Multi-axial uterine artery identification, characterization, and occlusion pivoting devices and methods

• US 20020188306A1
• Filed: 03/28/2002
• Published: 12/12/2002
• Est. Priority Date: 03/28/2001
• Status: Active Grant

• Current Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Original Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Inventors: Jones, Michael L., Burbank, Fred H., Altieri, Greig E.
• Granted Patent: US 6,905,506 B2
• Time in Patent Office: Days
• US Class Current: 606/151
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/2812 with a single pivotal connection A61B17/29 takes precedence
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

A system is provided for compressing one or both of the uterine arteries of a patient which is at least in part shaped to complement the shape of the exterior of the cervix, which allows the system to be self-positioning. One or more Doppler chips can be mounted or incorporated into the system which permit the practitioner to better identify the uterine artery and monitor blood flow therein. The system includes a pair of pivotally joined elements which can be moved toward and away from the cervix to compress a uterine artery.

Claims

1. A device useful for compressing a uterine artery of a patient comprising:

a handle having a proximal end and a distal end; and

a compressing portion mounted to the handle distal end, the compressing portion having a distal end face and a side surface.

2. A device in accordance with claim 1, wherein the compressing portion is a first compressing portion, and further comprising a second compressing portion spaced apart from the first compressing portion;

and

wherein the handle is connected to at least one of the two compressing portions.

3. A device in accordance with claim 2, further comprising:

at least one Doppler crystal mounted in the compressing portion, the at least one Doppler crystal having a direction of view away from the compressing portion distal end face.

4. A device in accordance with claim 2, wherein the at least one Doppler crystal is releasably mounted in the distal compressing portion.

5. A device in accordance with claim 2, wherein the at least one Doppler crystal is integrally formed in the distal compressing portion.

6. A device in accordance with claim 2, wherein the at least one Doppler crystal comprises a plurality of Doppler crystals mounted in the compressing portion.

7. A device in accordance with claim 6, wherein the Doppler crystals each have a direction of view, the directions of view of the Doppler crystals being parallel.

8. A device in accordance with claim 6, wherein the device has a longitudinal axis, and the Doppler crystals each have a direction of view parallel to the longitudinal axis.

9. A device in accordance with claim 6, wherein the Doppler crystals have diverging directions of view.

10. A device in accordance with claim 6, wherein the Doppler crystals have a plurality of directions of view, a first of the plurality of directions being perpendicular to the compressing portion distal end face, and at least a second of plurality of directions of view being at an angle to the first direction of view.

11. A device in accordance with claim 6, wherein the Doppler crystals are releasably mounted in the distal compressing portion.

12. A device in accordance with claim 6, wherein the Doppler crystals are integrally formed in the distal compressing portion.

13. A device in accordance with claim 6, wherein the Doppler crystals are equally spaced from each other.

14. A device in accordance with claim 1, further comprising:

at least one Doppler crystal mounted in the compressing portion, the at least one Doppler crystal having a direction of view away from the compressing portion distal end face.

15. A device in accordance with claim 14, wherein the at least one Doppler crystal is releasably mounted in the distal compressing portion.

16. A device in accordance with claim 14, wherein the at least one Doppler crystal is integrally formed in the distal compressing portion.

17. A device in accordance with claim 14, wherein the at least one Doppler crystal comprises a plurality of Doppler crystals mounted in the compressing portion.

18. A device in accordance with claim 17, wherein the Doppler crystals each have a direction of view, the directions of view of the Doppler crystals being parallel.

19. A device in accordance with claim 17, wherein the Doppler crystals each have a direction of view perpendicular to the compressing portion distal end face.

20. A device in accordance with claim 17, wherein the Doppler crystals have diverging directions of view.

21. A device in accordance with claim 17, wherein the Doppler crystals have a plurality of directions of view, a first of the plurality of directions being perpendicular to the compressing portion distal end face, and at least a second of plurality of directions of view being at an angle to the first direction of view.

22. A device in accordance with claim 17, wherein the Doppler crystals are releasably mounted in the distal compressing portion.

23. A device in accordance with claim 17, wherein the Doppler crystals are integrally formed in the distal compressing portion.

24. A device in accordance with claim 17, wherein the Doppler crystals are equally spaced from each other.

25. A device in accordance with claim 1, wherein the side surface is concave.

26. A device in accordance with claim 1, wherein the side surface is flat.

27. A device in accordance with claim 1, wherein the handle comprises:

a first arm;

a second arm; and

a hinge pivotally attaching the first arm to the second arm.

28. A device in accordance with claim 27, wherein the compressing portion comprises:

a first compressing portion attached to the first arm; and

a second compressing portion attached to the second arm.

29. A device in accordance with claim 28, wherein the distal end face is a first distal end face, the side surface is a first side surface, and the first distal end face and first side surface are on the first compressing portion, and further comprising:

a second distal end face and a second side surface, and the second distal end face and second side surface are on the second compressing portion.

30. A device in accordance with claim 29, wherein at least one of the first side surface and the second side surface is concave.

31. A device in accordance with claim 30, wherein the concave side surface has an inner diameter between about 2 cm and about 4 cm.

