Endometrium coagulating apparatus and surgical method for thermal destruction of the endometrium

Claim 2

Apparatus allowing direct visualization of a cervix, a uterus and its uterine cavity with an endometrial surface in a surgical procedures for coagulating the endometrial surface of the uterus comprising: a hysteroscope having a proximal portion for endocervical insertion at a depth into the uterus and a distal portion, and including a hollow barrel having optical means for viewing the uterine cavity disposed therein and, in the proximal portion, forming a hollow probe having an exterior surface and channel means for delivering tissue-coagulating heated liquid for a period of time at a selected temperature in direct contact with endometrium tissue lining the uterine cavity; thermally insulative sheath means disposed concentrically around said probe, which means is sufficiently insulative to avoid thermal damage to tissue other than said endometrial tissue during the period of said delivery; liquid transfer means in fluid communication with said channel for delivering heated liquid through said probe to and from the uterine cavity; and control means operatively associated with the probe for regulating the temperature of said liquid.

Claim 3

The apparatus of claim 1 wherein said thermally insulative sheath means further includes a shoulder means of increased lateral dimension contoured for contact with the exterior surface of the cervix.

Claim 4

Apparatus according to claim 1 where the probe is tubular in shape and the thermally insulative means comprises a tubular sheath telescopically engaging and covering the exterior surface of the probe.

Claim 5

Apparatus according to claim 3 where the tubular sheath comprises a tip end including thermocouple sensor means for determining the intrauterine temperature.

Claim 6

Apparatus according to claim 1 where the liquid transfer means comprises thermally insulated tubing in open communication with said hollow probe and channel means.

Claim 7

Apparatus according to claim 5 where the liquid transfer means comprises syringe means in open communication with said insulative tubing.

Claim 8

A surgical procedure for coagulating endometrial tissue of the uterus comprising distending the uterine cavity by filling the cavity and directly contacting the endometrial surface with a heated physiologically compatible solution under pressure sufficient to inflate and directly expose substantially the entire endometrial surface for a time sufficient to cause time and temperature dependent destruction of the endometrium.

Claim 9

A surgical procedure for coagulating endometrial tissue of the uterus comprising distending the uterine cavity by filling the cavity and directly contacting the endometrial surface with a heated physiologically compatible solution under pressure sufficient to inflate and directly expose substantially the entire endometrial surface for a time sufficient to cause time and temperature dependent destruction of the endometrium.

Claim 10

A surgical procedure for coagulating endometrial tissue of a uterus adjacent to oviducts, Fallopian tubes, and a lower abdominal cavity, said uterus having a uterine cavity with an endometrial surface and an internal architecture, and further having a cervix with an exterior surface, comprising the steps of: a) distending the uterine cavity with a physiologically compatible solution under direct vision by means of a hysteroscope having a proximal portion for endocervical insertion at a depth into the uterus, said proximal portion including probe means and insulative probe sheath means and further having channel means for delivering and introducing liquid to the uterine cavity under pressure sufficient to inflate and directly expose the endometrial surface; b) confirming that the proximal portion of the hysteroscope is properly located within the uterine cavity and that the cavity is properly inflated by visualization of the internal architecture of the cavity relative to said proximal portion; c) withdrawing said solution from the uterine cavity, thus causing the cavity to become substantially collapsed; and d) distending the uterine cavity while said cavity is under direct vision by means of said hysteroscope, by delivering and introducing to the uterine cavity an aqueous solution that is heated to an endometrial tissue-coagulating temperature and under pressure sufficient to directly contact and expose the endometrial surface for a time sufficient to thereby cause the destruction thereof.

Claim 11

A surgical procedure for coagulating endometrial tissue of a uterus adjacent to oviducts, Fallopian tubes, and a lower abdominal cavity, said uterus having a uterine cavity with an endometrial surface and an internal architecture, and further having a cervix with an exterior surface, comprising the steps of: a) distending the uterine cavity with a physiologically compatible solution under direct vision by means of a hysteroscope having a proximal portion for endocervical insertion at a depth into the uterus, said proximal portion including probe means and insulative probe sheath means and further having channel means for delivering and introducing liquid to the uterine cavity under pressure sufficient to inflate and directly expose the endometrial surface; b) confirming that the proximal portion of the hysteroscope is properly located within the uterine cavity and that the cavity is properly inflated by visualization of the internal architecture of the cavity relative to said proximal portion; c) withdrawing said solution from the uterine cavity, thus causing the cavity to become substantially collapsed; and d) distending the uterine cavity while said cavity is under direct vision by means of said hysteroscope, by delivering and introducing to the uterine cavity an aqueous solution that is heated to an endometrial tissue-coagulating temperature and under pressure sufficient to directly contact and expose the endometrial surface for a time sufficient to thereby cause the destruction thereof.

Claim 12

A surgical procedure for coagulating endometrial tissue of a uterus having, adjacent to oviducts, Fallopian tubes, and a lower abdominal cavity, a uterine cavity with an endometrial surface and an internal architecture, comprising the steps of: a) distending the uterine cavity with a fluoroscopically radiopaque, physiologically compatible solution under indirect vision by means of a hysteroscopic cannula for endocervical insertion at a depth into the uterus, said cannula having a proximal portion including probe means and insulative probe sheath means and further having channel means for delivery and introducing liquid to the uterine cavity under pressure sufficient to inflate the endometrial surface; b) confirming that the proximal portion of the hysteroscope is properly located within the uterine cavity and that the cavity is properly inflated by fluoroscopic visualization of the internal architecture of the cavity relative to said proximal portion; c) withdrawing said solution from the uterine cavity, thus causing the cavity to become substantially collapsed; and d) distending the uterine cavity while said cavity is under indirect fluoroscopic vision by means of said hysteroscopic cannula, by delivering and introducing to the uterine cavity aqueous, radiopaque solution heated to an endometrial tissue-coagulating temperature and under pressure sufficient to directly expose the endometrial surface, and keeping the heated solution in contact with said surface for a time sufficient to thereby cause the destruction thereof.

Claim 13

A surgical procedure for coagulating endometrial tissue of a uterus having, adjacent to oviducts, Fallopian tubes, and a lower abdominal cavity, a uterine cavity with an endometrial surface and an internal architecture, comprising the steps of: a) distending the uterine cavity with a fluoroscopically radiopaque, physiologically compatible solution under indirect vision by means of a hysteroscopic cannula for endocervical insertion at a depth into the uterus, said cannula having a proximal portion including probe means and insulative probe sheath means and further having channel means for delivery and introducing liquid to the uterine cavity under pressure sufficient to inflate the endometrial surface; b) confirming that the proximal portion of the hysteroscope is properly located within the uterine cavity and that the cavity is properly inflated by fluoroscopic visualization of the internal architecture of the cavity relative to said proximal portion; c) withdrawing said solution from the uterine cavity, thus causing the cavity to become substantially collapsed; and d) distending the uterine cavity while said cavity is under indirect fluoroscopic vision by means of said hysteroscopic cannula, by delivering and introducing to the uterine cavity aqueous, radiopaque solution heated to an endometrial tissue-coagulating temperature and under pressure sufficient to directly expose the endometrial surface, and keeping the heated solution in contact with said surface for a time sufficient to thereby cause the destruction thereof.