Method and apparatus for cystocele repair

Abstract

A method for cystocele repair comprising the steps of: establishing four pathways in tissue around a bladder of a patient, introducing a strap into each of said pathways, and positioning beneath said bladder of said patient a support member having each said strap connected thereto such that said bladder of said patient is supported by said support member and a bulge of said bladder into a vagina of said patient is reduced.

1 - 15 . (canceled) 
     
     
         16 . A surgical repair kit comprising:
 a support apparatus comprising at least two straps, each of said straps comprising a connector configured to mate with a tip of a needle;   a first helical needle configured to extend from an incision on a right side of a patient through a right obturator foramen of said patient, to an incision in a vagina of said patient; and   a second helical needle configured to extend from an incision on a left side of said patient through a left obturator foramen of said patient, to said incision in said vagina of said patient,   wherein said support apparatus comprises:
 a support member; 
 a first strap connected to the support member; 
 a second strap connected to the support member, and wherein the support member is made of an implant material different from an implant material of at least one of the first strap and the second strap. 
   
     
     
         17 . The kit recited in  claim 16  wherein said support member comprises a biologic graft, and the at least one strap comprises mesh. 
     
     
         18 . The kit recited in  claim 17  wherein said first strap comprises mesh, said second strap comprises mesh, and said biologic graft is pre-attached to said first and second mesh straps. 
     
     
         19 . The kit recited in  claim 16  wherein said support apparatus comprises: a pair of straps, each strap having a central portion and a connector at each end of said strap; and a biologic graft connected to said central portion of each strap. 
     
     
         20 . The kit recited in  claim 16  wherein said support apparatus comprises a biologic graft fixed over a knitted support member. 
     
     
         21 . The kit recited in  claim 16  wherein said support apparatus comprises:
 a mesh support member having two short sides and two long sides, a first end of said rectangular member at a first of said two short sides, a second end of said rectangular member at a second of said two short sides; 
 a first mesh strap connected to a first long side proximate said first end of said member; 
 a second mesh strap connected to a second long side proximate said first end of said member; 
 a third mesh strap connected to a first long side proximate a middle portion of said first long side; and 
 a fourth mesh strap connected to a second long side proximate a middle portion of said second long side, wherein the mesh support member has pores that are larger than pores of the first mesh strap, second mesh strap, third mesh strap, and fourth mesh strap. 
 
     
     
         22 . The kit recited in  claim 16  wherein said support apparatus comprises: a support member knitted with a first bar setting; and a plurality of straps straps knitted with a second bar setting. 
     
     
         23 . (canceled) 
     
     
         24 . The apparatus recited in  claim 22  wherein said first bar setting is:
 Bar 1: 1/0, 2/3, 2/1, 2/3, 1/0, 1/2, 1/0, 1/2; 
 Bar 2: 1/0, 2/3, 2/3, 1/0; and 
 Bar 3: 2/3, 1/0, 1/2, 1/0, 2/3, 2/1, 2/3, 2/1. 
 
     
     
         25 . The kit recited in  claim 16  further comprising:
 a third helical needle configured to extend from an incision on said right side of said patient, through said right obturator foramen of said patient, to said incision in said vagina of said patient; and 
 a fourth helical needle configured to extend from an incision on said left side of said patient, through said left obturator foramen of said patient, to said incision in said vagina of said patient. 
 
     
     
         26 - 28 . (canceled) 
     
     
         29 . A kit according to  claim 16  wherein:
 each strap comprises a plastic sheath, 
 each needle comprises a helical portion, 
 each connecter is configured to mate with a needle tip to produce a substantially permanent attachment between the connector and the needle tip. 
 
     
     
         30 . A kit according to  claim 16  wherein each needle comprises a handle and each handle comprises a length, a longitudinal axis along the length, opposing major surfaces along the length, opposing minor sides, and a cross section of each handle along the longitudinal axis exhibits an elongate, non-circular form. 
     
     
         31 . A kit according to  claim 29  wherein each needle comprises a handle and each handle comprises a length, a longitudinal axis along the length, opposing major surfaces along the length, opposing minor sides, and a cross section of each handle along the longitudinal axis exhibits an elongate, non-circular form. 
     
     
         32 . A kit according to  claim 16  wherein a connector includes an aperture configured to mate with a needle tip, the aperture having a shape that corresponds to a shape of the needle tip, the shape allowing entry of the needle tip into the connector at at least one rotational orientation of the needle tip relative to the connector, while preventing entry of the needle tip into the connector at at least one other rotational orientation of the needle tip relative to the connector. 
     
     
         33 . A kit according to  claim 29  wherein a connector includes an aperture configured to mate with a needle tip, the aperture having a shape that corresponds to a shape of the needle tip, the shape allowing entry of the needle tip into the connector at at least one rotational orientation of the needle tip relative to the connector, while preventing entry of the needle tip into the connector at at least one other rotational orientation of the needle tip relative to the connector. 
     
     
         34 . A surgical repair kit comprising:
 a support apparatus comprising at least two straps, each of said straps comprising a connector configured to mate with a tip of a needle;   a first helical needle configured to extend from an incision on a right side of a patient, through a right obturator foramen of said patient, to an incision in a vagina of said patient; and   a second helical needle configured to extend from an incision on a left side of said patient, lateral to an edge of said pubic ramus bone, through a left obturator foramen of said patient, to said incision in said vagina of said patient, wherein said support apparatus comprises:
 a substantially rectangular member having two short sides and two long sides, a first end of said rectangular member at a first of said two short sides, a second end of said rectangular member at a second of said two short sides; 
 a first strap connected to a first long side proximate said first end of said member; 
 a second strap connected to a second long side proximate said first end of said member; 
 a third strap connected to a first long side proximate a middle portion of said first long side; and 
 a fourth strap connected to a second long side proximate a middle portion of said second long side, and 
   wherein said support member is made of an implant material different from an implant material of at least one of the first strap and the second strap.   
     
     
         35 . The kit recited in  claim 34  wherein the mesh support member has pores that are larger than pores of the first mesh strap, second mesh strap, third mesh strap, and fourth mesh strap. 
     
     
         36 . The kit recited in  claim 16  wherein said support apparatus comprises: a support member knitted with a first bar setting; and a plurality of straps knitted with a second bar setting. 
     
     
         37 . The apparatus recited in  claim 36  wherein said first bar setting is: Bar 1: 1/0, 2/3, 2/1, 2/3, 1/0, 1/2, 1/0, 1/2;
 Bar 2: 1/0, 2/3, 2/3, 1/0; and 
 Bar 3: 2/3, 1/0, 1/2, 1/0, 2/3, 2/1, 2/3, 2/1. 
 
     
     
         38 . The kit recited in  claim 16  wherein said support member comprises a biologic graft, and the at least one strap comprises mesh. 
     
     
         39 . The kit recited in  claim 17  wherein said first strap comprises mesh, said second strap comprises mesh, and said biologic graft is pre-attached to said first and second mesh straps.