to manipulate the patch more effectively.
Without the need for general anesthesia, nor expensive laparoscopic instrumentation, a surgeon, when repairing an inguinal hernia, makes a small incision in the patient, approximately four to six centimeters-long, arranged obliquely, over the area of the internal ring location of the inguinal hernia. The external oblique fascia is opened through the external ring of the inguinal hernia.
Thereafter, the surgeon manually lays the patch under the level of the external oblique fascia and over the internal oblique muscle in the patient's inguinal canal space. The cord structures that extend to the testicle are allowed to pass through the slit in the patch which otherwise covers the hernia defect in the patient's abdominal wall. The incision is then closed with stitches.
Soon after surgery, the patient's body reacts to the mesh of the hernia mesh patch, and in a short time, the mesh becomes stuck, thereby keeping the hernia mesh patch in place. Thereafter, the patient's scar tissue grows into the mesh over a period of time, between thirty and sixty days, to permanently fix the hernia mesh patch in its intended position over the repaired area, where the hernia was located.
Preferably, small holes are cut through both layers of the mesh inside the fiber ring to increase friction and to minimize sliding or migration of the hernia mesh patch after it is positioned.
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Biggers Keith D.
Inman J. Douglas
Kugel Robert D.
Bard Asdi Inc.
Jackson Gary
Wolf Greenfield & Sacks P.C.
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