1. Field of the Invention
The present invention relates generally to medical devices and methods, and more particularly to methods and gynecological devices for mobilization of the female uterus prior to hysterectomy or other procedures.
Hysterectomy involves total or partial removal of the body and cervix of the uterus. Hysterectomy is one of the most common surgical procedures performed in the United States. By the age of sixty, nearly one in three American women will have undergone hysterectomy, and it is estimated that over a half million women undergo hysterectomy each year in the United States alone. The costs related to performing hysterectomies cost the United States healthcare system billions of dollars annually.
A majority of hysterectomies are performed by an open abdominal surgical procedure as surgeons have the most experience with this approach. An open abdominal surgical route allows for removal of a large sized uterus or other diseased organs or tissue, such as the ovaries, fallopian tubes, endometriosis, adenomyosis, and the like. However, open abdominal hysterectomy suffers from several drawbacks. The surgical procedure is often lengthy and complicated, requiring longer anesthesia periods and the increased risk of postoperative complications. Patients also suffer from prolonged recovery periods, pain and discomfort, and large visible scarring on the abdomen. Further, increased costs are associated with an open abdominal approach, such as prolonged hospital stays.
Two less invasive alternatives to performing hysterectomies are vaginal and laparoscopically assisted vaginal hysterectomy. A vaginal hysterectomy, which is of particular interest to the present invention, involves a surgical approach through the vaginal tubular tract to gain access directly to the uterus. Hysterectomies may also be performed with a range of laparoscopic assistance, often using a laparoscopic port for viewing only where all other steps are completed vaginally. Hysterectomies may be completely performed laparoscopically, typically requiring mobilization of the uterus and subsequent removal of the uterus through a laparoscopic port.
A problem common to both transvaginal and laparoscopic hysterectomies is the dissection of the uterus from the surrounding blood vessels, tubular structures, and ligaments which attach the uterus to surrounding tissue structures. In transvaginal procedures, it is often necessary to advance surgical blades, electrocautery elements or other dissection tools in a blind fashion in an effort to cut and seal the blood vessels, tubular structures, and ligaments. Even with laparoscopic viewing, such procedures for freeing the uterus from surrounding tissue structures are difficult.
For these reasons, it would be desirable to provide improved methods and apparatus for performing transvaginal and laparoscopic hysterectomies. In particular, it would be desirable to provide improved methods and apparatus for mobilizing the uterus by dissecting the blood vessels, tubular structures, and ligaments surrounding the uterus to free the uterus from surrounding tissue structures. Such improved methods and apparatus would desirably reduce procedure times and complexity, and result in improved patient outcomes while simultaneously reducing costs of the procedure. At least some of these objectives will be met by the inventions described hereinbelow.
2. Description of the Background Art
Electrosurgical cutting loops are described in U.S. Pat. No. 6,245,069. Methods and systems for organ resection are described in U.S. Pat. No. 6,123,701, licensed to the assignee of the present application and incorporated herein by reference. Bipolar forceps for coagulating blood vessels are described in U.S. Pat. No. 5,443,463. The use of radio frequency energy to necrose the endothelial lining of the uterus is described in U.S. Pat. No. 4,979,948. The following U.S. Patents may also be relevant to the present invention: U.S. Pat. Nos. 3,920,021; 3,845,771; 4,041,952; 4,671,274; 4,972,846; 5,037,379; 5,078,736; 5,151,102; 5,178,618; 5,207,691; 5,217,030; 5,267,998; 5,269,780; 5,269,782; 5,281,216; 5,282,799; 5,290,287; 5,295,990; 5,300,087; 5,324,289; 5,330,471; 5,336,229; 5,336,237; 5,342,381; 5,352,223; 5,352,235; 5,356,408; 5,391,166; 5,395,369; 5,396,900; 5,403,312; 5,417,687; 5,423,814; 5,445,638; 5,456,684; 5,458,598; 5,462,546; 5,482,054; 5,484,435; 5,484,436; 5,496,312; 5,496,317; 5,514,134; 5,531,744; 5,540,684; 5,540,685; 5,542,945; 5,549,606; 5,558,100; 5,558,671; 5,569,243; 5,573,535; 5,578,052; 5,599,350; 5,603,711; 5,611,803; 5,624,452; 5,637,110; 5,637,111; 5,653,692; 5,658,281; 5,665,085; 5,665,100; 5,667,526; 5,669,907; 5,674,184; 5,674,220; 5,681,282; 5,683,385; 5,683,388; 5,688,270; 5,693,051; 5,697,949; 5,700,261; 5,702,390; 5,707,369; 5,709,680; 5,713,896; 5,718,703; 5,733,283; 5,735,289; 5,735,848; 5,735,849; 5,741,285; 5,743,906; 5,755,717; 5,833,690; 6,743,229. The subject matter of this application is related to the following copending, commonly assigned applications: No. 60/680,937 (docket 025741-000100US); Ser. No. 11/137,970 (docket 025741-000300US); and Ser. No. 11/173,478 (docket 025741-000500US), the full disclosures of which are incorporated herein by reference.