US3926192A - Atraumatic uterine director - Google Patents

Atraumatic uterine director Download PDF

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Publication number
US3926192A
US3926192A US49684374A US3926192A US 3926192 A US3926192 A US 3926192A US 49684374 A US49684374 A US 49684374A US 3926192 A US3926192 A US 3926192A
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device
tip
element
set forth
end wall
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Maren Harold B Van
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Maren Harold B Van
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • A61B17/4241Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery

Abstract

A medical instrument particularly designed for manipulating and positioning the human uterus during a laparoscoptomy. The device is generally similar to the conventional Simms cervical tenaculum and includes a generally cup-shaped member whose end wall is connected to a source of vacuum through a tube or the like. Within the member is a conical element to which a plurality of different size tips may be releasably connected. The instrument is inserted through the vaginal passage and the cone placed against the cervical os, and the vacuum in the cup member causes the uterus to adhere to the cone. The tip, which is now in the uterus, and which is connected to the rigid tube, may be manipulated by corresponding movement of the tube.

Description

United States Patent [191 Van Maren Dec. 16, 1975 [54] ATRAUMATIC UTERINE DIRECTOR 22 Filed: Aug. 12,1974

211 Appl. No.: 496,843

[52] US. Cl. 128/303 R; '128/276 [51] Int. Cl. A61B 17/42; A61M 1/00 [58] Field of Search 128/20, 276, 277, 278, 128/303 R [56] References Cited UNITED STATES PATENTS 1,481,008 [/1924 Hodlick 128/278 2,082,782 6/1937 Allen 128/20 X 2,195,771 4/1940 Estler v t I 128/276 2,941,532 6/1960 Borin 128/276 3,113,688 12/1963 Campbell 128/276 X FOREIGN PATENTS OR APPLICATIONS 129,285 2/1959 U.S.S.R 1. 128/278 Primary Examiner-Channing L. Pace Attorney, Agent, or Firm-Harris Zimmerman 5 7 ABSTRACT A medical instrument particularly designed for manipulating and positioning the human uterus during a laparoscoptomy. The device is generally similar to the conventional Simms cervical tenaculum and includes a generally cup-shaped member whose end wall is connected to a source of vacuum through a tube or the like. Within the member is a conical element to which a plurality of different size tips may be releasably connected. The instrument is inserted through the vaginal passage and the cone placed against the cervical 0s, and the vacuum in the cup member causes the uterus to adhere to the cone. The tip, which is now in the uterus, and which is connected to the rigid tube, may be manipulated by corresponding movement of the tube.

9 Claims, 5 Drawing Figures US. Patent Dec. 16, 1975 ATRATJMATIC UTERINE DIRECTOR BACKGROUND OF THE INVENTION In performing laparoscope tubal fulguration,. irrespective of the particular procedure used, a laparoscope is inserted through an abdominal incision, and the physician uses such instrument to view the uterus and the tubes which areto be cut, cauterized or otherwise blocked. Whether the cutting'or cauterizing tool is associated with the laparoscope or whether it is inserted through a separate lower incision, it is imperative that the surgeon can'clearlyview the tubal area on both sides of the uterus in order to perform the tubal sterilization operation. The multigravidas patient as well as patients undergoing second trimester abortions concommitantly with the tubal fulgurations, has a larger uterine size, the uterus is generally flaccid and further difficulty is encountered in properly directing or manipulating the uterus for proper viewing of the tubes through the laparoscope.

In accordance with the teachings of the present invention, an instrument is provided which may safely, conveniently and readily manipulate, move and direct the uterus so as to provide the surgeon with both proper viewing and surgical accessibility to the tubes so that tubal fulguration may be performed.

The instrument is designed to utilize a range of tip sizes whereby the end of the tip may approach the fundus or top of the uterus to provide for maximum uterine mobility.

THE DRAWING 1 FIG. 1 is a side elevational view of the uterine director of the present invention.

FIG. 2 is a front view of a portion of the device, taken in the plane indicated by line 22 of FIG. 1.

FIG. 3 is an end view of the device.

FIG. 4 is a cross-sectional view taken in the plane indicated by line 44 of FIG. 3.

FIG. 5 is a side view of a typical tip.

