Fortified mesh for tissue repair

Abstract

A mesh to repair a hole in a muscle wall includes a resilient mesh body and fortifying structure such as mesh portions of thicker weave than other portions, or strengthening members that can be engaged with the mesh and then removed from the mesh once the mesh is place over the hole. The same principles can be applied to a plug that is engaged with the mesh for filling the hole.

1 . Apparatus, comprising:
 a flexible mesh having an insertion configuration, in which the mesh is smaller than a muscle hole to be repaired to facilitate advancing the mesh through the hole, and an implanted configuration, in which the mesh is substantially flat and larger than the hole to block the hole; and   a strengthening member engaged with the mesh.   
   
   
       2 . The apparatus of  claim 1 , wherein the strengthening member is removable from the mesh when the mesh is disposed against the hole in the implanted configuration. 
   
   
       3 . The apparatus of  claim 1 , wherein the strengthening member is made of shape memory material. 
   
   
       4 . The apparatus of  claim 2 , wherein the mesh includes a flexible mesh body and the strengthening member includes at least one filament engaged with the mesh body. 
   
   
       5 . The apparatus of  claim 4 , wherein the filament is a wire. 
   
   
       6 . The apparatus of  claim 4 , wherein the filament is a flat ribbon. 
   
   
       7 . The apparatus of  claim 4 , comprising plural filaments engaged with the mesh body. 
   
   
       8 . The apparatus of  claim 4 , wherein the at least one filament is arranged on the mesh body in a spoke configuration. 
   
   
       9 . The apparatus of  claim 4 , wherein the at least one filament is arranged on the mesh body in a petal configuration. 
   
   
       10 . The apparatus of  claim 4 , wherein the at least one filament is arranged on the mesh body in a spiral configuration. 
   
   
       11 . The apparatus of  claim 4 , wherein the at least one filament is arranged on the mesh body in a circular configuration. 
   
   
       12 . The apparatus of  claim 4 , wherein at least one end of the filament is exposed such that the end can be grasped and the filament pulled away from the mesh body. 
   
   
       13 . The apparatus of  claim 1 , wherein the mesh includes a mesh body defining strands of a first thickness and the strengthening member includes segments of a second thickness engaged with the mesh body, the second thickness being greater than the first thickness. 
   
   
       14 . The apparatus of  claim 13 , wherein each strand of the strengthening member is made of one and only one strand. 
   
   
       15 . The apparatus of  claim 13 , wherein each strand of the strengthening member is made of plural strands and has a tighter weave than a weave of the strands of the mesh body. 
   
   
       16 . The apparatus of  claim 13 , wherein the mesh body defines opposed surfaces, and the strengthening member is on at least one of the surfaces. 
   
   
       17 . The apparatus of  claim 13 , wherein the mesh body defines opposed surfaces, and the strengthening member is disposed between the surfaces. 
   
   
       18 . The apparatus of  claim 17 , wherein the strengthening member is non-linear in shape. 
   
   
       19 . The apparatus of  claim 17 , wherein the mesh body defines opposed surfaces, and a strengthening member is disposed between the surfaces. 
   
   
       20 . The apparatus of  claim 13 , comprising plural strengthening members spaced from each other on the mesh body. 
   
   
       21 . The apparatus of  claim 13 , comprising plural strengthening members each of a different configuration than other strengthening members. 
   
   
       22 . The apparatus of  claim 13 , wherein the mesh body defines a periphery, the strengthening member being disposed on the periphery. 
   
   
       23 . The apparatus of  claim 13 , comprising plural concentric strengthening members on the mesh body. 
   
   
       24 . Method comprising:
 providing a mesh body established by plural mesh strands, the mesh body being engaged with at least one strengthening member that is not a mesh strand;   deforming the mesh body to a first configuration in which the mesh body can be advanced through a hole in a muscle wall;   advancing the mesh body through the hole;   allowing the mesh body to assume a second configuration at least partially under influence of the strengthening member in which the mesh body expands to be larger than the hole and to be substantially flat; and   ensuring the strengthening member does not subsequently fracture within the patient to injure the patient.   
   
   
       25 . The method of  claim 24 , wherein the act of ensuring is executed by removing the strengthening member from the mesh body immediately after the act of allowing. 
   
   
       26 . The method of  claim 24 , wherein the mesh body defines segments of a first thickness and the act of ensuring is executed by forming the strengthening member of strands of a second thickness and weaving the strengthening member into the mesh body. 
   
   
       27 . A device to repair a hole in a muscle wall, comprising:
 a resilient fiber body; and   fortifying structure selected from the group consisting of: fiber portions of greater thickness than portions of the fiber body and engaged therewith;   strengthening members engaged with the fiber body and removable from the fiber body once the body is juxtaposed with the hole.   
   
   
       28 . The device of  claim 27 , wherein the fiber body establishes a mesh for covering the hole. 
   
   
       29 . The device of  claim 27 , wherein the fiber body establishes a plug for filling the hole. 
   
   
       30 . The device of  claim 28 , wherein the fortifying structure is at least one strengthening member removable from the mesh when the mesh is disposed against the hole in an implanted configuration. 
   
   
       31 . The device of  claim 27 , wherein the strengthening member includes at least one filament engaged with the mesh body. 
   
   
       32 . The device of  claim 31 , wherein the filament is a flat ribbon. 
   
   
       33 . The device of  claim 31 , comprising plural filaments engaged with the fiber body. 
   
   
       34 . The device of  claim 33 , wherein the filaments are arranged on the fiber body in a spoke configuration. 
   
   
       35 . The device of  claim 31 , wherein the at least one filament is arranged on the fiber body in a petal configuration and the fiber body establishes a petal-shaped plug to fill the hole. 
   
   
       36 . The device of  claim 31 , wherein the at least one filament is arranged on the fiber body in a spiral configuration. 
   
   
       37 . The device of  claim 31 , wherein the at least one filament is arranged on the fiber body in a circular configuration. 
   
   
       38 . The device of  claim 28 , wherein the fortifying structure includes at least one filament and at least one end of the filament is exposed such that the end can be grasped and the filament pulled away from the mesh. 
   
   
       39 . The device of  claim 27 , wherein the fortifying structure includes fiber segments of greater thickness than fibers of the fiber body and engaged therewith. 
   
   
       40 . The device of  claim 39 , wherein each segment of the fortifying structure is made of one and only one fiber strand. 
   
   
       41 . The device of  claim 39 , wherein each segment of the fortifying structure is made of plural strands and has a tighter weave than a weave of the strands of the fiber body. 
   
   
       42 . The device of  claim 39 , wherein the fiber body defines opposed surfaces, and the fortifying structure is on at least one of the surfaces. 
   
   
       43 . The device of  claim 39 , wherein the fiber body defines opposed surfaces, and the fortifying structure is disposed between the surfaces. 
   
   
       44 . The device of  claim 43 , wherein the fortifying structure is non-linear in shape. 
   
   
       45 . The device of  claim 43 , wherein the fiber body defines opposed surfaces, and a fortifying structure is disposed between the surfaces. 
   
   
       46 . The device of  claim 39 , comprising plural fortifying structures spaced from each other on the fiber body. 
   
   
       47 . The device of  claim 39 , comprising plural fortifying structures each of a different configuration than other fortifying structures. 
   
   
       48 . The device of  claim 39 , wherein the fiber body defines a periphery, the fortifying structure being disposed on the periphery. 
   
   
       49 . The device of  claim 39 , comprising plural concentric fortifying structures on the fiber body.