General uterine manipulator and system

• US 9,987,042 B2
• Filed: 05/26/2015
• Issued: 06/05/2018
• Est. Priority Date: 04/07/2011
• Status: Active Grant

• Current Assignee: Leapfrog Enterprises Pty Ltd
• Original Assignee: Jai Singh, Jiwan Steven Singh
• Inventors: Singh, Jai, Singh, Jiwan Steven
• Primary Examiner(s): WEISBERG, AMY REGINA
• Application Number:
  US14/722,025
• Publication Number:
  US 20160081717A1
• Time in Patent Office: 1,106 Days
• Field of Search: 606119, 606108, 606191, 604264
• CPC Class Codes: A61B 10/0291 for uterus A61B10/0045 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 17/4241 Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00464 for use with different instruments
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/309 using white LEDs
• CPC Class Codes: A61B 2090/3962 palpable
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A medical instrument configured to be inserted into a body cavity comprises a body comprises a first probe at a first end, the first probe comprising a first cylindrical portion with a first outer circumferential surface of a first diameter; a first circumferential edge at a distal end of the first probe; a first distal lip projecting outwardly from the first outer circumferential surface beyond the first circumferential edge and extending for at least a part of a circumference of the first circumferential edge; and a first marker lip projecting outwardly from the first outer circumferential surface and extending for at least a part of a circumference of the first outer circumferential surface; wherein the first distal lip is positioned distal to the first marker lip; and wherein the body comprises a hollow cavity to enable a second medical instrument to pass therethrough.

Claims

1. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure, and

wherein the probe comprises a hollow inner cavity; and

a pneumatic plug configured to pneumatically plug at least a portion of the probe.

2. The medical instrument of claim 1, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

3. The medical instrument of claim 1, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

4. The medical instrument of claim 1, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body.

5. The medical instrument of claim 1, further comprising:

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

6. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip, and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface;

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure, and

wherein the probe comprises a hollow inner cavity;

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end,

wherein the probe is disposed at the distal end of the elongate hollow body, and

wherein the elongate hollow body transitions smoothly into the outer circumferential surface of the probe;

a second probe disposed at the proximal end of the elongate hollow body, the second probe comprising a second outer circumferential surface comprising a different diameter than the outer circumferential surface of the probe disposed at the distal end of the elongate hollow body; and

a third lip projecting outwardly from the second outer circumferential surface and extending circumferentially about only a portion of the second outer circumferential surface, the third lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure.

7. The medical instrument of claim 6, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

8. The medical instrument of claim 6, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

9. The medical instrument of claim 6, wherein the second lip comprises the distal-most point of the probe.

10. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip;

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure, and

wherein the probe comprises a hollow inner cavity; and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

11. The medical instrument of claim 10, wherein the second lip comprises the distal-most point of the probe.

12. The medical instrument of claim 10, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

13. The medical instrument of claim 10, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

14. The medical instrument of claim 10, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body.

15. A method of using a medical instrument to perform a laparoscopic oncology procedure, the method comprising:

inserting a probe of the medical instrument into the human vaginal cavity, the probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure, and

wherein the probe comprises a hollow inner cavity;

positioning the lip of the medical instrument to act as a visual landmark that indicates where a surgeon should cut to remove a cuff from the vagina to excise cancer tissue;

cutting vaginal tissue to remove the cuff; and

removing the probe from the vaginal cavity.

16. The medical instrument of claim 15, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

17. The medical instrument of claim 15, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

18. The medical instrument of claim 15, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body.

19. The medical instrument of claim 15, further comprising:

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

20. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure,

wherein the probe comprises a hollow inner cavity, and

wherein the lip further comprises;

a distal face angled proximally with respect to a longitudinal axis of the instrument; and

a proximal face angled distally with respect to the longitudinal axis of the instrument; and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

21. The medical instrument of claim 20, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

22. The medical instrument of claim 20, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

23. The medical instrument of claim 20, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body.

24. The medical instrument of claim 20, wherein the second lip comprises the distal-most point of the probe.

25. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity, wherein the outer circumferential surface is substantially cylindrical; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe by approximately 20 millimeters and the outer circumferential surface extends both distally and proximally to the lip;

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure,

wherein the probe comprises a hollow inner cavity, and

wherein the circumferential surface extends proximally from the lip toward a tapered region that is tapered radially inwardly in a proximal direction; and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

26. The medical instrument of claim 25, wherein the lip extends circumferentially about the outer circumferential surface through an arc that subtends an angle of at least 100 degrees.

