Patent Publication Number: US-2005131393-A1

Title: Systems, methods and devices relating to delivery of medical implants

Description:
CROSS REFERENCE TO RELATED APPLICATIONS  
      This application is a continuation-in-part application of U.S. patent application Ser. Nos. 10/093,371, 10/093,398, 10/093,424, 10/093,450, 10/093,498, and 10/094,352 filed in the United States Patent Office on Mar. 7, 2002, which claim benefit of and priority to provisional patent application Ser. No. 60/274,843 filed in the United States Patent Office on Mar. 9, 2001 and provisional patent application Ser. No. 60/286,863 filed in the United States Patent Office on Apr. 26, 2001. The entire contents of these six nonprovisional applications are incorporated by reference herein. This application is also based on and claims priority to certain provisional U.S. patent applications, namely, Ser. No. 60/403,555 filed on Aug. 14, 2002, Ser. No. 60/418,827 filed on Oct. 15, 2002, Ser. No. 60/418,642, filed on Oct. 15, 2002, Ser. No. 60/434,167 filed on Dec. 17, 2002, Ser. No. 60/449,465 filed on Feb. 24, 2003, Ser. No. 60/465,722 filed on Apr. 25, 2003, and Ser. No. 60/483,534 filed on Jun. 27, 2003, the entire contents of all of which are incorporated herein by reference. 
    
    
     TECHNICAL FIELD  
      The invention relates generally to systems, methods and devices for delivering a medical implant, to an anatomical site in the body of a patient.  
     BACKGROUND INFORMATION  
      Urinary incontinence occurs in both men and women. Various types of incontinence are caused by different conditions and call for different treatments. For example, stress urinary incontinence (SUI) is known to be caused by at least two conditions, intrinsic sphincter deficiency (ISD) and hypermobility. In women, these conditions may occur independently or in combination. In ISD, the urinary sphincter valve, located within the urethra, fails to close properly (coapt), causing urine to leak out of the urethra during stressful activity. Hypermobility is a condition in which the pelvis floor is distended, weakened or damaged, causing the bladder neck and proximal urethra to rotate and descend in response to increases in intra-abdominal pressure (for example, due to sneezing, coughing, straining, etc.). As a result, the patient&#39;s response time becomes insufficient to promote urethral closure and, consequently, the patient suffers from urine leakage and/or flow.  
      One way to treat incontinence, both in men and women, is to place a surgical sling or suture in the periurethral tissue such as under the bladder neck or the urethra to provide a urethral platform. Placement of the sling limits the endopelvis fascia drop while providing compression to the urethral sphincter to improve coaptation. The sling may be affixed using a bone anchoring method. Alternatively, a medical professional can use an anchorless approach to stabilize the urethra with a sling by placing the sling in the periurethral tissue and relying on tissue compression and eventual tissue in-growth to secure the sling in position.  
     SUMMARY OF THE INVENTION  
      The invention addresses deficiencies of the prior art by providing devices, systems and methods for facilitating delivery of an implant to an anatomical site. According to a preferred embodiment, the device can be used to deliver an implant, such as a sling for treating urinary incontinence, to a mid-urethral location of a patient. The methods and systems of the invention simplify the delivery of the implant by using a delivery device that includes a shaft that is shaped to allow a medical operator to safely deliver a medical implant to a desired site without damaging any internal organs during the delivery process. In one example, the shaft includes a plurality of curves which are so designed that the shaft can be safely navigated past internal organs without puncturing them. In another example, the distal end of the shaft includes a substantially straight portion bent at an angle relative to the shaft located along the distal end of the shaft. One advantage of this configuration is that it allows the medical operator to safely navigate an implant around the pubic bone without damage to internal organs. The invention may be employed with any suitable implant such as a sleeve/sling combination.  
      In one aspect, the invention features a delivery device for delivering an implant to an anatomical site in a body of a patient. The device includes a handle, and a shaft having proximal and distal ends and shaped to describe a plurality of curves substantially in a single plane along its length, the proximal end of the shaft being attached either reversibly or permanently to the handle.  
      In one embodiment, the distal end of the shaft includes a substantially straight portion bent at an angle relative to the shaft. The bend is preferably in a direction toward a pubic bone of a patient to reduce the likelihood of inadvertently puncturing internal organs. The angle relative to the shaft is determined to accommodate a pubic bone of a patient and can be, for example, about 90 degrees, greater than about 90 degrees, and less than about 90 degrees.  
      The plurality of curves located on the shaft of the delivery device can have various configurations. For example, the most distal of the plurality of curves can include a concave portion and a convex portion and the bend is formed toward the concave portion. In another embodiment, at least one of the curves describes an arc of greater than about, for example, 45 degrees, 60 degrees or 90 degrees.  
      The implant can be joined to the delivery device by a connector known in the art. The connector, for example, can located at the distal end of the shaft for attaching to an end of the implant. The connector can be formed integral to the shaft. In one example, the connector includes a slot formed in the shaft. The slot, for example, extends from a surface of the shaft radially into the shaft and axially in a distal direction to form a substantially L-shape. In another example, the connector includes a plug portion for interfitting with a receptacle on the end of the implant. Alternatively, the connector can include a receptacle portion for interfitting with a mating plug connector on the end of the implant.  
      In another aspect, the invention features a delivery device for delivering an implant to an anatomical site in a body of a patient. The device includes a handle, and a shaft having proximal and distal ends, the proximal end being connected to the handle and the distal end including a substantially straight portion bent at an angle relative to the shaft. The bend in the shaft can be located along about a distal most 25%, 20%, 15%, 10% or 5% of the shaft.  
      In yet another aspect, the invention features a delivery system for delivering an implant, such as a sling, to an anatomical site, such as the midurethral location in a body of a patient. The system includes an implant having first and second ends, and a delivery device as described above. In one example, the implant includes a sling for treating urinary incontinence.  
      The invention also features a method of delivering an implant, such as a sling assembly for treating urinary incontinence, to an anatomical site in a body of a patient. The method includes inserting into a body of a patient a shaft as described above, attaching the distal end of the shaft to a first end of an implant, and positioning the implant at an anatomical site within the body of the patient. The shaft can be inserted suprapubically, prepubically, transobturally or transvaginally. In a further embodiment, the method includes introducing the implant into the body of the patient transvaginally. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      In the drawings, like reference characters generally refer to the same parts throughout the different views. The drawings are not necessarily to scale and emphasis instead is generally placed upon illustrating the principles of the invention.  
       FIG. 1  depicts a perspective side view of a delivery device including a handle and needle according to an illustrative embodiment of the invention.  
       FIG. 2  depicts an enlarged perspective side view of the handle and a portion of the needle of the device of  FIG. 1 .  
       FIG. 3  depicts a perspective side view of the delivery device of  FIG. 1  with a pusher assembly incorporated into the device according to an illustrative embodiment of the invention.  
       FIG. 4  depicts a perspective side view of the pusher assembly shown in  FIG. 3 .  
       FIG. 5  depicts an enlarged perspective side view of the handle and pusher assembly portion of the device shown in  FIG. 3 .  
       FIG. 6  depicts a longitudinal cross-sectional view of a pusher assembly on a delivery device according to an alternative embodiment of the invention.  
       FIG. 7A  depicts a perspective side view of a delivery device that includes a guide tube and a shaft, with the guide tube actuated to be in a first position relative to the shaft according to an embodiment of the invention.  
       FIG. 7B  depicts a perspective side view of the delivery device of  FIG. 7A  where the guide tube is actuated to be a second position relative to the shaft.  
       FIGS. 8A  depicts a perspective side view of a delivery device that includes a guide tube and a shaft, with the shaft actuated to be in a first position relative to the guide tube, according to an alternative embodiment of the invention.  
       FIGS. 8B  depicts a perspective side view of the delivery device of  FIG. 8A  with the shaft actuated to be in a second position relative to the guide tube.  
       FIG. 9A  depicts a perspective side view of a delivery device according to another illustrative embodiment of the invention.  
       FIG. 9B  depicts a cross-sectional view of the device shown in  FIG. 9A  along the line “ 9 B- 9 B.” 
       FIG. 10A  depicts a perspective side view of an exemplary guide tube according to one illustrative embodiment of the invention  
       FIG. 10B  depicts a side view of a portion of the guide tube of  FIG. 10A  according to an illustrative embodiment of the invention.  
       FIG. 11  depicts a side view of an alternative illustrative embodiment of a portion of a guide tube of the general type depicted in  FIG. 10A .  
       FIG. 12  depicts a perspective side view of a portion of a delivery device including a handle and a shaft according to another illustrative embodiment of the invention.  
       FIGS. 13A and 13B  depict perspective side views of delivery devices with multiple bends according to illustrative embodiments of the invention.  
       FIGS. 14-16  depict perspective side views of illustrative delivery devices, each having a variously angled distal end according to the invention.  
       FIG. 17  depicts a perspective side view of a particularly curved delivery device according to an illustrative embodiment of the invention.  
       FIG. 18  depicts a perspective side view of alternatively curved delivery devices according to another illustrative embodiment of the invention.  
       FIG. 19  depicts a top view of an exemplary sling assembly that may be employed with the various illustrative delivery devices of the invention.  
       FIG. 20  depicts a top view of another exemplary sling assembly that may be employed with the various illustrative delivery devices of the invention.  
       FIG. 21  depicts a top view of another exemplary sling assembly that may be employed with the various illustrative delivery devices of the invention.  
       FIG. 22A  depicts a side perspective view of a loop connector and mating receptacle connector prior to interconnection, according to an illustrative embodiment of the invention.  
       FIG. 22B  depicts a top view of the connectors of  FIG. 22A , with an interconnected state shown in phantom.  
       FIG. 22C  depicts a side view of the connectors of  FIG. 22A  partially interconnected according to an illustrative embodiment of the invention.  
       FIG. 22D  depicts a side view of the connectors of  FIG. 22A  fully interconnected.  
       FIG. 23  depicts a perspective top view of interconnected loop and receptacle connectors according to another illustrative embodiment of the invention.  
       FIG. 24  depicts a perspective side view of a receptacle connector of the type that may be employed with the loop connector of  FIG. 23 .  
       FIG. 25  depicts a perspective side view of a receptacle connector and a mating loop connector according to an illustrative embodiment of the invention.  
       FIG. 26  depicts a cross-sectional side view of an alternative receptacle connector of the type that may be employed with the loop connectors of  FIGS. 23 and 25 .  
       FIGS. 27-31  depict side views of various additional receptacle connectors of the type that may be employed with the loop connectors of  FIGS. 23 and 25 , according to various embodiments of the invention.  
       FIG. 32A  depicts a side view of another receptacle connector of the type that may be employed with the loop connectors of  FIGS. 23 and 25 .  
       FIG. 32B  depicts a side perspective view of the receptacle connector of  FIG. 32A .  
       FIG. 33  depicts a side perspective view of a loop and mating receptacle connector pair according to another illustrative embodiment of the invention.  
       FIG. 34  depicts a side perspective view of an alternative embodiment of the loop connector of  FIG. 33 .  
       FIG. 35A  depicts a side perspective view of a connector pair prior to interconnection.  
       FIG. 35B  depicts a side perspective view of the connector pair of  FIG. 35A  subsequent to interconnection.  
       FIG. 36A  depicts a side perspective view of a loop connector with an adjustable loop according to an embodiment of the invention.  
       FIG. 36B  depicts a cross-sectional view, along the line “ 36 B- 36 B,” of the loop connector shown in  FIG. 36A .  
       FIG. 37A  depicts a side perspective view of the loop connector of  FIG. 36A  interconnected with a mating receptacle connector with the loop connector in an extended state.  
       FIG. 37B  depicts a side perspective view of the connector pair of  FIG. 37A  with the loop connector in a retracted state.  
       FIG. 38  depicts a cross-sectional view of an adjustable loop connector according to another illustrative embodiment of the invention.  
       FIG. 39A  depicts a top perspective view of a plug and receptacle connector pair according to an illustrative embodiment of the invention.  
       FIG. 39B  depicts a top perspective view of the connector pair of  FIG. 39A  interconnected in an in-line configuration.  
       FIG. 39C  depicts a top perspective view of the connector pair of  FIGS. 39A  interconnected in an alternative configuration.  
       FIG. 40A  depicts a top perspective view of a plug and loop connector pair according to another illustrative embodiment of the invention.  
       FIG. 40B  depicts an enlarged top view of a portion of the loop connector of  FIG. 40A .  
       FIG. 41A  depicts a top perspective view of the plug connector of  FIG. 40A  and an alternative configuration of the loop connector of  FIG. 40A .  
       FIG. 41B  depicts a perspective side view of the connector pair of  FIG. 41A  in an interconnected state with an in-line configuration.  
       FIG. 41C  depicts a perspective side view of the connector pair of  FIG. 41A  in an interconnected state with an alternative configuration.  
       FIG. 42A  depicts a side perspective view of a plug and receptacle connector pair along with components of an implant delivery system including a shaft, a guide tube and a sling assembly, according to another illustrative embodiment of the invention.  
       FIG. 42B  depicts a side perspective view of an alternative embodiment to the plug and receptacle connector pair of  FIG. 42A .  
       FIGS. 43 and 44  depict side views of alternative embodiments of plug connectors of the type depicted in  FIGS. 42A and 42B .  
       FIG. 45  depicts a side perspective view of a plug and receptacle connector pair where the plug connector alternately contracts and expands to interlock with the receptacle connector, and a release tool, according to an illustrative embodiment of the invention.  
       FIG. 46A  depicts a side perspective view of a plug and receptacle connector pair where the receptacle connector alternately expands and contracts to interlock with the plug connector.  
       FIG. 46B  depicts a cross-sectional end view of the distal end of the receptacle connector shown in  FIG. 46A , along the line “ 46 B- 46 B.” 
       FIGS. 46C and 46D  depict longitudinal cross-sectional views of alternative embodiments of the receptacle connector shown in  FIG. 46A  along the line “ 46 C/ 46 D- 46 C/ 46 D.” 
       FIGS. 47 and 48  depict longitudinal cross-sectional views of receptacle and plug connector pairs at different stage of interconnection according to an illustrative embodiment of the invention.  
       FIG. 49A  depicts an exploded view in perspective of a portion of a plug and receptacle connector pair according to another illustrative embodiment of the invention.  
       FIG. 49B  depicts a cross-sectional view of a portion of the receptacle connector of  FIG. 49A , along the line “ 49 B- 49 B.” 
       FIG. 50A  depicts a side perspective view of a plug and receptacle connector pair where the receptacle opens and closes to facilitate interconnection, according to an illustrative embodiment of the invention.  
       FIG. 50B  depicts a side perspective view of an alternative embodiment of the connector pair of  FIG. 50A .  
       FIG. 5   1 A depicts a side perspective view of a plug and receptacle connector pair with a protuberance to facilitate interlocking, according to an embodiment of the invention.  
       FIG. 51 B  depicts a cross-sectional view of the receptacle connector of  FIG. 51A  along the line “ 51 B- 51 B.” 
       FIG. 52  depicts a side view partially in perspective of a receptacle connector similar to the receptacle connector of  FIG. 51A , but including a flap, according to an illustrative embodiment of the invention.  
       FIG. 53  depicts a side perspective view of a receptacle and plug connector pair, according to another illustrative embodiment of the invention.  
       FIG. 54A  depicts a side perspective view of a receptacle connector, according to another illustrative embodiment of the invention.  
       FIG. 54B  depicts a cross-sectional view of the connector of  FIG. 54A , along the line “ 54 B- 54 B.” 
       FIG. 54C  depicts a side perspective view of the receptacle connector of  FIG. 54A  partially interconnected with the type of plug connector depicted in  FIG. 53 .  
       FIG. 55  depicts a top schematic view of a connector pair as an alternative embodiment to the connector pair of  FIG. 54C .  
       FIG. 56A  is a perspective top view illustrating interconnection between a receptacle and plug connector pair, according to an embodiment of the invention.  
       FIGS. 56B-56D  depict cross-sectional views of the receptacle connector of  FIG. 56B , at various locations along its length.  
       FIG. 57  depicts a perspective side view in partial cross-section of a threadable receptacle and plug connector pair.  
       FIG. 58A  depicts a side view perspective of a plug and receptacle connector pair in which the receptacle and plug connectors adhere to each other during interconnection.  
       FIG. 58B  depicts a perspective side view of the connector pair of  FIG. 58A  subsequent to interconnection.  
       FIG. 59A  depicts a perspective side view of a plug and receptacle connector pair that employs a spring-loaded locking device for interconnection, according to another illustrative embodiment of the invention.  
       FIG. 59B  depicts a perspective side view of the connector pair of  FIG. 59A  subsequent to interconnection.  
       FIG. 60  depicts a side view in partial cross-section of a plug and receptacle connector pair, according to another illustrative embodiment of the invention.  
       FIG. 61A  depicts a longitudinal cross-sectional view of a receptacle connector, and a side view of its mating plug connector, according to another illustrative embodiment of the invention.  
       FIG. 61B  depicts a longitudinal cross-sectional view of the connector pair of  FIG. 61A .  
       FIG. 62  depicts a perspective side view partially in cross-section of a connector pair, according to another illustrative embodiment of the invention.  
       FIG. 63A  depicts a delivery system that includes a handle, a shaft, a guide tube, a sling assembly and connectors according to an illustrative embodiment of the invention.  
       FIG. 63B  depicts a radial cross-sectional view of the guide tube of  FIG. 63A  along the line “ 63 B- 63 B.” 
       FIG. 63C  depicts a longitudinal cross-sectional view of the plug connector of  FIG. 63A  along the line “ 63 C- 63 C.” 
       FIG. 63D  depicts a longitudinal cross-sectional view of the receptacle connector of  FIG. 63A  along the line “ 63 D- 63 D.” 
       FIG. 64  depicts a longitudinal cross-sectional view of the interconnection between the shaft, receptacle and plug connectors of  FIG. 63A .  
       FIG. 65A  depicts a perspective side view of a delivery device including a sheath at an advanced position, according to an illustrative embodiment of the invention.  
       FIG. 65B  depicts a perspective side view of a delivery device of the type depicted in  FIG. 65A  interconnected with a sleeve end through a loop connector and a slotted receptacle connector, where the sheath is in a retracted position.  
       FIG. 66A  depicts a perspective side view of interconnection between the delivery device and the sleeve end depicted in  FIG. 65B  with an alternative embodiment of the sheath.  
       FIG. 66B  depicts a partial cross-sectional view of the interconnection between a receptacle connector and a loop connector with a locking sheath embodiment.  
       FIG. 67A  depicts a side perspective view of an L-shaped receptacle connector and a mating loop connector, with a sheath located to enable interconnection according to an illustrative embodiment of the invention.  
       FIG. 67B  depicts a side perspective view of the connector pair of  FIG. 67A  with the loop and L-shaped receptacle interfitted and the sheath located to facilitate locking.  
       FIG. 68  depicts a cross-sectional view of a delivery device including a guide tube having connectors for mounting a sling assembly shown in perspective, according to an illustrative embodiment of the invention.  
       FIG. 69  depicts a perspective side view of the components shown in  FIG. 68  assembled together, according to an illustrative embodiment of the invention.  
       FIG. 70  depicts a perspective side view of an assembled delivery system with two guide tubes, a shaft with a handle, a sling assembly, and connectors, according to another illustrative embodiment of the invention.  
       FIG. 71  depicts a perspective side view of an assembled delivery system with two guide tubes that are alternative embodiments of the ones shown in  FIG. 70 , a shaft with a handle, a sling assembly, and connectors, according to another illustrative embodiment of the invention.  
       FIG. 72  depicts a perspective side view of an assembled delivery system with two ends of a sling assembly attached to two guide tubes where each guide tube slidably fits over a handled shaft next to a pusher assembly, according to one embodiment of the invention.  
       FIG. 73A  depicts a schematic view of the tunneling step, using an optional guide tube, in a suprapubic approach to delivering a sling to an anatomical site, according to illustrative embodiments of the invention.  
       FIG. 73B  depicts a schematic view of interconnection and other steps without using a guide tube subsequent to the step shown in  FIG. 73A .  
       FIG. 73C  depicts a schematic view of interconnection and other steps using guide tubes subsequent to the step shown in  FIG. 73A .  
       FIG. 73D  depicts a schematic view of steps subsequent to those shown in either  FIG. 73B  or  73 C.  
       FIG. 73E  depicts a schematic view of the final placement of a sling to treat urinary incontinence.  
      FIGS.  74  depicts a schematic view of a suprapubic delivery approach using the shaft of the type shown in  FIG. 14  where one previous position of the delivery device is shown in phantom, according to an illustrative embodiment of the invention.  
      FIGS.  75  depicts a schematic view of a prepubic delivery approach using the delivery device of  FIG. 74  where one previous position of the delivery device is shown in phantom, according to an illustrative embodiment of the invention.  
       FIGS. 76A and 76B  depict schematic views of steps in a transvaginal approach where a medical implant is interconnected to a distal end of a shaft for delivery to an anatomical site in the patient.  
       FIG. 77  depicts a schematic view of steps in a transvaginal approach where the implant is interconnected to a distal end of a guide tube for delivery to an anatomical site in the patient.  
       FIGS. 78A and 78B  depict schematic views of steps in a transvaginal approach where the implant is interconnected to a proximal end of a guide tube for delivery to an anatomical site in the patient.  
       FIGS. 79A and 79B  depict schematic views of steps in a transvaginal approach where the implant is interconnected to both distal and proximal ends of a guide tube for delivery to an anatomical site in the patient.  
       FIGS. 80A and 80B  depict schematic views of steps in a transvaginal approach where the implant is interconnected to two guide tubes simultaneously for delivery to an anatomical site in the patient.  
       FIGS. 81A and 81B  depict schematic views of steps in a trans-obturator approach to deliver a medical implant to an anatomical site in the patient, according to another illustrative embodiments of the invention.  
       FIG. 82  depicts a side perspective view of a sling assembly with two male guide members, and a delivery device, according to an illustrative embodiment of the invention.  
       FIG. 83  depicts a side perspective view of an alternative embodiment to the male guide members of  FIG. 82 , according to an embodiment of the invention.  
       FIG. 84A  depicts a schematic view of steps in a suprapubic or prepubic delivery approach using a delivery device including a shaft and a guide tube.  
       FIG. 84B  depicts a schematic view of steps in a transvaginal delivery approach using the delivery device shown in  FIG. 84A .  
       FIG. 84C  depicts a schematic view of steps using the male guide members of the general type shown in  FIG. 82  subsequent to steps shown in  FIG. 84A  or  84 B.  
       FIG. 85  depicts a side perspective view of an implant delivery system including two female guide members, according to an illustrative embodiment of the invention.  
       FIG. 86A and 86B  depict schematic views of steps in a suprapubic or prepubic delivery approach using the delivery device of  FIG. 85 .  
       FIG. 87A and 87B  depict schematic views of steps in a transvaginal delivery approach using the delivery device of  FIG. 85 . 
    
    
     DESCRIPTION  
      The invention relates to delivering and placing an implant, such as a sling, mesh, or suture, for the treatment of urinary incontinence, at an anatomical site (such as the periurethral tissue) in the body of a mammal. The patient may be either a female patient or a male patient.  
      The following description is divided into five sections. The first section, describes various illustrative delivery devices. The second section describes implants (such as sling assemblies) that may be delivered by, without limitation, any of the illustrative delivery devices. The third section describes connectors that may be used to interconnect two or more parts in an implant delivery system, such as, for example, interconnecting a sling assembly with a delivery device. The fourth section describes various illustrative methods for treatment of urinary incontinence, including illustrative embodiments that utilize components and systems described in this and the incorporated patents and patent applications. The fifth section describes guide members that may be interconnected with the sling assembly and their related methods of use. A delivery device, an implant, and optionally one or more guide members and/or connectors together generally form an implant delivery system.  
      It should be noted that, any of the described components (in any described variations) can be operatively combined with one or more of any of the other described components (in any described variations), and such operative combinations are intended to fall within the scope of the invention and are included herein even if not expressly called out.  
      I. Delivery Devices  
      Without limitation, exemplary delivery systems, slings, sling attachments and methodologies that may be employed in combination with the spacers of the invention can be found in U.S. patent application Ser. No. 10/093,498; U.S. patent application Ser. No. 10/093,398; U.S. patent application Ser. No. 10/093,450; U.S. patent application Ser. No. 10/094,371; U.S. patent application Ser. No. 10/094,352; U.S. patent application Ser. No. 10/093,424; U.S. provisional patent application Ser. No. 60/403,555; U.S. patent application Ser. No. 09/916,983; U.S. provisional patent application Ser. No. 60/465,722; U.S. provisional patent application Ser. No. 60/418,827; U.S. provisional patent application Ser. No. 60/418,642; U.S. provisional patent application Ser. No. 60/274,843; U.S. provisional patent application Ser. No. 60/286,863; and U.S. provisional patent application Ser. No. 60/434,167, the disclosures of which are incorporated herein by reference.  
