Uterine manipulator

1. A uterine manipulator system comprising:

(1) a collar including (a) (i) a first end comprising a first opening, having a first diameter, surrounded by a first rim, (a)(ii) a second end, opposite the first end, having a second opening, having a second diameter that is larger than the first diameter, surrounded by a second rim, (a)(iii) an inner surface, coupling the first end to the second end, adapted to contact a cervix, (a)(iv) an outer surface adapted to contact a vaginal wall, (a)(v) a hollow tunnel, including the inner surface, the first opening, and the second opening wherein the hollow tunnel is adapted to receive the cervix; and (a)(vi) a first shelf connected to the inner surface and located between the first and second ends; and wherein the first shelf includes a first surface and a second surface opposite the first surface, the first surface being between the second surface and the first end and the second surface being between the second end and the first surface;

(2) a stabilizer including (b)(i) a first stabilizer end comprised of a base portion with a stabilizer aperture, (b)(ii) a second stabilizer end, opposite the first stabilizer end, having a stabilizer rim adapted to couple to the first surface or the second surface, wherein a diameter of the first stabilizer end is less than a diameter of the second stabilizer end;

(3) a shaft configured to pass through the stabilizer aperture; wherein the shaft contains a hollow inner channel coupling a distal end of the shaft to a proximal end of the shaft; and

wherein the distal end of the shaft includes at least one of a distal shaft aperture in fluid communication with the hollow inner channel, and the proximal end of the shaft includes at least one of a proximal shaft aperture in fluid communication with the hollow inner channel;

(4) a bulbous portion having a maximum bulbous diameter greater than a maximum diameter of the shaft including a longitudinal axis;

wherein the bulbous portion includes a first portion, a second portion, and a third portion, and a thickness of sidewalls of the bulbous portion varies between the first portion and second portion and between the second portion and third portion;

wherein the second portion is located between the first portion and the third portion;

wherein the first portion is configured for coupling to the distal end of the shaft;

wherein the first portion, the second portion, and the third portion respectively include a first diameter, a second diameter, and a third diameter, wherein the bulbous portion includes a continuously convexly sloped perimeter extending from the third diameter and crossing the longitudinal axis to form a closed, rounded distal end of the bulbous portion;

wherein the second diameter is smaller than the first diameter and the third diameter; and

wherein a first outlet is located between the second portion and the distal end of the bulbous portion, and the first outlet is in fluid communication with the distal shaft aperture and the hollow inner channel, wherein the bulbous portion does not include an additional inlet and corresponding outlet extending in parallel to a longitudinal axis of the shaft before the second portion.

2. The system of claim 1 :

wherein the first rim includes a first inner edge, separated by a first gully from a first outer edge; and wherein the second rim includes a second inner edge, separated by a second gully from a second outer edge;

wherein the first outer edge is closer than the first inner edge to the second outer edge in a linear direction; and wherein the second outer edge is closer than the second inner edge to the first outer edge in a linear direction; and

wherein the first outer edge is farther from a center of the collar in a radial direction than the first inner edge; and the second outer edge is farther from the center of the collar in a radial direction than the second inner edge.

3. The system of claim 2 , wherein a diameter of the first rim is between 25 mm and 40 mm;

wherein a diameter of the second rim is between 25 mm and 45 mm;

wherein a diameter of the stabilizer rim is between 15 mm and 35 mm;

wherein a distance between the first end and second end is less than 40 mm; and

wherein the first diameter and the third diameter is 5 mm to 10 mm.

4. A uterine manipulator system comprising:

a collar including (a)(i) a first end comprising a first opening, having a first diameter, surrounded by a first rim, (a)(ii) a second end, opposite the first end, having a second opening, having a second diameter that is larger than the first diameter, surrounded by a second rim, (a)(iii) an inner surface, coupling the first end to the second end, adapted to contact a cervix, (a)(iv) an outer surface adapted to contact a vaginal wall, (a)(v) a hollow tunnel, including the inner surface, the first opening, and the second opening wherein the hollow tunnel is adapted to receive the cervix; and (a)(vi) a first shelf connected to the inner surface and located between the first and second ends;

wherein the first shelf includes a first surface and a second surface opposite the first surface, the first surface being between the second surface and the first end and the second surface being between the second end and the first surface; and

a stabilizer including (b)(i) a first stabilizer end comprised of a base portion with a stabilizer aperture, (b)(ii) a second stabilizer end, opposite the first stabilizer end, having a stabilizer rim adapted to couple to the first surface or the second surface, wherein a diameter of the first stabilizer end is less than a diameter of the second stabilizer end;

a shaft configured to pass through the stabilizer aperture;

wherein the distal end of the shaft includes a bulbous portion having a maximum bulbous diameter greater than a maximum diameter of the shaft, the bulbous portion including a first portion, a second portion, and a third portion respectively including a first diameter, a second diameter, a third diameter, and a longitudinal axis,

wherein the second portion is located between the first portion and the third portion and wherein the first portion is configured for coupling to the distal end of the shaft;

wherein the bulbous portion includes a continuously convexly sloped perimeter extending from the third diameter and crossing the longitudinal axis to form a closed, rounded distal end of the bulbous portion,

wherein a thickness of sidewalls of the bulbous portion varies between the first portion and second portion and between the second portion and third portion,

and wherein a first outlet is located on the continuously sloped perimeter between the third diameter and the distal end of the bulbous portion, wherein the bulbous portion does not include an additional inlet and corresponding outlet extending in parallel to a longitudinal axis of the shaft before the second portion.

