CN111053627A - Method of making a lightweight quadriaxial surgical mesh - Google Patents

Abstract

A method of making a lightweight, four-axis surgical mesh is disclosed. The method comprises the following steps: a first set of filaments is applied in a first wale direction and forms a first series of loops at each of the plurality of transverse stripes. A second set of filaments is applied in a first wale direction and a second series of loops is formed at a first adjacent wale adjacent to the first wale direction and a third series of loops is formed at a second adjacent wale opposite the first adjacent wale along the plurality of transverse stripes. In addition, a third set of filaments is applied in the first wale direction such that a second series of loops is formed at a second adjacent wale and a third series of loops is formed at the first adjacent wale along the plurality of transverse stripes. Additionally, a fourth set of filaments is applied, the fourth set of filaments being repeatedly interlaced with the first set of filaments along the first wale direction.

Description

Method of making a lightweight quadriaxial surgical mesh

The applicant is: hermite, ltd, e.e. terabouco, filed on the date: 6/16/2014, with application numbers: 201480049599.6, the name is: divisional application of the invention of a method of making a lightweight, four-axis surgical mesh.

Cross Reference to Related Applications

The present application claims priority from us application No.13/958347 filed on 8/2/2013, which is a continuation-in-part of us application No.12/454308 filed on 5/15/2009, and us application No.12/454308 also claims priority from italian patent application No. m 2008a001186 filed on 27/2008, 6/119, in accordance with 35 u.s.c. All of the above applications are incorporated herein by reference in their entirety.

Technical Field

The present invention relates to a textile material, and more particularly to a surgical mesh of knitted construction made using quadrilateral patterns forming an isotropic mesh.

Background

Hernia repair is a relatively common surgical procedure that may use mesh fabric prostheses. Such mesh prostheses are also used in other surgical procedures, including repairing anatomical defects of the abdominal wall, diaphragm and chest wall, correcting defects in the urogenital system, and repairing injured organs, such as the spleen, liver or kidney.

The artificial surgical mesh can be implanted in an open surgical procedure or via a laparoscopic procedure (i.e., a specialized tool is inserted into a narrow hole made in the surrounding tissue by the surgeon).

Mesh fabrics, as well as knitted and woven fabrics composed of a variety of synthetic fibers, may be used to form meshes for use in surgical repair. Surgical meshes are expected to exhibit certain properties and characteristics. In particular, a mesh for surgical applications should have a tensile strength sufficient to ensure that the mesh does not break or tear after implantation into a patient. The mesh should also have a pore size that allows tissue to penetrate or "grow through" the mesh after the mesh is implanted in a patient. Furthermore, the mesh should be configured to maximize flexibility. The increased flexibility helps the mesh to mimic the physiological properties of the bodily structure it replaces or enhances. The additional benefit of increased flexibility facilitates insertion of the mesh prosthesis into the patient during a surgical procedure.

There are competing mesh design concepts, one of which is the use of heavy meshes with small pore sizes or light meshes with large pore sizes. Heavy mesh is designed to provide maximum strength for a durable and secure repair of hernias. Heavy webs are formed using thick fibers and are intended to have relatively small pore sizes and very high tensile strengths. However, a heavy mesh may lead to increased patient discomfort due to increased scar tissue formation.

The light, large pore size mesh is better suited for physiological repair of the body and allows proper tissue integration. These meshes provide the possibility of forming a mesh of scars rather than a stiff scar plate, thereby helping to avoid previously known complications of meshes.

However, lightweight meshes have other drawbacks. First, the filaments used generally have a lower minimum tensile strength due to their smaller diameter and "open" weave. This is further exacerbated by the fact that such a mesh is formed anisotropically, and the difference in tensile strength in either direction of force can vary significantly. Another disadvantage of using a light mesh is that the anisotropic nature of the mesh has a tendency to cause the mesh to twist or deform when under tension, making placement more difficult.