      Referring to  FIG. 1 , an illustrative delivery device  10  includes a handle  12  associated with a curved shaft  14 . The shaft  14  may be, for example, any suitable needle, cannula, tubular member, tunneler, dilator or the like. The delivery device  10  may also include other components, such as connectors, sheaths, guide tubes and actuating assemblies, described in further detail below. A distal end  24  of the curved shaft  14  is marked by circle “A” to indicate that it may include one or more connectors such as the ones described below.  
      In one illustrative embodiment, the curved shaft  14  is formed from a rigid material, for example, a metal or a polymeric material. Examples of suitable metals include, but are not limited to, stainless steel, titanium, and alloys such as nitinol. Suitable polymers, which can be used as a coating on a metal to form the shaft  14 , include but are not limited to, plastics such as polytetrafluoroethylene (PTFE). In one embodiment, the shaft  14  is rigid. In another embodiment, the shaft  14  has some flexibility, and can be described as semi-rigid. The shaft  14  has a proximal end  22 , i.e., the end that is closest to an origin of attachment, typically the operator, and the distal end  24 . The shaft  14  generally has a pointed tip  26  at the distal end  24  that is designed for percutaneous punctuation and/or advances through the tissue. However, the tip  26  may be blunt or sharp. In some configurations, the tip  26  is conical. A blunt tip  26  may provide some resistance to unintended penetration through tissue or organ, such as the bladder. The distal end  24  of the shaft  14  may include a tapered section  28  that leads to the distal tip  26 . The tapered section  28  aids dilation and tunneling through the tissue.  
      The shaft  14  may be solid or hollow. If the shaft  14  is at least partly hollow, it may include a lumen (not shown) that has one or more openings on the shaft  14 , for example, at the distal tip  26  or along the side of the shaft  14 . The cross-section of the shaft  14  may have a constant shape and size, or its shape and size may vary along the length of the shaft  14 . The cross-section of the shaft  14  may assume any shape, for example, circular, semi-circular, oval, triangular or rectangular. In other embodiments, the distal end  24  may include an enlarged, flared portion to dilate tissue beyond the typical diameter of the shaft  14 .  
      Part or the entire shaft  14  may assume a curved, angled, a helical shape or any other suitable shape including substantially straight. Different shapes of the shaft  14  have advantages in different procedures, which is discussed in more detail below.  
      In one embodiment, the surface of the shaft  14  is smooth. However, the surface of the shaft  14  may be coated with one or more drugs such as anesthetic, anti-inflammatory, coagulating, anticoagulating, antibiotic or antimicrobial agents. The drug may be delivered to the patient&#39;s tissue while the shaft  14  is in contact with the tissue. The surface of the shaft  14  may be coated with a light-absorbing coating to reduce glare, for example, under a cystoscope. The coating may be a polymer, such as Teflon, or other suitable material, and may be colored to aid in detection. The surface of the shaft  14  may be painted so that one can easily tell it apart from surrounding tissue and fluid under a cystoscope to make it easier to detect under the cystoscope. In other illustrative embodiments, the shaft  14  is textured, for example, by stippling, to provide increased traction relative to a gloved hand of a medical operator. In another illustrative embodiment, the shaft  14  is fitted with a colored sheath, such as a blue plastic sheath or guide tube.  
      The handle disposed at the proximal end of the device for the various devices illustrated herein is depicted with particular configurations, but may be manufactured from rigid or flexible plastic, or a combination thereof, and may assume any suitable shape (such as a substantially cylindrical or T-shape) to fit a particular application with which it is used, for example, such applications described in detail below. Advantageously, the handle is of an ergonomic design and construction that reduces operator fatigue and discomfort, provides needed leverage and gripping surface for the user, orients the user as to the direction of the needle, and/or provides fingertip or palm control over the needle. For example, in  FIG. 2 , the handle  12  is substantially D-shaped or kidney-shaped, and has a proximal end  15 , a distal end  16 , a first face  18 , and a second, opposite face  19  (shown in  FIGS. 1 and 3 ). The proximal end  15  of the handle  12  is relatively flat with a slight curve, and rests comfortably against the operator&#39;s palm. The operator&#39;s fingers stabilize the distal end  16  of the handle  12  by gripping the two cut-off sections  20   a  and  20   b  that flank the distal end  16 . The handle  12  may also include external ribs  21   a  and  21   b  on one or both sides of the handle  12 . The external ribs  21   a ,  21   b  provide tactile orientation of the handle  12  for the operator. Optionally, the handle  12  includes ribs or grooves  17  on one or both faces  18  and  19  of the handle  12 , which may also assist gripping and inhibit slippage. This design is advantageous for both a pulling and pushing motion through the handle  12 .  
      Still referring to  FIG. 2 , the handle  12  includes on the first face  18  a recess  23 , such as a slot. The recess  23  has a proximal end  25 , a distal end  27 , and a floor  29 . A raised stop  34  is located at the distal end  27  of the recess  23  and projects away from the floor  29  of the recess  23 . The recess  23  may be used to fit an accessory part such as a pusher assembly, which will be discussed in more detail later in connection with  FIGS. 5 and 6 .  
      The connection between the proximal end  22  of the shaft  14  and the distal end  16  of the handle  12  may be permanent or reversible, i.e., removable and reusable. Such a connection may be accomplished through any suitable means, such as threading, chemical bonding, heat molding, gluing, tight-fitting, fastening, an O-ring fitting, and the like. In one embodiment, the material for the handle  12  and the shaft  14  is the same or compatible enough that the two are manufactured as one integral piece. In other words, the delivery device  10  can include a shaft  14  with an enlarged proximal end that serves as the handle  12 .  
      The illustrative handle  12  may be attached to the shaft  14  in a particular manner to select a desired orientation of the shaft  14 . In  FIG. 1 , the shaft  14  is attached to the handle  12  such that the shaft  14  curves toward the second face  19  of the handle  12 . A particular orientation between the shaft  14  and the handle  12  allows an operator to control the orientation of various parts of the shaft  14  inside a patient even when visualization is difficult or impossible.  
      Referring now to  FIG. 3 , a pusher assembly  30  can be incorporated into the delivery device  10 . The distal end  24  of the shaft  14  is marked by a circle “A” to indicate that it may include one or more connectors such as the ones described below. In the illustrative embodiment of  FIG. 3 , the pusher assembly  30  includes a pusher tube  31 , a pusher button  32 , and a tongue  33  (shown in  FIGS. 4 and 5 ). In the assembled state, the pusher tube  31  and the pusher button  32  are slidably moveable over the shaft  14 . The pusher assembly  30  is interconnected with the handle  12 , as explained below in connection with  FIG. 5 , through the tongue  33 . The pusher assembly  30  may be used, for example, to assist slidable removal or extension of a component slidably interfitted over at least part of the shaft  14 .  
      Referring to  FIGS. 4 and 5 , the illustrative pusher assembly  30  includes a pusher tube  31 , a pusher button  32 , and a tongue  33 . The pusher tube  31  has a proximal end  35 , a distal end  37 , and a lumen  39 , which extends from the proximal end  35  to the distal end  37 . The pusher button  32  has a proximal end  41 , a distal end  43 , and a lumen  45 , which extends from the proximal end  41  to the distal end  43  and which is in fluid communication with the lumen  39  of the pusher tube  31  when assembled.  
      The pusher tube  31  attaches at its proximal end  35  to the distal end  43  of the pusher button  32 . The pusher tube  31  and the pusher button  32  may form one integral component. Alternatively, the proximal end  35  of the pusher tube  31  may be placed within the lumen  45  of the pusher button  32  and be fixed by, for example, an adhesive to the surface of the lumen  45  of the pusher button  32 .  
      Specifically referring to  FIG. 4 , the pusher tube  31  may be manufactured from a metal, for example, stainless steel, or from suitable polymer, plastic or other materials that have sufficient durometer hardness to function as a pusher. In one embodiment, the lumen  39  of the pusher tube  31  has a size and shape that substantially matches the cross section of the shaft  14  such that the pusher  31  fits closely around the shaft  14  (shown in  FIG. 3 ). The outer surface and/or the inner surface of the pusher tube  31  may be coated or implanted with a hydrophilic agent, and/or other coating, to reduce surface friction. Similarly, the lumen  45  of the pusher button  32  may also be coated or implanted with a hydrophilic agent, and/or other coating or implantation, to reduce surface friction. Part or the entire outer surface and/or the inner surface of the pusher tube  31  and/or the inner surface of the pusher button  32  may, in some embodiments, be coated or implanted with one or more pharmaceuticals, for example, with anesthetic, anti-inflammatory, coagulating, anticoagulating, antibiotic or antimicrobial agents.  
      The pusher button  32  may assume any shape conducive to effecting motion to the pusher assembly  30 . In the illustrative embodiment, parts of the pusher button  32 , such as its proximal  41  and distal  43  ends are larger in cross-section than the pusher tube  31 . And there is a reduced diameter area  44  in between the two ends  41  and  43 . The reduced diameter area  44  is tapered and curved to allow easy identification and grasping (such as between two adjacent fingers on one hand, so that the pusher can be actuated while grasping the device with the same hand). In the particular illustrative embodiment of  FIG. 4 , the proximal end  41  of the pusher button  32  has a substantially rectangular or square perimeter. One side of the rectangular perimeter of the proximal end  41  is attached to the tongue  33 .  
      The tongue  33  of the pusher assembly  30  has a proximal end  47 , a distal end  49 , and a body  48  extending therebetween. The body  48  has two opposite surfaces: an inner surface  52  and an outer surface  54  (better shown in  FIG. 5 ), with the inner surface  52  facing the lumen  45  of the pusher button  32 . The illustrative tongue  33  includes, at its proximal end  47 , a projection  50 , which has a baseline  56 . The distance  58  between the distal end  49  of the tongue  33  and the baseline  56  can be varied through the manufacturing process.  
      Referring now to  FIG. 5 , the tongue  33  of the pusher assembly  30  is sized and shaped to be slidably moveable inside the recess  23  on the first face  18  of the handle  12  with the inner surface  52  of the tongue  33  facing the floor  29  of the recess  23 . At least the proximal end  47  of the tongue  33  can slide back and forth in the directions indicated by arrows  55 . Thus, an operator may slide the pusher assembly  30  a limited distance distally and proximally over the delivery shaft  14  ( FIG. 3 ) by advancing the pusher button  32  distally or withdrawing the pusher button  32  proximally, respectively. The limit for distal advance of the pusher assembly  30  is set when the projection  50  of the tongue  33  is stopped by the raised stop  34  on the handle  12  (see  FIGS. 2 and 4 ).  
      Similarly, the limit for proximal withdrawal of the pusher assembly  30  is set when the proximal end  47  of the tongue  33  is stopped within the recess  23  by the proximal end  25  of the recess  23 . Thus, the pusher assembly  30  is limited to a fixed travel distance, i.e., the distance  58  between the distal end  49  of the tongue  33  and the baseline  56  of the projection  50  of the tongue  33  (see  FIG. 4 ). The distance  58  may vary to suit a particular clinical application of the delivery device  10 . In one embodiment, the distance  58  that the pusher assembly  30  can travel is approximately one (1) inch (about 2.54 cm).  
      Another advantage of the illustrative pusher assembly embodiment illustrated here is that through the interaction between the projection  50  of the tongue  33 , the stop  34  of the handle  12 , and the proximal end  25  of the recess  23 , as described above, the tongue  33  of the pusher assembly  30  remains in constant contact with the handle  12 . As a result, the pusher button  32  is also prevented from rotating about the delivery shaft  14 .  
      Referring to  FIG. 6 , a recess  23 ′ similar to the described recess  23  on the face  18  of the handle  12  is made on the other face  19  of the handle  12 . The recess  23 ′ also has a raised stop  34 ′ similar to the stop  34  in the recess  23 . And the tongue  33  is duplicated on the opposite side of the pusher assembly  30  as a second tongue  33  ′, i.e., the tongue  33 ′ also has a projection  50 ′ similar to the projection  50  on the tongue  33 . As a result, the projection  50 ′ of the second tongue  33 ′ slides between stop  34 ′ and the proximal end  25 ′ of the recess  23 ′, simultaneously with the projection  50  of the first tongue  33 . The two-tongue configuration makes it even easier to operate the pusher assembly  30 .  
      Referring now to  FIGS. 7A, 7B ,  8 A and  8 B, according to alternative embodiments of the invention, a delivery device  57  includes a shaft  59  (which may be a needle or non-needle element), a guide tube  60 , and a handle  61 . In this particular embodiment, both the shaft  59  and the guide tube  60  are attached to the handle  61 . The guide tube  60  has a proximal end  62  and a distal end  64 , and can also function as a dilator tube. A tubular member or wall of the guide tube  60  forms a lumen that allows the shaft  59  to slidably move inside the guide tube  60 . The guide tube  60  may be made of a metal such as stainless steel or a plastic. In one embodiment, the guide tube  60  is made of the same material as the shaft  59 . The distal end  63  of the shaft  59  ( FIGS. 7B and 8A ), and the distal end  64  of the guide tube  60  ( FIGS. 7A and 8B ) are both marked by circles “A” to indicate that they may both include one or more connectors such as the ones described and illustrated in more detail below.  
      Specifically referring to  FIGS. 7A and 7B , the handle  61  includes an actuator  66  operatively connected to the proximal end  62  of the guide tube  60 . The connection between the actuator  66  and the proximal end  62  of the guide tube  60  may be permanent or reversible (removable and reusable). The illustrative actuator  66  operates through a mechanical interconnection. However, in alternative embodiments, it may operate through electrical, chemical, magnetic, mechanical, or other suitable mechanism, separately or in combination. In one embodiment, the actuator  66  includes a first set of threads (not shown) that interfits with a second set of threads (not shown) in the guide tube  60 . In the illustrative embodiment, the actuator  66  includes a mechanical slider that has at least two positions. In  FIG. 7A , the actuator  66  is at its distal position, and the distal end  64  of the guide tube  60  is positioned distal to the tip  67  of the shaft  59 , for example, by about 0.5 to about 2 inches. In  FIG. 7B , the actuator  66  is at a proximal position and resultantly withdraws the distal end  64  of the guide tube  60  to be proximal to the tip  67  of the shaft  59 . Through manipulating the actuator  66 , the operator can choose to either shield or expose the tip  67  of the shaft  59  at different stages in an operation. The illustrative guide tube  60  is longer than the shaft  59 . However, in other embodiments, the guide tube  60  may be of the same or shorter length than the shaft  59 . In one embodiment, the guide tube  60  is separate from, i.e., not attached to or connected with, the handle  61 .  
      Specifically referring to  FIGS. 8A and 8B , the actuator, for example, the slider  66 , is instead operatively connected to the proximal end  46  of the shaft  59 . The proximal end  62  of the guide tube  60  may be connected to the distal end  71  of the handle  61 , for example, through frictional fitting, adhesive, threading, or the like. In  FIG. 8A , the slider  66  is at its distal position. As a result, the tip  67  of the shaft  59  is exposed and at a position distal to the distal end  64  of the guide tube  60 . In  FIG. 8B , the actuator  66  is at a proximal position. As a result, the tip  67  of the shaft  59  is withdrawn proximal to the distal end  64  of the guide tube  60  and shielded by the guide tube  60 . Through manipulating the actuator  66 , the operator can, similar to using the embodiment depicted in  FIGS. 7A and 7B , choose to either expose or shield the tip  67  of the shaft  59  at different stages in an operation.  
      Referring now to  FIGS. 9A and 9B , according to another illustrative embodiment of the invention, the delivery device includes a guide tube  73 , a shaft  75  (which may be a needle or non-needle element), and a handle  76 . The handle  76  includes an axial lumen  70  extending between a distal opening  72  at the distal end of the handle  76  and with a proximal opening  74  at the proximal end of the handle  76 . The axial lumen  70  of the handle  76  is sized and shaped so that at least the proximal end  78  of the guide tube  73  is slidably moveable within at least part of the axial lumen  70 . In one embodiment, a proximal end  78  of the guide tube  73  can slide through the proximal opening  74  of the handle  76 . In an alternative embodiment, the proximal end  78  of the guide tube  73  does not exit the proximal opening  74  of the handle  76  as a proximal part of the lumen  70  of the handle can be narrower or completely blocked towards the proximal end of the handle  76 . In one embodiment, the handle  76  can be pulled off the proximal end  78  of the guide tube  73 .  
      The guide tube  73  has the proximal end  78 , the distal end  64 , and defines a lumen  65  that allows the shaft  75  to slidably move inside the tube  73 . The guide tube  73  may be made of a metal such as stainless steel, a polymer, plastic or other suitable material. In one embodiment, the guide tube  73  is made of the same material as the shaft  75 . The guide tube  73  may assume a shape substantially similar to that of the shaft  75 . Additionally, it may be substantially rigid, semi-rigid, semi-flexible or flexible. The guide tube  73  may include one or more curves.  
      The shaft  75  is slidably moveable inside the guide tube  73 . At one position, the tip  83  of the shaft  75  is distal to the guide tube  73  and thus exposed. The distal end  84  of the shaft  75  is marked by a circle “A” to indicate that it may include one or more connectors such as the ones described below. In one embodiment, the proximal end  87  of the shaft  75  includes a graspable structure, for example, a knob  77  or an enlarged end. By grasping the knob  77 , the operator can insert or withdraw the shaft  75  from the lumen  65  of the guide tube  73 , through the proximal opening  74  of the handle  76 .  FIG. 9B  illustrates the relative position between the shaft  75 , the guide tube  73 , and the handle  76  through a cross-sectional view. There can be clearance (not shown) between any of the three structures.  
      Referring now to  FIG. 10A , an illustrative guide tube  51  has openings on both its distal end  53  and its proximal end  57 . A lumen  44  is in fluid communication with both the ends  53 ,  57  of the guide tube  51 . One or more apertures  68  penetrate the wall of the guide tube  51  and are in fluid communication with the lumen  44 . In one embodiment, the apertures  68  penetrate the wall of the guide tube  51  between the convex  69  and the concave  71  regions defined by the curve of the guide tube  51 . Because of the apertures  68 , if the distal end  53  of the guide tube  51  inadvertently punctures an organ, such as the bladder, during the operation, the operator would be alerted when he sees fluid from the punctured organ, such as urine or blood, flowing out of the apertures  68 . Both the distal end  53  and the proximal end  57  of the guide tube  51 , marked by circles “A”, may include a connector or one member of a connector pair, to be described and illustrated in more detail below.  
      Referring to  FIG. 10B , in one illustrative embodiment, the apertures  68  are distributed along a longitudinal axis of the guide tube  51  such that at least two complementary apertures  68  are equidistant from one end  53  or  57  of the guide tube  51 . Referring to  FIG. 11 , alternatively, the apertures  68  may be distributed in an alternating pattern along the longitudinal axis of the guide tube  51 . The apertures  68  can be any shape, such as circular, elliptical, and slotted, for example. The edges of the apertures  68  may be beveled or rounded to prevent abrasion of surrounding tissue during use of the delivery system inside a patient.  
       FIG. 12  illustrates one way to associate the guide tube  73  and the handle  76 . A setscrew  79  is positioned at the distal end  46  of the handle  76  and extends into the axial lumen  70  of the handle  76 . The lumen  70  slidably receives the proximal end  78  of the guide tube  73 . The setscrew  79  can be tightened to hold the guide tube  73  stationary, and loosened to remove the handle  76  from the guide tube  73 . Alternatively, the guide tube  73  is associated with the handle  76  by any other detachable junction known in the art, such as a snap junction, threading, interference fit, for example. In other embodiments, the guide tube  73  is not detachable from the handle  76 .  
      Referring to  FIG. 13A , the delivery device  88   a  includes a shaft  80  and a handle  81 . In addition to the features and properties described above, the shaft  80 , according to this embodiment of the invention, includes a plurality of curves, bends, or arcs distributed between its proximal end  82  and the distal end  83 . For example, the shaft  80  may describe two, three, four arcs or more. In one embodiment, for example, the shaft  80  describes a first arc  84  next to the proximal end  82  and a second arc  85  next to the distal end  83 . The two arcs  84  and  85  can be adjacent each other and form a continuous curvature resembling a wave with a peak and a valley, for example. Alternatively, the two arcs may not be adjacent each other. In one embodiment, the multiple arcs  84  and  85  are substantially located in the same common plane.  
      The shaft  80 , in one embodiment, tapers from its proximal end  82  to its distal end  83 , with its widest part at its proximal end  82 . In another embodiment, the shaft  80  is not tapered and maintains a substantially uniform outer diameter. In one particular embodiment, the shaft  80  is not tapered and has an outer diameter of about 0.125 inches. The distal end  83  of the shaft  80  may include a tapered, for example, a conical, section  86  that leads to the tip  87 . The tip  87  may be sharp, pointed, or blunt. In the depicted embodiment, the shaft  80  is a solid shaft, but may be hollow or have a hollow portion.  
       FIG. 13B  depicts a delivery device  88   b  including a shaft  80 ′ attached to a handle  81 . The shaft  80 ′ includes a tubular member with an opening  89  at its distal end  83 ′. The opening  89  is in fluid communication with a lumen  96 . The distal ends  83  and  83 ′ of the shafts  80  and  80 ′ are marked by circles “A” to indicate that they may include various different types of connectors. Illustrative connectors are described in more detail below. Additionally, as with previously described delivery devices, the handles  81  and the shafts  80  and  80 ′ may be permanently, or removably and reusably attached to each other.  
      Referring now to  FIGS. 14-16 , in alternative embodiments of delivery devices  88   c ,  88   d , and  88   e , in addition to describing multiple arcs  84  and  85  along its length, the shaft  80  may further include an angled or further curved distal end  91   a ,  91   b , or  91   c  that is at an angle  97   a ,  97   b , or  97   c  relative to an adjacent portion  98  of the shaft  80 , according to the invention. In one embodiment, the angled distal end  91   a ,  91   b  or  91   c  is substantially straight. The adjacent portion  98  may include part or all of one of the arcs, for example, arc  85  which forms a concave region relative to the angled distal end  91   a ,  91   b  or  91   c . Alternatively, the adjacent portion  98  may be substantially straight. The degree and flexibility of the angle  97   a ,  97   b , or  97   c , and the length of the angled distal end  91   a ,  91   b , or  91   c  of the shaft  80 , may be selected according to the surgical application so that the distal end  91   a ,  91   b , or  91   c  of the shaft  80  and its adjacent portion  98  follow or accommodate the contour of part of the patient&#39;s anatomy, for example, the pubic bone. In one illustrative embodiment, the angle  97   a ,  97   b , or  97   c  and the length of the angled distal end  91   a ,  91   b , or  91   c  are pre-selected to conform to the front contour of the female pubic bones. For example, as illustrated in  FIG. 14 , the angle  97   a  between the distal end  91   a  and its adjacent portion  98  of the shaft  80  is obtuse. Alternatively, as illustrated in  FIG. 15 , the angle  97   b  is about 90°, and as illustrated in  FIG. 16 , the angle  97   c  is acute, for example, about 60°. In other embodiments, the angle of the bent by the distal end  97   a ,  97   b , or  97   c  can be greater than about 45°, or greater than about 60°. These angle embodiments may have advantages for accommodating particular body anatomy, such as the outline of the public bone. In one embodiment, the multiple arcs  84 ,  85 , and the angled distal end  91   a ,  91   b , or  91   c  are all substantially located in the same common plane. Preferably, the length of the angled distal end  91   a ,  91   b , or  91   c  constitutes no more than about 10%, 20% or 25% of the entire length of the shaft  80  that is outside the handle  81 .  
      In one embodiment, the angled distal end  91   a ,  91   b , or  91   c  is employed to deflect the shaft  80  over the patient&#39;s pubic bone. According to both the suprapubic-to-vaginal approach and the pre-pubic-to-vaginal approach, the angled distal end  91   a ,  91   b , or  91   c  of the shaft  80  is preferably pointed toward the pubic bone and away from internal organs.  
       FIG. 17  depicts an alternative illustrative delivery device  90   a  including a shaft  92   a  and a handle  93   a . The shaft  92   a , at least in part, describes an arc of a substantial degree, for example, no less than about 45, about 60, or about 90 degrees in various embodiments. In one embodiment, the curve in the shaft  92   a  forms a “C” configuration.  
       FIG. 18  depicts another alternative delivery device  90   b , including a shaft  92   b  attached to a handle  93   b . The shaft  92   b  describes a helical curve  94  of between one and two turns. However, the helical curve  94  may include any suitable number of turns. The delivery devices  90   a  and  90   b  may be used to perform a trans-obturator procedure to place an implant such as a sling for treating urinary incontinence as described in more detail below.  
      II. Implants  
      The delivery devices described above may be used to deliver and place any suitable implant, such as a sling assembly, at an anatomical site in a patient&#39;s body.  
