GB2441112A

GB2441112A - Uterine mesh

Info

Publication number: GB2441112A
Application number: GB0616701A
Authority: GB
Inventors: Mohamed Ali Mossa
Original assignee: Individual
Current assignee: Individual
Priority date: 2006-08-23
Filing date: 2006-08-23
Publication date: 2008-02-27
Also published as: GB0616701D0

Abstract

A uterine mesh to help arrest severe postpartum haemorrhage. The mesh may comprise a flat sheet of woven absorbable material such as polyglactin with four ties made of the same material which interlace the mesh material. The mesh may include two recessions on either side to avoid pressure on the tubo-uterine junction. The mesh may be folded to fit the exterior surface of the uterus and tied to maintain pressure and reduce bleeding. The mesh may reduce maternal mortality where facilities or expertise are not available whilst maintaining fertility.

Description

Uterine Mesh Severe postpartum haemorrhage (bleeding from the womb

after the delivery of baby) is one of the top 3 causes of maternal death in the UK and it ranks first in many third world countries. Currently, there is a number of available measures, which aim at arresting severe uterine bleeding with variable degrees of success. In many occasions the surgeon will have to resort to hysterectomy (surgical removal of the womb) when those measures fail to control the bleeding. Although the hysterectomy should be seen in those circumstances as a life saving procedure, it carries its own high morbidity rate and will obviously terminate the woman's reproductive career.

The Uterine Mesh I designed will hopefully help in arresting severe bleeding that does not respond to the currently available measures and will avoid the need for a more radical surgery such as hysterectomy. In other words it will potentially save lives and maintain the reproductive function. To my knowledge there are no similar products available in the pharmaceutical market.

One of the commonly used procedures employed in trying to stop uterine bleeding is "bimanual uterine compression". This entails applying firm pressure or compression between two hands. It is very effective in slowing or even stopping the bleeding, but it works only as long as the compression is applied. Therefore, it is only useful as a temporary measure, for example while waiting for a more experienced surgeon who can perform an emergency hysterectomy. The mode of action of the Uterine Mesh is based on the same principle of "bimanual uterine compression".

The Uterine Mesh (figure 1) will be made of woven absorbable material e.g. polyglactin, which is the material used in many available surgical sutures. Being an absorbable material means it will eventually dissolve in a few weeks i.e. will not need to be removed later after achieving its purpose. The Uterine Mesh will come in one size but the woven material will allow the Uterine Mesh to be expanded or tightened to fit all sizes & shapes of wombs. This will be achieved by special strands or ribbons (figure 1, 2 & 3) made of the same material and integrated into the mesh material (2 vertical and 2 horizontal). The lower horizontal strand will be strategically located in order to apply pressure on the main uterine vessels (figure 3).

Figure 1 shows the Uterine Mesh before its application to the uterus. It is a flat sheet with 2 longitudinal strands and 2 transverse stands. There are 2 recessions in middle in order to avoid any pressure on the junction between the womb and the fallopian tubes (tubo-uterine junction) when the mesh is applied to the uterus (figure 3). The Uterine Mesh is applied to the uterus through a laparotomy (open abdomen surgery). The urinary bladder is separated from the lower part of the uterus and cervix in order to allow the application of the Uterine Mesh without injury to the bladder or ureters. The lower half of the mesh is applied onto the posterior wall of the uterus and the mesh is then folded so that the upper half is applied onto the anterior uterine wall. The 4 strands are then gradually pulled to tighten Uterine Mesh enough to fit the uterus making sure that the Uterine Mesh is appropriately aligned and the tubo-uterine junctions are free. The 4 strands are then tightened further to apply enough compression to arrest the bleeding. They are then tied in front of the uterus to maintain the compression.

Figure 1: Shows the Uterine Mesh before its application on the uterus. It is a flat sheet of woven absorbable (biodegradable) material e.g. polyglactin.

There are 4 strands, made of the same material, which are interlaced through the mesh material. There 2 recessions in either side at the middle of the mesh.

Figure 2: Shows how the Uterine Mesh is folded to fit onto the uterus.

Figure 3: Shows the Uterine Mesh applied onto the uterus. Note the 4 strands tied in front of the uterus. The lower horizontal strand is located at the level of the uterine vessels. Note that the tubo-uterine junctions are free due to the location of the 2 recessions.

Claims

Claims 1. The Uterine Mesh I designed will probably help in arresting

severe postpartum haemorrhage.

2. According to claim 1, the Uterine Mesh will potentially reduce maternal mortality, especially in places where facilities and/or expertise needed for major radical surgery are not readily available.

3. According to claims 1 and 2, the Uterine Mesh will to save lives, while maintaining women fertility.