In addition, it is desirable that the surgical mesh have a tensile strength sufficient to ensure that the mesh does not break or tear after implantation into a patient. The minimum tensile strength of the mesh implanted to augment or reinforce an existing body structure should be at least 16N/cm. The tensile strength required to implant a mesh for the repair of a large ventral hernia can be increased to 32N/cm.

These and other objects and advantages of the present invention, which will be understood or appreciated by those skilled in the art upon practicing the present invention, will become more fully apparent from the following description and appended claims.

Disclosure of Invention

The present invention is a light knit surgical mesh comprising a first axis, a second axis perpendicular to the first axis, a third axis offset from the first axis by about 30 ° to 60 °, and a fourth axis perpendicular to the third axis. In addition, the mesh has a first braid extending parallel to the first axis, a second braid extending parallel to the second axis, a third braid extending parallel to the third axis, and a fourth braid extending parallel to the fourth axis. In an embodiment, the third axis is offset 45 ° from the first axis.

The first braid of the light knit surgical mesh may comprise a plurality of parallel filaments, wherein the filaments may be equally or randomly spaced. Alternatively, at least two of the first, second, third and fourth braids include a plurality of parallel filaments, wherein the filaments of the braids are equally or randomly spaced. In one embodiment, the filaments of the first braid, the second braid, the third braid, and the fourth braid are all equally spaced to form an isotropic mesh.

The first, second, third, and fourth braids may include filaments that are at least one of monofilament or multifilament. The filaments may have a diameter of 46dTex and/or a diameter of 60 μm to 180 μm. The filaments may also have a tenacity of 20% to 35% elongation. The light knit surgical mesh formed from fibers can have about 25 to 200g/m²The sum of specific gravities of more than 16N/cTensile strength of m or 32N/cm.

The first, second, third, and fourth braids may include clear filaments and dyed filaments. The spacing between dyed filaments may be 1/2 inches to 2 inches to form a striped pattern. In addition, areas of the mesh may be dyed to increase visibility.

The filaments of the light knit surgical mesh may be made of polypropylene, polyester, or polyvinylidene fluoride. Additionally, the filaments may be absorbable filaments and/or non-absorbable filaments. Additionally, the filaments may be made of expanded polytetrafluoroethylene,

And a biocompatible synthetic material.

The mesh may also be coated with at least one of a biocompatible synthetic material, titanium, silicone, an antimicrobial agent, absorbable collagen, non-absorbable collagen, and harvested material (harvested material).

Drawings

The above and other objects, features and advantages of the present invention will become apparent upon consideration of the following detailed description of specific embodiments thereof, particularly when taken in conjunction with the accompanying drawings, wherein like reference numerals in the various figures are utilized to designate like components, and in which:

FIG. 1 is a plan view of a surgical mesh of the present invention;

FIG. 2 is a detailed view of the mesh of FIG. 1;

3A, 3B, 3C, 3D and 3E are weave patterns for a single example;

FIG. 4 is a plan view of a strap for urinary incontinence (male or female) made from the web of the present invention;

FIG. 5 is a plan view of a band made from the mesh of the present invention for use in urinary incontinence in women with cystoceles;

FIG. 6 is a plan view of a strap for a female urinary incontinence and vaginal vault support made from the mesh of the present invention;

FIG. 7 is a plan view of a male inguinal hernia repair made from the mesh of the present invention;

FIG. 8 is a plan view of another male inguinal hernia repair made from a mesh of the present invention;

FIG. 9 is a plan view of a hernia of the abdominal wall made from the mesh of the present invention;

FIG. 10 is a plan view of a band for pelvic floor repair made from mesh of the present invention;

FIG. 11 is a plan view of another strap for pelvic floor repair made from the mesh of the present invention;

FIG. 12 is a plan view of another strap for urinary incontinence and pelvic floor repair made from the mesh of the present invention;

FIG. 13 is a plan view of a band for urinary incontinence made from the web of the present invention; and

fig. 14 is a plan view of another strap for urinary incontinence made from the web of the present invention.

