Systems for performing gynecological procedures with simultaneous tissue cutting and removal

• US 8,840,626 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:
  US11/852,200
• Publication Number:
  US 20080097471A1
• 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 for prostheses A61F2210/0014
• 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. The system is configured to permit simultaneous tissue cutting and removal from a target site. 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, an open distal end, and at least one lumen extending therethrough, the sheath adapted for transcervical access to the uterus, an outer diameter of a distal operative portion of the tubular sheath being less than about 7 mm and greater than about 2 mm;

a visualization element adapted to extend through the sheath for visualizing a site within the uterus;

a tissue removal device having a distal portion sized and adapted to extend through the sheath lumen and out the open distal end of the sheath, the tissue removal device comprising an internal tissue egress lumen and a window, and a tissue cutting mechanism configured for cutting tissue received in the window, wherein tissue removed from the site by the cutting mechanism is removed through the egress lumen when the lumen is placed in fluid communication with a vacuum source; and

at least one fluid port for permitting introduction of fluid through the sheath and into the uterus;

wherein the system is configured to permit simultaneous tissue cutting and tissue removal.

2. The intrauterine access and procedure system as in claim 1, wherein the distal end of the sheath is laterally deflectable.

3. The intrauterine access and procedure system as in claim 2, further comprising a pull wire for deflecting the distal end of the sheath.

4. The intrauterine access and procedure system as in claim 1, wherein the visualization element comprises a lens.

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

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

7. The intrauterine access and procedure system as in claim 1, wherein the tissue cutting mechanism comprises an oscillating cutter.

8. The intrauterine access and procedure system as in claim 1, wherein the tissue cutting mechanism comprises a rotating cutter.

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

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

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

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

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

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

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