      Without limitation, exemplary sling/sleeve configurations that may be operable with illustrative embodiments of the invention may be found in U.S. patent application entitled Medical Slings, to Rao et al, Attorney Document No.: BSC-265, filed on even day herewith; U.S. patent application entitled Medical Slings, to Chu, Attorney Document No.: BSC-276, filed on even day herewith; U.S. provisional patent application entitled Surgical Slings, to Li et al, Attorney Document No.: BSC-279PR, filed on even day herewith, U.S. patent application entitled Systems, U.S. patent application entitled Medical Implant, to Chu et al., Attorney Document No.: BSC-255, filed on even day herewith, U.S. provisional patent application Ser. No. 60/403,555; U.S. provisional patent application Ser. No. 60/465,722; U.S. patent application Ser. No. 10/460,112; and U.S. patent application Ser. No. 09/096,983, the entire contents of which are incorporated herein by reference.  
       FIG. 19  depicts an illustrative sling assembly  11  including a sling  95  and a sleeve  99  suitable for use with the previously described delivery devices. The sling  95  may be formed, for example, from a strip of mesh, a network of fabric, a suture, a permeable, non-permeable, pourous, non-pourous, or any other material constructed for support or constriction. Non-limiting examples of materials that can be employed to manufacture the sling  95  include polypropylene, polyesters, polyolefins, polytetrafluoroethylene, polyethylene, polyurethanes, nylons, and co-polymers thereof as described in U.S. Pat. No. 6,042,592 (“BSC-163”), the disclosure of which is incorporated herein by reference. The sling  95  may be formed natural tissues (such as human cadaveric, bovine, porcine, equine, etc.), or the sling may be formed from a hybrid of synthetic materials and natural tissues; and may contain features described in co-owned patent applications U.S. Ser. No. 09/916,983 (“BSC-183”) and U.S. Ser. No. 10/460,112 (“BSC-246”), the entire disclosures of both are incorporated by reference. The sling  95  may be coated, for example, with a pharmaceutical.  
      Optionally, the sling  95  may include rough edges containing projections called tangs. The sling  95  may also have a partly de-tanged edge that is free of any tangs. These and other optional features of the sling  95  are described in co-owned U.S. patent applications U.S. Ser .No. 10/092,872 (“BSC-205”) and Ser. No. 10/093,498 (“BSC-190-1”), the entire disclosures of both are incorporated herein by reference.  
      Still referring to  FIG. 19 , in certain embodiments, the sling  95  is at least partly enclosed in a sheath envelope or envelope-like structure, such as the sleeve  99 . In the illustrative embodiment, the sleeve  99  fully encloses the sling  95 , and the sling  95  is substantially free floating in the sleeve  99 . The sleeve  99  surrounding the sling  95  reduces the likelihood that the sling  95  will become contaminated with foreign matter, such as bacteria, during the delivery and placement procedure at an anatomical site. Additionally, the sleeve  99  provides added structural integrity to the sling  95  so that the sling  95  does not get twisted, or over-stretched during the delivery process. The sleeve  99  can also assist the operator in adjusting the position and tension in the sling  95  during placement or implantation.  
      The sleeve  99  may be coated, for example, with a pharmaceutical on its outer surface and/or its inner surface. Non-limiting examples of materials that can be employed to manufacture the sleeve  99  include polypropylene, polyethylene, polyester, polytetrafluoroethylene, or co-polymers thereof. The sleeve  99  may include tear features such as apertures to assist the operator in removing the sleeve  99  from the sling  95  after delivery. The sleeve may associate with other structures such as spacers, scaffolds, fasteners, tongues, and tabs that assist in the delivery and placement of the sling assembly  11 . These and other optional features of the sleeve  99  or other parts of the sling assembly  11 , including the sling  95 , are described in co-owned U.S. patent applications under Attorney Docket No. BSC-255 and under Attorney Docket No. BSC-278 both entitled “Systems, Methods and Devices Relating to Delivery of Medical Implants,” both of which filed on even date herewith, and the entire content of which is incorporated herein by reference.  
      The two ends  100   a  and  100   b  of the sleeve  99  may include structures such as tabs or dilators. Such structures can be made of the same material or a material different from the sleeve  99 . In some embodiments, such material is selected to have more structural rigidity than the sleeve  99 . The two ends  100   a  and  100   b  of the sleeve  99  are marked by circles “B” and “B′” to indicate that may include one or more connectors for connecting to the shafts, guides tubes, guide members, dilators and/or dilator tubes of delivery devices. Such connectors are described in detail below. In embodiments where the sling assembly  11  does not include the optional sleeve  99 , the two ends  102   a  and  102   b  of the sling  95  may include structures such as tabs, dilators, and connectors (also described below in detail).  
       FIG. 20  depicts an alternative sling assembly  101 , including a sleeve  105 , formed from two sleeve portions  105   a  and  105   b  and only partly enclosing the sling  95 . In this embodiment, the sleeve portions  105   a  and  105   b  are separated and distinct and provide for an interment portion of the sling  95  to be sleeveless. The two ends  102   a  and  102   b  of the sling  95  are fixedly attached to parts of the sleeve portions  105   a  and  105   b , for example, through heat bonding, a suture or any other suitable mechanism. The two ends  107   a  and  107   b  of the sleeve  105  are marked by circle “B” and “B′” to indicate that they may include one or more connectors as described in detail below.  
      Referring now to  FIG. 21 , in another alternative embodiment, a sling assembly  103  includes a sleeve  104  that also partly encloses the sling  95 . The sling  95  is free floating inside the sleeve  104 . The sleeve  104  includes two separate portions  104   a  and  104   b . However, the sleeve portions  104   a  and  104   b  are fastened to each other on one side through a fastener  106 , for example, a tab. Alternatively, the one side of the sleeve portions  104   a  and  104   b  is one integral piece that can be formed into a loop that is oriented within or around a fastener or spacer. Cutting across the fastener  106  allows the operator to remove the fastener  106  and the two sleeve portions  104   a  and  104   b  become separate from each other. Then, the operator can remove the sleeve portions  104   a  and  104   b  from the patient&#39;s body by pulling on two ends  108   a  and  108   b  of the sleeve portions  104   a  and  104   b . A more detailed description of the fastener  106  and other means of fastening the sleeve portions  104   a  and  104   b  are provided in the co-pending U.S. patent application filed on the even date under attorney Docket No. BSC-278 and entitled “Systems, Methods and Devices Relating to Delivery of Medical Implants.” The two sleeve ends  108   a  and  108   b , also marked by circle “B” and “B′” and to be shown in detail in subsequent figures, may include one or more connectors described below.  
      III. Connectors  
      Connectors can be used to interlock and/or attach various parts in a delivery system permanently or reversibly (i.e. removably and reusably). For example, connectors can be used to attach and/or interlock two or more of the following: an implant or implant assembly (for example, a sling assembly), a delivery device, or a guide member. Alternatively, connectors can be used to attach and/or interlock parts within the sling assembly, or within the delivery device, or within the guide member. Connectors may also serve additional functions besides the above, such as dilation or tunneling.  
      Some exemplary sling/sleeve termination configurations and connectors are disclosed in U.S. patent application Ser. No. 10/325,125; U.S. provisional patent application Ser. No. 60/418,827; U.S. provisional patent application Ser. No. 60/418,642; U.S. provisional patent application Ser. No. 60/434,167; and U.S. provisional patent application Ser. No. 60/403,555; the disclosures of which are incorporated herein by reference.  
      Each pair of connectors typically includes two connector members; each may be located on a part of the delivery system, for example, the sling assembly, the delivery device, or the guide member. For ease of reference, the part of the delivery system on which a connector is located is referred to as the “base part.” A connector can be integral with its base part, for example, the connector may be a slot, a reduced-diameter section, or an aperture in the base part or may be attached to its base part. Additionally, the connector may be made out of the same material as the base part, for example, through thermal extrusion or molding.  
      A connector and its base part may be attached in a permanent, or reversible, (i.e., removable and reusable) fashion. Any suitable mechanism may be used to attach a connector with its base part, for example, use of an O-ring or other fasteners, or use of heat bonding or an adhesive. For convenience of illustration, one member of each connector pair may be shown in the drawings as located on a particular structure, for example, a sling assembly, but it should be understood that each member of a connector pair can be interchangeably located with the other member of the pair.  
       FIGS. 22A-22D  depict a connector pair  110  including a loop connector  111 , and a mating slotted receptacle connector  112 . The illustrated loop connector  111  includes a loop portion  113  at its distal end and a base portion  115  at an opposite end, bridged by a neck portion  116 , which tapers inward from the loop portion  113  to the base portion  115 .  
      In this illustrative embodiment, the loop connector  111  is located at the sling assembly end  117 . More particularly, the illustrated base portion  115  of the loop connector  111  is attached to a dilator  118  located at the sling assembly end  117 . The base portion  115  may be, for example, insert molded to the dilator  118  or bonded by any suitable means.  
      The loop connector  111  may be formed from any filament such as wire, cable or suture, which may be made, for example, of plastic, steel or any other suitable material, including a shape memory material. In one embodiment, the loop connector  111  is rigid. In an alternative embodiment, the loop connector  111  is not rigid, but has sufficient durometer hardness to maintain a pre-selected shape. In a further embodiment, the loop connector  111  is malleable to fit the outline of a slot  120  after the connector  111  hooks onto the receptacle connector  102 . In yet another embodiment, the loop connector  111  is flexible. The loop connector  111  may be of a variety of shapes, for example, circular, semi-circular, oval, triangular or rectangular. The entire loop connector  111  can be made of a unitary material, or in sections.  
      The receptacle connector  112 , in this illustrative embodiment, is located at a shaft distal end  121  of a shaft  114  in a delivery device  119 . As shown, the connector  112  includes an L-shaped slot  120  formed in the distal end  121 . The connector  112  also includes two lateral grooves  122   a  and  122   b  extending axially in a distal direction from the L-shaped slot  120  to the tip  123  of the distal end  121 . The L-shaped slot  120  includes an entry slot  124  extending from a peripheral side of the shaft distal end  121  radially inwards. The L-shaped slot  120  also includes a retention slot  125  extending axially in distal direction.  
      Referring specifically to  FIG. 22B , the loop portion  113  of the loop connector  111  fits into the slot  120  and the tapered neck portion  116  interfits into the lateral grooves  122   a  and  122   b . Preferably, the tapering of the neck portion  116  is shaped to match the tapering of the shaft distal end  121 . This is illustrated in  FIG. 22B  where parts of the loop connector  111  are depicted in phantom lines. The tapered neck portion  116  is also sized to fit snugly in and interlock with the groves  122   a  and  122   b  when the loop connector  111  and the slotted, receptacle connector  112  are mated.  
       FIG. 22C  is illustrative the mating process between the loop connector  111  the receptacle connector  112 . As depicted, the loop portion  113 , which may be semi-rigid, is first hooked into the entry slot  124 . Then, the shaft distal end  112  and/or the loop connector  111  are moved in axially opposite directions, continuing into the retention slot  125 . The loop connector  111  is rotated in the direction shown by the arrow  126  toward the lateral grooves  122   a  and  122   b  ( FIG. 22B ). Because the neck portion  116  of the loop connector  111  is shaped and sized to fit snugly in the grooves  122   a  and  122   b , the operator needs to force the neck portion  116  against the periphery of the shaft distal end  121  as he rotates the loop connector  111 .  
       FIG. 22D  shows the neck portion  116  fitted into the grooves  122   a  and  122   b  (not shown) of the receptacle connector  112 . The neck portion  116  can be made, for example, of a material with some elasticity, for example, a metal or a polymer, such that the neck portion  116  returns to its original size after having been expanded temporarily to enter the lateral grooves  122   a  and  122   b . As a result, the neck portion  116  stays locked inside the grooves  122   a  and  122   b  of the receptacle connector  112 . This orientation provides for a smooth transition from shaft to sling assembly, in an end-to-end interconnection, which minimizes edges that could produce tissue trauma. To disconnect the two connectors, the procedure is simply reversed, i.e., the neck section  116  is forced against the periphery of the shaft distal end  121  to expand temporarily so that it can come out of the lateral grooves  122   a  and  122   b  ( FIG. 22B ).  
       FIG. 23  depicts a loop connector  111   a  interconnected with a receptable connector  112   a , according to another illustrative embodiment of the invention. The loop connector  111   a  includes a loop  113   a  that may be a flexible wire, suture, or cable, and may be made of, for example, a polymeric material or metal. The loop  113   a  may be of single strand, multiple strands, or coated. In one embodiment, the filament that makes up the loop  113   a  is between about 0.006 inch and about 0.016 inch in diameter.  
      In the illustrative embodiment, the loop connector  111   a  is bonded to the sling assembly end  117 , specifically, a dilator  118 . The receptacle connector  102   a  is illustrated as located on the shaft distal end  121  of the delivery device  119 . In this illustrative embodiment, the receptacle connector  112   a  includes an axially extending indentation, channel or slot  120   a  for retaining the loop  113   a .  
       FIG. 24  depicts a receptacle connector  112   b  located on the shaft distal end  121  of a delivery device  119  according to another illustrative embodiment of the invention. The receptacle connector  112   b  includes slot  120   b , extending radially into the distal end of  121  axially in a distal direction. As depicted, the slot  120   b  is curved. Optionally, the receptacle connector  112   b  also includes a section  127 , which extends axially both distally and proximally.  
       FIG. 25  depicts a perspective view of a loop connector  128  that can be interconnected with a slotted receptacle connector  132  according to an alternative embodiment of the invention. In this illustrative embodiment, the loop connector  128  attaches to a sling assembly end  129  and the receptacle connector  132  is disposed on the shaft distal end  121 . The loop connector  128  includes a tubular member  130  with an axial lumen  131  extending from a distal opening  133 . In one embodiment, the tubular member includes an optional axial opening  135  along the axial lumen  131 . The tubular member  130  includes an internal loop  136 , for example, a bar across the lumen  131 , that interconnect with a receptacle connector.  
      The illustrative receptacle connector  132  includes a slot  137 , for example, an oblique notch, which may further include a protuberance  138 . The protuberance  138  helps to prevent premature release of a captured loop, for example, the internal loop  136  of the loop connector  128 , as the protuberance  138  serves as a barrier for the filament&#39;s exit. The protuberance  138  can be of any size or shape as long as it effectively restricts the captured loop from exiting the slot  137 , for example, by creating a narrowing, a choke-point, or pinch-point  134 , having a narrower width than that of the loop filament.  
      To interconnect the connectors  128  and  132 , the operator slides the slotted receptacle connector  132  into the axial lumen  131  of the loop connector  128 , either through the distal opening  133  or the axial opening  135 . Then the operator orients the connectors such that the slot  137  on the connector  132  faces the internal loop  136  of the connector  128 . The operator slides the internal loop  136  into the slot  137 , and forces the internal loop  136  past the protuberance  138  in the slot  137 . The protuberance  138  then locks the internal loop  136  inside the slot  137 . Because the tubular member  130  of the loop connector  128  has a smooth cylindrical outer surface, having the internal loop  136  provides a smooth joint between parts of the delivery system that is advantageous for dilation and tunneling through patient tissue.  
       FIG. 26  depicts an optional recessed or rounded edge  139  in a receptacle connector  133   a . This feature tends to smooth the entrance to the receptacle connector  132   a  and reduce the likelihood of it catching on tissue. Additionally, the rounded edge  139  also increases the ease with which the receptacle connector  132   a  captures a loop such as the loop  113   a  of the loop connector  111   a  (described above in  FIG. 23 ), into the slot  137   a . The slot  137   a  may also include a locking mechanism, such as a protuberance  138   a.    
       FIG. 27  depicts a receptacle connector  146  including a slot  140  that is L-shaped. While the connector  146  may be attached to or disposed on any part of a delivery system, in the illustrative embodiment, it is formed in the shaft distal end  121  of the delivery device  119 . The slot  140  includes two legs: an entry notch  141 , and a retention slot  142 . In the illustrative embodiment, the entry notch  141  is a cutout substantially normal to a longitudinal axis of the distal shaft end  121 . In one exemplary embodiment, the retention slot  142  is substantially perpendicular to the entry notch  106 , and extends distally away from the entry slot  141 . Further, the illustrative retention slot  142  is longer than the illustrative entry slot  141 , with advantages in retaining a captured loop filament.  
      Both the entry slot  141  and the retention slot  142  can be of any dimension suitable to capturing a particular mating connector. In one embodiment, the retention slot  142  is narrower than the entry slot  141 , for example, to substantially match the outer diameter of the loop filament in a mating loop connector such as the loop connector  111   a  ( FIG. 23 ). For example, if the outer diameter of the loop filament is about 0.016 inches, the entry slot  141  may have a width  143  that is slightly wider, for example, about 0.018 inches, while the retention slot  142  may have a uniform width  144  that is about 0.016 inches. Alternatively, the retention slot  142  may be tapered to become narrower towards its distal end  145 . For example, the retention slot  142  may be tapered from 0.018 inches to about 0.016 inches towards its distal end  145 . A width  144  in the retention slot  142  that substantially matches or is less than that of the captured filament, for example, the loop portion  113   a  of the loop connector  111   a  ( FIG. 23 ), is advantageous in retaining the filament after capture.  
      The retention slot  142  meets the entry slot  141  at an inside corner  147  and outside corner  149 . Both the inside corner  147  and the outside corner  149  can assume a variety of shapes, for example, they can be smooth, (e.g., rounded), or sharp (e.g., angled). In  FIG. 27 , the illustrative inside corner  147  is sharp while the outside corner  149  is smooth. A smooth comer is advantageous in capturing a filament while a sharp corner may be advantageous in retaining the filament.  
       FIG. 28  depicts the slot  140  in an alternative receptacle connector  148  having retention features in addition to the features described in connection with the receptacle connector embodiment in  FIG. 27 . Specifically, the receptacle connector  148  has one or more protuberances  150 . The protuberance  150  may assume a variety of shapes. For example, the protuberance  150  may be hooked or straight, and may have flat or rounded edges, with flat or rounded transitions between edges. In the illustrative embodiment, the protuberance  150  is located on the inside corner  147  and extends into the retention slot  142 . However, in other embodiments, it may be alternatively or additionally located at the outside corner  149 . Additionally, one or more protuberances  150  may alternatively or additionally project into the entry slot  141 . In one embodiment, the protuberance  150  effectively imposes a choke point  151 , which is the narrowest point in the slot  140 , and is substantially the same or narrower than the diameter of a loop filament of a mating loop connector, for example, the loop portion  1   13   a  of the loop connector  111   a  ( FIG. 23 ). For example, if the loop filament is about 0.016 inches, the choke point  151  may provide about 0.014 inches of clearance. As a result, after the loop filament is forced into the retention, slot  142  past the protuberance  150 , it is prevented from exiting the retention section  142  absent a force directing it past the protuberance  150  in the other direction.  
      The protuberance  150  may be manufactured to make it easier to enter the retention slot  142  while also making harder to exit the retention slot  142 . For example, the illustrative protuberance  150  has a rounded entry corner  152  which an entering filament encounters. The rounded entry corner  152  facilitates the capture of the filament by facilitating the filament in its sliding into the retention slot  142 . On the other side of the protuberance  150 , however, an exit corner  153  which an exiting filament encounters, provides a sharp corner to make it harder for the filament to escape. To further hinder exit, the protuberance  150  has a substantially flat shoulder  154  facing the distal tip  123  of the shaft  114 .  
      The protuberance  150  can also be configured such that it effectively retains a captured connector permanently. For example, the choke point  151  can be so narrow that to free a captured filament, the protuberance  150  has to be broken off for the filament to exit the slot  140 . Such permanent retention can also be effected through the geometry of the protuberance  150 .  
       FIG. 29  depicts a receptacle connector  155  including an entry slot  158  and a substantially cylindrical retention section  157 . According to another alternative illustrative embodiment. In the illustrative embodiment, receptacle connector  155  is disposed on the distal shaft end  121 . In a similar fashion to, previously discussed embodiments, the entry slot  156  extends radially into the distal shaft end  121 . The substantially cylindrical retention section extends axially through the distal shaft end  121  and is located distally adjacent to the entry slot  156 . The retention  157  and entry  156  slots intersect at a reduced width passage  159  formed by the shoulder  158 . The retention cylinder has a diameter or width that is larger than the diameter of a captured filament, for example, the loop  113   a  of a loop connector  11   a , so that a section of the loop  113   a  can reside in it. The shoulder  158  projects into the passage  159  between the reservoir  157  to impose a choke point that restricts the passage of a captured filament. The shoulder  158  may be configured such that it effectively retains a captured connector permanently. Alternatively, the retention imposed by the shoulder  158  may be temporary and can be overcome.  
       FIG. 30  depicts a receptacle connector  160  including a slot  162  for receiving and retaining a filament, for example, the loop  113   a  of the loop connector  111   a  ( FIG. 23 ). The illustrative receptacle connector  160  is disposed on the shaft distal end  121 . The optionally curved slot  162  extends toward the distal tip  123  of the shaft distal end  121  has one or more protuberances  164   a  and  164   b  in between. In the specific embodiment depicted, the protuberances  164   a  and  164   b  are each disposed on one side of the slot  162  and roughly equidistant from a distal end  165  of the slot  162 . Therefore, the illustrative protuberances  164   a  and  164   b  are axially aligned relative to each other. The protuberances  164   a  and  164   b  impose a choke point  166  in between them. The choke point  166  serves to restrict loop filament movement within the slot  162 . In the illustrative embodiment, the protuberances  164   a  and  164   b  are stepped shoulder portions. The protuberance  164   a  and  164   b  may each have a sharp exit corner ( 168   a ,  168   b ) to discourage filament exit. An example of the loop filament that can be employed is the loop  113   a  of the loop connector  111   a  ( FIG. 23 ).  
       FIG. 31  depicts a receptacle connector  170  including a slot  171  where two protuberances  172   a  and  172   b  are not equidistant to a distal end  173  of the slot  171 . Therefore, the illustrative protuberances  172   a  and  172   b  are axially offset relative to each other. In the illustrative embodiment, the two protuberances  172   a  and  172   b  are diposed in such proximity that a choke point  174 , the narrowest point in the slot  171 , is the space or clearance between the two protuberances  172   a  and  172   b . In the illustrated embodiment, each of the protuberances  172   a  and  172   b , are formed as a curved bump.  
       FIGS. 32A and 32B  depict, respectively, a side view and a side perspective view of a receptacle connector  178  including an entry notch  179  joined to a retention slot  180 . In the illustrated embodiment, the entry notch  179  is substantially straight, and the retention slot  180  is curved. On one hand, a curved retention slot  180  may be advantageous in retaining a captured filament and preventing premature release because the curvature requires changes in direction as the captured filament maneuvers to escape. On the other hand, intended release of the captured filament may be accomplished with relative ease because an operator can manually direct the movement of the captured filament through the curvature of the slot  180 . In the particular embodiment illustrated, the retention slot  180  comprises a half-circular arc that resembles a hook.  
      In one embodiment, the retention slot  180 , as described earlier in other embodiments, may have a width that is substantially the same or less than the diameter of the captured filament, such that movement of the filament is restricted in the retention slot  180 . In one embodiment, the filament is immobilized as it is stuck in the narrow passage of the retention slot  180 . Optionally, there may be one or more protuberances along the length of the retention slot  180 , for example, at the inside comer  181  where the retention slot  180  meets the entry notch  179 . As described above, a protuberance assists in the retention of a captured filament.  
       FIG. 33  depicts a connector pair  183  including a loop connector  184  and a receptacle connector  185  before they become interconnected with each other, according to one illustrative embodiment of the invention. The loop connector  184  includes a loop  186  that is substantially of a triangular shape with an apex  187  and a base side  188 . While the loop connector  184  can be attached to any part of the delivery system, it is shown in this exemplary embodiment to be attached to an end  100   a  of a sleeve  99  of a sling assembly  11 . For example, one end  100   a  of the sleeve  99  is looped around the loop base side  188  and adhered to the sleeve end  100   a  itself to effect the attachment. The ends of the filament for the loop  186  may remain separated inside the sleeve end  100   a , or they may be joined by welding or through a connector, such as a hypo-tube (not shown). The hypo-tube may be crimped to secure the filament in place.  
      The loop filament  186  may be rigid or malleable. The substantially triangular shape of the loop  186  is advantageous for dilating tissue while passing through the body of a patient. According to a further advantage, flatness of the loop  186  causes the resultant tunnel to be relatively two-dimensional, which helps to keep the sling assembly  11  in its flat configuration instead of getting folded or twisted while passing through the tunnel. A relatively flat dilator or tunneler may also be advantageous in aligning or orienting parts of the delivery system.  
      Still referring to  FIG. 33 , the receptacle connector  185  includes a curved slot  190 . To interconnect the loop connector  184  with the receptacle connector  185 , the loop apex  187  of the loop connector  184  first approaches the slot  190  in the receptacle connector  185 . After entry into the slot  190 , the loop  186  slides into a retention section  192  and eventually resides close to the distal end  193  of the retention section  192 .  
