Prosthetic repair fabric

Abstract

An implantable prosthesis is provided for repairing or augmenting anatomical weaknesses or defects, and is particularly suitable for the repair of soft tissue and muscle wall openings. The prosthesis is configured to promote enhanced tissue ingrowth thereto, while limiting the incidence of post-operative adhesions between the fabric and tissue or organs. The prosthesis may include a layer of fabric that is constructed and arranged to allow tissue ingrowth and is susceptible to the formation of adhesions for tissue and organs. One or more barriers may be provided on selected portions of the fabric to inhibit the formation of adhesions with tissues and organs. The prosthesis may have an opening that is adapted to receive the esophagus or other tube-like structure, or other projection, that passes through an opening in or projects from a tissue, muscle or organ wall requiring repair and/or augmentation. The prosthesis may be configured for use in hiatal hernia repair and/or treatment of GERD. A method is also provided for the treatment of GERD.

What is claimed is:  
     
         1 . A prosthetic repair fabric comprising: 
 a body portion of implantable, biocompatible prosthetic material, the body portion including a middle section having a first width and a pair of end portions extending in a longitudinal direction from opposite sides of the middle section, each end portion having a second width that is greater than the first width.    
     
     
         2 . The prosthetic repair fabric according to  claim 1 , wherein the end portions are flared and have a width that increases in the longitudinal direction away from the middle section.  
     
     
         3 . The prosthetic repair fabric according to  claim 2 , wherein the body portion includes top and bottom edges that converge toward each other in the longitudinal direction from the end portions toward the middle section.  
     
     
         4 . The prosthetic repair fabric according to  claim 3 , wherein the top and bottom edges are curved.  
     
     
         5 . The prosthetic repair fabric according to  claim 1 , wherein the body portion has a generally bow-tie shape.  
     
     
         6 . The prosthetic repair fabric according to  claim 1 , wherein the body portion includes a layer of fabric that is susceptible to the formation of adhesions with tissue and organs, the layer of fabric including first and second surfaces and a fabric edge extending from the first surface to the second surface, the first surface adapted to face a tissue or muscle wall when the prosthetic repair fabric is placed in a patient, the second surface adapted to face away from the tissue or muscle wall and toward cavity viscera.  
     
     
         7 . The prosthetic repair fabric according to  claim 6 , wherein the body portion includes a surface barrier that inhibits the formation of adhesions with tissue and organs, the surface barrier being disposed on the second surface of the layer of fabric to inhibit the formation of adhesions between the second surface and adjacent tissue and organs when the prosthetic repair fabric is placed in a patient.  
     
     
         8 . The prosthetic repair fabric according to  claim 7 , wherein the surface barrier is formed from ePTFE.  
     
     
         9 . The prosthetic repair fabric according to  claim 6 , wherein the body portion includes an edge barrier that inhibits the formation of adhesions with tissue and organs, the edge barrier extending about at least a portion of the fabric edge to inhibit the formation of adhesions between the portion of the fabric edge and adjacent tissue and organs.  
     
     
         10 . The prosthetic repair fabric according to  claim 6 , wherein the layer of fabric is formed from one of collagen, PTFE mesh and polypropylene mesh.  
     
     
         11 . A method of treating gastroesophageal reflux disease, the method comprising: 
 (a) creating at least one external fold on the external wall of the esophagus; and    (b) cinching the at least one external fold to create at least one external plication on the esophagus.    
     
     
         12 . The method according to  claim 11 , wherein step (a) includes creating a plurality of external folds on the external wall of the esophagus, and step (b) includes cinching the plurality of external folds to create a plurality of external plications.  
     
     
         13 . The method according to  claim 11 , wherein step (a) includes creating first and second external folds on the external wall of the esophagus, and step (b) includes cinching the first external fold to the second external fold to create the at least one external plication.  
     
     
         14 . The method according to  claim 13 , wherein step (a) includes creating a plurality of pairs of first and second external folds, and step (b) includes cinching the first external fold to the second external fold of each of the plurality of pairs of first and second external folds to create a plurality of external plications.  
     
     
         15 . The method according to  claim 13 , wherein step (b) includes suturing the first external fold to the second external fold.  
     
     
         16 . The method according to  claim 11 , wherein step (a) includes applying suction to a portion of the external wall of the esophagus to draw the portion of the external wall outwardly.  
     
     
         17 . The method according to  claim 16 , wherein step (a) includes inserting a suture through the portion of the external wall.  
     
     
         18 . The method according to  claim 11 , wherein the at least one external plication extends in a longitudinal direction along a length of the esophagus.  
     
     
         19 . The method according to  claim 11 , wherein the at least one external plication extends in a lateral direction about an external circumference of the esophagus.  
     
     
         20 . The method according to  claim 11 , wherein steps (a) and (b) are performed laparoscopically.  
     
     
         21 . The method according to  claim 11 , further comprising a step (c) of repairing a hiatal hernia.  
     
     
         22 . The method according to  claim 21 , wherein step of (c) includes implanting a prosthetic repair fabric proximate the hiatal hernia.