Auto-graft bio-synthetic mesh for ventral and parastomal hernia repair and method of attachment as well as a suture clip

Abstract

An auto-graft bio-synthetic mesh and a method of application for wound closure is described. The mesh is utilized for wound closure wherein an abdominal incision is effected through the peritoneum and the rectus abdominal sheath of the rectus muscle such as when repairing ventral or paracoslostomy hernias. The mesh comprises a flexible patch of woven fibers and wherein the patch is one of a substantially circular patch or a patch having a substantially circular delineation thereon whereby to provide guidance for the formation of stitches in at least one circle to secure the patch to the peritoneal peritoneum and the rectus abdominal sheath of the rectus muscle. The patch is secured by applying stitches all about an outer circular edge of the patch and an inner circle thereof. A suture clip for joining portions of bodily soft tissue is also described.

I claim: 
     
         1 . A suture clip for joining portions of bodily soft tissue, said suture clip comprising a pair of identical flexible compression strips and formed of biodegradable and bio-absorbable polymer and adapted to interlock with one another with said portions of said bodily soft tissue compressed therebetween to arrest blood vessels in said portions of bodily soft tissue, each said compression strip having at least two equidistantly spaced-part tissue piercing teeth projecting forwardly of a flat clamping surface of said strip, each piercing tooth having a pointed free end portion and opposed latch formations, at least two latching guide openings formed integral and extending through said strip and each disposed to a side of said piercing teeth for latching engagement of said opposed latch formations with said teeth of one strip aligned with said retention means of the other strip, said latching guide openings having opposed spaced-apart tooth latching guide ramps extending rearwardly from said clamping surface, flexible arresting means associated with each said tooth latching guide ramps angulated towards one another and forming a tooth latching passage therebetween, each said tooth latching guide ramps having a fixed arresting means, said flexible arresting means engaging an associated one of said opposed latch formations when said pointed free end portion of said piercing tooth is forced in said tooth latching passage, each said pointed free end portion having opposed outwardly sloped flat walls extending rearwardly from said pointed free end portions of said tooth, said opposed outwardly sloped flat walls terminating in an abrupt rear edge of said piercing tooth to constitute said latch formation, said flexible arresting means being a flexible lip formed integral with said compression strip and disposed on opposed sides of said tooth latching guide opening and align for friction contact with said opposed outwardly sloped walls and biased for captive engagement with said abrupt rear edge of said piercing tooth. 
     
     
         2 . A suture clip as claimed in  claim 1 , wherein at least one of an anesthetic, an analgesic and an antibiotic substance is integrated in at least one of the flexible compression strips. 
     
     
         3 . A suture clip as claimed in  claim 1 , wherein said fixed and flexible arresting means are formations, said opposed being offset engaging notches adapted to be engaged by associated ones of said gripping formations. 
     
     
         4 . A suture clip as claimed in  claim 3 , wherein the gripping formations of said tooth latching guide ramp is constituted by a rear pointed edge of a flat upwardly sloped top face of said guide ramp. 
     
     
         5 . A suture clip as claimed in  claim 4 , wherein said gripping formation of said flexible arresting means is constituted by a gripping edge formation formed in a gripping head of said flexible arresting means, said gripping head being supported in spaced alignment above said tooth latching guide ramp and a flexible post interconnecting said gripping head with a base of said flexible compression strip, said base defining said clamping surface. 
     
     
         6 . An auto-graft bio-synthetic mesh for ventral and parastomal hernia repair wherein an abdominal incision is effected through the alba linea and the peritoneum for access to the intra-peritoneal cavity, said mesh being formed of woven synthetic fibers and wherein said mesh is one of a substantially circular mesh or a mesh having a substantially circular delineation thereon whereby to provide guidance for the formation of stitches in at least two substantially concentric circles to secure the mesh to the parietal peritoneum and the posterior rectus sheath, said mesh permitting said hernia repair without dissecting the subcutaneous flaps and without bilateral fascial relaxing incisions. 
     
     
         7 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said woven fibers are polyester or polypropylene fibers and coated with patient's own tissue. 
     
     
         8 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said first outer circle of stitches is spaced from a center point of said mesh a predetermined distance depending on the size of the hernia repair, said second inner circle of stitches is spaced about 3.5 cm inwardly of said first outer circle of stitches. 
     
     
         9 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said fibers provide a scaffold support for tissue culture and resulting in a patch which is less susceptible to shrinkage/contraction complication after securement in a patient and wherein said tissue culture isolates said fibers. 
     
     
         10 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said stitches are continuous spiral stitches. 
     
     
         11 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said substantially circular delineation is a circular marking on at least one of opposed surfaces of said patch. 
     
     
         12 . A method of wound closure wherein an abdominal incision is effected through the alba linea and the peritoneum for access to the intra-peritoneal cavity for the repair of ventral and parastomal hernias, said method comprising:
 i) providing a flexible bio-synthetic mesh formed of woven synthetic fibers and wherein said mesh is one of a substantially circular mesh or a mesh having a circular delineation thereon;   ii) introducing said mesh in the peritoneal cavity through said abdominal incision;   iii) applying stitches all about an outer circle of said mesh and an inner circle to secure said mesh to the parietal peritoneum and the posterior rectus sheath and wherein said mesh permits said hernia repair without dissecting the subcutaneous flaps and without bilateral fascial relaxing incisions; and   iv) closing said abdominal incision over said mesh.   
     
     
         13 . A method as claimed in  claim 12 , wherein said step of applying stitches is comprised by the formation of continuous spiral stitches. 
     
     
         14 . A method as claimed in  claim 12 , wherein there is further provided the step of treating said mesh with patient's own tissue, said bio-synthetic mesh being formed by woven polypropylene or polyester fibers to provide elasticity to said mesh and providing a scaffold for the culture of said tissue. 
     
     
         15 . A method as claimed in  claim 12  wherein there is provided the step of pre-coating said mesh with patient collagen. 
     
     
         16 . A method as claimed in  claim 12 , wherein said step (iv) comprises applying a suture clip to join portions of bodily soft tissue to close said abdominal incision to arrest blood vessels in said portion of bodily soft tissue. 
     
     
         17 . The method of  claim 12 , wherein said incision is related to the repair of ventral or parastomal hernias. 
     
     
         18 . An auto-graft bio-synthetic mesh as claimed in  claim 6 , wherein said mesh is formed of bio-degradable polymers coated with patient tissue.