       FIG. 34  depicts a loop connector  194  including a loop filament  195  that is at least partly embedded in the sleeve end  100   a  of the sling assembly  11 . An aperture  196  is defined at least partly by the embedded loop filament  195 . The aperture  196  can be of a variety of shapes, for example, a triangular shape. The loop connector  194  shown in this embodiment can interconnect with various embodiments of the receptacle connectors, including the ones shown in all the previous figures, for example,  FIGS. 22A-33 , in a manner similar to the embodiment described in connection with  FIG. 33 .  
       FIGS. 35A and 35B , depict a connector  200  including a malleable portion  202  that can be inserted into the slotted receptacle connector  185 , and preferably be retained after the malleable portion  202  changes its shape or form. In the illustrated example where the connector  200  is attached to the sleeve end  100   a  of the sling assembly  11 , the malleable portion  202  includes part of the sleeve end  100   a  that envelopes a loop filament  204 . The sleeve end  100   a  is typically made of a soft, flexible plastic, and therefore, the shape and form of the connector  200  is largely determined by the shape and form of the loop filament  204 . For example, the loop filament  204  may bend in a normal direction to the plane, in which the sleeve end  100   a  resides, as indicated by the arrows  205 .  
      During interconnections the malleable portion  202  enters the slot  190  with its distal end  206  first. As the malleable portion  202  passes through the slot  190  into the retention section  192 , the malleable portion  202  bends to conform to the curvature of the slot  190  until the distal end  206  of the malleable portion  202  reaches the distal end  193  of the retention section  192 . The connector  185  can also be used to interconnect with other slotted receptacle connectors described herein.  
       FIGS. 36A and 36B , depict, through a side perspective view and a cross-sectional view, a loop connector  210  with an adjustable loop  211 . The loop connector  210  is illustrated as attached to a base part, for example, the sling assembly  11 . In one embodiment, the loop connector  210  includes a housing  212  that at least partly encloses a locking mechanism  214 . A filament  215  that makes up the loop  211  is threaded inside the housing  212 , for example, through a lumen  216 , so that the locking mechanism  214  can lock the loop  211  at a particular size as its filament  215  moves through the housing  212 . Numerous structures can be used as the locking mechanism  214 .  
      For example, in  FIG. 36B , the illustrative locking mechanism  214  includes a clip where one or more teeth  217  can engage each other to lock the positions of the loop filament  215 . Engagement of the teeth  217  may b,e prompted by compression of a spring-loaded housing  212 . Disengagement of the teeth  217 , hence, release of the filament positions, may be prompted by a second action of compressing the housing  212  where one or more springs  218  act to deactivate the locking mechanism  214 , for example, by disengaging the teeth  217 . Another example of the locking mechanism is a ratchet in which a pawl engages the sloping teeth of a wheel or bar, permitting motion in one direction only.  
       FIGS. 37A and 37B  depict the extended state and the retracted state, respectively, of the adjustable loop  211  of the loop connector  210  for interconnection purpose. Referring specifically to  FIG. 37A , the loop  211  is typically at an extended state when a receptacle connector  220  captures the loop  211  in a slot  219 . To adjust the loop  211  to its retracted state, the operator can pull both ends  222   a  and  222   b  of the loop filament  215 . Alternatively, the operator can hold one filament end ( 222   a  or  222   b ) fast while pulling on the other filament end ( 222   b  or  222   a ). Further alternatively, the operator can hold both filament ends  222   a  and  222   b  fast and push the housing  212  towards the receptacle connector  220 . The size of the loop  211  can be reduced until the housing  212  is in contact with the receptacle connector  220  as shown in  FIG. 37B . The locking mechanism  214  can be activated during this process to lock the loop  211  at a particular size. In the illustrative embodiment in  FIG. 37B , the loop  211  is retracted until it wraps snugly around portions of the receptacle connector  220 , including the distal end  223  of the slot  219 . At this point, the locking mechanism  214  ( FIG. 36B ) can be activated to lock in the loop size such that the loop connector  210  and the receptacle connector  220  form a snug joint so that they move as one piece.  
      To enlarge the size of the loop  211 , the operator deactivate the locking mechanism  214 , then pulls the housing  212  away from the receptacle connector  220  while holding the latter fast.  
       FIG. 38  depicts an alternative loop connector  225  including an adjustable loop  226  made from a filament  227  threaded through the housing  212 . One end  228  of the loop filament  227  is fixedly attached to the housing  212  such that only the other filament end  229  is threaded through the lumen  216  and affected by the locking mechanism  214 . Adjusting the size of the loop  226  is similar to the procedure described in connection with  FIGS. 37A and 37B , except that only one filament end  229  is needed and available for manipulation.  
       FIGS. 39A-39C  depict an illustrative connector pair  233  including a plug connector  234  and a receptacle connector  236 , which interconnect with each other through a receptacle loop  235  in the receptacle connector  236 . The illustrative plug connector  234  is attached to the shaft distal end  121  of the delivery device  119 . The illustrative plug connector  234  has a reduced-diameter section  238  proximal to a conical, tapered distal section  240 . In the illustrative embodiment, the tapered distal section  240  tapers towards a tip  241 . The tip  241  may be blunt or sharp. The tapered distal section  240  has its thickest point at its proximal base  237  which is adjacent the reduced-diameter section  238 . A diameter  239  at the base  237  is larger than a diameter  243  of the reduced diameter section  238 . The plug connector  234  may have a variety of shapes in cross-sections along its length, for example, circular, oval, triangular, or rectangular.  
      The receptacle connector  236  is characterized by the receptacle loop  235 , which receives and retains the plug connector  234 . The illustrative receptacle connector  236  is attached to the sleeve end  100   a  of the sling assembly  11 . In other embodiments, the receptacle connector  236  is attached to other types of medical implants (not shown). In an exemplary embodiment, the receptacle connector  236  includes an optional support loop  242 , which may be of a substantially triangular shape or of any other suitable shapes. For purpose of attaching the receptacle connector  236  with the sling assembly  11 , the sleeve end  100   a  may simply wrap around a base side  244  of the support loop  242 , and be heat-bonded to the sleeve end  100   a  itself. The two ends of the support loop  242 , which may therefore be embedded in the sleeve end  100   a , can remain separate, or joined by welding or through a hypo-tube (not shown). The hypo-tube may add structural support when the support loop  242  is used in dilation or tunneling.  
      The helical receptacle loop  235  may be disposed at any location in the receptacle connector  236 , with any orientation. In the illustrative embodiment, the helical receptacle loop  235  is located at the apex  245  of the triangular support loop  242 . Further, the illustrative helical receptacle loop  235  is oriented substantially normal to the plane where the support loop  242  resides. Such an orientation helps to facilitate end-to-end alignment between the distal shaft end  119  and the sling assembly  11 . As discussed above, such alignment makes it easier to tunnel the implant, such as the sling assembly  11 , through patient tissue without twisting or king the sling assembly  11 , and causes less trauma for the patient.  
      Since the receptacle loop  235  only needs a structure to support it, the first loop  242  can be replaced with any suitable support structure, without, deviating from the scope of the invention. For example, a rod or a solid, flat substrate with or without any aperture in it can easily replace the support loop  242 . However, a loop structure, while can be used for support purpose, as described in previous embodiments, can also be used, much as a loop connector, to hook into a slot in a slotted receptacle connector. Advantages from having a relatively flat dilator like the support loop  242 , which is triangular is also described above.  
      In  FIG. 39A , the illustrative receptacle loop  235  is formed, for example, in a spiral or helical structure, by a filament, for example, the same filament that forms the triangular support loop  242 . In one preferred embodiment, the filament is a stainless steel wire with about a 0.028 inch diameter. The receptacle loop  235  may include less than one complete loop, one loop, or more than one loop. In one preferred embodiment, the receptacle loop  235  is about 1.5 loops. The loop  235  may assume any suitable shape, for example, circular, oval, triangular, rectangular or a horseshoe shape. In one embodiment, the filament that makes up both the first support loop  242  and the second receptacle loop  235  has certain flexibility and elasticity. As a result, the operator, by pressing or squeezing both sides of the triangular support loop  242 , for example, at “release regions”  246   a  and  246   b , which are regions adjacent the apex  245  of the triangular loop  242 , can enlarge the size of the receptacle loop  235  where the filament crosses over to form the receptacle loop  235 , such as in the illustrated embodiment. Once the operator stops squeezing the release regions  246   a  and  246   b , its elasticity in the filament causes the receptacle loop  235  to return to its original size. Such a feature is useful for initial mating and subsequent releasing of a connector.  
       FIGS. 39B and 39C  depict at least two ways to interconnect the plug connector  234  with the receptacle connector  236 . Specifically referring to  FIG. 39B , in a head-on approach, the two distal ends of the connectors  234  and  236  start the interconnecting process by facing each other. Then, the distal tapered section  240  of the plug connector  234 , with the tip  241  first, enters the receptacle loop  235  and into the space above the support loop  242 . In one embodiment, the receptacle loop  235 , in its relaxed state, has an inner diameter smaller than the diameter of the thickest point in the tapered distal section  240  of the plug connector  234 . As described earlier, however, the tapered section  240  can ply and expand the receptacle loop  235  where allowed by the flexibility of the loop filament. Once the entire distal section  240  passes the receptacle loop  235 , the receptacle loop  235  drops into the reduced-diameter section  238 . As dictated by the elasticity in its filament, the receptacle loop  235  returns to much of its original size and therefore is retained in the reduced-diameter section  238 .  
      An advantage of this embodiment of the connector pair is that, one connector can easily rotate about its longitudinal axis while remaining interconnected with the other connector but without rotating the other connector. This allows an operator to unwind twisted base parts, for example, the sling assembly  11 . This type of head-on interconnection can be useful in implanting a urinary sling using the so-called “top-down,” supra-pubic, pre-pubic, or trans-obturator approach.  
      Specifically referring to  FIG. 39C , in an alternative “backend” approach, the interconnecting process starts with the distal tip  241  of the plug connector  234  behind the receptacle loop  235  and above the support loop  242 . Then, with the tip  241  first, the distal tapered section  240  of the plug connector  234  enters the receptacle loop  235  from the space above the triangular support loop  242 . Similar to the head-on approach, once the distal section  240  of the plug connector  234  passes the receptacle loop  235  of the receptacle connector  236 , the reduced-diameter section  240  in the plug connector  234  engages the receptacle loop  235 . As a result, the plug connector  234  remains interconnected with the receptacle connector  236 . This type of backend connection can be useful in implanting a urinary sling using the so-called “bottom-up,” trans-vaginal, or trans-obturator approach.  
      To disconnect the connectors, as described in connection with  FIG. 39A , the operator can squeeze both sides of the triangular support loop  242  of the receptacle connector  236 , for example, at the release regions  246   a  and  246   b , to temporarily expand the receptacle loop  235  for releasing the plug connector  234 .  
       FIGS. 40A-41C  depict receptacle connectors  247  and  248 , both including receptacle loops  249  and  250  that resemble U-shaped horseshoes. Both the illustrative receptacle connectors  247  and  248  can employ the plug connector  234  of the type previously described with respect to  FIG. 39A . Specifically referring to  FIG. 40A , a support loop  252  supports the receptacle loop  249  of the receptacle connector  247 . Further, the illustrative receptacle connector  247  including the support loop  252  and the receptacle loop  249  is made of a single filament.  
       FIG. 40B  depicts an enlarged top view of the distal portion of the receptacle connector  247 . In the illustrative embodiment, the width  251  of the loop  249  can be measured as the curvature  253  from the center of the loop to two unconnected ends  254   a  and  254   b . The curvature  253  is preferably between about 270 and about 360 degrees. Additionally, the receptacle loop  249  resides in a plane that is at an angle  255  to the plane of the support loop  252 . The angle  255  is preferably about 90 degrees, but may be anywhere between 0 and 180 degrees. Both the curvature  253  and the angle  255  of the horseshoe receptacle connector  247  can be varied to accommodate a wide range of shapes of mating plug connectors, and to accommodate variations in operative procedures.  
       FIG. 41A  depicts an alternative embodiment  248  of the horseshoe receptacle connector  247 . In the embodiment of  FIG. 41A , the support structure of the receptacle loop  250  includes a narrowed neck portion  258  extending between the receptacle loop  250  and the triangular support loop  256 . Again, the entire illustrative receptacle connector  248  is made from a single filament. In the narrowed neck portion  258 , the two opposite sides  258   a  and  258   b  are arranged substantially in parallel and are closer together than the diameter of the receptacle loop  250 .  
      The narrowed neck portion  258  reduces the likelihood of premature release of a captured plug connector such as the plug connector  234 . More specifically, the narrowed neck portion  258  helps to prevent unintended expansion in the receptacle loop  250  because its length serves to dissipate any expansive force transferred from the support loop  256 , for example, when the sides of the support loop  256  are squeezed during dilation. This advantage of the narrowed neck portion  258  is especially apparent when the receptacle loop includes a filament cross-over such as the 1.5-turn helical structure depicted in receptacle loop  235  (for example,  FIG. 39A ). This is because the filament cross-over, much like the pivot in a pair of scissors, causes one side to open up when the other side closes. Accordingly, the feature of a narrowed neck portion in combination with other receptacle loop structures, such as the one depicted in  FIG. 39A  is specifically contemplated by this invention.  
      A second advantage of having the neck portion  258  is illustrated through  FIGS. 41B and 41C , which show the plug connector  234  and the receptacle connector  248  interconnected in a head-on (or in-line) approach and a backend approach, respectively. Interconnection between a plug connector and horseshoe receptacle connector under either approach is similar to what is described in connection with FIG.  39 B and  39 C except that the circular receptacle loop  235  has been replaced with a horseshoe-shaped receptacle loop, for example,  249  or  250 . As shown by  FIGS. 41B and 41C , because there is little space within the narrowed neck portion  258 , it serves as a physical barrier against the plying of the tapered distal section  240  ( FIG. 41B ) or a base section  260  ( FIG. 41C ) of a captured plug connector  234 . As a result, the narrowed neck section  258  serves as a locking mechanism.  
       FIG. 42A  depicts a further embodiment of a plug connector  261  and a receptacle connector  262 . In the illustrated embodiment, the receptacle connector  262  is attached to the sleeve end  100   a  of the sling assembly  11 . The plug connector  261  is attached to a guide tube  264 . The guide tube  264  slidably interfits over a handled shaft  265 .  
      The plug connector  261  includes a tapered distal section  269  and a base section  270 , bridged by a circular notch  271 . The distal section  269  of the plug connector  261  tapers towards a distal tip  272 , which may be sharp or blunt. In the illustrative embodiment, the distal section  269  is of a conical shape. The illustrative base section  270  is over molded to a distal end  273  of the guide tube  264 . In another embodiment, the base section  270  is attached to a distal end of the shaft  265 . The base section  270  and other parts of the plug connector  261  may be made of a variety of materials, for example, polymers such as acrylonitrile butadiene styrene (ABS).  
      The receptacle connector  262  includes a relatively flat substrate  275 . The substrate  275  is preferably of a thickness that is less than or equals the length of the circular notch  271  in the plug connector  261 . The sleeve end  100   a  may be heat bonded, molded or otherwise attached to the substrate  275 . The substrate  275  has an eyelet or aperture  277 . The aperture  277  may have a rim (not shown) around it. In a preferred embodiment, the aperture  277  is of a size slightly smaller than the cross-section of the thickest point in the distal section  269  of the plug connector  261 .  
      To interconnect the plug connector  261  with the receptacle connector  262 , the plug tip  272  enters the aperture  277  first. The rest of the plug distal section  269  is then forced through the aperture  277  until the substrate  275  drops into the plug connector  261 &#39;s circular notch  271  in a “snap-on” action. The interconnection can take either the head-on approach or the backend approach as described above. In the particular application where the plug connector  261  is attached to a guide tube  264 , the shaft  265  may first be inserted into the guide tube  264  to give support for the interconnection.  
       FIG. 42B  depicts an alternative embodiment of a plug and receptacle connector pair including the plug connector  261  and an alternative receptacle connector  280 . The illustrative plug connector  261  is disposed at the distal end  121  of the shaft  114 . The receptacle connector  280  includes an elongated substrate  281  extending from a first distal end  282  to a second proximal end  283 . A lateral aperture through  284  is located in the substrate end  282 . The substrate end  283  attaches to the dilator  118  of the sling assembly end  117 . In one embodiment, the elongated substrate  281  is strap-like (i.e., narrow, flat, and elongated) and is bendable, but has sufficient tensile strength to be pulled through the patient&#39;s tissues. The elongated substrate  281  has a length that is substantially greater than conventional embodiments of receptacle connectors used to interconnect the delivery device and the sling assembly. In one embodiment, the elongated substrate  281  is at least about 8 inches, which is longer than the typical length between a lower abdominal incision and the anterior vaginal wall (not shown) of a patient. In one embodiment, the elongated substrate  281  is made of a flexible plastic. In another embodiment, the elongated substrate  281  is made of a malleable metal.  
      The plug connector  261  can be interconnected with the receptacle connector  280  in a way similar to the method described in connection with  FIG. 42A , e.g., by forcing the plug distal section  269  into the aperture  284  until the substrate  281  advances into the reduced diameter section  271 . In an exemplary procedure, a percutaneous passage between the anterior vaginal wall and a lower abdomen incision is required for delivery of a sling assembly. In an embodiment where the elongated substrate  281  spans the length of that percutaneous passage, the shaft  114  and an interconnected receptacle connector  280  can travel the entire length of the percutaneous passage before the dilator  118  has to enter the patient&#39;s tissue. As a result, less drag is created in the patient&#39;s tissue and the stress or tension at the connection point between the receptacle connector  280  and the plug connector  261  is reduced by the stress otherwise created by dilation. Once the shaft  114  passes through the patient&#39;s tissue, the operator may then separate the receptacle connector  280  from the plug connector  261 . The operator can pull the remaining portions of the receptacle connector  280 , together with the dilator  118  and the rest of the sling assembly, through the patient&#39;s tissues. At this time, the dilation takes place and the resultant tension on connector pairs falls on an attachment site  285  between the proximal connector end  283  and the dilator  118 . Because a permanent or otherwise more durable attachment can be manufactured with respect to the attachment site  285  beforehand, the attachment site  285  is more likely to withstand the tension brought by the dilation process than the interconnection between connectors  280  and  261 , especially if that interconnection is reversible. Accordingly, the elongated substrate  281  reduces the risk of separation between two interconnected parts during a trans-percutaneous procedure.  
       FIGS. 43 and 44  depict alternative embodiments  261   a  and  261   b  to the plug connector  261 . Each of the alternative embodiments ( 261   a ,  261   b ) has a distal section ( 269   a ,  269   b ) that is separated from a base section ( 270   a ,  270   b ) by an reduced-diameter section ( 271   a ,  271   b ). The reduced-diameter section ( 271   a ,  271   b ) functions much like the reduced diameter section  271  of the plug connector  261  described in  FIGS. 42A and 42B , and they can substitute each other for purpose of this invention. In  FIG. 43 , the illustrative distal section  269   a  includes a bulbous head and the illustrative reduced-diameter section  271   a  is a circular notch or a stepped-down portion. In  FIG. 44 , the illustrative distal section  269   b  includes a spearhead and the illustrative reduced-diameter section  271   b  includes multiple valleys  286 .  
       FIG. 45  depicts a connector pair  289  including a plug connector  290  and a receptacle connector  291  where the plug connector  290  alternately contracts and expands to interlock with the receptacle connector  291 . The illustrative plug connector  290  is attached to the distal end  121  of the shaft  114  of the delivery device  119 . The illustrative receptacle connector  291  is attached to the sleeve end  100   a  of the sling assembly  11 . The plug connector  290  includes a distal section  292  and an reduced-diameter section  293 , for example, a circular notch, which is disposed between the distal section  292  and the rest of the shaft  114 . In one illustrative embodiment, the reduced-diameter section  293  is a stepped-down portion of the shaft  114 , and the plug connector  290  is made out of the same material as and formed integrally with the rest of the shaft  114 . However, in other embodiments these components may be made from different materials and attached together using any suitable approach. Optionally, one or more slits  295  are disposed along at least part of the distal section  292  of the plug connector  290 , substantially parallel to a long axis of the shaft  114 . In the illustrative embodiment, the slits  295  extend to the tip  296  of the plug connector  290  and therefore, the tip  296  of the plug connector  290  is hallowed. Although the illustrative embodiment employs four slits  295 , any number may be used. There may be any number of slits  295 , for example, four. The slits  295  allow the distal section  292  to compress inwardly. If the material that makes up the distal section  292  has sufficient elasticity, for example, as is the case with many metals and plastics, the distal section  292  will return to its relaxed and more expanded configuration once the compressive force disappears.  
      The illustrative receptacle connector  291  attaches to the sleeve end  100   a  through an extension tongue  294 . The illustrative tongue  294  is elongated and spaces the receptacle  297  away from the sleeve end  100   a . This makes it easier for the operator to interfit the plug connector  290  with the receptacle connector  291  using the head-on approach or the backend approach. In one embodiment, the tongue  294  is between about 0.5 inch to about one inch long.  
      The receptacle connector  291  includes a receptacle  297  for receiving and retaining the plug connector  290 . In one embodiment, the receptacle  297  is tubular and includes a lumen  301  extending between first  300  and second  302  axially spaced apertures. The receptacle  297  has a length  304  that is preferably less than or equal to the length of the reduced-diameter section  293  of the plug connector  290 .  
      In one embodiment, the lumen  301  in the receptacle connector  291  has a smaller diameter than the thickest point in the distal section  292  of the plug connector  290  and/or the thickest point on the shaft  114 . To interconnect the two connectors, the tip  296  of the plug connector  290  enters the receptor lumen  301  through either the distal opening  300  (head-on approach) or the proximal opening  302  (backend approach) of the receptacle  297 . The slits  295  constrict and compress as the thicker portion of the distal section  292  of the plug connector  290  as it squeezes into the receptor lumen  301 . However, when the plug distal section  292  passes through the receptacle  297  to radially align the receptacle  297  with the reduced-diameter section  293  of the plug connector  290 , the plug distal section  292  expands and returns to its relaxed configuration, acting as a barrier for separation from the receptacle connector  291 .  
       FIG. 45  also depicts a release tool  306 , for separating and releasing the receptacle connector  291  from the plug connector  290 . The release tool  306  includes a first end  307 , a second end  308 , a lumen  310 , and an opening  311  on the second end  308  in fluid communication with the lumen  310 . Optionally, the release tool  306  may also have a second opening (not shown) in fluid communication with the lumen  310 , however, for the purpose of this invention, the lumen  310  only needs one opening  311 . The diameter of the illustrative lumen  310  in the release tool  306  is substantially similar to the diameter of the lumen  301  of the receptacle  297 . Preferably, the length of the lumen  310  is greater than or equal to the length of the plug distal section  292 . In a preferred embodiment, the lumen  310  in the release tool  306  is of a conical shape with the opening  311  being the base of the cone.  
      To separate the receptacle connector  291  from the plug connector  290 , the operator slides the release tool  306 , through its opening  311 , first over the tip  296  and then over the distal section  292  of the plug connector  290 . The lumen  310  of the release tool  306  contracts and compresses the plug distal section  292  as the release tool  306  advances over it. Once the plug distal section  292  is substantially inside the lumen  310 , the receptacle  297  can slide over the now compressed distal section  292  towards the tip  296  of the plug connector  290 . This motion replaces the receptacle connector  291  with the release tool  306 . Accordingly, the release tool  306  and the receptacle connector  291  are removed, in tandem, from the distal section  292  of the plug connector  290 . This disconnection procedure works for interconnected connectors whether they were interconnected through a head-on or backend approach.  
       FIG. 46A  depicts a plug connector  314  and a receptacle connector  315  where the receptacle connector  315  alternately expands and contracts to interlock with the plug connector  314 . The illustrative plug connector  314  is disposed at the shaft distal end  121  of the delivery device  119 . The plug connector  314  includes a distal section  316  that tapers to a tip  317  and an reduced-diameter section  318 , for example, a circular notch, which is disposed between the distal section  316  and the rest of the shaft  114 . The tapered distal section  316  has a proximal base  324  adjacent the reduced-diameter section  318 . The tapered distal section  316  reaches its maximum diameter  333  at the proximal base  324 . The maximum diameter  333  in the tapered distal section  316  is larger than the diameter  335  of the reduced-diameter section  318 . The diameter  338  for the shaft distal section  121  is also larger than the diameter  335  of the reduced-diameter section  318 . The illustrative distal section  316  of the plug connector  314  is conical in shape and includes telescoped sections  336  and  337 .  
