Device for attaching, relocating and reinforcing tissue and methods of using same

Abstract

A device for attaching, relocating or reinforcing tissue includes a first tissue anchoring portion having a support plate and a plurality of barbs extending from the support plate for engaging tissue at a first location, a second tissue anchoring portion having a support plate and a plurality of barbs extending from the support plate for engaging tissue at a second location which is different from the first location, and a connection element, such as a suture or a mesh structure, interposed between and interconnecting the first tissue anchoring portion and the second tissue anchoring portion. The support plate of at least one of the first tissue anchoring portion and the second tissue anchoring portion may have longitudinally axially formed therethrough a bore for receiving the connecting element so that the surgeon may pull on the end of the connecting element to adjust the distance between the first tissue anchoring portion and the second tissue anchoring portion.

1 . A device for attaching, relocating or reinforcing tissue, which comprises: 
 at least two tissue engagement means, including a first tissue engagement means and a second tissue engagement means; and    connection means interposed between and interconnecting the first tissue engagement means and the second tissue engagement means.    
     
     
         2 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the connection means slidably engages at least one of the first tissue engagement means and the second tissue engagement means to allow the distance between the first tissue engagement means and the second tissue engagement means to be adjusted.  
     
     
         3 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein at least one of the first tissue engagement means and the second tissue engagement means includes a support plate having an exposed surface, and a plurality of barbs extending angularly outwardly from the exposed surface.  
     
     
         4 . A device for attaching, relocating or reinforcing tissue as defined by  claim 3 , wherein the barbs extend from the exposed surface of the support plate at an angle thereto of between about 30 degrees and about 60 degrees.  
     
     
         5 . A device for attaching, relocating or reinforcing tissue as defined by  claim 3 , wherein the barbs extend outwardly from the exposed surface of the support plate at an angle of about 45 degrees thereto.  
     
     
         6 . A device for attaching, relocating or reinforcing tissue as defined by  claim 3 , wherein the support plate further has formed longitudinally axially therethrough a bore for receiving the connection means therethrough.  
     
     
         7 . A device for attaching, relocating or reinforcing tissue as defined by  claim 6 , wherein the support plate includes ratchet teeth extending into the axial bore for engaging the connection means and to prevent movement of the connection means with respect to the support plate in at least one direction.  
     
     
         8 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein at least one of the first tissue engagement means and the second tissue engagement means includes gripping means for engaging the connection means and preventing movement of the connection means with respect to the at least one of the first tissue engagement means and the second tissue engagement means in at least one direction.  
     
     
         9 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the connection means includes at least one suture extending between the first tissue engagement means and the second tissue engagement means.  
     
     
         10 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the connection means includes a mesh structure extending between the first tissue engagement means and the second tissue engagement means.  
     
     
         11 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein at least one of the first tissue engagement means and the second tissue engagement means includes a mesh structure.  
     
     
         12 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein at least one of the first tissue engagement means and the second tissue engagement means includes a resilient pawl, and wherein the connection means includes an elongated member having opposite lateral sides, and ratchet teeth situated on at least one of the lateral sides, the resilient pawl of the at least one of the first tissue engagement means and the second tissue engagement means engaging the ratchet teeth of the connection means to prevent movement of the connection means with respect to the at least one of the first tissue engagement means and the second tissue engagement means in at least one direction.  
     
     
         13 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , which further comprises a third tissue engagement means, the connection means being interposed between and interconnecting the first tissue engagement means, the second tissue engagement means and the third tissue engagement means.  
     
     
         14 . A device for attaching, relocating or reinforcing tissue as defined by  claim 13 , wherein the connection means includes a mesh structure extending between the first tissue engagement means, the second tissue engagement means and the third tissue engagement means.  
     
     
         15 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the first tissue engagement means includes a first support plate having a first exposed surface, and a plurality of barbs extending angularly outwardly from the first exposed surface; and wherein the second tissue engagement means includes a second support plate having a second exposed surface, and a plurality of barbs extending angularly outwardly from the second exposed surface, the second support plate having formed longitudinally axially therethrough a bore for receiving the connection means therethrough.  
     
     
         16 . A device for attaching, relocating or reinforcing tissue as defined by  claim 15 , wherein the connection means is one of a mesh structure and at least one suture.  
     
     
         17 . A device for attaching, relocating or reinforcing tissue as defined by  claim 16 , wherein the second tissue engagement means includes gripping means for engaging the connection means and for preventing movement of the connection means with respect to the second tissue engagement means in at least one direction.  
     
     
         18 . A device for attaching, relocating or reinforcing tissue as defined by  claim 15 , wherein the second support plate includes a resilient pawl extending at least partially into the axial bore formed in the second support plate, and wherein the connection means includes an elongated member having opposite lateral sides, and ratchet teeth situated on at least one of the lateral sides, the resilient pawl of the second support plate engaging the ratchet teeth of the elongated member to prevent movement of the elongated member with respect to the second support plate in at least one direction.  
     
