Systems for performing gynecological procedures with closed visualization lumen

• US 8,840,625 B2
• Filed: 09/07/2007
• Issued: 09/23/2014
• Est. Priority Date: 10/18/2006
• Status: Active Grant

• Current Assignee: Hologic Incorporated
• Original Assignee: Hologic Incorporated
• Inventors: Adams, Ronald D., Gruber, William H., Connors, Kevin G., Pardo, Geoffrey B., Cole, James Daniel, Flaherty, J. Christopher
• Primary Examiner(s): Nguyen, Victor
• Assistant Examiner(s): EVERAGE, KEVIN D
• Application Number:
  US11/852,121
• Publication Number:
  US 20080097468A1
• Time in Patent Office: 2,573 Days
• Field of Search: 606/119, 606/193, 604/22, 604/514, 604/515, 604/517
• US Class Current: 606/119
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12099 characterised by the location of the occluder
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• 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 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2017/4225 Cervix uteri
• CPC Class Codes: A61B 2017/4233 Operations on Fallopian tubes, e.g. sterilization A61B2017/1125 takes precedence
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61B 90/02 : Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61N 5/1016 : Gynaecological radiation therapy

Abstract

Systems, methods, apparatus and devices for performing improved gynecologic and urologic procedures are disclosed. An access sheath is provided with at least one lumen, and a lens attached thereto. The various embodiments enable procedures to be performed outside the hospital setting, such as in a doctor'"'"'s office or clinic.

Claims

1. An intrauterine access and procedure system, comprising:

an elongate, tubular sheath having a proximal end, a distal end and at least one lumen extending therethrough, the sheath adapted for transcervical access to a uterus;

a tissue removal device adapted to extend through the sheath lumen for removing tissue from the site, the tissue removal device having a closed distal end and a window spaced proximally from the closed distal end and a cutting element operable to cut tissue received in the window; and

a visualization apparatus adapted to extend through the sheath for visualizing a site within the uterus, the visualization apparatus including a sleeve, the sleeve slidingly surrounding the tissue removal device.

2. The intrauterine access and procedure system as in claim 1, wherein the tissue removal device comprises an ablation element.

3. The intrauterine access and procedure system as in claim 1, further comprising a stabilization device.

4. The intrauterine access and procedure system as in claim 1, further comprising a drug delivery assembly.

5. The intrauterine access and procedure system as in claim 1, wherein an outside diameter of the sheath is less than about 7 mm.

6. The intrauterine access and procedure system as in claim 1, wherein the visualization apparatus comprises a fiber optic device.

7. The intrauterine access and procedure system as in claim 1, wherein the visualization apparatus comprises an ultrasound transducer.

8. The intrauterine access and procedure system as in claim 1, wherein the sheath comprises at least one radiopaque marker.

9. The intrauterine access and procedure system as in claim 1, wherein the tissue removal device comprises a tissue cutter.

10. The intrauterine access and procedure system as in claim 1, wherein the tissue removal device comprises a tissue morcellator.

11. The intrauterine access and procedure system as in claim 1, further comprising a pull wire for deflecting the distal end of the sheath.

12. The intrauterine access and procedure system as in claim 1, further comprising an inflatable balloon carried by the sheath.

13. The intrauterine access and procedure system as in claim 1, further comprising a mechanical distension element.

14. The intrauterine access and procedure system as in claim 1, further comprising a volume occupying device.

15. The intrauterine access and procedure system as in claim 1, further comprising a tissue penetrating assembly.

16. The intrauterine access and procedure system as in claim 1, wherein the sheath is a metal hysteroscope.

17. The intrauterine access and procedure system as in claim 1, wherein the visualization apparatus includes a shaft for advancing and retracting the visualization apparatus relative to the sheath.

18. The intrauterine access and procedure system as in claim 1, wherein the visualization apparatus includes a camera.

19. The intrauterine access and procedure system as in claim 18, wherein the camera includes one of a CCD or MEMS.

20. The intrauterine access and procedure system as in claim 18, wherein the camera includes a motion sensing element.