      The illustrative receptacle connector  315  is attached to the sleeve end  100   a  of a sling assembly. The receptacle connector  315  has a tubular portion  320  with a free and enlarged head portion  321 . The illustrative head portion  321  is substantially conical. One or more slits  322  are disposed along the head portion  321  and optionally, part of the tubular portion  320 , substantially parallel to a long axis of the receptacle connector  315 . In one embodiment, the slits  322  extend to the very distal end  323  of the receptacle connector  315 . There may be any number of slits  322 . In the illustrative embodiment, four slits  322  results in four axial projections  326   a ,  326   b ,  326   c , and  326   d . For example, the axial projections  326   a ,  326   b , and  326   c  extend from their respective base portions  331   a ,  331   b , and  331   c  to their respective enlarged head  332   a ,  332   b , and  332   c . The base portions  331   a ,  331   b  and  331   c , and the base portion (not shown) of the projection  326   d , together form part of the radial structure of the receptacle tubular portion  320 . The enlarged heads  332   a ,  332   b ,  332   c , and  332   d  (of the projection  326   d ), which extend radially outward from the receptacle connector  315 , together form the substantially conical head portion  321  of the receptacle connector  315 .  
       FIG. 46B  depicts a cross-sectional end view of the distal end  323  of the receptacle connector  315 . Each of the slits  322  extends radially from the periphery of the head portion  321  to an axial channel  325 . The channel  325  radially circumscribed by the enlarged heads  332   a - 332   d  and the axial projections  326   a - 326   d . When the enlarged heads  332   a - 332   d  expand radially outward, the channel  325  expands as well, and the channel diameter  327  increases. Although the channel  325  is depicted as being generally cylindrical in shape, any suitable shape for mating with the plug connector  314  may be employed. Once the expansive force is removed, the head portion  321  returns to its relaxed and less expansive state, and the channel diameter  327  returns to its smaller, default value.  
       FIGS. 46C and 46D  depict two exemplary embodiments of receptacle connectors  315  and  315   a , where the channels  325  and  325   a  extend from openings  330  and  330   a  at the head portions  321  and  321   a  into the tubular portions  320  and  320   a  respectively. One or more protuberances  328  or  328   a  are disposed inside the channel  325  or  325   a , for example, in the tubular portion  320  ( FIG. 46C ), or in the head portion  321   a  ( FIG. 46D ). In the illustrative embodiments, the protuberance  328  or  328   a  is an annular ring with an axial length  334  or  334   a  that is less or the same as the reduced diameter section  318  ( FIG. 46A ) of the plug connector  314 . The channel diameter  339  or  339   a  between the annular protuberance  328  or  328   a  is less than the maximum diameter  333  of the plug distal section  316  ( FIG. 46A ) and/or the diameter  338  of the shaft distal end  121 ( FIG. 46A ). Preferably, the diameter  339  or  339   a  is greater than or equal to the diameter  335  of the reduced-diameter section  318  of the plug connector  314  ( FIG. 46A ). The channel diameter  327  or  327   a  in the rest of the channel  325  or  325   a  is substantially the same or larger than both the diameter  333  of the plug distal section  316  and the diameter  338  of the shaft distal end  121 .  
      To interconnect the plug connector  314  with the receptacle connector  315 , for example, the operator slides the distal opening  330  of the receptacle connector  315  over the tip  317  and then the distal section  316  of the plug connector  314 . The plug distal section  316  travels further into the receptacle channel  325  until stopped by the protuberances  328 . However, because of the slits  322 , which preferably extend to the protuberance  328 , the channel  325  expands further to allow the distal section  316  of the plug connection  314  to pass the protuberance  328  so as to engage the protuberance  328  with the reduced-diameter section  318 . Because the diameter  339  at the protuberance  328  is selected to be less than the diameter  333  of the plug distal section  316  or the diameter  338  of the shaft distal end  121 , the protuberance  328  locks the plug connector  314  inside the receptacle connector  315 .  
       FIG. 47  depicts a cross-sectional view of the connector pair according to another illustrative embodiment of the invention. The connector pair if  FIG. 47  includes a plug connector  234  of the type previously described with respect to  FIG. 39A . The connector pair also includes a receptacle connector  352 . The receptacle connector  352  includes a tubular member  358  and a tightening collar  366 . The tubular member  358  includes an inner wall  363  which defines a receptacle  360 . The inner wall  363  includes an annular shoulder  364  which protrudes radially inward from and extends around the inner wall  363  to define a housing opening  362 . The tightening collar  366  interfits concentrically around the tubular member  358 . In some embodiments, the tubular member  358  includes axially extending slits (not shown) disposed around its circumference to enhance its ability to expand and contract.  
      In some embodiments, the tubular member  358  is made from a semi-rigid or flexible material and the tightening collar  366  is made from a substantially rigid material.  
      To interconnect the plug connector  234  with the receptacle connector  352 , with the tightening collar  366  in the unlocked state of  FIG. 47 , inserts the plug connector  234  into the opening  362  until the annular shoulder aligns with  364  the reduced-diameter section  238 . Then, the operator slides the tightening collar  366  in the proximal direction indicated by arrow  368  to compress the tubular member  358  around the plug connector  234 . Referring now to  FIG. 48 , once the tightening collar  366  is slid over the tubular member  358  and a portion of the distal end  121  of the shaft  114 , the lumenal diameter in the tubular member  358  is reduced such that the shoulder  364  engages the reduced diameter section  238  and locks the tapered distal section  240  of the plug connector  234  in place. To release the plug connector  234  from receptacle  360 , the above procedure is reversed: the second collar  366  is slide in the distal direction opposite the arrow  368 .  
       FIG. 49A  depicts an exploded view of portions of the plug connector  380  and a receptacle connector  382 . The plug connector  380  attaches to or is an integral part, for example, of the shaft distal end  121  of the delivery device  119 . The plug connector  380  includes, from its distal tip  383 , a conical distal section  384 , a cylindrical section  386 , and a reduced-diameter section  388 . The cylindrical section  386  includes proximal base  381  adjacent the reduced-diameter section  388 . The conical distal section  384  and the cylindrical section  386  constitute a tip section  385 . The tip section  385  reaches its maximum diameter  387  at the proximal base  381 , which is larger than the diameter  395  of the reduced-diameter section  388 . Accordingly the maximum diameter  387 , in this illustrative embodiment, is also the maximum diameter of the plug connector  380 . The diameter  395  of the reduced-diameter section  388  is also smaller than the diameter  397  of the shaft distal end  121 .  
      The receptacle connector  382  includes a first portion  390  and a second portion  392 . In one embodiment, the second portion  392  includes one or more rails  394 . The rails  394  may extend along the full length of the second portion  392 , or, alternatively, only partially along the length of the second portion  392 . The first portion  390  includes grooves or slots  396  complementary to the rails  394  on the second portion  392 . Portions  390  and  392  can assume a variety of shapes. For example, as illustrated, the first portion  390  may resemble part of a box, while the second portion  392  may resemble part of a tube. The two portions can, of course, assume similar shapes.  
      Referring now to  FIG. 49B , the first portion  390  of the receptacle connector  382  includes a protuberance  398  that complements or conforms to at least a substantial part of the reduced-diameter section  388  in the plug connector  380 , illustratively about half of the reduced-diameter section  388 . Accordingly, the protuberance  398  may be, for example, semi-annular in shape.  
      To interconnect the receptacle connector  382  with the plug connector  380 , the operator, in one embodiment, places the first portion  390  of the receptacle connector  382  on the plug connector  380 . The protuberance  398  mates with the reduced-diameter section  388  of the plug connector  380 . Then, the operator, matching the rails  394  with the slots  396 , slides the second portion  392  onto the first portion  390 , in the direction indicated by arrow  399 . The first portion  390  and the second portion  392  should be sized such that when they are slid together, with the help of the protuberance  398  inside the first portion  390 , they effectively prevent the captured plug connector  380  from exiting. To release the plug connector  380  from the receptacle connector  382 , the operator slides the second portion  392  of the receptacle connector  382  in the direction opposite the arrow  399  and separates the second portion  392  from the first portion  390 . Then, the first portion  390  and the plug connector  380  are free to separate from each other.  
      In an alternative embodiment, to interfit the first portion  390  with the second portion  392 , rather than sliding the rails  394  of the second portion  392  into the complementary slots  396  of the first portion  390 , the operator snaps the rails  394  into the complementary slots  396  to force-fit the second portion  392  onto the first portion  390 .  
       FIG. 50A  depicts a plug connector  400  and an opened receptacle connector  402  where the receptacle connector  402  locks the plug connector  400  inside when a lid portion  406  of the receptacle connector  402  closes. The plug connector  400  is attached to, for example, the shaft distal end  121  of the delivery device  119 . The plug connector  400  includes one or more reduced-diameter sections  404 A and  404 B.  
      The receptacle connector  402  includes a lid portion  406  and a body portion  408  linked by, for example, a longitudinal hinge  410  that enables the lid portion  408  to open and close in a radial direction. In its closed configuration (not shown), the receptacle connector  402  may substantially match the shape of the plug connector  400 . For example, if the plug connector  400  is substantially cylindrical, the receptacle connector  402 , in its closed configuration, may be substantially tubular with at least one opening  412  through which the shaft distal end  121  can extend. The receptacle connector  402  may further include a snapping member  414  positioned on the lid portion  406  and a locking member  415  positioned on the body portion  408 . The body portion  408  of the receptacle connector  402  includes one or more projections or protuberances  416   a  and  416   b  that complements or conforms to a substantial part of the reduced-diameter sections  404   a  and  404   b , for example, half of the reduced-diameter sections  404   a  and  404   b . Accordingly, the protuberances  416   a  and  416   b  may each be, for example, semi-annular in shape. Optionally, the lid portion  406  may include similar protuberances  417   a  and  417   b  to complement its half of the reduced-diameter sections  404   a  and  404   b . In one embodiment, the interior of the receptacle connector  402  is molded to mirror the entire contour of the plug connector  400 , much like the box of a musical instrument would typically form-fit the instrument.  
      To interfit the receptacle connector  402  over the plug connector  400 , the operator first opens the two portions  326 ,  328  of the receptacle connector  402  to the illustrated open configuration. The operator then places the plug connector  400  in the lumen  411  of the body portion  408  of the receptacle connector  402  such that the protuberances  416   a  and  416   b  of the body portion  408  mate with the reduced-diameter sections  404   a  and  404   b . To lock the plug connector  400  inside the receptacle connector  402 , the operator rotates the lid portion  406  in the direction indicated by arrow  413  onto the body portion  408  and snaps the snapping member  414  into the locking member  415 . To release the plug connector  400 , the operator reverses the aforementioned steps.  
       FIG. 50B  depicts an alternative receptacle connector  402   a  that can also lock the plug connector  400  (described above with respect to  FIG. 50 ) by closing a lid portion  406   a . The receptacle connector  402   a  includes features similar to those of the receptacle connector  402 , described with respect to  FIG. 50 , except that a lateral hinge  410   a  replaces the longitudinal hinge  410 . The lateral hinge  410   a  is located along a portion of the circumference of the receptacle connector  402   a , links the lid portion  406   a  and the body portion  408   a , and enables the lid portion  406   a  to open and close in an axial direction.  
       FIGS. 51A and 51B  depict, through a perspective side view and a cross-sectional view, a receptacle connector  1352  having a protuberance  1362  that facilitates interlocking with plug connector  380  of the type previously described with respect to  FIG. 49A . The receptacle connector  1352  includes a substantially tubular housing  1356  open at least at one end  1357  for receiving the plug connector  380 . The tubular housing  1356  includes one or more apertures  1358 . In the illustrated embodiment, two apertures  1358   a  and  1358   b  extend axially along the tubular housing  1356 . A protuberance  1362  extends radially into the housing  1356 .  
      In one embodiment, the length  1366  of the protuberance  1362  is less than or equal to the depth of the reduced-diameter section  388  in the plug connector  380 . In the illustrative embodiment, the protuberance  1362  is a retractable or spring-loaded pin. In an alternative embodiment, the protuberance  1362  is a flap made of a moldable material, such as, for example, rubber, and is capable of being bent or displaced upon insertion of the plug connector  380 , as described in more detail below. In one embodiment, the flap is insert molded to the inner surface of the tubular wall  1360  of the receptacle connector  1352 . In another embodiment, the flap is a cutout portion of the tubular wall  1360  that remain attached to the tubular housing  1356  through a hinge, which enables the operator to rotate the flap up and down, as explained below in connection with  FIG. 52 .  
      In one embodiment, the receptacle  1364  in the tubular housing  1356  has a diameter  1365  that is equal to or less than the maximum diameter  387  of the plug connector  380 . However, because the locking function by the protuberance  1362  the receptacle  1364  may have a diameter larger than the maximum diameter  387  of the plug connector  380 . In the latter embodiment, the tubular housing  1356  does not need to have any of the apertures  1358   a  or  1358   b.    
      To interfit the receptacle connector  1352  over the plug connector  380 , the operator inserts the tip  383  of the plug connector  380  into the opening at the end  1357  of the receptacle connector  1352 . As the operator advances the plug connector  380  further into the receptacle  1364 , the apertures  1358   a  and  1358   b  in the tubular housing  1356  allow the receptacle  1364  to expand and accommodate the tapered distal section  384  and the cylindrical section  386  of the plug connector  380 . Alternatively, if no apertures  1358  are present on the receptacle connector  1352 , the operator force fits the plug connector  380  into the receptacle  1364  of the receptacle connector  1352 .  
      In an embodiment where the protuberance  1362  is a spring-loaded pin, the protuberance  1362  is initially biased to project radially into the receptacle  1364 . As the operator advances the plug connector  380  into the receptacle  1364 , the tapered distal section  384  of the plug connector  380  gradually deflects the protuberance  1362 , either axially or radially. After the entire tapered distal section  384  and the cylindrical section  386  pass the protuberance  1362 , the protuberance  1362  returns to its original untensioned position in the adjacent reduced-diameter section  388  in the plug connector  380 . By engaging with the reduced diameter section  388 , the protuberance  1362  locks the plug connector  380  inside the receptacle connector  1352 .  
      In an embodiment where the protuberance  1362  is manually retractable, it can be initially retracted as the operator advances the plug connector  380  into the lumen  1364  of the receptacle connector  1352 . When the reduced-diameter section  388  in the plug connector  380  reaches the protuberance  1362 , the operator can let the protuberance  1362  extend or simply fall back into the receptacle  1364  to engage the reduced-diameter section  388 , thereby locking the plug connector  380 .  
      In an embodiment where the protuberance  1362  is a flap, for example, insert molded to the inner surface of the tubular housing  1356  of the receptacle connector  1352 , the flap can be bent and displaced by the operator inserting the plug connector  1234  into the receptacle  1364 . The flap rides along the surface of the plug connector  380  until it reaches the reduced-diameter section  388  of the plug connector  234 , at which point it engages the reduced-diameter section  388 , locking the plug connector  234 .  
       FIG. 52  depicts an embodiment of the receptacle connector  1352 , in which a receptacle connector  1352   a  includes a protuberance that is a flap  1368  attached to the tubular housing  1356   a  through a hinge  1370 . In some embodiments, the flap  1368  may be formed as a cutout of the tubular hosing  1356   a . The operator initially deflects the flap  1368  in the direction indicated by arrow  1372 , and holds the flap  1368  coplanar with one side of the tubular housing  1356   a . The operator then advances the plug connector  380  into the receptacle  1364   a . When the reduced-diameter section  388  of the plug connector  380  is aligned with the flap  1368 , the operator deflects the flap  1368  in the direction opposite the arrow  1372  to engage the reduced-diameter section  388 , thereby locking the plug connector  380 . The operator may use any suitable tool to accomplish the flap deflection.  
       FIG. 53  depicts a receptacle connector  1382  that can be side mounted onto the plug connector  380  of the type previously described with respect to  FIG. 49A . The illustrative receptacle connector  1382  includes a cylindrical tubular member  1390  defining a channel  1392 . The tubular member  1390  has a first end  1391  that can attach to a part of a delivery system, for example, a sling assembly end (not shown), and a second end  1393 . A slot  1394  extends axially in the tubular member  1390  from the first end  1391  to the second end  1393 . The illustrative slot  1394  exposes a channel  1392  and has a width  1396  that is less than or equal to the diameter  395  of the reduced-diameter section  388  of the plug connector  380 . The illustrative slot  1394  has a length that is less than or equal to that of the reduced-diameter section  388 . Optionally, in one embodiment, the channel  1392  has a diameter that is greater than or equal to that of the reduced-diameter section  388 .  
      To interconnect the receptacle connector  1382  with the plug connector  380 , the operator aligns the slot  1394  with the reduced-diameter plug section  388 . The operator then interfits the reduced-diameter section  388  through the slot  1394  into the channel  1392 . Then the tubular member  1390  snaps onto the reduced-diameter section  388  as the slot  394  returns to its normal width to lock the plug connector  380  into the receptacle connector  1382 .  
      After the two connectors  1380  and  1382  have been interconnected, the operator can rotate either the connector  1380  or  1382  about a longitudinal axis without rotating the other connector and while maintaining the interconnection. This is advantageous where a base part, for example, the sling assembly, attached to either connector needs to be untwisted after getting twisted or wound during the delivery or placement.  
       FIGS. 54A and 54B  depict a receptacle connector  1410  where an axially extending receptacle  1412  includes a radially enlarged portion  1414  for accommodating the tip section  385  of the plug connector  380  previously described with respect to  FIG. 49A .  
      The illustrative receptacle connector  1410  includes a substantially tubular housing  1416  with a distal opening  1418 . The housing  1416  can attach to a component of a delivery system such as a sling assembly (not shown) through its proximal end  1420 . The illustrative proximal housing end  1420  does not contain any proximal opening, but in an alternative embodiment, there can be such an opening. Better shown in  FIG. 54B  through a longitudinal view, the receptacle  1412  extends axially from a distal opening  1418  into the housing  1416 . The receptacle  1412  includes an enlarged portion  1414  and a narrow portion  1422 . A substantially annular ring  1424  with a shoulder  1415  projects from an inner wall  1426  and narrows the receptacle  1412  to its narrow portion  1422 . The narrow portion  1422  is similar to the channel  1392  described with respect to  FIG. 53  and for receiving the reduced diameter section  388  of the plug connector  380  ( FIG. 49A ). The enlarged portion  1414  is sized and shaped to receive the tip section  385  of the plug connector  380  ( FIG. 49A ).  
      Referring specifically to  FIG. 54A , an axial slot  1428  extends radially from the housing outer surface  1430  into the receptacle  1412 . Corresponding to and aligned with the enlarged receptacle portion  1412  and the narrow receptacle portion  1422 , the illustrative axial slot  1428  includes an enlarged portion  1432  and a narrow portion  1434 . The enlarged slot portion  1432  and the narrow slot portion  1434  are narrower than the tip section maximum diameter  387  and diameter  395  of the reduced-diameter section  388  of the plug connector  380  ( FIG. 49A ), respectively, for locking the plug connector  380 . In an alternative embodiment, the slot  1428  has uniform width.  
      Side-mounting the receptacle connector  1410  onto the plug connector  380  is similar to the steps described above in connection with  FIG. 53  except that at least part of the plug connector  380  is snapped into the enlarged receptacle portion  1412  through the enlarged slot portion  1432 .  
       FIG. 54C  depicts an additional method of interfitting the receptacle connector  1410  with the plug connector  380 , as it may be advantageous to use this method during certain delivery procedures. The operator inserts a part of the tip section  385  of the plug connector  380  into the enlarged slot portion  1432  at an angle, with the reduced-diameter section  388  above the narrow slot portion  1434 . The operator moves the shaft  114  in a clockwise direction indicated by the arrow  1406  towards the receptacle connector  1410 . Through this motion, the operator snap fits the reduced-diameter section  388  of the plug connector  380  through the narrow slot portion  1434  into the narrow receptacle portion  1422  ( FIG. 54B ), and the tip section  385  through the enlarged slot portion  1432  into the enlarged receptacle portion  1414  ( FIG. 54B ).  
       FIG. 55  depicts a schematic view of a receptacle connector  1410   a  which is an alternative embodiment to the receptacle connector  1410 . The receptacle connector  1410   a  includes a tubular housing  1416   a  formed from a substantially tubular wall  1417 , and defines an enlarged receptacle portion  1414   a  and a narrow receptacle portion  1422   a . The receptacle connector  1410   a  also includes an enlarged slot portion  1432   a , aligned with the enlarged receptacle portion  1414   a , and a narrow slot portion  1434   a , aligned with the narrow receptacle portion  1422   a . In this embodiment, the slot portion  1432   a  overhangs the enlarged receptacle portion  1414   a , both axially and radically, and the slot portion  1434   a  overhangs the narrow receptacle portion  1422   a  axially. In some embodiments, the enlarged receptacle portions  1414   a  is sized to be axially longer than the plug connector tip section  385 . In such embodiments, subsequent to mating and in response to exerting axially opposing forces on the plug  380  and receptacle  1410   a  connectors, the tip section  385  slides axially in the direction indicated by an arrow  1408  under the overhang  1417   a  and  1417   b . The tip section  385  stops when its base  381  abuts shoulders  1415   a  and  1415   b  of the enlarged receptacle portion as indicated in phantom and becomes locked in place.  
      In other embodiments, the receptacle portions  1414   a  and  1422   a  are sized as are their counterparts  1414  and  1422  of  FIG. 54B , and the overhangs of the slot portions  1432   a  and  1434   a  have reduced length and/or width relative to their counterparts  1432  and  1434  of  FIG. 54B  and/or relative to the receptacle portions  1414   a  and  1422   a . In all the above embodiments, the overhangs provide further more secure interlocking between the plug connector  380  and the receptacle connector  1410   a , and reduce the likelihood of inadvertent separation.  
      The receptacle connector  1410   a  further includes an enlarged slot portion  1432   a  and a narrow slot portion  1434   a  similar to the enlarged slot portion  1432  and the narrow slot portion  1434 , respectively ( FIG. 54B ). However, the enlarged slot portion  1432   a  and the narrow slot portion  1434   a  are not aligned with but offset from their counterpart receptacle portions  1414   a  and  1422   a . Portions  1417   a  and  1417   b  of the tubular wall  1417  narrows the slot space radially outside distal parts  1440   a  and  1440   b  of the enlarged receptacle portion  1414   a  such that the narrow slot portion  1434   a  is longer than its counterpart  1434  in connector  1410 .  
      The receptacle connector  1410   a  is mounted on the plug connector  380  as with the receptacle connector  1410 . However, the operator can move the shaft  114  in a direction indicated by an arrow  1408  to move the tip section  385  into the roofed distal parts  1440   a  and  1440   b  of the enlarged receptacle portion  1414   a  until the base  381  abuts shoulders  1415   a  as indicated by phantom line. As a result, the interconnection between the two connectors  380  and  1410   a  is more secure than between connectors  380  and  1410 .  
       FIG. 56A  depicts another receptacle connector  419  which interfits, with the plug connector  380  described previously with respect to  FIG. 49A . After they are interfitted, both connectors  419  and  380  can rotate independently while maintaining interfitted. In the illustrative embodiment of the plug connector  380 , the reduced-diameter section  388  has substantially the same length as the receptacle connector  419 .  
      The receptacle connector  419  includes a cylindrical housing  421  with a first  425  and second  423  ends. Preferably, the end  423  attaches to a part of a delivery system such as a medical implant. The housing  421  includes a transverse aperture  418  that extends from a top surface  420  of the connector  419  to a bottom surface  422 . The receptacle connector  419  further includes a first channel  424  on the top surface  420  and a second channel  426  on the bottom surface  422 . The first channel  424  extends from the transverse aperture  418  to the first housing end  425 , and the second channel  426  extends from the transverse aperture  418  to the second housing end  423 . The illustrative housing  421  includes an optional cavity  428  that extends from an opening  430  at the second housing end  423  axially toward the first end  425 . The cavity  428  preferably is dimensioned and shaped to accommodate the tip section  385  of the plug connector  380 . In the illustrative embodiment, the cavity  428  terminates at a back-wall  432 .  
       FIG. 56B  depicts a cross-sectional view of the housing  421  of the receptacle connector  419 , showing the first channel  424 .  FIG. 56C  is a cross-sectional view of the housing  421  showing the second channel  426  at a point between the transverse aperture  418  and the back wall  432 .  FIG. 56D  is a cross-sectional view of the housing  421  showing the second channel  426  and the cavity  428 . As depicted in  FIG. 56B-56D , the first channel  424  includes a first substantially cylindrical receptacle  436 , and the second channel  426  includes a second substantially cylindrical receptacle  438 . Both receptacles  436  and  438  are sized and shaped to accommodate the reduced-diameter section  388  of the plug connector  380 . Specifically, the diameter  437  of the first receptacle  436  and the diameter  439  of the second receptacle  438  are both greater than or equal to the diameter  395  ( FIG. 56A ) of the reduced-diameter section  388 . A first axial opening  427  in the housing top surface  420  provides access to the first channel receptacle  436 . A second axial opening  429  in the housing bottom surface  422  provides access to the second channel receptacle  438 . Both the first and second axial openings  427  and  429  are narrower than the diameter  395  of the reduced-diameter section  384  to lock the reduced-diameter section  388  within the receptacles  436  and  438 .  