32. A device in accordance with claim 31, wherein the concave side surface an inner diameter of about 3 cm.

33. A device in accordance with claim 29, wherein both of the first side surface and the second side surface are concave and are oriented toward each other.

34. A device in accordance with claim 33, wherein the concave side surface has an inner diameter between about 2 cm and about 4 cm.

35. A device in accordance with claim 34, wherein the concave side surface an inner diameter of about 3 cm.

36. A device in accordance with claim 27, further comprising:

a Doppler crystal mounted in the compressing portion, the Doppler crystal having a direction of view parallel to the compressing portion distal end face.

37. A device in accordance with claim 36, wherein the Doppler crystal is releasably mounted in the distal compressing portion.

38. A device in accordance with claim 36, wherein the Doppler crystal is integrally formed in the distal compressing portion.

39. A device in accordance with claim 27, further comprising:

a plurality of Doppler crystals mounted in the compressing portion.

40. A device in accordance with claim 39, wherein the Doppler crystals each have a direction of view, the directions of view of the Doppler crystals being parallel.

41. A device in accordance with claim 39, wherein the Doppler crystals are equally spaced from each other.

42. A device in accordance with claim 28, wherein at least one of the first and second compressing portions comprises a loop.

43. A device in accordance with claim 42, wherein the loop has an inner length X and an inner width Y, and X>

Y.

44. A device in accordance with claim 43, wherein X is greater than about 1.5 inches, and Y is between about 0.75 inches and about 1.25 inches.

45. A device in accordance with claim 43, wherein X is about 2 inches, and Y is about 0.8 inches.

46. A device in accordance with claim 42, further comprising:

at least one Doppler crystal mounted in the compressing portion,

47. A device in accordance with claim 46, wherein the at least one Doppler crystal has a direction of view perpendicular to the compressing portion distal end face.

48. A device in accordance with claim 46, wherein the at least one Doppler crystal has a direction of view at an angle α

to the longitudinal axis of the device, and α

>

0.

49. A device in accordance with claim 46, wherein the at least one Doppler crystal has a direction of view and at least a portion of the loop defining a plane, the direction of view being at an angle β

to the plane, and β

>

0.

50. A device in accordance with claim 46, wherein the at least one Doppler crystal is releasably mounted in the distal compressing portion.

51. A device in accordance with claim 46, wherein the at least one Doppler crystal is integrally formed in the distal compressing portion.

52. A device in accordance with claim 42, further comprising:

a plurality of Doppler crystals mounted in the compressing portion.

53. A device in accordance with claim 52, wherein the Doppler crystals each have a direction of view, the directions of view of the Doppler crystals being parallel.

54. A device in accordance with claim 52, wherein the plurality of Doppler crystals have a direction of view and at least a portion of the loop defining a plane, the direction of view being at an angle β

to the plant, and β

>

0.

55. A device in accordance with claim 52, wherein the Doppler crystals each have a direction of view perpendicular to the compressing portion distal end face.

56. A device in accordance with claim 52, wherein the Doppler crystals are releasably mounted in the distal compressing portion.

57. A device in accordance with claim 52, wherein the Doppler crystals are integrally formed in the distal compressing portion.

58. A device in accordance with claim 52, wherein the Doppler crystals are equally spaced from each other.

60. A method in accordance with claim 59, further comprising:

sensing the blood flow through the uterine artery with a Doppler crystal.

61. A method in accordance with claim 59, wherein the step of pushing to compressing the uterine artery against the uterus is stopped after the step of sensing blood flow indicates that blood flow through the uterine artery has stopped.

62. A method in accordance with claim 59, wherein the step of pushing the compressing member to compress the uterine artery comprises pushing to compress two uterine arteries against the uterus.

63. A method in accordance with claim 59, further comprising:

pushing the uterine artery with the compressing member medially to compress the uterine artery against the uterus.

64. A method in accordance with claim 63, further comprising:

pushing the uterine artery with the compressing member upwardly, and wherein the steps of pushing the uterine artery medially and of pushing the uterine artery upwardly are performed simultaneously.

65. A method in accordance with claim 59, further comprising:

selecting a patient who has at least one fibroid; and

performing the pushing steps to at least reduce the blood supply to the at least one fibroid.

66. A method in accordance with claim 59, further comprising:

selecting a patient who has DUB; and

performing the pushing steps to at least slow bleeding from the uterus.

67. A method in accordance with claim 59, further comprising:

selecting a patient who is bleeding from a Caesarian incision; and

performing the pushing steps to at least slow bleeding from the Caesarian incision.

68. A method in accordance with claim 59, further comprising:

selecting a patient who is has PPH; and

performing the pushing steps to at least slow bleeding from the uterus.

69. A method in accordance with claim 59, further comprising:

removing the compressing member.

59. A method of occluding a uterine artery of a female human patient, the patient having a uterus, a cervix with a cervical os, and a vaginal wall with a vaginal fornix, comprising:

pushing a compressing member toward the uterine artery until the compressing member reaches the vaginal fornix;

pushing the compressing member upwardly to distend the vaginal wall at the vaginal fornix adjacent to the uterine artery; and

pushing the uterine artery with the compressing member to compress the uterine artery against the uterus.