Detailed Description

Referring to fig. 1, asurgical mesh 100 of the present invention is shown. Thesurgical mesh 100 may be surgically implanted into a patient to treat urinary or fecal incontinence caused by hypermotility of the urethra or Internal Sphincter Deficiency (ISD). In addition, thesurgical mesh 100 can be implanted to augment soft tissue defects. This includes, but is not limited to, pubic urethral and bladder stents, urethral and vaginal prolapse repair, pelvic organ prolapse, colon and rectal prolapse repair, incontinence, pelvic floor reconstruction, sacral-colossal surgery, abdominal wall hernias, and thoracic wall hernias. To accomplish the necessary scaffolding, themesh 100 can be made into a preformed design, a strap, a three-dimensional plug, or a flat plate, as needed for each condition to be corrected.

Thesurgical mesh 100 is a two bar warp knit construction. Theweb 100 is subjected to a number of forces under tension. These forces are generally along the X and Y axes X-X; Y-Y is applied to the web. Additionally, the force may be applied to the web along an intermediate vector between the X and Y axes. As shown, these forces may be exerted on the T and W axes T-T, W-W. The angle between X and W may be between 30 ° and 60 °, in a preferred embodiment 45 °. The angle between the Y and T axes is between 30 and 60, and in a preferred embodiment is 45. The mesh is isotropic when the angle between the X and W axes, and the Y and T axes is 45 °. It is achievable by those skilled in the art that angles can be similarly measured between the X and T axes and between the Y and W axes.

Referring to fig. 2, amesh 100 is formed from a first braid 102 and asecond braid 104. The first andsecond braids 102, 104 are long filaments that are guided along two opposite axes. For example, thebraids 102, 104 may be guided along the X and Y or W and T axes. Fig. 1 and 2 show the first andsecond braids 102, 104 guided along the W and T axes. In one embodiment, the W and T axes are perpendicular, and the braids are equally spaced from each other along each axis. As shown in fig. 1 and 2, the first andsecond braids 102, 104 may form a square or diamond shape. In an alternative example, the first braid 102 may be spaced differently than thesecond braid 104, and the two braids may form a rectangle.

In addition to the first andsecond braids 102, 104, thethird braid 106 and thefourth braid 108 are braided along the remaining two axes. In the illustrated embodiment, thethird braid 106 is braided along the X-axis and thefourth braid 108 is braided along the Y-axis. In one embodiment, the third andfourth braids 106, 108 may be perpendicular to each other. Again, the third andfourth braids 106, 108 may form a square, diamond, or rectangular shape based on their positioning and spacing between adjacent braids on the same axis and on opposite axes.

The third andfourth braids 106, 108 also intersect the first andsecond braids 102, 104 at or near the intersection 110 of the first andsecond braids 102, 104. Thus, in one embodiment, all fourbraids 102, 104, 106, 108 are interwoven with at least oneother braid 102, 104, 106, 108 at an intersection 110. This interlacing adds strength to the surgical braid along the four axes X, Y, T, W and provides an isotropic pattern to themesh 100 when the braids are properly spaced apart.

Fig. 3A-3E illustrate different weave examples that may be used to formmesh 100. A card chain for weavingpattern 200 is shown. Fig. 3A shows aweave pattern 200 representing a surgical mesh that can be made on a single needle bed due to the use of four guide bars (movement of which is shown in the same drawing).First yarn 202 creates a wale structure that provides stability to the fabric in the vertical direction. The twoyarns 204 and 206 of the wale are interlaced with thefirst yarn 202 creating an elastic and uniform structure. Thelast yarn 208 is a cross-machine direction stripe (course) that is repeatedly interlaced withyarn 202, increasing the strength of the fabric in the cross-machine direction.

Fig. 3B shows asecond weave pattern 210. The first, second andthird filaments 202, 204, 206 perform the same structural purposes as previously described. However, the first, second andthird filaments 202, 204, 206 have slightly different bar patterns, with the fifth filament 212 (for the fourth of thepattern 210, but distinct from the fourth filament 208) being woven in a separate pattern. A card chain for weavingpattern 210 is shown.