     
         19 . A device for attaching, relocating or reinforcing tissue as defined by  claim 15 , wherein the barbs of the first support member are larger that the barbs of the second support member.  
     
     
         20 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the first tissue engagement means includes a support plate having an exposed surface, and a plurality of barbs extending angularly outwardly from the exposed surface; wherein the second tissue engagement means includes a mesh structure; and wherein the connection means includes an elongated mesh strip interposed between and interconnecting the mesh structure of the second tissue engagement means and the support plate of the first tissue engagement means.  
     
     
         21 . A device for attaching, relocating or reinforcing tissue as defined by  claim 20 , wherein the support plate further has formed longitudinally axially therethrough a bore for receiving the elongated mesh strip of the connection means therethrough.  
     
     
         22 . A device for attaching, relocating or reinforcing tissue as defined by  claim 1 , wherein the first tissue engagement means includes a support plate having an exposed surface, and a plurality of barbs extending angularly outwardly from the exposed surface; wherein the second tissue engagement means includes a mesh structure; and wherein the connection means includes a suture interposed between and interconnecting the mesh structure of the second tissue engagement means and the support plate of the first tissue engagement means.  
     
     
         23 . A device for attaching, relocating or reinforcing tissue as defined by  claim 22 , wherein the support plate has formed longitudinally axially therethrough a bore for receiving the suture of the connection means therethrough.  
     
     
         24 . A method of using a device for attaching, relocating or reinforcing tissue, which comprises the steps of: 
 attaching a first tissue engagement means of at least two tissue engagement means to tissue at a first location;    attaching a second tissue engagement means of the at least two tissue engagement means to tissue at a second location, the second location being different from the first location, a connection means being interposed between and interconnecting the first tissue engagement means and the second tissue engagement means; and    adjusting the connection means to change the distance between the first tissue engagement means and the second tissue engagement means.    
     
     
         25 . A method of using a device for attaching, relocating or reinforcing tissue, which comprises the steps of: 
 implanting a first tissue engagement means of at least two tissue engagement means of the device in tissue at a first location; and    implanting a second tissue engagement means of the at least two tissue engagement means in tissue at a second location, the second location being different from the first location, the first tissue engagement means and the second tissue engagement means being connected to a connection means interposed between and interconnecting the first tissue engagement means and the second tissue engagement means.    
     
     
         26 . A minimally invasive method for relocating a malar fat pad in a facial plastic surgery procedure performed on a patient, which comprises the steps of: 
 implanting a soft tissue anchor in the malar fat pad of the patient, the soft tissue anchor including a support plate having an exposed surface and a plurality of barbs extending angularly outwardly from the exposed surface, the soft tissue anchor being connected to a first portion of a suture;    inserting a hollow needle through the subcutaneous cheek tissue and up into the temple of the patient;    passing a second portion of the suture through the hollow needle to the temple of the patient;    removing the hollow needle from the suture;    mounting a strong tissue anchor to the suture at the second portion thereof, the strong tissue anchor including a support plate having an exposed surface and a plurality of barbs extending angularly outwardly from the exposed surface, and further having formed longitudinally axially therethrough a bore for receiving the second portion of the suture;    implanting the strong tissue anchor beneath the temporalis fascia of the patient through a small incision; and    adjusting the suture until the malar fat pad is situated in a desired location.    
     
     
         27 . A method of using a device for attaching, relocating or reinforcing tissue as defined by  claim 14  to support a patient's vaginal vault in a pelvic floor repair surgical procedure, which comprises the steps of: 
 positioning the first tissue engagement means and the second tissue engagement means in locations that are anterior and posterior to the patient's vagina in the space between the vagina and the urethra and the space between the vagina and the rectum, respectively; and    positioning the third tissue engagement means at a location near the sacrum and securing the third tissue engagement means to the periosteum.    
     
     
         28 . A method of using a device for attaching, relocating or reinforcing tissue as defined by  claim 14  for surgically treating patients with congestive heart failure, which comprises the steps of: 
 implanting the first tissue engagement means at a location at the apex of the heart and on the anterior surface thereof;    implanting the second tissue engagement means and the third tissue engagement means at locations in the atrio-ventricular septum of the heart; and    adjusting the mesh structure with respect to the first tissue engagement means, the second tissue engagement means and the third tissue engagement means until the desired level of ventricular volume change is achieved.    
     
     
         29 . A method of using a device for attaching, relocating or reinforcing tissue as defined by  claim 14  in order to provide support to the vagina in pelvic organ prolapse repair, which comprises the steps of: 
 placing the mesh structure anterior and posterior to the vagina through a transvaginal incision or through an endoscopic approach;    implanting the first tissue engagement means, the second tissue engagement means and the third tissue engagement means at locations near the entroitus and into the sacrospinus ligament or the periosteum near the sacrum; and    adjusting the mesh structure to provide the appropriate placement of the vaginal vault.