27. The medical instrument of claim 25, wherein sides of the lip transition smoothly from the outer circumferential surface to limit damage to body tissue when the medical instrument is rotated within the human vaginal cavity.

28. The medical instrument of claim 25, wherein the lip comprises a tapered shape that is wider adjacent the outer circumferential surface than at an outer edge of the lip.

29. The medical instrument of claim 25, wherein the outer circumferential surface comprises a diameter of approximately 40 millimeters.

30. The medical instrument of claim 25, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

31. The medical instrument of claim 25, wherein the probe is tapered at the distal-most point of the probe, wherein a first diameter of the distal-most point of the probe is larger than a second diameter of a proximal end of the probe.

32. The medical instrument of claim 25, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body.

33. The medical instrument of claim 25, wherein the second lip comprises the distal-most point of the probe.

34. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure,

wherein the lip comprises a tapered shape that is wider adjacent the outer circumferential surface than at an outer edge of the lip, and

wherein the lip further comprises;

a distal face angled proximally with respect to a longitudinal axis of the instrument; and

a proximal face angled distally with respect to the longitudinal axis of the instrument; and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

35. The medical instrument of claim 34, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

36. The medical instrument of claim 34, wherein

the second lip comprises the distal-most point of the probe.

37. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure,

wherein the lip comprises a tapered shape that is wider adjacent the outer circumferential surface than at an outer edge of the lip, and

wherein the circumferential surface extends proximally from the lip toward a tapered region that is tapered radially inwardly in a proximal direction; and

a pneumatic plug configured to pneumatically plug at least a portion of the probe.

38. The medical instrument of claim 37, wherein

a second lip comprises the distal-most point of the probe.

39. The medical instrument of claim 37, further comprising:

an elongate hollow body comprising surgical grade material, the elongate hollow body extending in a longitudinal direction from a proximal end to a distal end;

wherein the probe is disposed at the distal end of the elongate hollow body; and

a second probe disposed at the proximal end of the elongate body, the second probe comprising a second outer circumferential surface comprising a different diameter than the outer circumferential surface of the probe disposed at the distal end of the elongate body.

40. The medical instrument of claim 37, wherein the probe comprises a hollow inner cavity.

41. The medical instrument of claim 37, wherein the outer circumferential surface is substantially cylindrical.

42. The medical instrument of claim 37, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

43. A medical instrument for performing a laparoscopic oncology procedure, the medical instrument comprising:

a probe comprising;

an outer circumferential surface, the outer circumferential surface extending in a longitudinal direction and sized for non-traumatic insertion into a human vaginal cavity; and

a lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the lip configured to raise vaginal tissue to provide a visual landmark for dissection during the laparoscopic oncology procedure, the lip positioned such that the lip is set back from a distal-most point of the probe and the outer circumferential surface extends both distally and proximally to the lip,

wherein the outer circumferential surface comprises a surgical grade material comprising sufficient stiffness to support the lip in raising the vaginal tissue to provide the visual landmark for dissection during the laparoscopic oncology procedure,

wherein the lip comprises a tapered shape that is wider adjacent the outer circumferential surface than at an outer edge of the lip; and

a second lip projecting outwardly from the outer circumferential surface and extending circumferentially about only a portion of the outer circumferential surface, the second lip configured to raise vaginal tissue to provide a visual landmark for dissection, the second lip positioned such that at least a portion of the second lip extends distally beyond a distal end of the outer circumferential surface.

44. The medical instrument of claim 43, wherein the probe further comprises:

a passage configured to enable a medical device to pass therethrough; and

the medical device, wherein the medical device comprises a uterine manipulator.

45. The medical instrument of claim 43, wherein

the second lip comprises the distal-most point of the probe.