Methods and apparatus for natural orifice vaginal hysterectomy
First Claim
Patent Images
1. An assembly for transuterine visualization of a transvaginal hysterectomy, comprising:
- an elongated transuterine cannula configured for advancement through the vagina and uterus to a distal wall of the uterus;
at least one sealing device engaged with the transuterine cannula to engage the cannula with the distal wall;
at least one penetrating element associated with the transuterine cannula to fenestrate the distal wall to form an opening therein;
at least one endoscope advanceable through the cannula and opening in the distal wall of the uterus into a peritoneal space to provide visualization of anatomical structure in the peritoneal space; and
a vaginal guide shaped and sized for being closely received in a vagina of a patient, the guide being formed with a hole sized to closely receive the transuterine cannula therethrough, in slidable support, the guide further including one or more bands attachable with the patient'"'"'s skin to hold the guide in place at the vaginal opening, the guide being made of a soft elastomer, the guide stabilizing the vaginal orifice during hysterectomy while providing access portals and preventing injury that might otherwise occur due to repeated insertion and manipulation of instruments into the patient, the guide also providing a resting point and fulcrum for the transuterine cannula.
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Abstract
A transuterine cannula through which an endoscope can be advanced into the peritoneal space to provide visualization of tissue cutting in the peritoneal space pursuant to a vaginal hysterectomy.
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Citations
26 Claims
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1. An assembly for transuterine visualization of a transvaginal hysterectomy, comprising:
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an elongated transuterine cannula configured for advancement through the vagina and uterus to a distal wall of the uterus; at least one sealing device engaged with the transuterine cannula to engage the cannula with the distal wall; at least one penetrating element associated with the transuterine cannula to fenestrate the distal wall to form an opening therein; at least one endoscope advanceable through the cannula and opening in the distal wall of the uterus into a peritoneal space to provide visualization of anatomical structure in the peritoneal space; and a vaginal guide shaped and sized for being closely received in a vagina of a patient, the guide being formed with a hole sized to closely receive the transuterine cannula therethrough, in slidable support, the guide further including one or more bands attachable with the patient'"'"'s skin to hold the guide in place at the vaginal opening, the guide being made of a soft elastomer, the guide stabilizing the vaginal orifice during hysterectomy while providing access portals and preventing injury that might otherwise occur due to repeated insertion and manipulation of instruments into the patient, the guide also providing a resting point and fulcrum for the transuterine cannula. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A method for conducting a hysterectomy on a patient, comprising:
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insufflating the abdominal cavity; advancing a transuterine cannula into the vagina of the patient, through the cervix and into the uterus; securing the transuterine cannula to the distal wall of the uterus; fenestrating the distal wall of the uterus; advancing an endoscope through the transuterine cannula into the abdominal cavity of the patient; viewing at least portions of the uterus with attached anatomical structures using the endoscope; and removing at least the uterus using at least one instrument placed through the transuterine cannula and/or a working lumen of the endoscope and/or delivered transvaginally. - View Dependent Claims (21, 22, 23, 24, 25, 26)
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Specification