Transvaginal tube as an aid to laparoscopic surgery

a technology of transvaginal tube and laparoscopic surgery, which is applied in the direction of vaginoscope, catheter, diagnostics, etc., can solve the problems of increasing the operative time of laparoscopic surgery, fiddly use, and difficulty in pulling out of the abdominal por

Inactive Publication Date: 2005-11-24
MCCARTNEY ANTHONY JOHN
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0009] Preferably, the proximal end of the transvaginal tube is bevelled so that the leading or anterior edge of the tube protrudes beyond the posterior edge. In this respect, the anterior edge is, for example, 1 to 2 cm longer than the posterior edge. To avoid tissue damage in use, the edge of the tube surrounding the open bevelled end may be adapted to have a smooth edge. This may, for exam

Problems solved by technology

The disadvantage is that the additional laparoscopic surgery increases operative time.
However, these are fiddly to use and can be difficult to drag out of the a

Method used

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  • Transvaginal tube as an aid to laparoscopic surgery
  • Transvaginal tube as an aid to laparoscopic surgery
  • Transvaginal tube as an aid to laparoscopic surgery

Examples

Experimental program
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example 1

[0054] A tube 10, 110 made of firm or flexible smooth transparent plastic, with a valve 16, 116 mounted at one end, is sterilised in preparation for gynaecological laparoscopic surgery. When the patient is anaesthetised, positioned, cleansed and draped according to local custom, the tube is passed through the female vagina. The proximal end 12, 112 of the tube circumscribes the cervix from the vagina as depicted in FIG. 4. The tube is removed to allow the uterus and appendages to be exteriorised, following which the tube is replaced and the proximal end of the tube is intraperitoneal. The distal end 14, 114 is closed with a valve or headpiece 16, 116 and the pneumoperitoneum is maintained. No other device is needed to maintain the pneumoperitoneum but the tube is secured in place. Any fixation is acceptable but it is usually held by an assistant surgeon or one end is rested on a table. The tube is positioned according to need.

[0055] The proximal end of the tube when located intra-a...

example 2

[0057] The tube was sterilised with ethylene oxide gas. However, it will be appreciated that any method of sterilisation may be employed to sterilise the apparatus.

[0058] The first steps of a true laparoscopic hysterectomy are to secure and divide the ovarian, uterine and cervical branch of the uterine artery and reflect the bladder. The uterus is separated from the vagina and its uterosacral ligaments using the tube. The tube diameter depends on the patient. A 5 cm diameter tube is ideal for multiparous and overweight women but a smaller 4 or 3.5 cm diameter tube is needed for postmenopausal and nulliparous women to make it fit the vagina. It is inserted through the introitus and advanced to the cervix. This elevates and defines the cervicovaginal junction and further bladder mobilisation can be performed at this stage if more vagina exposure is necessary. The tube position also facilitates identification of the uterine vessels for a safe point for electrocoagulation or suture occ...

example 3

[0063] Use of the transvaginal tube as an aid to bladder neck surgery.

[0064] At either open or laparoscopic surgery, designed to elevate the bladder neck for treatment of stress incontinence of urine in the female, by either the Birch, Cato-Murray or similar procedure, the transvaginal tube previously described can also be used without the valve at the distal end to enhance bladder neck surgery. The tube may be any length from 5 cms to 35 cm in length, made of the same clear, rigid or semi-rigid plastic as previously described.

[0065] At that time in the procedure when the para-vesical area is being prepared to expose the lateral vaginal fornices, the tube is inserted with a telescope, either a direct (0 degrees) or a forward oblique type for example, with a 30 degree angle.

[0066] The tube acts to expand the vaginal walls, particularly the vaginal fornices so that they are made more prominent and fixed so that definite identification from either the open procedure or the retro-per...

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Abstract

It will be understood that the invention disclosed and defined herein extends to all alternative combinations of two or more of the individual features mentioned or evident from the text or drawings. All of these different combinations constitute various alternative aspects of the invention. Various changes and modifications may be made to the embodiments described and illustrated without departing from the present invention.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application is a continuation of application Ser. No. 09 / 443,503, filed Nov. 19, 1999, which is a continuation-in-part of application Ser. No. 08 / 586,856, filed Feb. 4, 1998, which is a National Stage of PCT / AU94 / 00630, filed Oct. 13, 1994.FIELD OF THE INVENTION [0002] This invention relates to a transvaginal tube which is particularly useful in laparoscopic surgery, and also to a procedure for the use of such a tube. BACKGROUND ART [0003] Modern advances in laparoscopic surgical equipment have meant that surgeons are able to remove the uterus and / or ovaries laparoscopically, removing the need for a long abdominal incision. [0004] A laparoscopic radical hysterectomy for cancer has evolved from the efforts of a few oncology centres with an interest in minimising invasive surgery. The operative technique is analogous to a modification of the operation originally described by Wertheim and Meigs. The laparoscope surgeon passes a 10 mm ...

Claims

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Application Information

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IPC IPC(8): A61B1/303A61B1/307A61B1/31A61B1/32A61B17/34A61B17/42
CPCA61B1/32A61B17/3462A61B17/42A61B2017/3466A61B2017/3419A61B2017/3445A61B2017/3449A61B17/4241
Inventor MCCARTNEY, ANTHONY JOHN
Owner MCCARTNEY ANTHONY JOHN
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