Fig. 3C is a third weave pattern 214. The first, second andthird filaments 202, 204, 206 remain as previously described in fig. 3B, however, the sixth filament 216 (for the fourth of the pattern 214, but distinct from thefourth filament 208 and the fifth filament 212) is braided in a separate pattern. A card chain for a weave pattern 214 is shown.

Fig. 3D is afourth weave pattern 218. The first, second andthird filaments 202, 204, 206 remain as previously described in fig. 3B, however, the seventh filament 220 (for the fourth of thepattern 218, but distinct from the fourth 208, fifth 212 and sixth 216 filaments) is woven in a separate pattern. A card chain for weavingpattern 218 is shown.

Fig. 3E is afifth weave pattern 222. Thefirst filament 202 is woven similarly to thefirst filament 202 in fig. 3A, while the second andthird filaments 204, 206 remain as previously described in fig. 3B. However, eighth filament 224 (used for the fourth ofpattern 218, but distinct fromfourth filament 208,fifth filament 212,sixth filament 216, and seventh filament 220) is braided in a separate pattern. A raspbook chain for weavingpattern 222 is shown.

Associating filaments (first to eighth 202, 204, 206, 208, 212, 216, 220, 224) with braids (first to fourth 102, 104, 106, 108), thefirst filament 202 forming thethird braid 106. Second andthird filaments 204, 206 form first andsecond braids 102, 104, andfourth filament 208,fifth filament 212,sixth filament 216,seventh filament 220, and eighth filament 228 formfourth braid 108.

Each filament (first to eighth 202, 204, 206, 208, 212, 216, 220, 224) may be a monofilament or multifilament yarn comprising a single yarn. The diameter of the filaments may be between 60 μm and 180 μm. The diameters of the individual filaments (first to eighth 202, 204, 206, 208, 212, 216, 220, 224) may be the same or different, depending on the application. In embodiments, the filaments may be made of polypropylene (PP), polyester, or polyvinylidene fluoride (PVDF). The individual filaments may be formed from expanded polytetrafluoroethylene (ePTFE),

And/or other biocompatible synthetic material. In addition, certain sections of the filament may be coated on one or both sides, depending on the application.

In another embodiment, the filaments may be an interwoven combination of PP and absorbable polymer filaments such as lactide-glycolide copolyester/blend (PGLA), polylactic acid (PLLA), polydioxanone/polydioxanone (PDO or PDS), polycaprolactone, or poliglecaprone (polyglecaprone). This embodiment reduces the amount of PP left in the body. In this regard, one or more of the filaments (first through eighth 202, 204, 206, 208, 212, 216, 220, 224) may be PP, while the remaining filaments are absorbable polymers. Alternatively, the PP mesh graft may be coated on one or both sides or a portion of the graft mesh with a polymer (PLLA, PGLA) that may or may not be absorbable. Also, the PP mesh graft may be coated with titanium, silicone, or an antimicrobial agent.

In yet another embodiment, the PP mesh graft may be coated, either completely or only partially, on one or both sides, with a natural material such as collagen. The collagen may be equine, porcine or bovine, and may be absorbable or non-absorbable. In an alternative embodiment, the PP mesh may be fully or partially delaminated from the harvested material (i.e., human cadaver tissue or suitable non-human tissue). Collagen or harvested material is used to prevent erosion of tissue with which the mesh is in contact.

The coating of the filaments and/or mesh serves different purposes. The mesh is preferably implanted in the human body between two or more molecules. Surgical meshes transplanted into contact with organs or tissues can form adhesions or erosions. Certain of the above coatings reduce the likelihood of the mesh forming an adhesive or eroding the organ or tissue with which it is in contact. The corrosion problem is partly due to the fact that the cutting edge protects the roughness when the mesh is resized and can lead to tissue/organ damage over time. In addition, the texture of the PP mesh itself causes a foreign body response, so when it contacts an organ or is in a subcutaneous position, the rate of adhesion and/or erosion is greater. However, coating too much of the mesh surface reduces the ability of the mesh to incorporate into the surrounding tissue, and the Foreign Body Response (FBR) of the PP mesh results in fibrous tissue growth into the repair material and fixation of the actual mesh.

