Telescopic Uterine Manipulator with Variable Length
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current uterine cannulae and manipulators face challenges such as the risk of uterine perforation, cervical trauma, and inefficient uterine visualization due to fixed lengths and inadequate sealing, particularly in retroverted uteri, requiring cumbersome procedures like uterine sounding and often necessitating two physicians for laparoscopic procedures.
Innovation Solution
A uterine manipulator with a variable length between the cervical stop and the distal end, allowing adjustment during insertion, featuring a telescopic design with a spring-loaded mechanism and a movable cervical stop for secure sealing, eliminating the need for pre-measurement and enabling single-physician operation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a narrow distal end portion is used to ease insertion into the cervix, then ease of operation is improved, but the risk of uterine perforation increases
Solution Approach 1:
The distal end portion is designed to be telescopic, allowing it to dynamically adjust its length. During insertion, it remains retracted to a narrow profile for safe passage through the cervix. Once positioned, it can be extended to provide adequate uterine manipulation while maintaining safety margins. This dynamic adjustment resolves the contradiction between needing a narrow profile for insertion and sufficient length for safe manipulation.
Solution Approach 2:
The manipulator is divided into distinct segments: a fixed proximal portion and a telescopic distal end portion. The distal end portion can be independently adjusted relative to the proximal portion, allowing the operator to optimize the length of the intra-uterine segment based on individual patient anatomy and procedural needs, thereby reducing perforation risk while maintaining ease of insertion.
2Device complexity
If a fixed length cannula is used, then device complexity is reduced, but adaptability to different uterine sizes and orientations is worsened
Solution Approach 1:
The telescopic mechanism allows the distal end portion to be extended or retracted based on the specific uterine depth and orientation encountered. This dynamic adjustment provides adaptability to various uterine anatomies without requiring multiple fixed-length cannulae, thus maintaining relatively simple device construction while achieving versatility.
Solution Approach 2:
A single telescopic manipulator design can accommodate a wide range of uterine sizes, shapes, and orientations by adjusting the distal end portion length. This universal design eliminates the need for multiple specialized instruments, reducing overall device complexity while enhancing adaptability across different clinical scenarios.
3Measurement precision
If uterine sounding is performed to measure depth, then measurement precision is improved, but the duration and complexity of the procedure increases
Solution Approach 1:
The telescopic manipulator allows the operator to visually and tactilely assess the appropriate extension length during the procedure itself, eliminating the need for a separate sounding procedure. The manipulator essentially performs its own measurement function by allowing gradual extension until the desired position is achieved, thereby reducing procedure time while maintaining adequate positioning accuracy.
4Area of stationary object
If the distal end portion is extended to reach the fundus, then pelvic exposure is improved, but the risk of cervical tearing and incompetence increases
Solution Approach 1:
The telescopic distal end portion can be extended to the optimal length that reaches the uterine fundus for adequate pelvic exposure while stopping before excessive force is applied to the cervix. This dynamic control allows the operator to achieve sufficient exposure without over-extending the instrument, thereby preventing cervical trauma while maintaining adequate visualization.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The solution reduces the risk of uterine perforation, enhances pelvic exposure, and allows effective manipulation of the uterus regardless of size or orientation, eliminating the need for uterine sounding and enabling single-physician procedures, thus improving safety and efficiency.
Implementation Method 1
The shaft is telescopic, the distal end portion being extendable or retractable during insertion into the uterus in use
Data Source
AI summary
Universal laparoscopic uterine manipulators/dilators with variable intra-uterine length to match the length of the uterus in order to avoid any risk of perforation and to provide excellent pelvic exposure irrespective of uterine size, shape and position. Moreover, semirigid/semi-flexible dilators are less likely to form false passages in the cervix and the body of the uterus as they follow the natural track of the cervical canal.