Surgery – Instruments – Obstetric or gynecological instruments
Patent
1994-12-21
1999-03-09
Dawson, Glenn K.
Surgery
Instruments
Obstetric or gynecological instruments
606184, 606180, A61B 1742, A61B 1714
Patent
active
058793585
DESCRIPTION:
BRIEF SUMMARY
The invention relates to a cervical punch or biopsy clamp for the decortication of the cervical fasciae from the uterine tissue for uterine extirpation.
It has hitherto been conventional practice to completely remove the uterus when there is a benign change indication. However, in the attempt to endoscopically remove the uterus, difficulties are encountered in the decortication of the cervix from the highly vascular pericervical tissue.
The object of the invention is to provide a medical instrument able to very carefully remove the uterine tissue in a clearly defined area of the cervix.
According to the invention this object is achieved by the cervical punch according to claim 1. Advantageous further developments of the invention form the subject matter of subclaims.
The risk of a malignant degeneration of the genital canal left behind after supracervical uterus removal emanates almost exclusively from the transition area in the vicinity of the portio cervicalis, the endothelium of the cervix and the endometrium. Whereas hitherto the cervical fasciae have been removed from the surrounding tissue from the outside, i.e. the uterine artery, the uterine veins, the urethra, the periureteral tissue and the corresponding neuroplexus, the present invention makes it possible to decorticate the cervical fasciae from the uterine tissue within the cervix.
For this purpose the cervix diameter must be very accurately determined to the millimetre beforehand by transvaginal ultrasonics. A guide rod is then inserted in the uterus, which longitudinally orients the latter and pierces the uterine base as centrally as possible. The basic body of the cervical punch is then engaged on the guide rod and inserted, accompanied by a rotary movement, into the cervical canal, in order to cylindrically punch out the latter with a corresponding, predetermined spacing from the cervical fasciae. The remaining hollow cylinder which is subsequently used for drainage purposes, after transabdanimal or pelvisccpic ligature, can be left behind without any risk with regards to subsequent malignant degeneration. Thus, the patient loses none of her vaginal functions and there is no transvaginal abdominal infection risk. After drawing out the basic body together with the punched out tissue, it is possible to seal open vessels by inserting a cylindrical coagulation probe, namely a hemostat.
The thin-walled, hollow cylindrical, distal part of the basic body has a distal opening, which is provided with a cutting edge. The latter has a very sharp wave grinding pattern which, in the case of a rotary movement of the basic body, brings about an exact cutting in the uterine tissue without the remaining tissue being excessively traumatized. Thus, uterine tissue can be decorticated without deforming the cervical fasciae during this process. At the distal end of the cervical punch on the inside of the hollow cylindrical basic body sharp-edged folding members can be formed which, on retracting the basic body in the proximal direction, swing from the axial position into a radial position and thereby bring about a separation of the punched out uterine tissue at the distal end of the punched out tissue plug.
At its proximal end the basic body has a radially extending, circular handle or grip plate, whose edge is profiled, in order to permit easier operation, particularly with regards to the adjustment of a rotary movement during the cutting process.
The distal half of the length of the basic body is preferably constructed as a thin-walled hollow cylinder for receiving the uterine tissue to be decorticated, whereas the proximal half of the length of the basic body has a through-bore with an internal diameter which only slightly exceeds the external diameter of the guide rod, i.e. is designed with an accurate fit, so that in said proximal area the guide rod is only guided for an axial movement.
The internal diameter transition from the proximal to the distal part is as progressive or conical as possible, to prevent a sticking of removed tissue on corners or edges.
REFERENCES:
patent: 4142517 (1979-03-01), Stavropoulos
patent: 4306570 (1981-12-01), Matthews
patent: 4461305 (1984-07-01), Cibley
patent: 4543966 (1985-10-01), Islam et al.
patent: 4573448 (1986-03-01), Kambin
patent: 4696308 (1987-09-01), Meller et al.
patent: 4785826 (1988-11-01), Ward
patent: 4798213 (1989-01-01), Doppelt
patent: 4913143 (1990-04-01), Oloff
patent: 5040542 (1991-08-01), Gray
patent: 5049150 (1991-09-01), Cozad
patent: 5271414 (1993-12-01), Partika et al.
patent: 5341816 (1994-08-01), Allen
patent: 5372583 (1994-12-01), Roberts et al.
Dawson Glenn K.
WISAP Gesellschaft fuer wissenschaftlichen Apparatebau mbH
LandOfFree
Cervical punch does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Cervical punch, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Cervical punch will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-1315899