The use of absorbable coatings and filaments serves the purpose of increasing the structural stability of the mesh without increasing the overall PP load in the patient. The additional absorbable fiber/coating stiffens the mesh making implantation easier for the surgeon. The absorbency of the material is such that: over a period of time (days to months) after the mesh is implanted, the material is absorbed into the body. Now, this provides the mesh with the desired flexibility, which results in reduced corrosion and increased comfort to the patient, as reduced FBR results in less dense fibrous tissue.

Regardless of the filament material and/or coating, one or more of the filaments (first through eighth 202, 204, 206, 208, 212, 216, 220, 224) may be colored. The colored filaments may be spaced apart to form a band to improve visibility of theweb 100 after the web is wetted by bodily fluids. The pitch of the colored filaments may be 1/2 inches to 2 inches. Additionally, a portion of the mesh may be colored to help center the mesh in the necessary location. For example, for placement of the mesh under the urethra, the central portion of the mesh (2-4 cm)²) May be colored. The coloring may beTo be an FDA approved color for PP, and in one embodiment, the filaments may be blue. In another embodiment, some materials and polishing of the filaments may result in greater light reflectivity. The higher reflectivity filaments may be interwoven to form the same band or center identifying pattern (when colored).

As discussed above, the diameter of the filaments may be between 60 μm and 180 μm. In one embodiment, the filaments are 80 μm 10%. The filament diameter corresponds to about 46 dTex. The filaments may be spun to have a tenacity of about 4.5 cN/dTex. Additionally, the filament may have an elongation at break once elongated. In one embodiment, the tenacity can be from 20% to 35% elongation. The thickness of the woven mesh may vary from 0.25 to 0.80 millimeters, and in one embodiment is 0.32mm 10%. The mesh may have about 30g/cm²Conventional weight of ± 8%. The specific gravity of the mesh may be between about 25 and 200g/cm²To change between. The tensile strength of the web is at least 16N/cm, and may further be 32N/cm. In one embodiment, the tensile strength is greater than 20N/cm while still maintaining 20% -35% elasticity.

Fig. 4-14 illustrate different examples of surgical straps made from the mesh of the present invention. The dimensions shown in the figures are in table 1 below. Fig. 4 shows a strap for urinary incontinence (male or female). Figure 5 shows a band for urinary incontinence in women with cystocele. Fig. 6 shows a strap for a female urinary incontinence and vaginal vault support. Figure 7 shows a man inguinal hernia repair, the same construct without a hole can be used for a woman inguinal repair. Figure 8 shows another men inguinal hernia repair. Figure 9 shows abdominal hernia repair. Fig. 10 shows a device for pelvic floor repair. Fig. 11 shows another device for pelvic floor repair. Figure 12 shows another strap for urinary incontinence and pelvic floor repair. Fig. 13 shows a strap for urinary incontinence. Fig. 14 shows another strap for urinary incontinence.

TABLE 1

While there have been shown and described and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions and substitutions and changes in the form and details of the devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, it is expressly intended that all elements and/or steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the invention. Substitutions of elements from one described embodiment to another are also fully intended and contemplated. It should also be understood that the drawings are not drawn to scale, but that they are merely conceptual in nature. Accordingly, it is intended that the invention be limited only by the scope of the appended claims.

Claims (21)

