Minimally invasive levator avulsion repair

Abstract

Described are pelvic implants and methods of surgically placing pelvic implants that provide treatment for pelvic floor disorders by support of the levator by creating an incision that allows access to a region of tissue of the pelvic floor and inserting a pelvic implant comprising a tissue support portion delivered by a delivery tool. A pelvic implant for supporting levator tissue comprising: a tissue support portion having a first end and a second; a tissue fastener disposed on the first end of the tissue support portion for fastening it to levator tissue; a guide extension portion disposed on the second end of the tissue support portion; and a support backer member attachable to the guide extension portion to adjust a tension of the tissue support portion and concomitantly the levator tissue.

1 - 8 . (canceled) 
     
     
         9 . A pelvic implant for supporting levator tissue, the implant comprising:
 a tissue support portion having a first end and a second;   a tissue fastener fixedly connected to the first end of the tissue support portion for fastening to levator tissue;   a guide extension portion fixedly connected to the second end of the tissue support portion, the guide extension portion comprising a rod; and   a support backer member movably attachable to the guide extension portion to adjust a tension of the tissue support portion and concomitantly the levator tissue.   
     
     
         10 . The implant of  claim 9  wherein the tissue support portion has a shape substantially of a figure selected from a square, rectangle, a rhombus, a symmetric trapezoid, a non-symmetric trapezoid, a symmetric rectangle, and a non-symmetric rectangle. 
     
     
         11 . (canceled) 
     
     
         12 . The implant of  claim 9  wherein the support backer member comprises a grommet having an outer ring and a plurality of inwardly radiating teeth to engage a portion of the tissue support portion. 
     
     
         13 . The implant of  claim 9  further comprising a delivery tool attachable to the tissue fastener for delivering the tissue support portion to the levator tissue. 
     
     
         14 . The implant of  claim 13  wherein the delivery tool comprises a handle and a needle extending away from a portion of the handle. 
     
     
         15 . The implant of  claim 14 , wherein the needle has a shape selected from the group comprising, straight, bent, curved, or helical. 
     
     
         16 . The implant of  claim 13  wherein the delivery tool comprises a deployment mechanism to deploy the tissue fastener. 
     
     
         17 . The implant of  claim 13  in combination with a backer delivery device capable of engaging the support backer member to guide it along the guide extension portion. 
     
     
         18 . The implant of  claim 13  further comprising a support backer advancement tool having an engagement portion to engage and advance the support backer member along the guide extension portion. 
     
     
         19 . A kit to treat levator defects comprising:
 a tissue support portion having a first end and a second;   a tissue fastener fixedly connected to the first end of the tissue support portion for fastening to levator tissue;   a guide extension portion fixedly connected to the second end of the tissue support portion, the guide extension portion comprising a rod; and   a support backer member movably attachable to the guide extension portion to adjust a tension of the tissue support portion and concomitantly the levator tissue.   
     
     
         20 . A kit according to  claim 19  further comprising a support backer advancement tool having an engagement portion to engage and advance the support backer member along the guide extension portion. 
     
     
         21 . A pelvic implant according to  claim 9 , wherein the first end of the tissue support portion comprises mesh. 
     
     
         22 . A kit according to  claim 19 , wherein the first end of the tissue support portion comprises mesh. 
     
     
         23 . A kit according to  claim 19  comprising a carrier, the carrier comprising a rod, the rod comprising a mating feature at an end, wherein the mating feature mates with an end of an extension guide portion. 
     
     
         24 . A kit according to  claim 23  wherein the carrier carries a plurality of support backer members along the rod. 
     
     
         25 . The implant of  claim 9  wherein the tissue support portion comprises an elongate mesh, the first end comprises the mesh, the second end comprises the mesh, the tissue fastener is fixedly connected to the mesh at the first end, and the guide extension portion is fixedly connect to the mesh at the second end. 
     
     
         26 . The implant of  claim 9  wherein the tissue support portion is sized and shaped to contact tissue selected from tissue of levator, coccygeous, rectum, and external anal sphincter. 
     
     
         27 . The kit of  claim 19  wherein the tissue support portion comprises an elongate mesh, the first end comprises the mesh, the second end comprises the mesh, the tissue fastener is fixedly connected to the mesh at the first end, and the guide extension portion is fixedly connect to the mesh at the second end. 
     
     
         28 . The kit of  claim 19  wherein the tissue support portion is sized and shaped to contact tissue selected from tissue of levator, coccygeous, rectum, and external anal sphincter.