      Referring back to  FIG. 56A , to interfit the plug connector  380  within the illustrative receptacle connector  419 , the operator inserts the plug tip section  385  through the transverse aperture  418  from the top surface  420  to the bottom surface  422 . After the reduced-diameter section  388  emerges from the bottom surface  422 , the operator rotates the shaft  114  relative to the receptacle connector  419  in the direction indicated by arrows  434   a  and  434   b . The reduced-diameter section  388  snap fits into the first and second receptacles  436  and  438 , while the proximal base  381  of the tip section  385  fits into the cavity  428 .  
      In response to axially opposing forces on the interfitted connectors  419  and  380 , as indicated by the arrows  440 , the plug tip section  385  backs into the housing cavity  428  until the base  381  of the tip section  385  abuts the back wall  432 . This further locks the plug connector  380  inside of the receptacle connector  419 .  
       FIG. 57  depicts a threaded plug  442  connector and receptacle  444  connector pair according to another illustrative embodiment of the invention. The illustrative plug connector  442  is depicted as being attached to or located at the distal end  121  of the shaft  114  in the delivery device  119 , and the illustrative receptacle connector  444  is depicted as being attached to the sleeve end  100   a  of the sling assembly  11 . However, as previously discussed the plug  442  and receptacle  444  connectors may be located on any delivery system component.  
      The receptacle connector  444  includes a threaded receptacle  446  having an opening  447 . The receptacle  446  includes, on its inside wall  449 , a first set of threads  448 . The plug connector  442  includes a second set of corresponding threads  450  diposed around its periphery. The illustrative plug connector  442  optionally includes a conical distal section  452 . To interfit the plug connector  442  with the receptacle connector  444 , the operator positions the distal opening  447  over the plug distal section  452  and screws (i.e., rotates or threads), the first set of threads  448  onto the second set of threads  450 . To separate the connectors  442  and  444 , the operator rotates receptacle  444  and the plug  442  connectors in a counter clockwise direction relative to each other.  
       FIGS. 58A and 58B  depict an illustrative plug  380  and receptacle  454  connector pair in which the receptacle connector  454  includes an adhesive surface  456 . Preferably, illustrative adhesive surface  456  is sealed with a protective layer  458 , which may be removed prior to use. The receptacle connector  454  further includes an optional support  462 . While the illustrative support  462  is a substantially cylindrical, it can be of any other suitable shape. The illustrative support  462  attaches, through its proximal end  463 , for example, to the sleeve end  100   a . The adhesive surface  456  can be disposed anywhere on the support  462 , for example, as in the illustrative embodiment, at its distal end  460 . In the illustrative embodiment, the adhesive surface  456  include two adhesive flaps  456   a  and  456   b  that are diametrically opposed to each other, forming a pair of adhesive surfaces substantially normal to the support  462 .  
      Referring now to  FIG. 58B , to interconnect the receptacle connector  454  with the plug connector  380 , the operator peels off the protective layer  458  or otherwise removes it to expose the adhesive surface  456 . The operator then interfits the plug  380  and receptacle  454  connectors and folds down the two adhesive flaps  456   a  and  456   b  such that they wrap around the plug connector  380 . A plug connector of any shape can be employed with the receptacle connector  454  and the same embodiment, extended onto and/or around the distal shaft end  121 . In a preferred embodiment, the plug connector  380  and/or the shaft distal end  121  include a roughened surface or contours to facilitate bonding to the adhesive flaps  456   a  and  456   b . The receptacle adhesive surface  456  can be used, for example, to form a non-detachable (e.g., non-reusable) connection between a medical implant and another delivery system component.  
       FIGS. 59A and 59B  depict a receptacle  464  and plug  380  connector pair that interfit through a spring-loaded mechanism. The receptacle connector  464  includes a substantially tubular housing  468  with three portions: a distal portion  468   a  and a proximal portion  468   b , axially separated by an intermediary portion  468   c . The intermediary portion  468   c  includes a wall portion  466  with one or more through apertures  470   a  and  470   b . The illustrative receptacle connector  464  also includes two spring members  472   a  and  472   b  mounted on or formed integrally with the distal housing portion  468   a . Each spring member  472   a  and  472   b  has on its respective proximal end  473   a  and  473   b  a protuberance  474   a  and  474   b . In a rest state, the protuberance  474   a  extends into the aperture  470   a  and the protuberance  474   b  extends into the aperture  470   b . A coaxial tube  478  slidably fits over the distal housing portion  468   b  and the two spring members  472   a  and  472   b . The coaxial tube  478  provides an exemplary mechanism for securing the spring members  472   a  and  472   b  around the distal housing portion  468   a.    
      The tubular member  468  has a tubular cavity  469  into which the protuberances  474   a  and  474   b  radically project. The tubular cavity  469  is sized and shaped to accommodate the plug connector  380 . The distance  480  between the two spring protuberances  474   a  and  474   b , when the spring members  472   a  and  472   b  are not tensioned, is less than the maximum diameter  387  of the plug tip section  385 , but no less than the diameter  395  of the reduced-diameter section  388 .  
      Referring now to  FIG. 59B , to interfit the two connectors  464  and  380 , the operator slides the distal housing portion  468   a  over the tip section  385  of the plug connector  380 . In response to the distal section  385  of the plug connector  380  advancing into the intermediary portion  468   c , the spring protuberances  474   a  and  474   b  are forced to expand radially outward via the apertures  470   a  and  470   b . However, when the reduced-diameter section  388  aligns with the apertures  470   a  and  470   b , the spring protuberances  474   a  and  474   b  spring back into the cavity  469  and engage the reduced-diameter section  388 . With the reduced diameter section so engaged, the operator can slide the coaxial tube  478  over the proximal spring ends  473   a  and  473   b  to lock the spring members  472   a  and  472   b  in place.  
       FIG. 60  depicts a receptacle  495  connector and a plug  503  connector pair that mate through a keying feature according to another illustrative embodiment of the invention. The illustrative plug connector  503  is attached to or otherwise located, for example, at a distal end  492  of a delivery shaft  494 . Shown in a cross-sectional view, the illustrative receptacle connector  495  is attached, for example, to an end of a sling assembly  11 .  
      The illustrative receptacle connector  495  includes a substantially cylindrical receptacle  496  having a distal opening  500 . A cavity  499  extends axially from the distal opening  500  into the receptacle  496 . An inside wall  498  of the receptacle  496  includes a projection  502  that projects radially into the cavity  499 . An internal projection, such as the projection  502 , is advantageous in a surgical procedural including sling placement procedures because it will not catch tissue. Consequently, the internal protuberance  502  makes it easier to tunnel through tissue and reduces tissue trauma. The protuberance  502  may assume any shape and size that allows it to fit into a mating slot  490  in the plug connector  503 . The illustrative protuberance  502  has a substantially rectangular longitudinal cross-section for ease of use, there may be a marking  501  on the outside of the receptacle  496  to indicate the location of the protuberance  502 .  
      The plug connector  503  includes a slot  490  that extends axially towards a shaft distal tip  505 . The slot  490  has an access terminal  506  in a conical tip section  504 . The tapering of the conical tip section  504  allows a key element, such as the protuberance  502  in the receptacle connector  495 , to enter or exit the slot  490 . The illustrative slot  490  is substantially J-shaped and includes three distinct legs  490   a ,  490   b , and  490   c . While all three illustrative legs  490   a ,  490   b , and  490   c  are substantially straight, any number of them may be curved. Each illustrative leg  490   a ,  490   b , and  490   c  meets its adjacent leg at about a right angle, although other angles are contemplated by the invention as well. Traveling between the access terminal  506  and a locking terminal  508  of the slot  490  requires a substantially 180-degree reverse in travel direction. Optionally, other retention features described herein can be combined with the present feature. For example, the slot section  490   c  may narrow towards the locking terminal  508  such that the protuberance  502  is immobilized at the terminal  508 . Alternatively, a locking protuberance such as those described in connection with  FIG. 25, 28 ,  30 , or  31  can be incorporated in the slot  490  for retaining a captured key element, such as the protuberance  502 .  
      To interfit the receptacle-plug connector pair  495  and  503 , the operator, with the visual aid of the marking  501  on the outside of the receptacle  496 , aligns the internal protuberance  502  with the access terminal  506  of the slot  490 . The operator then slides the receptacle opening  500  over the plug tip  505 , and advances the plug distal section  504  into the receptacle cavity  499 . The protuberance  502  slides into the access terminal  506  of the slot  490  and travels axially the length of the first leg  490   a . Then, the operator rotates the receptacle connector  495  in the direction indicated by an arrow  512  to travel the length of the second slot leg  490   b . Finally, the operator pulls back the receptacle connector  495  in the direction indicated by an arrow  510  to travel the length of the final leg  490   c , and lock the protuberance  502 , adjacent to the end  508  of the leg  490   c . To unlock the connector  495  from the connector  503 , the operator performs the above-described steps in reverse.  
       FIGS. 61A and 61B  depict a connector pair  516  and  530  that mate through an internal clip-like protuberance  514  and a roofed slot  538  according to another illustrative embodiment of the invention. The illustrative receptacle connector  516  is attached, for example, to the sling assembly  11 . The illustrative plug connector  530  is attached to or otherwise disposed at, for example, a distal end  532  of a delivery shaft  534 .  
      An illustrative receptacle connector  516 , depicted in longitudinal cross-section, includes a substantially cylindrical receptacle  518 . A cavity  520  extends from an opening  522  axially into the receptacle  518 . The internal protuberance  514  has a base  521  attached to or integrally formed with an inside wall  525  of the receptacle  518 . The protuberance  514  may assume a variety of shapes and orientations. In the illustrative embodiment, the protuberance  514  resembles a clip with a clip tip  523  projecting towards an end  524  of the cavity  520 . The illustrative protuberance  514  extends substantially axially resulting in an elongated space  526  between the protuberance  514  and the inside wall  525 . The internal protuberance  514  may be made of an elastic material. There may be a marking  528 , which may be a paint mark, on the outside of the receptacle  518  to indicate the location and orientation of the protuberance tip  523 .  
      Referring to  FIG. 61B , the mating plug connector  530  includes the slot  538  for capturing and retaining the internal protuberance  514 . The illustrative slot  538  extends axially from a proximal end  544  to a distal end  543 . The slot distal end  543  is under an overhang  531 . The overhang  531 , the slot distal end  543 , and a slot floor  546  form a retention space  548  in the slot  538 . An outer surface  536  of the overhang  531  is ramped downward toward the slot  538  and provides easy entrance into the slot  538 . An outer surface  540  also ramps downward toward the slot  538  at the slot proximal end  544 . The ramped surface  540  provides exit from the slot  538 . Both ramped surfaces  536  and  540  can optionally include steps (not shown). The slot  538  is at least as long as the internal protuberance  514 , so that the entire protuberance  514  can fit inside it. In an alternative embodiment, the slot  538  passes through from a first side  548  to a second side  550  of the connector  530 .  
      To interfit the receptacle connector  516  with the plug connector  530 , the operator, in one exemplary method and with the aid of the marking  528  on the outside of the receptacle connector  516 , aligns the internal protuberance  521  with the distal end  541  of the ramped surface  536 . The operator then slides the cavity opening  522  of the receptacle connector  516  over the conical section  535  of the plug connector  530 , and advances the plug connector  530  into the receptacle cavity  520 . During the advancement, the internal protuberance  514  starts to slide down the ramped surface  536  into the slot  538 , until the protuberance base  521  is stopped by the proximal slot end  544 . Then, the operator reverses his motion and pulls the receptacle connector  516  in the direction indicated by an arrow  550  so that the protuberance tip  523  slides into the retention space  548  in the slot  538 . Meanwhile, the overhang  531  enters the elongated space  526  next to the protuberance  514 . With the protuberance  514  and the overhang  531  projecting in the opposite directions, they interlock and thereby interlock the connectors  516  and  530 .  
       FIG. 62  depicts an open loop  552  and a plug  556  connector pair according to another illustrative embodiment of the invention. The illustrative open loop connector  552  is attached, through a proximal bridge  558 , for example, to the sling assembly  11 .  
      The illustrative plug connector  556  is attached to or otherwise located, for example, at a distal end  571  of a delivery shaft  574 .  
      The illustrative loop connector  552  is formed from a single filament  554 , and includes a first leg  560   b  and a second leg  560   b . The two legs  560   a  and  560   b  are joined at their proximal ends  557   a  and  557   b  to form the C-shaped proximal bridge  558 . Extending distally from the bridge  558 , the two legs  560   a  and  560   b  cross, but do not couple to, each other at a crossing point  562 , and terminate in ends  564   a  and  564   b  of the two legs  560   a  and  560   a , respectively. Each of the ends  564   a  and  564   b  includes a hooks  566   a ,  566   b , respectively. The hooks  566   a  and  566   b , at a relaxed state, approach each other, with or without contacting each other. In the illustrative embodiment, there is a gap  567  between the two hooks  566   a  and  566   b  at the relaxed state.  
      Between the crossing point  562  and the bridge  558 , the legs  560   a  and  560   b  provide a grip section  570   a  and  570   b , respectively, which may be textured. The illustrative grip sections  570   a  and  570   b  run parallel to each other in a relaxed state. When the grip sections  570   a  and  570   b  are compressed towards each other, the first leg  560   a  moves in the direction indicated by an arrow  572   a  while the second leg  560   b  moves in the direction indicated by an arrow  572   b . However, because the legs  560   a  and  560   b  cross over each other, the hooks  566 A and  566 B move away from each other to increase the gap  567 . Where the entire or part of the filament  554  is elastic, such as a spring, the two legs  560   a  and  560   b  spring back to their relaxed state in response to the compressive force against the grip sections  570   a  and  570   b  is removed.  
      A first notch  578   a  is located on a first side  576   a  of the plug connector  556 . A second notch  578   b  is located on a second, opposite side  576   b . The diameter  581  of the plug connector is greater than the gap  567  between the two hooks  566   a  and  566   b  at a relaxed state. Therefore, after the hooks  566   a  and  566   b  engage the notches  578   b  and  578   a , respectively and the operator removes the compressive force, they will be locked inside the plug connector  556 . The illustrative notches  578   a  and  578   b  remain separated by a barrier  582  in between, but they can be joined to form a traverse opening (not shown). The illustrative plug connector  556  also includes a conical section  580  distal to the notches  578   a  and  578   b.    
      To interconnect the two connectors  552  and  556 , the operator compresses, manually or through an instrument, at least one of the grip sections  570   a  and  570   b  towards each other, causing the two distal hooks  566   a  and  566   b  to part and the open loop  568  to expand. Then the operator slides the two legs  560   a  and  560   b  onto the two sides  576   a  and  576   b  of the plug connector  556  until the hooks  566   a  and  566   b  enter the notches  578   b  and  578   a , respectively. Then the operator releases the grip sections  570   a  and  570   b , and the hooks  566   a  and  566   b  return from the compressed state to the relaxed state and converge to each other and project radically into respectively the notches  578   a  and  578   b . To separate the two connectors  552  and  556 , the operator reverses the above steps.  
       FIG. 63A  depicts connectors that can potentially interconnect more than two parts of the delivery system, even if only temporarily, during use. This inventive aspect is illustrated with applications involving a guide tube, but are equally applicable to other parts of the delivery system.  
      In the illustrative embodiment, plug connectors  626   a  and  626   b  are provided to interconnect a shaft  600 , a guide tube  602 , and a sling assembly  604 . The shaft  600  can optionally connect with a handle  606 , for example, with a proximal shaft end  608  that slidably resides in an axial lumen in the handle  606 . An opposite, distal end  610  of the shaft  600  slides into a proximal opening  612  of the guide tube  602  such that at least part of the shaft  600  slidably resides in an axial lumen  614  ( FIG. 63B ) of the guide tube  602 . The illustrative shaft distal end  610  includes a tapered distal tip  611 . The lumen  614  ( FIG. 63B )of the guide tube  602  extends between a proximal opening  612  and a distal opening  616  of the guide tube  602  (not shown). The guide tube  602  includes a distal end  617  and a proximal end  619 . In one embodiment, the proximal end  619  is flared, i.e., having an outer diameter larger than the rest of the guide tube  602 . The sling assembly  604  includes two identical free ends: a first end  618   a  and a second end  618   b , and a sling  620  at least partly enveloped in a sleeve member  622 .  
      Optionally, the two ends  618   a  and  618   b  of the sling assembly  604  each include a dilator ( 624   a ,  624   b ). A first plug connector ( 626   a ,  626   b ) is attached to each of the free sling assembly ends  618   a  and  618   b , for example, through pre-associating with the dilators  624   a  and  624   b , respectively. The first connector ( 626   a ,  626   b ) can be manufactured as an integral piece with the dilator ( 624   a ,  624   b ).  
       FIG. 63C  depicts, in a cross-sectional view, the illustrative plug connector  626   a  including a “barbed” distal section  628  and a reduced-diameter section  630 , for example, a circular notch. The distal section  628  has a maximum diameter  629  at its base  634 . The maximum diameter  629  is greater than diameter  633  of the reduced-diameter section  630 . The distal section  628  tapers radically inward towards a distal end  632  to facilitate insertion into a mating receptacle connector  640  and forms a shoulder  634  for hindering movement in the proximal direction as indicated by an arrow  633  by the distal section  628 . The shoulder  634  may be formed at any angle  636  less than or equal to about 90° relative to a longitudinal axis of the connector  626   a . Illustratively, the angle  636  is depicted as being 90°. The distal end  632  of the distal section  628  includes an opening  638  that is shaped and sized to fit at least a portion of the distal tip  611  of the shaft  600 . The connector  626   a  may be made of any suitable material, for example, plastics, rubber, or a metal, through processes known in the art, for example, tip molding.  
      Referring back to  FIG. 63A , the distal  617  and/or proximal  619  ends of the guide tube  602  can include a second receptacle connector  640 .  FIGS. 63B and 63D  depict, in cross-sectional views, the second receptacle connector  640  including an optional annular stepped-up portion  642  narrowing the lumen  614 . The resultant lumen space  614   a  between the protuberance  642  is narrower than the maximum diameter  629  in the distal section  628  of the first connector  626   a  ( FIG. 63C ). The illustrative stepped-up portion  642  is disposed at the opening  612  or  616  of the lumen  614 . The internal protuberance  642  may be manufactured as an integral part of the receptacle connector  640  or the guide tube  602 .  
       FIG. 64  depicts the first plug connector  626   a  interconnecting with both the distal tip  611  of the shaft  600  and the second receptacle connector  640 . There are a few ways to accomplish this connection. In a first example, the tip  611  of the shaft  600  is first inserted into the distal opening  638  in the first connector  626   a  when the tip  611  is extended outside the distal opening  616  of the guide tube  602 . This insertion step can be accomplished by either moving the first connector  626   a  or the shaft  600  or both. Then, the operator can push the base part of the first connector  626   a , for example, the dilator  624   a , under the guidance of the interconnected shaft tip  611  into the distal opening  616  of the guide tube  602 . Optionally, to facilitate the insertion of the first connector  626   a  past the internal protuberance  642 , either or both the distal section  628  of the first connector  626   a  or the second connector  640  can include longitudinal slots as described in connection with  FIGS. 45 and 46 A. After the first connector  626   a  enters the distal opening  616  of the guide tube  602  and passes the protuberance  642 , the protuberance  642  encircles the reduced-diameter section  630  of the first connector  626   a  and locks it in.  
      In a second example, the shaft tip  611  is inserted into and retained in the distal opening  638  of the first connector  626   a , for example, if the distal opening  638 &#39;s lumenal diameter is no larger than the thickest point on the shaft tip  611  such that the shaft tip  611  gets stuck once inserted into the distal opening  638 . In alternative embodiments, any of the connector pairs or their associating features described in this specification can be utilized to retain or lock the connection between the shaft tip  611  and the distal opening  638  of the first connector  626   a  once the connection is made. Then, the operator withdraws the shaft tip  611  back into the lumen  614 , guiding the first connector  626   a  into the distal opening  616  of the second connector  640 . Of course, the operator can interconnect the first connector  626   a  with the second connector  640  by holding fast the second connector  640  in one hand and insert the first connector  626   a  through the distal opening  616  in the second connector  640 . The rest of the steps are the same as described immediately above.  
      With the second connector  640  disposed in the proximal end  619  of the guide tube  602  and using one of the above described methods, the first connector  626   a  can be interconnected with the second connector  640  when the shaft  600  is withdrawn out of the guide tube  602 . It is also contemplated by the invention that the shoulder  634  can form a barb  631  that is sufficient to interfit and retain itself inside the second connector  640  even if the second connector  640  does not have the internal protuberance  642 , but instead a smooth inner wall. In that case, the shoulder  634  preferably has a cross-sectional dimension (for example, a diameter in a circular cross section) at least as large as the cross-sectional dimension of at least the narrowest part of the lumen  614  in the guide tube  602 , so that the barb  631  engages the lumenal wall in the guide tube  602  to impede disconnection.  
       FIG. 65A  depicts a sheath  650  that can be used in combination with any connector pair, including the connectors described in this application. The sheath  650  slidably encloses a part in the delivery system, for example, at least a portion of a shaft  652 . The sheath  650  can be disposed on other parts of the delivery system, such as the sling assembly. The sheath is preferably colored, for example, blue, so that a medical operator can distinguish it from surrounding tissue during a cystoscopy. The sheath  650  may be made, for example, of medical-grade plastics, silicone rubber, polymer or similar materials. In an alternative embodiment, the sheath  650  is made of a metal. The sheath  650  has a distal portion  654  and, optionally, a proximal “hub”  656  with an enlarged outer diameter. An annular collar  655  is, optionally, disposed in the distal portion  654  of the sheath  650 . In one embodiment, the surface of the annular collar  655  is textured. The shaft  652  has a distal portion  657  and a proximal portion  658  that is associated with a handle  660 . The sheath  650  may or may not be operatively connected to the handle  650  for slideable actuation along the shaft  652 . Additionally, the length of the sheath  650  can range from less than about two inches to almost as long as the shaft  652 .  
      In one embodiment, the stopper  662  extends from the handle  660  in the direction of the sheath  650 . A stopper  662 , when deployed, stops the sheath  650  from moving in the proximal direction, toward the handle  660  to maintain the distal portion  654  of the sheath  650  over the distal portion  657  of the shaft  652  (the “advanced position” of the sheath  650 ). When the stopper  662  is not deployed, the sheath  650  can slide in the proximal direction into a withdrawn position, for example, until the hub  656  meets the handle  660 . An example of a suitable stopper  662  includes a spring lever that remains deployed unless compressed.  
      To advance the sheath  650  to its advanced position, the operator can manually push the proximal hub  656  in the distal direction. Alternatively, if there is a pusher assembly such as the one described in connection with  FIGS. 3-6 , the operator can actuate the pusher assembly to advance the sheath  650 . Further, if the operator is pulling the sheathed shaft  652  in the proximal direction through a tunnel in the tissue, the surrounding tissue will push and squeeze the sheath or optionally the annular collar  655  at the distal portion  654  of the sheath  650  such that the sheath  650  advances in relation to the shaft  652 .  
      Referring now to  FIG. 65B , when the sheath  650  is at the retracted position. The retracted sheath  650  exposes a slotted connector at the distal shaft portion  657 . In one embodiment, the connector is a receptacle connector  666  similar to receptacle connectors previously described in connection with  FIGS. 22A-35 . In the illustrative embodiment, the loop connector  664  is similar to loop connectors already described, such as those described in connection with  FIGS. 22A-25 ,  33 ,  34 , and  36 A- 38 .  
      Once the loop  664  and receptacle  666  connectors are interfitted, the sheath  650  is axially actuated to the position shown in  FIG. 65A  to shield at least the receptacle connector  666 . The stopper  662  is deployed to lock the sheath  650  at the advanced position. An otherwise exposed slot  668  shown in  FIG. 65B  can catch tissue during subsequent maneuver through patient tissue. In another embodiment, at the advanced position, the distal portion  654  of the sheath  650  abuts the dilator  680  to shield not only the receptacle connector  666  but also the interconnected loop connector  664  and a portion of the dilator  680 . Accordingly, the interconnected shaft-dilator complex may have a smooth transition and a constant diameter, and the sheath  650  also serves a locking and retention function. To separate the connectors  664  and  666 , the operator can deactivate the stopper  662  ( FIG. 65A ), and pull the proximal hub  656  towards the handle  660  to expose and separate the connectors.  
      Further, because the sleeve end  684  surrounds (e.g., through heat bonding) the proximal portion  686  of the dilator  680 , the proximal portion  686 , especially the back edge  688 , will not be caught in the tissue during sling delivery or adjustment, for example, when the operator has to pull the sling assembly  678  back through a tunnel to reposition it. The sling assembly  678  needs to be repositioned when the bladder has been punctured during the delivery process. To aid the detection of bladder puncture under a cystoscope, the sleeve assembly  678 , for example, the sleeve  682  or the mesh sling (not shown), may be colored (e.g., blue). In use, an operator can delay any cystoscopy until one or both sleeve ends of the sling assembly  678  are in one or two tissue tunnels to check for visual signs of the colored sling assembly and/or other colored components of the delivery system such as the shaft  652 , the sheath  650 , or a guide tube.  