5. The system of claim 4 ,

wherein the shaft contains a hollow inner channel coupling a distal end of the shaft to a proximal end of the shaft;

wherein the proximal end of the shaft includes at least one of a proximal shaft aperture in fluid communication with the hollow inner channel; and

wherein the shaft includes a middle portion between the proximal end of the shaft and the distal end of the shaft.

6. The system of claim 5 :

wherein the middle portion includes a middle portion long axis and the distal end includes a distal end long axis that intersects the middle portion long axis at an intersection angle between 0 to 90 degrees.

7. The system of claim 4 wherein the stabilizer includes at least one of a window between the stabilizer rim and the base portion.

8. The system of claim 5 wherein in a first configuration the stabilizer rim couples to the first surface and not the second surface; and

wherein in a second configuration the stabilizer rim couples to the second surface and not the first surface.

9. The system of claim 5 , comprising a second shelf connected to the inner surface and located between the second end and the first shelf;

wherein in a first configuration the stabilizer rim connects directly to the first shelf and not the second shelf; and

wherein in a second configuration the stabilizer rim connects directly to the second shelf and not the first shelf.

10. The system of claim 5 , wherein the inner surface of the collar includes two or more inner shelves; and

wherein the stabilizer rim is configured to couple to at least one inner shelf.

11. The system of claim 5 ,

wherein the maximum bulbous diameter is configured to resist withdrawal of the distal end from the cervix, wherein the first outlet is located on the bulbous portion and is in fluid communication with the proximal shaft aperture and the hollow inner channel.

12. The system of claim 11 ,

wherein the second diameter is smaller than the first diameter and the third diameter.

13. The system of claim 5 , including a fulcrum configured to slidably couple to the shaft and wherein the shaft pivots about the fulcrum, wherein the fulcrum is selected from the group comprising a disc, a plate, a ball, a rim with prongs, and a sponge; and

wherein the fulcrum is configured to fit within a vaginal canal that comprises the vaginal wall; and wherein the fulcrum contains a hole to receive the shaft.

14. The system of claim 5 including a fulcrum configured to slidably couple to the shaft and wherein the shaft pivots about the fulcrum and a powered linkage configured to articulate the system;

wherein the linkage is a robotic arm configured to articulate the system through six degrees of freedom; and

wherein the powered linkage includes an end effector configured to interface with the system.

15. The system of claim 12 having a conduit wherein the conduit is hollow with an inner diameter greater than the diameter of the stabilizer aperture and a diameter of the shaft;

wherein the distal end of the conduit is configured couple to the base portion;

wherein the conduit is configured to slide between the proximal end of the shaft and the distal end of the shaft; and

wherein the base portion is distal to the conduit, and the first outlet is distal to the stabilizer.

16. The system of claim 15 , wherein a proximal end of the conduit is adapted to couple to a fastener to fixedly fasten the conduit to the shaft.

17. The system of claim 5 :

wherein the middle portion includes a middle portion longitudinal axis and the distal end includes a distal end longitudinal axis that intersects the middle portion longitudinal axis; and wherein the angle between the two axis is adjustable and the curvature of the shaft is malleable.

18. The system of claim 12 :

wherein a diameter of the first rim is between 25 mm and 40 mm;

wherein a diameter of the second rim is between 25 mm and 45 mm;

wherein a diameter of the stabilizer rim is between 15 mm and 35 mm;

wherein a distance between the first end and second end is less than 40 mm; and

wherein the first diameter and the third diameter is 5 mm to 10 mm.

19. A uterine manipulator system comprising:

(1) a shaft;

wherein the shaft contains a hollow inner channel coupling a distal end of the shaft to a proximal end of the shaft; and

wherein the distal end of the shaft includes at least one of a distal shaft aperture in fluid communication with the hollow inner channel, and the proximal end of the shaft includes at least one of a proximal shaft aperture in fluid communication with the hollow inner channel;

(2) a bulbous portion having a maximum bulbous diameter greater than a maximum diameter of the shaft;

wherein the bulbous portion includes a first portion, a second portion, a third portion, and a longitudinal axis;

wherein the second portion is located between the first portion and the third portion;

wherein the first portion is configured for coupling to the distal end of the shaft;

wherein the first portion, the second portion, and the third portion respectively include a first diameter, a second diameter, and a third diameter, and a thickness of sidewalls of the bulbous portion varies between the first portion and second portion and between the second portion and third portion,

wherein the second diameter is smaller than the first diameter and the third diameter;

wherein the bulbous portion includes a continuously convexly sloped perimeter extending from the third diameter and crossing the longitudinal axis to form a closed, rounded distal end of the bulbous portion,

wherein a first outlet is located on the continuously sloped perimeter between the third diameter and the distal end of the bulbous portion and is in fluid communication with the distal shaft aperture and the hollow inner channel; and

wherein the bulbous portion does not include an additional inlet and corresponding outlet extending in parallel to a longitudinal axis of the shaft before the second portion.

20. The system of 19 , including

(1) a stabilizer comprising (a) (i) a first stabilizer end comprised of a base portion with a stabilizer aperture, (a)(ii) a second stabilizer end, opposite the first stabilizer end;

wherein a diameter of the first stabilizer end is less than a diameter of the second stabilizer end;

wherein in a first configuration the stabilizer aperture is slidable along the shaft;

wherein the first outlet is distal to the stabilizer; and

(2) a conduit wherein the conduit is hollow with an inner diameter greater than the diameter of the stabilizer aperture and a diameter of the shaft;

wherein the distal end of the conduit is configured couple to the base portion;

wherein the conduit is configured to slide between the proximal end of the shaft and the distal end of the shaft;

wherein the base portion is distal to the conduit, and the first outlet is distal to the stabilizer; and

wherein a proximal end of the conduit is adapted to couple to a fastener to fixedly fasten the conduit to the shaft.