Methods for performing a medical procedure

• US 9,392,935 B2
• Filed: 10/24/2007
• Issued: 07/19/2016
• Est. Priority Date: 11/07/2006
• Status: Active Grant

• Current Assignee: Hologic Incorporated
• Original Assignee: Hologic Incorporated
• Inventors: Adams, Ronald D., Gruber, William H., Foshee, David L., Mosler, Theodore J., Drew, Douglas R.
• Primary Examiner(s): Nguyen, Anhtuan T
• Assistant Examiner(s): NEAL, TIMOTHY JAY
• Application Number:
  US11/923,482
• Publication Number:
  US 20080146873A1
• Time in Patent Office: 3,191 Days
• Field of Search: 600/104, 600/105, 600/115, 600/116, 600/153, 600/156, 600/158, 600/201, 600/204, 600/215, 600/221, 600/229
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/303 for the vagina, i.e. vaginoscopes
• 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 17/42 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 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/320775 Morcellators, impeller or propeller like means
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61M 25/0023 by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/0097 characterised by the hub connectors A61M39/10

Abstract

Methods are disclosed, for performing therapeutic or diagnostic procedures at a remote site. According to one embodiment, the methods include the use of a system including an introducer designed for transcervical insertion into the uterus. The introducer is constructed to include a fluid lumen, an instrument lumen, and a visualization lumen. The system may include a fluid source, which is coupled to the fluid lumen and is used to deliver a fluid to the uterus either for washing the uterus or for fluid distension of the uterus. The system additionally includes a tissue modifying device, such as a morcellator, and a distension device for distending the uterus and/or for maintaining the uterus in a distended state. The tissue modifying device and the distension device are alternately deliverable to the uterus through the instrument lumen. The system may further include a hysteroscope deliverable to the uterus through the visualization lumen.

Claims

1. A method of performing a medical procedure, said method comprising the steps of:

a) using a mechanical expansion structure to maintain a uterus in a distended state equivalent to that achieved by introduction of a liquid distension media at a pressure of at least 40 mm Hg; and

b) performing at least one of examining and treating tissue located within the distended uterus.

2. The method as claimed in claim 1 further comprising, prior to the maintaining step, distending the uterus with a fluid.

3. The method as claimed in claim 1 wherein said step of examining tissue within the distended uterus comprises visualizing the tissue using a transcervically placed hysteroscope.

4. The method as claimed in claim 1 wherein said step of treating tissue comprises cutting tissue.

5. The method as claimed in claim 1 further comprising, prior to said maintaining step, transcervically inserting an introducer into the uterus.

6. The method as claimed in claim 5 further comprising, after said step of transcervically inserting the introducer into the uterus and prior to said maintaining step, the step of delivering the mechanical expansion structure to the uterus through the introducer.

7. The method as claimed in claim 5 further comprising, after said step of transcervically inserting the introducer into the uterus and prior to said maintaining step, the step of delivering the mechanical expansion structure to the uterus outside of the introducer.

8. The method as claimed in claim 1 further comprising, after the maintaining step, the step of transcervically inserting an introducer into the uterus.

9. A method of performing a medical procedure, said method comprising the steps of:

a) inserting an introducer into a body to an internal site, the introducer including a visualization lumen and an instrument lumen;

b) delivering a visualization device to the internal site through the visualization lumen;

c) delivering a mechanical expansion structure to the internal site;

d) deploying the mechanical expansion structure to distend the internal site;

e) observing the distended internal site using the visualization device;

f) after delivering the mechanical expansion structure, delivering a tissue modifying device to the internal site through the instrument lumen; and

g) modifying tissue at the internal site using the tissue modifying device.

10. The method as claimed in claim 9 wherein the internal site is within the uterus.

11. The method as claimed in claim 9 wherein the mechanical expansion structure is delivered to the internal site outside of the introducer.

12. The method as claimed in claim 9 wherein the introducer further includes a distension lumen and wherein the mechanical expansion structure is delivered to the internal site through the distension lumen.

13. The method as claimed in claim 9 wherein the mechanical expansion structure is delivered to the internal site through the instrument lumen.

14. The method as claimed in claim 9 wherein the introducer further includes a fluid lumen, the method further comprising the step of delivering a fluid to the internal site through the fluid lumen.

15. The method as claimed in claim 9 wherein the mechanical expansion structure delivery and deployment steps are performed prior to the introducer delivery step.