Devices and methods for mobilization of the uterus
An electrocautery device comprises first and second continuous loop electrode structures. The electrodes are typically coupled together at one end, permitting the electrodes to be introduced anteriorly and posteriorly over a uterine body. The electrodes may be clamped together, and radiofrequency energy may be delivered through the clamped electrodes to sever and cauterize blood vessels, tubular structures, and ligaments which connect the uterine body to surrounding tissue structures. The mobilized uterine body may then be removed by conventional hysterectomy.
1. A method for mobilizing a uterus, said method comprising:
positioning a first continuous loop electrode having a pear-shaped or ovoid configuration over lateral blood vessels, tubes, and ligaments attached to the uterus;
positioning a second continuous loop electrode having a pear-shaped or ovoid configuration beneath the lateral blood vessels, tubes, and ligaments;
clamping the first and second loop electrodes together to capture the blood vessels, loops, and ligaments therebetween; and
delivering current through or between the loop electrodes to sever and cauterize the blood vessels, tubular structures, and ligaments.
2. A method as in claim 1 , wherein positioning the loop electrodes comprises passing the loop electrodes transvaginally through incisions in the rear vaginal well near the cervix.
3. A method as in claim 2 , wherein the loop electrodes are laterally collapsed as they pass through the incisions.
4. A method as in claim 3 , wherein the electrodes are advanced through a collar positioned adjacent the cervix, wherein the collar defines the lateral width of the loop electrodes as they pass through the incisions.
5. A method as in claim 3 , wherein the loop electrodes are constrained by an outer structure when advanced through the incisions, further comprising releasing the loop electrodes from constraint to deploy the loop electrodes about the uterus.
6. A method as in claim 1 , further comprising dissecting the cervix and removing the uterus.
7. A method as in claim 6 , wherein the uterus is removed through the vagina.
8. A method as in claim 7 , wherein the uterus is removed by pulling on the loop electrodes which provide at least a portion of the traction for pulling the uterus through the cervix.
9. A method as in claim 8 , wherein an inner edge of at least one of the loop electrodes grasps the uterus while traction is applied.
10. A method as in claim 9 , wherein grasping comprises penetrating barbs on the loop electrode into the uterine body.
11. A method as in claim 7 , wherein the uterus is removed by engaging the uterus with forceps and pulling on the forceps to provide at least a portion of the traction for pulling the uterus through the cervix.
12. A method as in claim 6 , wherein the uterus is removed through an abdominal incision.
13. A method as in claim 12 , wherein the uterus is first morcellated and then removed through a cannula positioned in the abdominal incision.