Translated fromChinese

1.一种用于在四梳栉单针床机上制造轻的针织手术网状物的方法，包括以下步骤：1. A method for making a lightweight knitted surgical mesh on a four-bar single needle bed machine, comprising the steps of:将第一细丝施加在单针床机上；applying the first filament on a single needle bed machine;通过在第一编织图案中将第一梳栉以2-1、1-2、2-1、1-2、2-1、1-2、2-1和1-2的次序从第一行移动到第八行而编织第一细丝(202)；By placing the first bar in the first weave pattern in the order of 2-1, 1-2, 2-1, 1-2, 2-1, 1-2, 2-1 and 1-2 from the first row Move to the eighth row to weave the first filament (202);将第二细丝施加在单针床机上；applying the second filament on a single needle bed machine;通过在第二编织图案中将第二梳栉以2-1、3-4、3-4、3-4、5-6、4-3、3-4和3-4的次序从第一行移动到第八行而编织第二细丝(206)；By placing the second bar in the second weave pattern in the order 2-1, 3-4, 3-4, 3-4, 5-6, 4-3, 3-4 and 3-4 from the first row moving to the eighth row to weave the second filament (206);将第三细丝(204)施加在单针床机上；applying a third filament (204) on a single needle bed machine;通过在第三编织图案中将第三梳栉以5-6、4-3、4-3、4-3、2-1、3-4、4-3和4-3的次序从第一行移动到第八行而编织第三细丝；By placing the third bar in the third weave pattern from the first row in the order 5-6, 4-3, 4-3, 4-3, 2-1, 3-4, 4-3 and 4-3 Move to the eighth row and weave the third filament;将第四细丝施加在单针床机上；和applying a fourth filament on a single needle bed machine; and通过在第四编织图案中将第四梳栉以6-6、1-1、2-2、1-1、6-6、1-1、2-2和1-1的次序从第一行移动到第八行而编织第四细丝(224)。By placing the fourth bar in the fourth weave pattern from the first row in the order 6-6, 1-1, 2-2, 1-1, 6-6, 1-1, 2-2 and 1-1 Move to the eighth row and weave the fourth filament (224).2.如权利要求1所述的方法，2. The method of claim 1,其中在第一纵行将第一细丝(202)施加在单针床机上，第一细丝在用于手术网状物的多个横向条纹的每个之处形成第一系列部分线圈；wherein a first filament (202) is applied on a single needle bed machine in a first wale, the first filament forming a first series of partial loops at each of the plurality of transverse stripes for the surgical mesh;其中沿第一纵行将第三细丝(204)施加在单针床机上，第三细丝以交替方式在与第一纵行相邻的第一相邻纵行形成第二系列完整线圈和沿着多个横向条纹在与第一相邻纵行相对的第二相邻纵行相对于第一纵行形成第三系列完整线圈；Wherein a third filament (204) is applied on a single needle bed machine along a first wale, the third filament forming a second series of complete loops in a first adjacent wale adjacent to the first wale in an alternating manner and along the forming a third series of complete coils with respect to the first wale at a second adjacent wale opposite the first adjacent wale with a plurality of transverse stripes;其中第二细丝(206)沿着多个横向方向在第二相邻纵行和第一相邻纵行形成一系列完整线圈；和wherein the second filament (206) forms a series of complete coils in the second adjacent wale and the first adjacent wale along the plurality of transverse directions; and其中第四细丝(224)沿着第一纵行在横向方向与第一细丝和第二细丝重复交错。Wherein the fourth filament (224) is repeatedly interleaved with the first filament and the second filament in the transverse direction along the first wale.3.如权利要求1所述的方法，其中第二细丝和第三细丝与第一细丝交错，以给手术网状物形成弹性且均匀结构。3. The method of claim 1, wherein the second and third filaments are interleaved with the first filament to provide a resilient and uniform structure to the surgical mesh.4.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括单丝或多丝中的至少一个。4. The method of claim 1, wherein the first, second, third and fourth filaments comprise at least one of monofilaments or multifilaments.5.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括透明细丝和染色细丝中的至少一种。5. The method of claim 1, wherein the first, second, third and fourth filaments comprise at least one of clear filaments and dyed filaments.6.如权利要求5所述的方法，还包括将染色细丝间隔开¹/₂英寸至2英寸的步骤。6. The method of claim 5, further comprising the step of spacing the dyed filaments^1/2 inch to₂ inches apart.7.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括一涂层，所述涂层包括膨体聚四氟乙烯/聚四氟乙烯、