DESCRIPTION OF THE PREFERRED EMBODIMENT The device of the present invention, as illustrated in the drawing, includes a rigid tube 10, preferably having a straight portion 12 and an angularly related portion 14. The distal end of the latter has an enlarged portion 16 for releasable attachment to a hose 18 or the like, which may be connected to a suitable pump or other source of vacuum, not shown. Tube may be formed of stainless steel and has an axial passage 20 through which a vacuum may be induced. Extending laterally outwardly from a portion of the tube portion 12, adjacent its juncture with tube portion 14, is a generally rectangular plate 22, whose function will be later described.

Secured in any suitable manner to the other end of the tube portion 12 is a member 24 which includes a central block-like conical element 26 which emerges from the transaxial base plate 28 of member 24 and which is co-axial with tube 12. Element 26 terminates in a flat transaxial wall 30 having a central threaded opening 32.

Also extending from plate 28 is a wall 34 which diverges outwardly and which terminates in a smooth lip 36 lying substantially in the same plane as the cone wall An annular space 38 is defined between the cone 26 and wall 34, and such space is in flow communication with the tube passage 20 by means of a passage 40 interconnecting the same.

The threaded opening 32 is'adapted to receive the threaded end portion'42 of a tip 44, the latter having a slight arcuate configuration. The shoulder 46 between the end 42 and the tip is adapted to seat against the wall 30 when the tip is threadedly engaged with the opening 32. It is also significant and important to note that when such seating occurs the curve of the tip 44 always oriented in a particular manner relative to the plate 22. This function will also be later described. The tip 44 is removable from member 24 so as to permit the use of different length or sizes of tips. i

The manner of using the device in connection with performing a laparoscopic tubal fulguration (following an abortion) will now be briefly described.

First, after determining the uterus location and dilating the cervic in any acceptable conventional manner, an abortion may be performed. Then, whether an abortion has been performed or not, the physician, having already sounded the uterus to determine its size, location, etc., will select a tip 44 of a length which will generally approximate the distance from the cervical os to the fundus.

The instrument is then inserted (tip first) through the vagina, the tip passing through the cervix and entering the uterus, until the cone wall 38 engages the cervical os. At this time, a vacuum is induced through hose l4, tube 10, passage 40 and the space or chamber 38. This causes the uterine wall surrounding the cervical os to be pulled against the lip 36 whereby the device is now held in position.

The normal abdominal incision may then be made and carbon dioxide pumped into the abdominal cavity. The laparoscope is inserted through such incision, and the physician, in looking into the laparoscope, may manually engage the portion of tube 10 which extends outwardly from the vaginal passage and effect rotation or other motion to the instrument so as to direct or orient the uterus accordingly. The plate 22, as above mentioned, is specifically oriented relative to the curve of the tip 44 so that the physician can immediately determine by merely grasping the plate, in which direction the tip is curved, and thus more readily direct or manipulate the uterus.

Because of the vacuum the uterus will be retained in position against the instrument until deliberately reoriented by turning of the device.

The total fulguration may then be performed in any suitable manner.

While the device has been described in connection with a particular type of surgical procedure, it should be understood that the instrument may be used in other situations where deliberate directing and movement of the uterus is required.

What is claimed is:

1. A device of the character described comprising a member having an end wall, a continuous side wall extending axially outwardly from the periphery of said end wall, an element extending axially from a central portion of said end wall and spaced radially inwardly from said side wall to define a continuous space therebetween, a tip extending axially from said element, a rigid tube connected to said end wall and extending in a contra direction to said side wall, and means defining a passage placing said tube and said continuous space 3 in flow communication.

2. A device as set forth in claim 1, in which said tip is releasably connected to said element whereby tips of different sizes may be used.

.3. A device as set forth in claim 1, in which said tip is curved along the axial extent thereof.

4. A device as set forth in claim 1 in which said element has a distal end wall disposed in a transaxial direction and generally coterminous with the distal end of said side wall.

5. A device as set forth in claim 4 in which said element is of generally frusto-conical configuration with its maximum dimension adjacent said end wall.

6. A device as set forth in claim 1 in which said passage extends through said element.

7. A device as set forth in claim 4 in which said element has a tapped hole extending to the end wall thereof, and said tip is provided with a threaded end portion releasably engageable with said tapped hole.

8. A device as set forth in claim 1 in which said tube is provided with a manually engageable orienting plate axially spaced from said end wall.

