Method and apparatus for the detection and ligation of uterine arteries

• US 7,229,465 B2
• Filed: 03/28/2002
• Issued: 06/12/2007
• Est. Priority Date: 03/28/2001
• Status: Expired due to Fees

• Current Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Original Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Inventors: Jones, Michael L., Burbank, Fred H., Werneth, Randy, Uyeno, Jill, Serra, R. J., Altieri, Greig, Wong, Yu-Tung
• Primary Examiner(s): Woo; Julian W.
• Application Number:
  US10/113,096
• Publication Number:
  US 20020183771A1
• Time in Patent Office: 1,902 Days
• Field of Search: 606/119, 606/157, 606/158, 606205-207, 600454-456, 600/462, 600/492, 600/504, 600/473, 128/898, 604/533
• US Class Current: 606/205
• 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
• 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

The invention provides devices, systems and methods for occluding arteries without puncturing skin or vessel walls. The devices, systems and methods for occluding arteries are configured to be applied to arteries externally of the arteries. Occlusion may be temporary or permanent, and may be partial or complete. Clamping a device to tissue near to an artery is effective to compress tissue around the artery and to indirectly compress the artery. The methods, devices and systems of the invention find use in, for example, treatment of uterine disorders and conditions which may be treated by occlusion of the uterine arteries. A uterine artery may be accessed via a patient'"'"'s vagina by compressing a portion of the vaginal wall around a portion of a uterine artery to occlude a uterine artery. Clamping of an artery may also be performed by clamping a device directly onto an artery.

Claims

1. An intravaginal clamping device for occluding a female patient'"'"'s uterine artery, comprising:

a) a pair of releasable clamping members which are configured to press against the patient'"'"'s vaginal tissue, which have opposed clamping surfaces and which are releasably lockable in a clamped configuration to apply pressure to the patient'"'"'s vaginal tissue to occlude an underlying uterine artery,

b) an ultrasonic blood flow sensor on at least one of the clamping surfaces for locating the patient'"'"'s uterine artery or for detecting blood flow therethrough, and

c) a delivery mechanism comprising connected handles, wherein each of the clamping members is releasably secured to clamp applicators on distal portions of said handles.

2. The clamping device of claim 1, wherein said blood flow sensor comprises a doppler ultrasound sensor.

3. The clamping device of claim 1 wherein the pair of clamping members are disposed with clamping surfaces thereof in an opposing relationship with respect to each other.

4. The clamping device of claim 3, wherein the clamping members are configured to be closed together so that at least one clamping surface thereof applies sufficient pressure to the patients uterine artery to at least partially occlude the artery.

5. The clamping device of claim 3, wherein the two clamping members are configured to be closed together by said clamp applicators.

6. The clamping device of claim 1, wherein the clamping members are lockable by a ratchet mechanism configured to hold the clamping members in a clamping position.

7. The clamping device of claim 6, wherein said ratchet mechanism has an unlocking mechanism.

8. The device of claim 7 wherein the unlocking mechanism is a cord.

9. The device of claim 8 wherein the cord is a lanyard.

10. The clamping device of claim 1, wherein the clamping surfaces of the clamping members are on distal portions of the clamping members.

11. The clamping device of claim 10, wherein the blood flow sensor is disposed on a damping surface of at least one of the clamping members.

12. The device of claim 1 wherein the pair of releasable clamping members has an extending guide member configured to fit within an enclosing guide member.

13. The clamping device of claim 1 including a clamping device applicator configured for intravaginal delivery and having one elongated member configured to releasably engage one clamping member and one elongated member configured to releasably engage the other clamping member.

14. The device of claim 13, wherein said blood flow sensor comprises a doppler ultrasound sensor.

15. The device of claim 13, comprising a plurality of blood flow sensors.

16. The device of claim 13 wherein at least one of the clamping members has a recovery member.

17. The device of claim 16, wherein said recovery member comprises a lanyard.

18. The system of claim 13 wherein the releasable clamping assembly has an extending guide member configured to fit within an enclosing guide member.

19. The uterine artery occluding device of claim 18 wherein the blood flow sensor on the pressure applying surface of one of the releasable clamping elements has a sensing direction toward the pressure applying surface of the other releasable clamping element.

20. A method of treating a uterine disorder in a female patient by occluding a uterine artery of the patient, comprising:

providing a clamping device which is releasably mounted to a clamping device applicator configured for intravaginal delivery, which has a pair of clamping members with clamping surfaces configured to apply pressure to the patient'"'"'s uterine artery, which is lockable in a pressure applying configuration, and which has a blood flow sensor on a clamping surface;

compressing a portion of the patients uterine artery by locking at least one clamping member of the clamping device against the patient'"'"'s vaginal tissue adjacent to the uterine artery to compress the underlying uterine artery; and

sensing a level of blood flow in the uterine artery with said blood flow sensor on the at least one clamping member.

21. The method of claim 20, wherein the uterine artery is located by the blood flow sensor.

22. The method of claim 20, wherein the at least one clamping member is clamped against a portion of the vaginal wall around a portion of said uterine artery to compress the underlying uterine artery.

23. The method of claim 20, wherein the clamping member is unlocked after a predetermined time period so that said uterine artery remains occluded for only a limited time.

24. The method of claim 23, wherein said limited time ranges from about 0.5 hours and to about 4 hours.

25. A uterine artery occluding device, comprising:

a. a first elongated pressure applying member which has a proximal handle portion, a distal handle portion and a first clamping element which is releasably disposed on the distal handle portion and which has a pressure applying surface;

b. a second elongated pressure applying member which has a proximal handle portion, a distal handle portion and a second clamping element which is releasably disposed on the distal handle portion and which has a pressure applying surface;

c. a pivotal connection between the first and second pressure applying members at a location proximal to the releasable clamping element and distal to the proximal handle portions thereof; and

d. an ultrasonic blood flow sensor disposed on the pressure applying surface of at least one of the releasable clamping elements.

26. The uterine artery occluding device of claim 25 wherein the releasable clamping elements are configured to engage the patient'"'"'s vaginal fornix and clamp against the tissue thereof to occlude an underlying uterine artery.