和生物相容性合成材料中至少一种。7. The method of claim 1, wherein the first, second, third and fourth filaments comprise a coating comprising expanded polytetrafluoroethylene/polytetrafluoroethylene,

and at least one of biocompatible synthetic materials.8.如权利要求1所述的方法，其中，所述手术网状物包括一涂层，所述涂层包括生物相容性合成材料、钛、硅树脂、抗微生物剂、可吸收胶原质、不可吸收胶原质和收获材料中的至少一种。8. The method of claim 1, wherein the surgical mesh comprises a coating comprising a biocompatible synthetic material, titanium, silicone, antimicrobial agents, absorbable collagen, At least one of non-absorbable collagen and harvest material.9.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括可吸收细丝和不可吸收细丝中的至少一种。9. The method of claim 1, wherein the first, second, third and fourth filaments comprise at least one of absorbable filaments and non-absorbable filaments.10.如权利要求1所述的方法，还包括以下步骤：10. The method of claim 1, further comprising the steps of:由第一、第二、第三和第四细丝形成第一编织物、第二编织物、第三编织物和第四编织物；forming a first braid, a second braid, a third braid and a fourth braid from the first, second, third and fourth filaments;沿第一轴线平行地施加第一编织物；applying the first braid in parallel along the first axis;沿垂直于第一轴线的第二轴线平行地施加第二编织物；applying a second braid in parallel along a second axis perpendicular to the first axis;沿与第一轴线偏移约30°至60°的第三轴线平行地施加第三编织物；以及applying a third braid parallel to a third axis offset from the first axis by about 30° to 60°; and沿垂直于第三轴线的第四轴线平行地施加第四编织物。The fourth braid is applied in parallel along a fourth axis that is perpendicular to the third axis.11.如权利要求10所述的方法，还包括使第三轴线从第一轴线偏移45°的步骤。11. The method of claim 10, further comprising the step of offsetting the third axis by 45° from the first axis.12.如权利要求10所述的方法，还包括等距地间隔开第一编织物的细丝的步骤。12. The method of claim 10, further comprising the step of equally spaced apart the filaments of the first braid.13.如权利要求10所述的方法，还包括等距地间隔开第一编织物、第二编织物、第三编织物和第四编织物中的至少两个的细丝的步骤。13. The method of claim 10, further comprising the step of equally spaced apart filaments of at least two of the first braid, the second braid, the third braid, and the fourth braid.14.如权利要求10所述的方法，还包括等距地间隔开第一编织物、第二编织物、第三编织物和第四编织物从而形成各向同性网状物的步骤。14. The method of claim 10, further comprising the step of equally spaced apart the first braid, the second braid, the third braid, and the fourth braid to form an isotropic mesh.15.如权利要求1所述的方法，其中，手术网状物包括大于16N/cm的抗张强度。15. The method of claim 1, wherein the surgical mesh comprises a tensile strength greater than 16 N/cm.16.如权利要求15所述的方法，其中，抗张强度大于20N/cm，而手术网状物仍保持20％-35％的弹性。16. The method of claim 15, wherein the tensile strength is greater than 20 N/cm while the surgical mesh retains 20%-35% elasticity.17.如权利要求1所述的方法，其中，手术网状物包括约25至200g/m²的比重。17. The method of claim 1, wherein the surgical mesh comprises a specific gravity of about 25 to²⁰⁰ g/m2.18.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括46dTex的直径。18. The method of claim 1, wherein the first, second, third and fourth filaments comprise a diameter of 46dTex.19.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括60μm至180μm的直径。19. The method of claim 1, wherein the first, second, third and fourth filaments comprise diameters of 60 μm to 180 μm.20.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括20％至35％伸长率的韧度。20. The method of claim 1, wherein the first, second, third, and fourth filaments comprise a tenacity of 20% to 35% elongation.21.如权利要求1所述的方法，其中，第一、第二、第三和第四细丝包括聚丙烯、聚酯、聚偏二氟乙烯或一种乙烯。21. The method of claim 1, wherein the first, second, third and fourth filaments comprise polypropylene, polyester, polyvinylidene fluoride, or an ethylene.

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