9. A device as set forth in claim 8 in which said tip is curved along its axial extent, and releasably connected to said element, and in which said plate is disposed in a predetermined angular orientation with respect to the curvature of said tip.

Claims (9)

1. A device of the character described comprising a member having an end wall, a continuous side wall extending axially outwardly from the periphery of said end wall, an element extending axially from a central portion of said end wall and spaced radially inwardly from said side wall to define a continuous space therebetween, a tip extending axially from said element, a rigid tube connected to said end wall and extending in a contra direction to said side wall, and means defining a passage placing said tube and said continuous space in flow communication.
2. A device as set forth in claim 1, in which said tip is releasably connected to said element whereby tips of different sizes may be used.
3. A device as set forth in claim 1, in which said tip is curved along the axial extent thereof.
4. A device as Set forth in claim 1 in which said element has a distal end wall disposed in a transaxial direction and generally coterminous with the distal end of said side wall.
5. A device as set forth in claim 4 in which said element is of generally frusto-conical configuration with its maximum dimension adjacent said end wall.
6. A device as set forth in claim 1 in which said passage extends through said element.
7. A device as set forth in claim 4 in which said element has a tapped hole extending to the end wall thereof, and said tip is provided with a threaded end portion releasably engageable with said tapped hole.
8. A device as set forth in claim 1 in which said tube is provided with a manually engageable orienting plate axially spaced from said end wall.
9. A device as set forth in claim 8 in which said tip is curved along its axial extent, and releasably connected to said element, and in which said plate is disposed in a predetermined angular orientation with respect to the curvature of said tip.
US49684374 1974-08-12 1974-08-12 Atraumatic uterine director Expired - Lifetime US3926192A (en)

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Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3980078A (en) * 1974-07-23 1976-09-14 Fuji Photo Optical Co., Ltd. Endoscope with cleaning device
US4047532A (en) * 1975-04-21 1977-09-13 Phillips Jack L Vacuum forcep and method of using same
EP0400458A1 (en) * 1989-06-01 1990-12-05 Edward Weck Incorporated Laparoscopy cannula
US5209754A (en) * 1992-04-02 1993-05-11 Ahluwalia Prabhat K Vaginal cervical retractor elevator
US5259836A (en) * 1987-11-30 1993-11-09 Cook Group, Incorporated Hysterography device and method
US5350355A (en) * 1992-02-14 1994-09-27 Automated Medical Instruments, Inc. Automated surgical instrument
US5464409A (en) * 1993-12-09 1995-11-07 Mohajer; Reza S. Uterine manipulator and protector
US5626595A (en) * 1992-02-14 1997-05-06 Automated Medical Instruments, Inc. Automated surgical instrument
EP0786962A1 (en) * 1994-10-18 1997-08-06 Blairden Precision Instruments, Inc. Vaginal extender for colpotomy surgery
US5728178A (en) * 1993-03-25 1998-03-17 The Ohio State University Guide tube for gastrostomy tube placement
US20030078471A1 (en) * 2001-10-18 2003-04-24 Foley Frederick J. Manipulation of an organ
US6558314B1 (en) 2000-02-11 2003-05-06 Iotek, Inc. Devices and method for manipulation of organ tissue
US6641604B1 (en) 2000-02-11 2003-11-04 Iotek, Inc. Devices and method for manipulation of organ tissue
US6663622B1 (en) 2000-02-11 2003-12-16 Iotek, Inc. Surgical devices and methods for use in tissue ablation procedures
US6773418B1 (en) * 1999-08-18 2004-08-10 Iotek, Inc. Device and method for delivery of agents to the female reproductive tract
US20050085827A1 (en) * 2003-10-15 2005-04-21 G. Anselmo N. Uterine manipulating device
US20090005785A1 (en) * 2006-12-05 2009-01-01 Norman Plassky Mounting for a bone drill and bone drill mounting system
WO2010151429A2 (en) 2009-06-25 2010-12-29 University Of Maryland, Baltimore Electrosurgical element and uterine mainpulator for total laparoscopic hysterectomy
WO2011140604A1 (en) * 2010-05-14 2011-11-17 Alan Lam A uterine manipulator
US8323278B2 (en) 2010-12-06 2012-12-04 Soulor Surgical, Inc. Apparatus for treating a portion of a reproductive system and related methods of use
US20130066328A1 (en) * 2011-04-07 2013-03-14 Jai Singh General uterine manipulator and system
US20130197536A1 (en) * 2011-04-07 2013-08-01 Jai Singh General uterine manipulator and system
USD750779S1 (en) * 2014-03-11 2016-03-01 Prabhat Kumar Ahluwalia Medical device
USD751198S1 (en) * 2014-03-11 2016-03-08 Prabhat Kumar Ahluwalia Medical device
US20160081717A1 (en) * 2011-04-07 2016-03-24 Jai Singh General uterine manipulator and system
US9327097B2 (en) 2013-03-12 2016-05-03 Minimally Invasive Surgical Technologies, Inc Uterine manipulator
USD755967S1 (en) * 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
USD755966S1 (en) * 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
USD755968S1 (en) 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
USD763446S1 (en) 2014-03-11 2016-08-09 Prabhat Kumar Ahluwalia Medical device
USD763445S1 (en) 2014-03-11 2016-08-09 Prabhat Kumar Ahluwalia Medical device
US9532837B2 (en) 2012-04-20 2017-01-03 Jiwan Steven Singh Repositionable medical instrument support systems, devices, and methods
WO2017123891A1 (en) * 2016-01-13 2017-07-20 Memorial Sloan-Kettering Cancer Center Uterine manipulator arrangement

