SYSTEMS AND METHODS FOR ENDOMETRIAL ABLATION

1 . A system for endometrial ablation comprising:

an elongated shaft with a working end comprising an expandable-contractible frame;

a compliant energy-delivery surface carried by the frame, the surface having an interior chamber and the frame and surface being configured to engage against the interior of a patient's uterine cavity when the working end is inserted into the cavity and the frame is expanded; and

an electrode structure carried on an exterior of the energy-delivery surface.

2 . The system of claim 1 , wherein energy-delivery surface is configured for primary expansion in a lateral direction by the frame.

3 . The system of claim 2 , wherein energy-delivery surface is configured for secondary expansion in an anterior-posterior direction generally perpendicular to the lateral direction by inflation of the interior chamber.

4 . The system of claim 1 , wherein the energy-delivery surface comprises a thin-walled elastomer.

5 . The system of claim 4 , wherein the electrode structure is bonded to the thin-walled elastomer.

6 . The system of claim 4 , wherein energy-delivery surface comprises at least partly a silicone elastomer.

7 . The system of claim 1 , wherein the energy-delivery surface circumscribes the interior chamber.

8 . The system of claim 1 , wherein energy-delivery surface is maintained in the contracted shape when present in a passageway of the shaft.

9 . The system of claim 1 , further comprising a fluid pressure source coupled to the interior chamber.

10 . The system of claim 1 , further comprising at least one temperature sensor carried by the energy-delivery surface.

11 . The system of claim 10 , further comprising a controller operatively coupled to the at least one temperature sensor.

12 . A method of treating a patient's uterus, comprising:

positioning a probe end into a uterine cavity; and

expanding the probe end in a first direction by actuating a frame within an interior chamber of a balloon portion of the probe end;

expanding the probe end in a second direction by introducing a fluid medium into the interior chamber; and

delivering energy from the probe end to tissue of the uterine cavity.

13 . The method of claim 12 , wherein positioning comprises trans-cervically inserting the probe end into the uterine cavity.

14 . The method of claim 12 , wherein delivering energy comprises delivering from or through a surface of the expanded portion of the probe.

15 . The method of claim 12 , wherein the first direction is laterally across the uterine cavity.

16 . The method of claim 15 , wherein the second direction lies along an anterior-posterior axis.

17 . The method of claim 14 , wherein the energy is delivered from at least one electrode carried by the probe end.

18 . The method of claim 17 , wherein the energy is delivered by bi-polar electrodes carried by the probe end.

19 . The method of claim 14 , wherein the energy is delivered by conductive heating from the surface.

20 . A method for performing endometrial ablation comprising:

trans-cervically introducing a probe working end into a patient's uterine cavity, the working end comprising an expandable-contractible frame that carries a complaint energy-delivery surface;

actuating the frame to expand the energy-delivery surface in the uterine cavity;

actuating an inflation source to further expand the energy-delivery surface in the uterine cavity; and

delivering energy from or through the energy-delivery surface to cause endometrial ablation.

21 . The method of claim 20 , wherein the frame expands the surface in a first plane and the inflation expands the surface generally transverse to said plane.

22 . The method of claim 20 , wherein the energy is delivered from at least one electrode carried by the energy-delivery surface.

23 . The method of claim 22 , wherein the energy is delivered by bipolar electrodes carried by the energy-delivery surface.

24 . The method of claim 20 , wherein the energy is delivered by conductive heating the energy-delivery surface.

25 . A method as in claim 20 , wherein the inflation source delivers an inflation pressure to the working end of at least 20 mmHg.

26 . A method as in claim 25 , wherein the working end comprises an inflation chamber surrounded by a thin wall elastomeric membrane, wherein a circulating gas stream within the chamber is maintained at least 20 mmHg above ambient.

27 . A method for performing endometrial ablation comprising:

trans-cervically introducing a probe working end into a patient's uterine cavity, the working end comprising a thin wall energy-delivery surface;

expanding the working end in the uterine cavity;

delivering energy from the energy-delivery surface to cause endometrial ablation; and

observing the depth of ablation by means of signals from an ultrasound transducer carried by or within the working end.