Doppler directed suturing and compression device and method

• US 20030191391A1
• Filed: 04/04/2002
• Published: 10/09/2003
• Est. Priority Date: 04/04/2002
• Status: Active Grant

• Current Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Original Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Inventors: Burbank, Fred H., Jones, Michael L., Altieri, Greig E., Serra, R.J.
• Granted Patent: US 7,207,996 B2
• Time in Patent Office: Days
• US Class Current: 600/453
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/282 Jaws
• 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 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• 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 compression and ligation device includes a pair of jaws including one or more Doppler chips oriented to send and receive Doppler signals across the jaws, to assist a practitioner in determining whether or not a uterine artery is between the jaws. A suture leader with an attached suture can be pushed through a channel on one of the jaws, through tissue behind the uterine artery, into another channel on the other jaw, and proximally out the device so that the practitioner can ligate the artery and effect hemostasis.

Claims

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

a first jaw having a distal end and a first distal end face;

a second jaw having a distal end and a second distal end face;

a pivot, the first jaw and the second jaw movably attached at the pivot;

wherein the first and second jaws are configured and arranged so that when the first and second jaws are pivoted relative to each other at the pivot in a first direction to a relatively closed orientation, the first and second distal end faces are oriented toward each other; and

at least one Doppler crystal mounted in one of the first or second distal end faces, the at least one Doppler crystal having a direction of view, the direction of view being toward the other of the first and second distal end face in the relatively closed orientation.

2. A device in accordance with claim 1, wherein the at least one Doppler crystal is releasably mounted in the one of the first and second distal end faces.

3. A device in accordance with claim 1, wherein the at least one Doppler crystal is integrally formed in the one of the first and second distal end faces.

4. A device in accordance with claim 1, wherein the at least one Doppler crystal comprises at least one Doppler crystal mounted in each of the first and second distal end faces.

5. A device in accordance with claim 1, wherein the at least one Doppler crystal comprises a plurality of Doppler crystals mounted in each of the first and second distal end faces.

6. A device in accordance with claim 1, wherein the at least one Doppler crystal comprises a plurality of Doppler crystals mounted in the one of the first and second distal end faces.

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

a first guide channel formed on the first jaw, the first guide channel having a proximal opening, a distal opening, and a lumen extending between the proximal and distal openings; and

a second guide channel formed on the second jaw, the second guide channel having a proximal opening, a distal opening, and a lumen extending between the proximal and distal openings.

8. A device in accordance with claim 7, wherein the first guide channel distal opening and the second guide channel distal opening are oriented toward each other when the device is in the relatively closed orientation.

9. A device in accordance with claim 7, further comprising:

a suture leader sized and configured to pass through the first guide channel lumen and the second guide channel lumen; and

a length of ligation material attached to the suture leader.

10. A device in accordance with claim 1, wherein at least one of the first and second jaws has a shaped selected to allow tissue to accumulate proximal of the first and second distal end faces when the device is in the relatively closed orientation.

11. A device in accordance with claim 10, wherein at least one of the first and second jaws are C-shaped.

12. A device in accordance with claim 10, wherein both of the first and second jaws are C-shaped.

13. 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 and on two substantially opposite sides of the uterine artery; and

compressing the uterine artery with the compressing member.

14. A method in accordance with claim 13, further comprising:

sensing the blood flow through the uterine artery with at least one Doppler crystal.

15. A method in accordance with claim 14, wherein the step of sensing blood flow comprises sensing blood flow along a direction of view of the at least one Doppler crystal between said two substantially opposite sides of the uterine artery.

16. A method in accordance with claim 14, wherein the step of compressing the uterine artery is continued for a therapeutically effective time after the step of sensing blood flow indicates that blood flow through the uterine artery has stopped.

17. A method in accordance with claim 13, wherein the step of compressing the uterine artery comprises:

compressing the uterine artery between two end faces of two pivoting jaws.

18. A method in accordance with claim 13, wherein the step of compressing the uterine artery comprises:

ligating the uterine artery with a length of ligation material.

19. A method in accordance with claim 18, wherein the step of ligating comprises passing a length of ligation material through the vaginal wall, through tissue distally behind the uterine artery, and again through the vaginal wall.

20. A method in accordance with claim 18, wherein the step of ligating comprises temporarily ligating with a resorbable ligation material.

21. A method in accordance with claim 18, wherein the step of ligating comprises ligating with a non-resorbable ligation material.

22. A method in accordance with claim 21, further comprising:

removing the non-resorbable ligation material.

23. A method in accordance with claim 13, further comprising:

selecting a patient who has at least one fibroid; and

performing the compressing step to at least reduce the blood supply to the at least one fibroid.

24. A method in accordance with claim 13, further comprising:

selecting a patient who has DUB; and

performing the compressing step to at least slow bleeding from the uterus.

25. A method in accordance with claim 13, further comprising:

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

performing the compressing step to at least slow bleeding from the Caesarian incision.

26. A method in accordance with claim 13, further comprising:

selecting a patient who is has PPH; and

performing the compressing step to at least slow bleeding from the uterus.

27. A method in accordance with claim 13, further comprising:

removing the compressing member.