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1481008A (en) * 1922-05-17 1924-01-15 Sharp & Smith Nasal suction apparatus
US2082782A (en) * 1935-10-03 1937-06-08 Alfred G Allen Vacuum tenaculum
US2195771A (en) * 1937-11-09 1940-04-02 Estler Louis Edmond Surgical suction drainage cup
US2941532A (en) * 1957-10-10 1960-06-21 American Hospital Supply Corp Drainage tube and hood
US3113688A (en) * 1961-09-14 1963-12-10 Campbell Ruth Rasmussen Blood collector

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1481008A (en) * 1922-05-17 1924-01-15 Sharp & Smith Nasal suction apparatus
US2082782A (en) * 1935-10-03 1937-06-08 Alfred G Allen Vacuum tenaculum
US2195771A (en) * 1937-11-09 1940-04-02 Estler Louis Edmond Surgical suction drainage cup
US2941532A (en) * 1957-10-10 1960-06-21 American Hospital Supply Corp Drainage tube and hood
US3113688A (en) * 1961-09-14 1963-12-10 Campbell Ruth Rasmussen Blood collector

Cited By (48)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3980078A (en) * 1974-07-23 1976-09-14 Fuji Photo Optical Co., Ltd. Endoscope with cleaning device
US4047532A (en) * 1975-04-21 1977-09-13 Phillips Jack L Vacuum forcep and method of using same
US5259836A (en) * 1987-11-30 1993-11-09 Cook Group, Incorporated Hysterography device and method
EP0400458A1 (en) * 1989-06-01 1990-12-05 Edward Weck Incorporated Laparoscopy cannula
US5632758A (en) * 1992-02-14 1997-05-27 Automated Medical Instruments, Inc. Automated surgical instrument
US5350355A (en) * 1992-02-14 1994-09-27 Automated Medical Instruments, Inc. Automated surgical instrument
US5626595A (en) * 1992-02-14 1997-05-06 Automated Medical Instruments, Inc. Automated surgical instrument
US5209754A (en) * 1992-04-02 1993-05-11 Ahluwalia Prabhat K Vaginal cervical retractor elevator
WO1993019801A1 (en) * 1992-04-02 1993-10-14 Prabhat Kumar Ahluwalia Vaginal cervical retractor elevator
US5728178A (en) * 1993-03-25 1998-03-17 The Ohio State University Guide tube for gastrostomy tube placement
US5464409A (en) * 1993-12-09 1995-11-07 Mohajer; Reza S. Uterine manipulator and protector
EP0786962A4 (en) * 1994-10-18 1998-09-16 Blairden Precision Instr Inc Vaginal extender for colpotomy surgery
EP0786962A1 (en) * 1994-10-18 1997-08-06 Blairden Precision Instruments, Inc. Vaginal extender for colpotomy surgery
US6773418B1 (en) * 1999-08-18 2004-08-10 Iotek, Inc. Device and method for delivery of agents to the female reproductive tract
US6558314B1 (en) 2000-02-11 2003-05-06 Iotek, Inc. Devices and method for manipulation of organ tissue
US6641604B1 (en) 2000-02-11 2003-11-04 Iotek, Inc. Devices and method for manipulation of organ tissue
US6663622B1 (en) 2000-02-11 2003-12-16 Iotek, Inc. Surgical devices and methods for use in tissue ablation procedures
US20030078471A1 (en) * 2001-10-18 2003-04-24 Foley Frederick J. Manipulation of an organ
US20050085827A1 (en) * 2003-10-15 2005-04-21 G. Anselmo N. Uterine manipulating device
US20090005785A1 (en) * 2006-12-05 2009-01-01 Norman Plassky Mounting for a bone drill and bone drill mounting system