       FIG. 66A  depicts a sheath  671  that can be used as an alternative to the sheath  650 . In the illustrative embodiment, the sheath  671  slidably fits over the distal portion  657  of the shaft  652 . The slotted receptacle connector  666  is disposed at the shaft distal portion  657  as previously described with respect to  FIG. 65B . The loop connector  664  interconnects with the receptacle connector  666 . An optional stopper  673  is disposed adjacent the shaft distal portion  657  to prevent the sheath  671  to travel past it over the shaft  652 . The illustrated stopper  673  is an annular ring. In another embodiment, the stopper  673  is a stepped up portion of the shaft  652  that can extend proximally to any length. Alternatively, the sheath  671  can be friction fitted onto the shaft distal portion  657  such that no stopper is  673  needed and the sheath  671  will substantially maintain its position relative to the shaft  652 . There are various ways to achieve a frictional fit. For example, the sheath  671  can have an inner diameter that matches or is slightly less than the outer diameter of the shaft distal portion  657 . For example, the sheath  671  can have an axial opening and an inner diameter slightly less than the shaft outer diameter so that the sheath  671  can be snapped onto the shaft distal portion  657  through the opening. Alternatively, the sheath  671  can be heat shrunk over the shaft distal portion  657 .  
      The illustrative sheath  671  is of a length that covers the joint length between the receptacle connector  666  and the loop connector  664  when the connectors are interconnected. In another embodiment, the sheath  671  is of a length that only covers the connector slot  668 . In one embodiment, the sheath  671  is less than about one inch. The operator, after interconnecting the two connectors  664  and  666 , can manually slide the sheath  671  over the connectors to lock the interconnection. In an alternative embodiment, the sheath  671  is located on the sleeve assembly, for example, the dilator  680 , and can also be manually actuated to slidably shield the slotted receptacle connector  666 , or both connectors  666  and  664 .  
       FIG. 66B  depicts a partial cross sectional view of another alternative sheath  681  that covers at least part of the slot  668  in the receptacle connector  666 . The illustrative sheath  681  abuts a stepped-up portion  683  of the shaft  652 . A distal portion  681  a of the sheath  681  covers a portion of an entry notch  670  of the connector slot  668 . In use, a loop  676  of a mating loop connector  664  has to deflect the sheath distal portion  681  a to enter the entry notch  670 . The illustrative sheath  681  is flexible and returns to the overlaying position afterwards and locks the mating loop  676  inside the receptacle slot  668 . The illustrated sheath  681  can be deflected to release the mating loop  676 . In one embodiment, the sheath  681  is heat shrunk plastics such as polytetrafluoroethylene (PTFE) or tetrafluoroethylene (TFE).  
       FIGS. 67A and 67B  depict an alternative sheath  690  that automatically locks in the connection between two connectors, even before the interconnected devices travel through the patient&#39;s tissue. The sheath  690  slidably encloses at least a portion of in the delivery system, for example, at least a portion of the shaft  652 . The shaft  652  has the receptacle connector, for example, a receptacle connector  666 , at the distal portion  657  of the shaft  652 . The receptacle connector  666  includes a slot  668  that, in one embodiment, includes an entry notch  670  and a retention slot  672  connected at the bottom  671  of the entry notch  670 , forming an “L.” 
      The sheath  690  may share many features with the sheath embodiment  650  described immediately above. In addition, the sheath  690  has a slot  692  that extends from the periphery towards the long axis of the sheath  690 . The slot  692  in the sheath  690  substantially matches, in size and shape, the entry notch  670  of the L-slot  668  in the receptacle connector  666 .  
      The plug connector, for example, the loop connector  664  has a loop  676  and is attached to the dilator  680  of the sling assembly  678 . The loop  676  may be formed fromm a suturing material. Alternatively, the loop  676  may be formed from a semi-flexible, shape-retaining material. To interconnect the loop connector  664  with the receptacle connector  666 , the operator matches up the slot  692  in the sheath  690  with the entry notch  670  in the receptacle connector  666 , and hooks the loop  676  of the loop connector  664  into the slot  692 /entry notch  670 . The operator then sinks the loop  676  into the bottom  671  of the entry notch  670  of the receptacle connector  666 .  
      Specifically referring to  FIG. 67B , after the loop  676  reaches the bottom  671  of the entry notch  670  of the receptacle connector  666 , the operator can pull the dilator  680  in a direction indicated by an arrow  694  such that the loop  676  of the loop connector  664  slides down the retention slot  672  of the receptacle connector  666 . Alternatively, if the loop  676  is an adjustable and lockable loop as described in connection with  FIGS. 36A-38 , the operator can tighten and lock the loop  676  against the distal portion  657  of the shaft  652 , which would similarly cause the loop  676  of the loop connector  664  to slide down the retention slot  672  of the receptacle connector  666 . Because the loop  676  is still hooked in the sheath slot  692 , the sheath  690  advances in the direction indicated by the arrow  694  along with the loop  676  of the loop connector  664 . Now that the sheath slot  692  is no longer matched up with the entry notch  670  in the receptacle connector  666 , the sheath  690  locks the loop  676  inside the retention slot  672 . To unlock the two connectors  664  and  666 , the operator can pull the sheath  690  in the direction opposite to the arrow  694 , or, in the case of a adjustable and lockable loop  676 , unlocks and lengthens the loop  676 , until the sheath slot  692  is matched up with the entry notch  670  in the receptacle connector  666 .  
       FIG. 68  illustrates, in a cross-sectional view, connectors with applications in associating an implant to the side of one or more guide tubes. A delivery device  700  includes a shaft  702  and a guide tube  704 . The shaft  702  has a distal portion  706  and a proximal portion  708 . The shaft  702  may be straight or curved, and may have features described elsewhere in this application. The proximal end  708  of the shaft  702  connects to the handle  710 . The guide tube  704  may function as a dilator tube. In one embodiment, the guide tube  704  is separate from and not attached to, the handle  710 . However other embodiments, the guide tube  704  attaches either reversibly or permanently the handle  710  through an actuator, such as those described in connection with  FIGS. 7A and 7B .  
      The guide tube  704 , according to an illustrative embodiment of the invention, is elongated and includes a wall  712 . The wall  712  has a proximal end  714 , a distal end  716 . A lumen  718  axially extends between a distal opening  722  and a proximal opening  720 . According to one feature of the illustrative embodiment, the lumen  718  slidably receives the shaft  702  through a proximal opening  720 . In alternative embodiments, the guide tube  704  may instead include port  721  in the side of the wall  712  for receiving the shaft  702 . The illustrative guide tube  704  is of a length such that when the shaft  702  resides inside the lumen  718 , the distal tip  707  of the shaft  702  extends outside the distal opening  722 . According to another feature, the proximal end  714  of the dilator tube  704  flares so that the outside diameter of the proximal end  714  is wider than the outside diameter of the remainder of the dilator tube  704 . However, in alternative embodiments the outside diameter of the dilator tube  704  is substantially uniform from the proximal end  714  to the distal end  716 .  
      According to one feature of the invention, the guide tube  704  has first  724   a  and second  724   b  connectors axially separated along it. Preferably the first connector  724   a  is located at the distal end  716  and the second connector  724   b  is located at the proximal end  714 . In one embodiment, both the first and second connectors  724   a  and  724   b  include side openings or sockets and may extend into the lumen  718 . In another embodiment, the first and second connectors  724   a  and  724   b  are depressions or indentations in the side of the guide tube  704  and do not extend into the lumen  718  of the guide tube  704 . The first and second connectors  724   a  and  724   b  may be any suitable connectors, including those described elsewhere in this application. The first and second connectors  724   a  and  724   b , in an optional feature, align with each other radically along guide tube  704 . In another embodiments (not shown), the first connector  724   a  and second  724   b  may be radically offset from each others.  
      With continued reference to  FIG. 68 , an implant, for example, a sling assembly  726  is shown with a mesh sling  728  at least partly enveloped in an optional sleeve member  730 . The sling assembly  726  attaches to the guide tube  704  via connectors  732   a  and  732   b , which interfit with connectors  724   a  and  724   b , respectively.  
      Referring now  FIG. 69 , an assembled delivery system includes the delivery device  700  guide tube  704  and sling assembly  726 . As shown, with the sling assembly  726  and guide tube  704  interconnected as described above, the guide tube  704  slidably interfitted proximal end  720  first over the shaft  702 , to expose the distal tip  707  of the shaft  702 . In an alternative embodiment (not shown), the guide tube  704  is longer than the shaft  702 . In such an embodiment, the guide tube  704  can slidably retract to expose the distal tip  707  of the shaft  702  during a tissue piercing procedure. For example, the guide tube  704  can slidably retract into the handle  710 . In another alternative embodiment, without regard to their comparative lengths, the shaft tip  707  is exposed by an actuator that is either operatively associated with the guide tube  704  or the shaft  702 , an which can actuate the shaft  702  or the guide tube  704  axially, related to the other. Examples, of such embodiment are described in connection with  FIGS. 7A-8B .  
       FIG. 70  depicts a side view of a delivery system in which the sling assembly  726  is attached at the connector  732   a  to a proximal end  746   a  of the first guide tube  740   a  and at the connector  732   b  to a proximal end  746   b  of a second guide tube  740   b . The second guide tube  740   b  slidably interfits over the shaft  702  via proximal opening  750 . The first guide tube  740   a  slidably interfits over the second guide tube  740   b  via a proximal opening  744 . The distal tip  707  of the shaft  702  extends through a distal opening  742  of the first guide tube  740   a . Both illustrative proximal tube ends  746   a  and  746   b  are flared. Each of the guide tubes  740   a  and  740   b  has a connector  748   a  and  748   b  for mating interconnection with the sling assembly connectors  732   a  and  732   b , respectively.  
       FIG. 71  depicts an alternative embodiment where the sling assembly  726  is interconnected with guide tubes  752   a  and  752   b  having side ports  754   a  and  754   b  through which the shaft  702  is inserted. More particularly, the shaft  702  is passed through the guide tube  752   b  via the side port  754   b , and the guide tube  752   a  slidably interfits over the guide tube  752   b  via the side port  754   a . Similar to the guide tubes  740   a  and  740   b  depicted in  FIG. 70 , each of the guide tubes  752   a  and  752   b  has the connector  748   a  and  748   b  for mating interconnection with the sling assembly connectors  732   a  and  732   b , respectively.  
       FIG. 72  depicts a sling delivery system  731  where the sling assembly  103  is attached to a guide tube  735   a , the guide tube  735   a  slidably interfits over the shaft  14 , and the pusher assembly  30  facilitates the removal of the guide tube  735   a  from the delivery shaft  14 . The sling delivery system  731  includes at least one delivery device  10 , the pusher assembly  30 , the sling assembly  103 , and two guide tubes  735   a  and  735   b . The delivery device  10  is of the general type described above in  FIGS. 1 and 2 , and includes the handle  12 , and the shaft  14  fixedly disposed at its proximal end  22  within the handle  12  and extending away from the handle  12 .  
      The shaft  14  includes a first straight section  743   a , a curved section  745 , and a second straight section  743   b . The first straight shaft section  743   a  attaches to and extends distally from a distal end  16  of the handle  12 . The curved shaft section  745  extends distally from the first straight section  743   a . The second straight section  743   b  extends distally from the curved section  745 , and terminates at a conical distal tip  26 .  
      The pusher assembly  30 , described above with respect to  FIGS. 3-6 , includes the pusher tube  31  slideable fitted over a portion of the first straight shaft section  743 . Both the illustrative shaft  14  and the illustrative pusher assembly  103  are formed of surgical grade stainless steel, and excluding the conical tip  26 , have a constant diameter along their respective lengths.  
      The illustrative sling assembly  103  is of the type described above with respect to  FIG. 21 . The sleeve ends  108   a  and  108   b  connect to first ends  733   a  and  733   b  of guide tubes  735   a  and  735   b , respectively. The illustrative sleeve ends  108   a  and  108   b  are heat bonded to the first tube ends  733   a  and  733   b . The illustrative guide tubes  735   a  and  735   b  each include a first opening  737   a  or  737   b , a second opening  739   a  or  739   b  and a lumen  741  extending there between. The second tube ends  747   a  or  747   b  includes a tapered section  749   a  or  749   b , respectively, that substantially conforms to part of the conical shaft tip  26 .  
      Each of the two guide tubes  735   a  and  735   b  slidably fits over the conical shaft tip  26  and along the length of the shaft  14 , one at a time, to abut the pusher assembly  30 . Each illustrative guide tube  735   a  or  735   b  is a blue, flexible polymer tube. When the pusher assembly  30  is retracted and the first tube end  733   a  abuts the pusher assembly  30 , the conical shaft tip  26  extends beyond the distal tube end  747   a  or  747   b , and can be used for tissue piercing or tunneling. When the operator pushes the pusher  30  into the advanced position, the second tube end  747   a  or  747   b  moves distal to the conical shaft tip  26  and becomes accessible for removal from the shaft  14 . During removal, the medical operator grasps the tube end  747   a  or  747   b , either by hand or using forceps and pulls in a proximal direction on the delivery device  10 .  
      IV. Exemplary Procedures  
      Described below are various illustrative methods for delivering an implant, such as a sling or its assembly, to an anatomical site in the body of a mammalian patient. The illustrative methods include suprapubic, prepubic, trans-obtruator and transvaginal approaches.  
       FIGS. 73A-73E  depict steps in an illustrative suprapubic-to-vaginal approach (the “suprapubic approach”) to delivering a sling to a midurethral location or other suburethral tissue. Specifically referring to  FIG. 73A , a delivery device  760  includes a shaft  762  attached at a proximal end  768  to a handle  764 . A first optional guide tube  766  slidably interfits over a distal end  770  of the shaft  762  via a proximal opening  774 . Interfitted as such, a conical tip  772  at a distal end  770  of the shaft  762  extends through a distal opening  776  in the guide tube  766 . The shaft  762  may be curved or straight or include both curved and straight sections, and can be any of the various embodiments described in this application. The proximal end  775  of the guide tube  766  may or may not be operatively connected to the handle  764 . The delivery device  760  may further include a pusher assembly, for example, as described in connection with  FIGS. 3-6 , for activating the guide tube  766  off the shaft  762 . In the illustrated embodiment, the proximal end  775  of the guide tube  766  is depicted as being flared. However, this need not be the case. Either or both of the distal end  770  of the shaft  762  and a distal end  777  of the guide tube  766  include a first connector  779  marked in general with a circle, which can be any suitable connector, such as and without limitation, any of the connectors described herein or in a disclosure incorporated by reference.  
      The procedure of  FIGS. 73A-73C  employ a sling assembly  788 . The sling assembly  788  may be any suitable sling assembly, such as and without limitation, any of the sling assemblies disclosed herein or in disclosures incorporated by reference. The particular sling assembly  788  includes a mesh sling  790 , partially enclosed by a sleeve  792 . A tab or fastener  794  attaches to the sleeve  792  at an intermediate location to aid in sling placement and in removal of the sleeve  792  from the body of the patient. The sling assembly  788  at end  796   a  includes or attaches to a connector  798   a . Similarly, the sling assembly at end  796   b  attaches to or includes a connector  798   b . The connectors  798   a  and  798   b  may be any suitable connector, such as and without limitation, any connector described herein or in a disclosure incorporated by reference.  
      In use, the medical operator grasps the proximal end  768  of the shaft  762  or the handle  764 , and introduces the shaft  762 , optionally sheathed in the guide tube  766 , into a patient through a puncture  778  in the abdominal skin  780 . The delivery device  760  tunnels through the abdominal wall, abdominal fascia, and rectus fascia until the shaft tip  772  emerges through a second puncture  782  in the vaginal wall  784 , creating a first tunnel  785  between the abdominal puncture  778  and the vaginal puncture  782  on one side of the urethra  786 .  
      To make sure that the bladder (not shown) is not accidentally punctured by the advance of the delivery device  760 , a cystoscopy may be performed at any point during the surgical procedure to look inside the urethra  786  and the bladder. In a preferred embodiment, the guide tube  766  and/or the shaft  762  and/or the sleeve  792  and/or the sling  790  exhibits a visible or discernable optical property, for example, by being blue or green in color, to distinguish it from the tissue and fluid in the urethra and the bladder. In the embodiment where the guide tube  766  includes apertures as described in connection with  FIGS. 10A, 10B  and  11 , the operator can skip the cystoscopy step and instead rely on being alerted by bodily fluid from the bladder, such as urine or blood, flowing out of one of the apertures, in case of inadvertent puncture of the bladder. Further, if the shaft  762  is sheathed by the guide tube  766 , the guide tube  766  may be placed and cystoscopy delayed until another guide tube is placed on the contralateral side, and only one cystoscopy needs to be performed.  
      Referring also to  FIG. 73B , in the embodiment where the delivery device  760  does not include a guide tube, the operator interconnects the shaft connector  779  with the sling assembly end connector  798   a , and withdraws the shaft  762  back into the first tunnel  785  and out of the abdominal puncture  778  until the sling assembly end  796   a  emerges from the abdominal puncture  778 . The operator then separates the connector  779  from the connector  798   a.    
      The operator then repeats the above steps on the contralateral side of the urethra  786  and creates a second tunnel  800  with the same shaft  762  or a second shaft. As mentioned above, if a second shaft is used, the operator can leave the first shaft  762  in the first tunnel  785  and wait until this point to conduct a single cystoscopy to confirm that neither shaft has punctured the bladder. Assuming the operator is using the same shaft  762 , however, the operator interconnects the shaft connector  779  to the sling assembly connector  798   a . The operator then withdraws and pulls the shaft  762 , along with the interconnected sling assembly end  796   b , through the second tunnel  800  until the end  796   b  emerges on the contralateral side. The operator separates the connector  779  from the connector  798   a  or dissociates the connector  798   b  from the sling assembly  788 , for example, by cutting.  
      Referring specifically to  FIG. 73C , in the optional embodiment where the delivery device  760  includes a guide tube  766 , after the distal end  777  of the guide tube  766  becomes interconnected with the sling assembly end  796   a  through the connector  779  and the connector  798 , the operator withdraws the shaft back from the first tunnel  785  and out of the abdominal puncture  778 , leaving the guide tube  766  inside the first tunnel  785 . Subsequent to confirming through cystoscopy that the bladder has not been punctured or perforated, the operator pulls the guide tube  766  out of the abdominal puncture  778  through the first tunnel  785 , along with the sling assembly end  796   a . Alternatively, the operator can wait until a second guide tube is placed similarly on the contralateral side before pulling the first guide tube  766  out of the first tunnel  785 , allowing a single cystoscopy to be performed. The proximal end  775  of the first guide tube  766  may be held in place, if necessary, with a hand or a medical instrument for example, a clamp. However, in the embodiment where the proximal end  775  of the first guide tube  766  is flared, i.e., has a larger outer diameter than rest of the guide tube  766 , the flaring on the guide tube  766  helps to prevent the guide tube  766  from slipping into the first tunnel  785 .  
      The operator repeats the above steps on the contralateral side of the urethra  786  and creates a second tunnel  800  with the delivery device  760 , substituting the guide tube  766  with a guide tube  766 ′ having a connector  779 ′ at its distal end  802 . The guide tube  766 ′ is preferably identical to the guide tube  766 . After the distal end  802  of the guide tube  766 ′ emerges from a second vaginal puncture  782 ′ in the vaginal wall  784 , the operator interconnects the connector  779 ′ attached to the guide tube  766 ′ with the sling assembly connector  798   b . The operator then pulls the guide tube  766 ′ by its proximal end  775 ′ through the second tunnel  800  until the end  796   b  of the sling assembly  788  emerges out of the abdominal incision through the second tunnel  800 . After performing cystoscopy in series with the placement of each guide tube, or a single cystoscopy after both tubes are placed, to make sure that neither guide tube  766  or  766 ′ has punctured the bladder, the operator separates the guide tube  766  from the sling end  796   a  and separates the guide tube  766 ′ from the sling assembly end  796   b . If a puncture is found in either the bladder or the urethra  786 , the operator may remove either or both the guide tubes  766  and  766 ′ and repeat the above steps to reinsert the guide tube(s).  
      Referring now to  FIG. 73D , regardless of whether guide tubes ( FIG. 73C ) or only shafts ( FIG. 73B ) are used, the operator adjusts the position and tension in the sling assembly  788  to finish the delivery process. The operator may also use a medical instrument, for example, forceps, to adjust the sling assembly  788 . Subsequently, the operator removes the sleeve  792 , and other components of the sling assembly  788  such as the connectors  798   a  and  798   b  if still attached, from the patient. For example, the operator may cut the fastener tab  794  to separate the sleeve  792  into two sleeve segments  792   a  and  792   b . Then the operator can pull the sleeve segments  792   a  and  792   b  by their ends  796   a  and  796   b  out the first  785  and second  800  tunnels, respectively. Only the mesh sling  790  is left within the patient body in the periurethral tissue, for example, underneath the midurethra  786  or the bladder neck, and may be trimmed at each end to just below the skin of the abdomen.  
      Referring now to  FIG. 73E , after the mesh sling  790  has been delivered and placed in the periurethral tissue, the abdominal and vaginal wounds are sutured if needed. The implanted sling  790  elevates part of the vaginal wall  784  and its surrounding tissue, as a solution to treat urinary incontinence.  
      The above methodology may be employed for any abdominal entry approach, such as, for example, a prepubic approach.  
      In the above-described suprapubic and prepubic approaches, specific advantage may be achieved where a shaft  762  of the type described in connection with  FIGS. 13A, 13B , and  14 - 16  is used. That advantage is now described in the context of tunneling from the abdominal puncture to the vaginal puncture using the shaft  80 . The other steps in this embodiment of the approach are similar to the ones described in connection with the shaft  762  and will not be repeated.  
       FIG. 74  illustrates, through a schematic side view of the female pelvic area, an illustrative embodiment of the invention casing the delivery device described with respect to  FIG. 15 . The illustrative shaft  80  is attached to the handle  81 . The shaft  80  includes at least two arcs  84  and  85 . The shaft  80  also optionally includes an angled distal end  91   b . The operator grasps the handle  81  and introduces the shaft  80  through the abdominal skin  780 , abdominal wall, abdominal fascia, and rectus fascia in the suprapubic region of the pubic area until the distal end  91  of the shaft  80  emerges through the incision on one side of the vaginal wall  784 . The arcs  84  and  85  enable the operator to pass through the suprapubic region to the vagina and navigate around internal organs more easily than a single arc/curve configuration. The shaft  80  is inserted at a first position  810  (phantom line) through the abdominal skin  780 , abdominal wall, abdominal fascia, to the suprapubic region of the pubic area, near the pubic bone  812 . In a preferred embodiment, the distal tip  91   b  is pointed toward the pubic bone  812 , and away from other organs such as the bladder  811  to prevent puncturing them.  
      The operator moves the shaft  80  from the first position  810  to a second position  814  in a direction indicated by a first arrow  816 . The arcs  80  and  82  enable the operator to move the distal tip  91  of the shaft  80  along the contour of the pubic bone  812 . From the second position  814 , the operator pushes the shaft  80  in the direction indicated by a second arrow  818  and the shaft  80  passes adjacent the posterior side  820  of the pubic bone  812  on its way towards the vagina  815 .  
      With continued reference to  FIG. 74 , during the procedure, the operator directs the angled distal end  91  along the posterior side  820  of the pubic bone  812  to avoid accidental perforation of other organs while advancing towards the target area. The plurality of arcs in the shaft  80  provides ergonomic benefits. For example, the first arc  80  provides the medical operator with clearance between the medical operator&#39;s hand and the patients body while allowing the operator to exert sufficient force onto the shaft  80  to advance the shaft  80  in its intended course, for example, from the second position  814  in the direction indicated by the second arrow  818  during the above-described embodiment of suprapubic approach. The contour of the shaft  80  and the angle of the distal end  91  of the shaft  80  work together to lessen the risk of injuring organs including the urinary bladder  811 , which could otherwise be harmed during the surgical procedure. The operator may perform cystoscopy to determine if the bladder had been perforated.  
      Referring now to  FIG. 75 , the operator may opt for the pre-pubic approach, which tunnels between the abdominal skin  780  and the anterior side  821  of the pubic bones  812  to eliminate any chance of perforating the bladder  811 . In an illustrative embodiment, the delivery device described with respect to  FIG. 15  having the shaft  80  with at least two arcs  84  and  85  is again used as an example to illustrate the principle of this approach, while shafts of other shapes and structures may be used for the pre-pubic approach as well. The medical operator grasps the handle  81  and introduces the shaft  80  through a puncture  822  in the abdominal skin  780 , with the angled distal end  91   b  first, into the abdominal fascia, and through the pre-pubic region of the pubic area until the distal end  91   b  of the shaft  80  emerges through an incision on the vagina wall  826 . Specifically, the shaft  80  passes along the anterior surface  821  of the pubic bone  812 , for example, from a first position  826  (shown in phantom) to a second position  828 , while the angled distal end  91   b  of the shaft  80  follows the contour of the anterior surface  821  of the pubic bone  812 . Because the bladder  811  and other vital organs are posterior to the pubic bone  812 , the operator eliminates the risk of inadvertent perforation of these organs by passing through the pre-pubic region to the vagina  815 . Similar to what is described in connection with the suprapubic approach, the plurality of arcs  84  and  85  in the shaft  80  provides ergonomic benefits for the procedure. In the pre-pubic-to-vaginal method, the operator does not need to conduct any cystoscopy to confirm the integrity of the bladder and the urethra.  
