Adjustable Sling and Method of Treating Pelvic Conditions

Abstract

Systems for providing support within the pelvic region of a patient. The systems can include an elongated incontinence sling having a central support portion adapted to be positioned to support any one of the urethra or anus, and a sling tension adjustment mechanism operatively attached to the elongated sling. The sling tension adjustment mechanism can include a plunger device adapted for traversal within an interior of the housing, and an inflatable bladder provided within the housing to selectively control traversal of the plunger. Alternatively, the adjustment mechanism can include a bobbin device within the housing and one or more retention devices to selectively restrict unwinding of a suture from the bobbin device.

1 . A system for providing support within the pelvic region of a patient, comprising:
 an elongated sling having a sling length, a central support portion positionable to support the urethra of the patient, and first and second sling end portions extendable through body tissue;   a tension adjustment assembly operatively connected with the elongated sling to selectively adjust the sling length, the tension adjustment mechanism at least partially contained within a housing and having;
 a plunger device adapted for traversal within an interior of the housing; and 
 an inflatable bladder to selectively control the traversal of the plunger device within the interior of the housing. 
   
   
   
       2 . The system of  claim 1 , wherein the plunger device includes a rod portion and a head portion. 
   
   
       3 . The system of  claim 2 , wherein the inflatable bladder is provided within the interior of the housing for selective abutable contact with the head portion of the plunger device. 
   
   
       4 . The system of  claim 1 , wherein the plunger device includes a body portion having a cavity defined therein such that the inflatable bladder is at least partially disposed within the cavity. 
   
   
       5 . The system of  claim 4 , wherein the plunger device further includes a head portion. 
   
   
       6 . The system of  claim 1 , further including an inlet in fluid communication with the inflatable bladder. 
   
   
       7 . The system of  claim 1 , further including a housing inlet in fluid communication with the interior of the housing. 
   
   
       8 . A system for providing support within the pelvic region of a patient, comprising:
 an elongated sling having a sling length, a central support portion positionable to support the urethra of the patient, and first and second sling end portions extendable through body tissue;   a tension adjustment assembly operatively connected with the elongated sling to selectively adjust the sling length, the tension adjustment mechanism at least partially contained within a housing and having;
 a bobbin device provided within an interior of the housing and having a length of a suture wrapped therearound, with at least one end of the suture operatively connected to the elongated sling; and 
 a retention device provided within the interior of the housing to selectively restrict unwinding of the suture from the bobbin device. 
   
   
   
       9 . The system of  claim 8 , wherein the bobbin device includes a generally transverse flange portion to selectively restrain a portion of the suture to restrict unwinding of the suture from the bobbin device. 
   
   
       10 . The system of  claim 9 , wherein the flange portion at least partially constructed of a resilient material. 
   
   
       11 . The system of  claim 8 , further including at least one member provided within the interior of the housing to facilitate in selectively restricting unwinding of the suture from the bobbin device. 
   
   
       12 . The system of  claim 11 , wherein the at least one member is a biasing member. 
   
   
       13 . The system of  claim 12 , wherein the biasing member is a spring. 
   
   
       14 . The system of  claim 11 , wherein the at least one member selectively restrains a portion of the suture to restrict unwinding of the suture from the bobbin device. 
   
   
       15 . The system of  claim 8 , wherein the bobbin device further includes a central bore defined therein, and the housing further includes a recess axially alignable with the central bore. 
   
   
       16 . The system of  claim 15 , further including a locking member disposable within the central bore and the recess to selectively restrict unwinding of the suture from the bobbin device. 
   
   
       17 . The system of  claim 8 , further including a plurality of detents defined in a generally transverse flange portion of the bobbin device. 
   
   
       18 . The system of  claim 17 , further including a member adapted to engage one or more of the plurality of detents to selectively restrict unwinding of the suture from the bobbin device. 
   
   
       19 . The system of  claim 8 , further including a set screw operatively provided with the housing and the bobbin device to selectively restrict unwinding of the suture from the bobbin device. 
   
   
       20 . A method of providing support within the pelvic region of a patient, comprising:
 providing an elongated sling having a sling length, a central support portion positionable to support the urethra of the patient, and first and second sling end portions extendable through body tissue   providing a tension adjustment assembly operatively connected with the elongated sling to selectively adjust the sling length, the tension adjustment mechanism at least partially contained within a housing;   providing a plunger device adapted for traversal within an interior of the housing;   providing an inflatable bladder within the housing; and   adjusting fluid volume within the inflatable bladder to selectively control the traversal of the plunger device within the interior of the housing.   
   
   
       21 . A method of providing support within the pelvic region of a patient, comprising:
 providing an elongated sling having a sling length, a central support portion positionable to support the urethra of the patient, and first and second sling end portions extendable through body tissue   providing a tension adjustment assembly operatively connected with the elongated sling to selectively adjust the sling length, the tension adjustment mechanism at least partially contained within a housing;   providing a bobbin device within an interior of the housing, the bobbin device having a length of a suture wrapped therearound, with at least one end of the suture operatively connected to the elongated sling; and   providing a retention device within the interior of the housing; and   adjusting the retention device to selectively restrict unwinding of the suture from the bobbin device