US8709017B2 (en) * 2006-12-05 2014-04-29 Brainlab Ag Mounting for a bone drill and bone drill mounting system
EP3345558A1 (en) 2009-06-25 2018-07-11 University of Maryland, Baltimore Electrosurgical element and uterine manipulator for total laparoscopic hysterectomy
WO2010151429A2 (en) 2009-06-25 2010-12-29 University Of Maryland, Baltimore Electrosurgical element and uterine mainpulator for total laparoscopic hysterectomy
US9033977B2 (en) 2009-06-25 2015-05-19 University Of Maryland, Baltimore Electrosurgical element and uterine manipulator for total laparoscopic hysterectomy
WO2011140604A1 (en) * 2010-05-14 2011-11-17 Alan Lam A uterine manipulator
US8323278B2 (en) 2010-12-06 2012-12-04 Soulor Surgical, Inc. Apparatus for treating a portion of a reproductive system and related methods of use
US8608738B2 (en) 2010-12-06 2013-12-17 Soulor Surgical, Inc. Apparatus for treating a portion of a reproductive system and related methods of use
US10034687B2 (en) 2010-12-06 2018-07-31 Surgigyn, Inc. Apparatus for treating a portion of a reproductive system and related methods of use
US20150012009A1 (en) * 2011-04-07 2015-01-08 Jai Singh General uterine manipulator and system
US9101390B2 (en) * 2011-04-07 2015-08-11 Jai Singh General uterine manipulator and system
US20130066328A1 (en) * 2011-04-07 2013-03-14 Jai Singh General uterine manipulator and system
US9987042B2 (en) * 2011-04-07 2018-06-05 Jai Singh General uterine manipulator and system
US20160081717A1 (en) * 2011-04-07 2016-03-24 Jai Singh General uterine manipulator and system
US9974567B2 (en) 2011-04-07 2018-05-22 Jiwan Steven Singh General uterine manipulator and system
US9451985B2 (en) 2011-04-07 2016-09-27 Jiwan Steven Singh General uterine manipulator and system
US20130197536A1 (en) * 2011-04-07 2013-08-01 Jai Singh General uterine manipulator and system
US10004569B2 (en) 2012-04-20 2018-06-26 Jiwan Steven Singh Repositionable medical instrument support systems, devices, and methods
US9532837B2 (en) 2012-04-20 2017-01-03 Jiwan Steven Singh Repositionable medical instrument support systems, devices, and methods
US9327097B2 (en) 2013-03-12 2016-05-03 Minimally Invasive Surgical Technologies, Inc Uterine manipulator
US9522252B2 (en) 2013-03-12 2016-12-20 Prabhat K. Ahluwalia Uterine manipulator
USD755968S1 (en) 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
USD763445S1 (en) 2014-03-11 2016-08-09 Prabhat Kumar Ahluwalia Medical device
USD763446S1 (en) 2014-03-11 2016-08-09 Prabhat Kumar Ahluwalia Medical device
USD751198S1 (en) * 2014-03-11 2016-03-08 Prabhat Kumar Ahluwalia Medical device
USD755966S1 (en) * 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
USD750779S1 (en) * 2014-03-11 2016-03-01 Prabhat Kumar Ahluwalia Medical device
USD755967S1 (en) * 2014-03-11 2016-05-10 Prabhat Kumar Ahluwalia Medical device
WO2017123891A1 (en) * 2016-01-13 2017-07-20 Memorial Sloan-Kettering Cancer Center Uterine manipulator arrangement

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