      After a first tunnel from the abdominal skin  780  to the vaginal wall  826  is created through the above steps, the remaining aspects of the pre-pubic approach is the same as the supra-pubic approach described above. The prepubic approach can also be performed with two needles with or without guide tubes.  
       FIGS. 76A and 76B  depict steps of a transvaginal approach according to an illustrative embodiment of the invention. Specifically, referring to  FIG. 76A , a delivery device  840  includes a shaft  842  attached at a proximal end to a handle  843 .  
      The shaft  842  has a distal end  846  with a distal tip  848 . The shaft  842  may be curved or straight or include both curved and straight sections. As in the case of the shaft  762  ( FIGS. 73A and 73B ), the shaft  842  can be any suitable shaft, including without limitation any of those shafts disclosed herein or in disclosures incorporated by reference. The distal end  846  of the shaft  842  includes a connector  850 , marked in general with a circle. The connector  850  can be any suitable connector, including without limitation, any of those disclosed herein or in disclosures incorporated by reference.  
      As in the case of the suprapubic and prepubic approaches of  FIGS. 73A-73E , the delivery device  840  may be any suitable delivery device, including without limitation, any of those delivery devices disclosed herein or in the disclosures incorporated by reference.  
      As in the case of the procedures of  FIGS. 73A-73E , the procedures of  FIGS. 76A and 76B  employ the sling assembly  788 . In use, the medical operator interfits or interconnects the sling assembly end  796   a  to the shaft  842 , for example, by way of the shaft connector  850  and sling assembly connector  798   a . Alternatively, in embodiments where the sling assembly  788  attaches to dilator tubes, such as the dilator tubes  735   a  and  735   b  of  FIG. 72 , the operator slidably interfits the shaft  842  through the dilator tube  735   a  or  735   b , without any interconnection. Next, the operator grasps the proximal end  844  of the shaft  842  or the handle  843 , and introduces the shaft  842  tip  848  first, into a puncture  854  in the vaginal wall  784  on one side of the urethra. The operator, using the shaft  842 , tunnels transvaginally through the rectus fascia, abdominal fascia, and abdominal wall in the region of the pubic tubercle until the distal end  846  of the shaft  842  emerges through a puncture  856  on one side of the abdominal skin  780 , creating a first tunnel  858  between the vaginal puncture  854  and the abdominal puncture  856 . Similar to the suprapubic and prepubic approaches, the shaft  842  (where a dilator tube is not employed) or the sleeve  792  preferably exhibits a visibly discernable optical property such that the shaft  842  can be distinguished from the surrounding tissue during a cystoscopy.  
      The operator then separates the shaft connector  850  from the sling assembly connector  798   a . The operator keeps the sling assembly end  796   a  from slipping back into the abdominal puncture  856  using, for example, a clamp. The operator proceeds to create a second tunnel  860  on the contralateral side of the urethra  786  by repeating the above steps with the sling assembly end  796   b . The same shaft  842  or a second shaft may be used.  
      After both ends  796   a  and  796   b  have emerged on the abdominal side, and the cystoscopy confirms that the bladder and the urethra  786  have not been perforated, the operator then adjusts the position and tension in the sling assembly  788  to finish the delivery and implanting process as described earlier in connection with the suprapubic approach.  
      Referring now to  FIG. 77 , in another illustrative transvaginal approach, a distal end  868  of a guide tube  866  attaches to an implant such as a sling assembly. This approach is essentially the same as the approach of  FIGS. 76A and 76B  except that the interconnection is between the sling assembly and the distal end  868  of the guide tube  866 . An advantage of this embodiment is that two guide tubes may be placed, one on each side of the urethra, using a single shaft. Once both guide tubes are placed a single cystoscopy may be performed to verify placement. A pusher assembly such as the pusher assembly  30  of  FIG. 72  may be employed to facilitate removal of the dilator tubes from the shaft  864 .  
      Referring now to  FIG. 78A , in another illustrative transvaginal approach, a proximal end  880  of a guide tube  876  attaches to the sling assembly end  796   a . The interconnection between the sling assembly connector  798   a  and the proximal end connector  882  on the guide tube  876  may be made prior to insertion of the guide tube  876  into the body, as shown in  FIG. 72 , or subsequent to guide tube insertion, as shown in  FIG. 78A . The delivery device  870  may also include a pusher assembly such as that shown in  FIG. 72 , and as described in connection with  FIGS. 3-6 , for axially actuating the guide tube  876  off the shaft  842 . One example of the guide tube  876  is described in connection with  FIGS. 63A-63D  and  64 . Another exemplary guide tube is described with respect to  FIG. 72  where a proximal end of the guide tube is interconnected, for example, through heat bonding, with an end of a sling assembly. As in the embodiments, the distal tip  848  of the shaft  842  extends outside the distal end  878  of the guide tube  876  for piercing through the tissue. The operator, using the shaft  842  sheathed in the guide tube  876 , tunnels transvaginally to create the first tunnel  858  as described in connection with  FIGS. 76A and 76B .  
      Referring also to  FIG. 78B , if a pusher assembly such as the pusher assembly  30  with respect to  FIG. 72  is employed, the operator actuates in the distal direction to edge enough of the guide tube  876  off the shaft  842  so that the operator can grasp the distal end  878  of the guide tube  876  by hand or with the assistance of an instrument. Once the guide tube  876  is grasped, the operator withdraws the remainder of the shaft  842  from the first tunnel  858  by pulling it out of the vaginal puncture  854 . With the guide tube  876  remaining in the tunnel  858 , the operator can clamp its distal end  878  to stop the tip  878  from slipping back into the tunnel  858 . The operator can perform a cystoscopy and remove the guide tube  876  at this point (as shown in  FIG. 78B ) or repeats the above steps on the contralateral side of the urethra  786  and creates a second tunnel from the vaginal wall  784  to the abdominal skin  780 , substituting the first guide tube  876  with a second substantially identical guide tube. The operator can use the same shaft  842  or a different one. If two shafts are used, cystoscopy may be done in series, or both tubes may be inserted on both side before single cystoscopy is performed. Once the contralateral guide tube is placed and placement is verified, both guide tubes can be pulled through the respective vaginal incisions to position the sling assembly  788 . Then the guide tubes can be separated from the sling assembly  788  by, for example, cutting.  
       FIGS. 79A and 79B  illustrate another transvaginal approach, in which both distal and proximal ends of the guide tube  704  are attached to the sling assembly  726 . The delivery system  700  is described in connection with  FIGS. 68 and 69 , and includes the shaft  702  and the guide tube  704 . The guide tube  704  has the first connector  724   a  at the distal end  716  and the second connector  724   b  at the proximal end  714 , for connecting to the two ends of the sling assembly  726 . Two sleeve ends  734   a  and  734   b  of the sling assembly  726  are interconnected with the distal end  716  and the proximal end  714  of the guide tube  704 , respectively. As in previously discussed guide tube embodiments where the guide tube does not connect to the handle, the guide tube  704  slidably interfits over the shaft  702  without interconnection. The operator, using the shaft  702  slidably interfitted in the guide tube  704 , tunnels transvaginally to create the first tunnel  858  as described in connection with  FIGS. 76A and 76B , until the distal end  716  of the guide tube  704  and its interconnected sleeve end  734   a  of the sleeve assembly  726  both emerge from the abdominal skin  780 .  
      Referring also to  FIG. 79B , the operator then separates the sleeve end  734   a  from the distal end  716  of the guide tube  704 , and withdraws the delivery device  700  out of the vaginal wall  784  via the first tunnel  858 . The sleeve end  734   a  of the sling assembly  726  remains outside the abdominal skin  780  with part of the sling assembly  726  residing inside the first tunnel  858 . The other sleeve end  734   b  remains interconnected to the proximal end  714  of the guide tube  704 . The operator creates a second tissue tunnel  890  from the vaginal wall  784  to the abdominal skin  780  on the contralateral side of the urethra  786 , similar to the first tunnel  858 , using the delivery device  700 . After the distal end  716  of the guide tube  704  emerges from the abdominal skin  780 , the operator slides the shaft  702  out of the proximal opening  720  of the guide tube  704 , and withdraws the shaft  702  out of the vaginal wall  784  via the second tunnel  890 . The operator grasps the distal end  716  of the guide tube  704  and pulls the guide tube  704  and its interconnected sleeve end  734   b  out of the abdominal skin  780  via the second tunnel  890 . Once the sleeve end  734   b  of the sling assembly  726  emerges out of the abdominal skin  780 , the operator separates it from the proximal end  714  of the guide tube  704 . The operator further adjusts the position and tension in the sling assembly  726  before removing the sleeve member  730  from the sling  728  for implanting.  
       FIGS. 80A and 80B  illustrate another transvaginal approach, which employs the delivery system of FIGS.  70  or  71 . As described previously, the sling assembly  726  is interconnected to the proximal end  746   a  of the first guide tube  740   a  and to the proximal end  746   b  of the second guide tube  740   b . The second guide tube  740   b  slidably interfits over the shaft  702  via proximal opening  750  ( FIG. 70A ), or via the side port  754   b  ( FIG. 71 ). The first guide tube  740   a  slidably interfits over the second guide tube  740   b  via the proximal opening  744  ( FIG. 70 ), or via the side port  754   b  ( FIG. 71 ). The distal tip  707  of the shaft  702  extends through a distal opening  742  of the first guide tube  740   a.    
      In use, the operator tunnels transvaginally to create the first tunnel  858  as described in connection with  FIGS. 76A and 76B , until the distal end  910  of the first guide tube  740   a  emerges from the abdominal skin  780 . The operator then slides the second guide tube  740   b  from inside the first guide tube  740   a , and withdraws the second guide tube  740   b  out of the vaginal wall  784  via the first tunnel  858 . The distal end  910  of the first guide tube  740   a  is clamped outside the abdominal skin  780  with the rest of the first guide tube  740   a  remaining inside the first tunnel  858 . The end  930   a  of the sling assembly  726  remains interconnected with the proximal end  746   a  of the guide tube  740   a . The operator then creates a second tissue tunnel  940  from the vaginal wall  784  to the abdominal skin  780  on the contralateral side of the urethra  786 , similar to the first tunnel  858 , using the shaft  702  slidingly interfitted through the second guide tube  740   b . After a distal end  942  of the second guide tube  740   b  emerges from the abdominal skin  780 , the operator slides the shaft  702  out of the second guide tube  740   b , and withdraws the shaft  702  out of the vaginal wall  784  via the second tunnel  940 . Subsequent to cystoscopy, the operator grasps both distal ends  910  and  942  of the first and second guide tubes  740   a  and  740   b , and pulls the two guide tubes  740   a  and  740   b  out of the abdominal skin  780  via the first and second tunnels  858  and  940 . Once the ends  930   a  and  930   b  of the sling assembly  726  emerge out of the abdominal skin  780 , the operator separates the ends  930   a  and  930   b  from the proximal tube ends  920   a  and  920   b , respectively. The operator further adjusts the position and tension in the sling assembly  726  before removing the sleeve member  730  from the body of the patient. Cystoscopy can be performed while the guide tubes are in the tunnel before being pulled through.  
       FIG. 81A and 81B  depict an illustrative trans-obtruator approach using the delivery device  90   a  of  FIG. 17  or the delivery device  90   b  of  FIG. 18 . Other embodiments of delivery devices including those described here or incorporated by reference can also be used for this approach. Taking the delivery device  90   a  as an example: as previously described, the delivery device  90   a  includes a shaft  92   a  and a handle  93   a . The shaft  92   a , at least in part, describes an arc of a substantial degree, for example, no less than about 45, about 60, or about 90 degrees in various embodiments. In one embodiment, the curve in the shaft  92   a  forms a “C” configuration. In the alternative delivery device embodiment  90   b  described previously with respect to  FIG. 18 , the needle shaft  92   b  describes the helical curve  94 .  
      According to one exemplary embodiment of the trans-obturator approach using the delivery device embodiment  90   a , a first incision  962   a  is made on the inside of the patient&#39;s thigh, for example, about 1 cm outside the external margin of the labia majora. The operator inserts the shaft  92   a , tip first, into the first incision  962   a  on the thigh and continues to penetrate a first obturator foramen  964   a . With a rotating wrist motion, the shaft is guided along the posterior ischiopubic ramus to a first vaginal incision  966   a  on the vaginal wall  968 . After a distal portion  958  of the shaft  92   a  emerges out of the vaginal wall  968 , the operator interconnects a first connector  960  attached to the shaft distal end  958 , with a second connector  798  attached to the sleeve end  796   a . Alternatively, a guide tube such as previously described and having a connector attached to a distal end, can be slid over the shaft  952  before the incision, and the connector on the guide tube can interconnect with the sleeve end  796   a . Then, the operator withdraws the delivery device  90   a  back out of the obturator foramen  964   a , bringing the sleeve end  796   a  of the sling assembly  788  out of the first thigh incision  963   a.    
      Referring also to  FIG. 81B , the operator repeats the above steps on the contralateral side of the urethra  970  and threads or tunnels the other sleeve end  796   b  through the other obturator foramen  964   b  and out of a second thigh incision  962   b . After proper adjustment of the position, the thigh incisions may be closed. In some embodiments the sling ends are anchored to the pelvic bones. However, in other embodiments, the sling ends remain unanchored. Alternatively, the operator can reverse the direction in the trans-obturator approach by starting from a vaginal incision and tunneling through the obturator foramen to the thigh incision using the same embodiments described above.  
      V. Guide Member  
      According to one aspect of the invention, an implant, for example, a sling assembly, can be equipped with guide members that facilitate the delivery of the implant. The guide members can have a male insertive feature or a female receptive feature. The guide member can be solid or hollow and may include laterally placed apertures. Various illustrative guide member embodiments will now be discussed.  
       FIG. 82  depicts an illustrative sling assembly  1000 . The sling assembly  1000  includes a sling  1002 , and two guide members  1004   a  and  1004   b . In this embodiment, the guide members  1004   a  and  1004   b  are formed as solid rods, each having a first end ( 1006   a ,  1006   b ) and a second end ( 1008   a ,  1008   b ). However, in other embodiments, the guide members  1004   a  and  1004   b  may be hollow. In one embodiment, the second ends  1008   a  and  1008   b  taper and are advantageous in performing insertive functions. In some configurations, the distal ends  1008   a  and  1008   b  terminate in conical tips capable of tissue piercing functions. Alternatively, the guide members  1004   a  and  1004   b  have a substantially constant diameter. The guide members  1004   a  and  1004   b  are shaped and sized to slidably move within an axial lumen  1009  of a guide tube  1010 .  
      The illustrated guide members  1004   a  and  1004   b  are substantially straight and made from flexible materials that permit them to flex. In one embodiment, the guide members  1004   a  and  1004   b  have enough flexibility to negotiate a curve, for example, a curve in the lumen  1009  of the guide tube  1010 . According to another feature, the outer diameter of the guide members  1004   a  and  1004   b  are less than the inner diameter of the lumen  1009  of the guide tube  1010 . In one embodiment, the first ends  1006   a  and  1006   b  of the guide members  1004   a  and  1004   b  are adjacent dilators  1020   a  and  1020   b , respectively. In one embodiment, the guide members  1004   a  and  1004   b  are longer than the guide tube  1010 . However, the guide members  1004   a  and  1004   b  may be of any suitable length, including less than or equal to that of the guide tube  1010 .  
      With continued reference to  FIG. 82 , the sling assembly  1000  may include a sleeve member  1022  that at least partly encloses the sling  1002 . The first end  1006   a  of the guide member  1004   a  secures to the sleeve assembly end  1021  a, for example, by heat bonding or other suitable mechanism. Similarly, the first end  1006   b  of the guide member  1004   b  attaches to the sling assembly end  1021   b . In some embodiments, the guide members  1004   a  and  1004   b  interconnect with the sleeve assembly ends  1021   a  and  1021   b  through connectors such as those previously described and/or incorporated by reference in this application.  
       FIG. 83  depicts a sling assembly  1000 ′ employing an alternative embodiment of the guide members  1004   a  and  1004   b . More particularly, the sling assembly  1000 ′ includes two guide member  1004   a ′ and  1004   b ′, which each have an axial lumen extending from a first end ( 1006   a ′,  1006   b ′) a second end ( 1008   a ′,  1008   b ′). Optionally, the guide members  1004   a ′ and  1004   b ′ each include one or more apertures  1024   a  and  1024   b , respectively, which are in fluid communication with the axial lumen. As described previously in connection with  FIGS. 10A, 10B  and  11 , the apertures  1024   a  and  1024   b  are advantageous in alerting the operator of any perforation in an organ, such as the bladder, during the delivery procedure. The guide members  1004   a ′ and  1004   b ′ may or may not have a distal opening that is communicative with the axial lumen.  
      The guide members, which are interconnected with the sling assembly  1022 , can facilitate the delivery of the sling assembly to an anatomical site, whether in a suprapubic, prepubic, transvaginal, or trans-obturator approach. In a preferred embodiment, the guide members are used in conjunction with a guide tube. Referring to  FIG. 84A and 84B , in one illustrative embodiment, the guide tube  1010  and  1010 ′ are installed between the vaginal wall  1034  and the abdominal skin  1032  on either side of the urethra using any suitable transvaginal, suprapubic or prepubic.  
      Referring to  FIG. 84C , the guide members  1004   a  and  1004   b  can then be inserted transvaginally through the guide tubes  1010  and  1010 ′, respectively. The operator pulls the second ends  1008   a  and  1008   b  of the guide members  1004   a  and  1004   b  and the respective guide tubes  1010  and  1010 ′ from the first and second tunnels  1030  and  1036  until the sleeve ends  1021   a  and  1021   b  emerge from the abdominal skin  1032 . The operator then grasps the sleeve ends  1021   a  and  1021   b  and adjusts the position and tension of the sleeve member  1022 . Once positioned, the sleeve member  1022  is removed from the patient&#39;s body as previously described, leaving the sling  1002  in place.  
       FIG. 85  depicts an illustrative embodiment of a sling assembly  1050  including guide members  1054   a  and  1054   b  having receptacle connectors at their free ends  1058   a ,  1058   b . Each of the guide members  1054   a  and  1054   b  has a first end  1056   a ,  1056   b ) and a second, free end  1058   a ,  1058   b . A receptacle  1057   a ,  1057   b  extends from a terminal opening  1059   a ,  1059   b  of the guide members  1054   a  and  1054   b  and terminates anywhere along the length of the guide members  1054   a  and  1054   b . According to one feature, the guide members  1054   a  and  1054   b  have a tubular structure with openings at both the first end ( 1056   a ,  1056   b ) and the second end ( 1058   a ,  1058   b ) that are in fluid communication with the axial lumen ( 1057   a ,  1057   b ). In one embodiment, the free ends  1058   a  and  1058   b  of the guide members  1054   a  and  1054   b  taper axially inward and are advantageous in performing tissue dilation. Alternatively, the guide members  1054   a  and  1054   b  have a substantially constant diameter. The receptacles  1057   a  and  1057   b  are shaped and sized to slidably fit over a distal end of a delivery shaft  1060 . The shaft  1060  attaches at a proximal end  1065  to a handle  1064 . Optionally, each of the guide members  1054   a  and  1054   b  may have one or more apertures  1066   a  and  1066   b , respectively, that are in fluid communication with the receptacles  1057   a  and  1057   b , respectively.  
      The illustrated guide members  1054   a  and  1054   b  may be made sufficiently rigid to slide over the shaft  1060  against the pressure from surrounding tissue inside a tissue tunnel. For example, in one embodiment, the guide members  1054   a  and  1054   b  are made of stainless steel. In one feature, the first end ( 1056   a ,  1056   b ) of the guide members  1054   a  and  1054   b  are adjacent to an optional dilator ( 1070   a ,  1070   b ). In one embodiment, the guide members  1054   a  and  1054   b  are longer than the shaft  1060 . However, the guide members  1054   a  and  1054   b  may be of any suitable length, including less than or equal to that of the shaft  1060 .  
      With continued reference to  FIG. 85 , the sling assembly  1050  may include a sleeve member  1072  that at least partly encloses the sling  1052 . The guide members  1054   a  and  1054   b  may be secured to the sleeve ends  1071   a  and  1071   b , respectively, via the dilators  1070   a  and  1070   b , for example, by heat bonding or other suitable mechanism. Alternatively, the guide members  1054   a  and  1054   b  can be interconnected with the sleeve ends  1071   a  and  1071   b , respectively, via connectors such as those described previously.  
      The guide members  1054   a  and  1054   b  can facilitate the delivery of the sling assembly  1050  to an anatomical site, using a suprapubic, prepubic, transvaginal, trans-obturator, or any other approach. Referring to  FIG. 86A , in an illustrative embodiment of both the suprapubic and prepubic approaches, a first tunnel  1080  between the abdominal skin  1082  and the vaginal wall  1084  is created by the insertion of the delivery device  1062  from the abdominal side to the vaginal side as described above in other method embodiments. Once the operator has determined that the bladder has not been perforated, the operator slides the receptacle  1057   a  of the first guide member  1054   a  onto the shaft  1060 . The operator proceeds to advance the first guide member  1054   a  inside the first tunnel  1080  onto the shaft  1060  until the second end  1058   a  of the first guide member  1054   a  emerges from the patient&#39;s abdominal skin  1082 . The optional tapering feature at the second end  1058   a  of the first guide member  1054   a  is advantageous for the advancing step as the first guide member  1054   a  dilates the first tunnel  1080  to advance. If the first guide member  1054   a  includes the optional apertures  1066   a , fluid seeping through the apertures  1066   a  will alert the operator to perforation of the bladder.  
      Referring also to  FIG. 86B , the operator withdraws the shaft  1060 , leaving the first guide member  1054   a  in the first tunnel  1080  with the first end  1058   a  outside the abdominal skin  1082 . The operator then uses the same shaft  1060  or a second shaft to create a second tunnel  1086  in a similar fashion on the contralateral side of the urethra  1088 . The operator, repeating the steps with respect to the first guide member  1054   a , advances the second guide member  1054   b  inside the second tunnel  1086  over the shaft  1060  until the second end  1058   b  of the second guide member  1054   b  emerges from the abdominal skin  1082 . The operator then pulls the first and second guide members  1054   a  and  1054   b  from the patient&#39;s tissues through the first  1080  and second  1086  tunnels, respectively, and out of the abdominal skin  1082 , and completes the delivery procedure as described above.  
      In an alternative embodiment, the shaft  1086  interfits tightly into the receptacles  1057   a  and  1057   b , and the operator withdraws the shaft  1086  to withdraw the respective sleeve ends  1071   a  and  1071   b  through the abdominal incisions.  
      Referring now to  FIG. 87A , in an illustrative embodiment of a transvaginal approach, the first tunnel  1080  between the vaginal wall  1084  and the abdominal skin  1082  is created by the insertion of the delivery device  1062  from the vaginal wall  1084  to get to the abdominal skin  1082  as described above in other method embodiments. The handle  1064 , which is reversibly associated with the shaft  1060 , is taken off the proximal end  1065  of the shaft  1060  ( FIG. 85 ). The operator slides the first guide member  1054   a  over the proximal end  1065  of the shaft  1060  ( FIG. 85 ), and advances the first guide member  1054   a  in the first tunnel  1080  until the second end  1058   a  of the first guide member  1054   a  emerges from the abdominal skin  1082 .  
      Referring also to  FIG. 87B , the operator then uses a second shaft  1090  to create the second tunnel  1086  in a similar fashion on the contralateral side of the urethra  1088 . The operator, repeating the steps with respect to the first guide member  1054   a , removes the handle  1064  and slides the second guide member  1054   b  over a proximal end of the second shaft  1090 . The operator advances the second guide member  1054   b  inside the second tunnel  1086  over the second shaft  1090  until the distal end  1058   b  of the second guide member  1054   b  emerges from the abdominal skin  1082 . The operator then pulls the first and second guide members  1054   s  and  1054   b , with the first and second shafts  1060  and  1090 , out of the patient&#39;s body through the first  1080  and second  1086  tunnels, respectively. After the first and second guide members  1054   a  and  1054   b  are out of the abdominal skin  1082 , the operator completes the delivery procedure as described above.  
      Variations, modifications, and other implementations of what is described may be employed without departing from the spirit and the scope of the invention. More specifically, any of the method, system and device features described above or incorporated by reference may be combined with any other suitable method, system or device features disclosed herein or incorporated by reference, and is within the scope of the contemplated inventions.