General uterine manipulator and system

Abstract

A general uterine manipulator 10 incorporates an elongated hollow tube 12 defining an internal passage 14 . Tube 12 has opposite first and second ends 16 and 18 , formed with internal threads T 1 and T 2 ; and a smooth continuous outer surface 20 of constant outer diameter. A first fitting comprising a tail screw 22 is screwed into thread T 1 and a second fitting cervical screw 24 is screwed in thread T 2 . An inner manipulator rod 26 extends through the first fitting 22 , tube 12 , and second fitting 24 . A range of alternate first and second fitting is provided. A forceps holder 70 is attachable to the tube 12 between ends 16 and 18 . The manipulator 10 may also support a cervical funnel 90 and a plug 92.

1 . A general uterine manipulator comprising:
 an elongated hollow tube defining an internal passage and having opposite first and second ends, a smooth continuous outer surface of constant outer diameter extending between the first and second end, and internal first and second screw threads formed in the elongated hollow tube, the first screw thread being formed at the first end and the second screw thread being formed at the second end; and   a first fitting having a screw thread arranged to engage the first screw thread, the first fitting also having an axial through hole and configured to receive an inner manipulator shaft.   
     
     
         2 . The general uterine manipulator according to  claim 1  comprising a hydrotubation port in fluid communication with the internal passage wherein a fluid injected into or through the hydrotubation port is able to flow into the internal passage. 
     
     
         3 . The general uterine manipulator according to  claim 1  comprising a hydrotubation port formed in the first fitting and in fluid communication with the axial through hole wherein a fluid injected into or through the hydrotubation port is able to flow into the internal passage. 
     
     
         4 . The general uterine manipulator according to  claim 3  wherein the axial through hole comprises a first length which opens onto an end of the first fitting distant the screw thread of the first fitting, and a second contiguous length wherein the first length has a first internal diameter and the second length has a second internal diameter which is greater than the first internal diameter; and wherein the hydrotubation port opens onto the second length of the axial through hole. 
     
     
         5 . The general uterine manipulator according to  claim 1  comprising a second fitting having a threaded portion provided with a screw thread configured to engage the second internal thread on the elongated hollow tube and a body portion extending co-linearly from the threaded portion. 
     
     
         6 . The general uterine manipulator according to  claim 5  wherein the body portion comprises a tubular member which is open at one end distal the threaded portion and is closed at an end near to the threaded portion to form a cavity. 
     
     
         7 . The general uterine manipulator according to  claim 5  wherein the body portion is of a frusto-conical shape with decreasing outer diameter in a direction away from the threaded portion and is provided with an external coarse screw thread. 
     
     
         8 . The general uterine manipulator according to  claim 7  wherein the second fitting is provided with an axial through hole. 
     
     
         9 . The general uterine manipulator according to  claim 8  comprising an inner manipulator shaft, the shaft capable of being received in the axial through hole of the first fitting and the axial through hole of the second fitting and extending through the internal passage. 
     
     
         10 . The general uterine manipulator according to  claim 1  comprising a forceps holder supported on the elongated hollow tube and configured to be releasably lockable in a plurality of positions along the elongated hollow tube. 
     
     
         11 . The general uterine manipulator according to  claim 1  comprising a cervical funnel mounted on the tube. 
     
     
         12 . A general uterine manipulator system comprising:
 an elongated hollow tube defining an internal passage and having opposite first and second ends, a smooth continuous outer surface of constant outer diameter extending between the first and second ends, and internal first and second screw threads formed in the elongated hollow tube, the first screw thread being formed at the first end and the second screw thread being formed at the second end;   at least one first fitting the or each first fitting having a screw thread arranged to engage the first screw thread, the first fitting also having an axial through hole; and   
       at least one second fitting the or each second fitting having a threaded portion provided with a screw thread configured to engage the second internal thread on the elongated hollow tube and a body portion extending co-linearly from the threaded portion;
 wherein the at least one first fitting comprises one or both of: (a) a clamping first fitting configured to apply increasing clamping force on a received inner manipulator when the first fitting is screwed further into the first end; and (b) a hydrotubation first fitting which has a hydrotubation port in fluid communication with the internal passage wherein a fluid injected into or through the hydrotubation port is able to flow into the internal passage; and wherein 
 the at least one second fitting comprises one or both of: (c) a cervical second fitting wherein its body portion is of a frusto-conical shape with decreasing outer diameter in a direction away from the threaded portion and is provided with an external coarse screw thread; and (d) a tubular second fitting wherein its body portion comprises a tubular member which is open at one end distal the threaded portion of the second fitting and is closed at an end near to the threaded portion of the second fitting to form a cavity. 
 
     
     
         13 . The general uterine manipulator system according to  claim 12  comprising an inner manipulator shaft arranged to extend through the axial through hole, the internal passage and the second fitting when the second fitting is the cervical second fitting, the inner manipulator shaft having one end which is bent and protrudes from the cervical second fitting. 
     
     
         14 . The general uterine manipulator system according to  claim 13  comprising a resistance mechanism enabling an axial and rotational position of the inner manipulator shaft to substantially held in the absence of adjustment by a user. 
     
     
         15 . The general uterine manipulator system according  claim 12  comprising a cervical funnel configured to mount on the tube. 
     
     
         16 . The general uterine manipulator system according to  claim 1  comprising a capable of being mounted on the hollow tube, the tube medical instrument comprising:
 a body provided with opposite first and second end portions, the first end portion having a first opening and the second end portion having a second opening; 
 a throughway extending between the first and second openings, the throughway arranged to enable the body to be supported on a shaft to facilitate insertion of one of the first and second end portions into a body cavity, the first and second end portions being different in one or more of their shape, size and configuration. 
 
     
     
         17 . The general uterine manipulator system according to  claim 16  wherein the first end portion is of a tubular configuration and has a first outer diameter. 
     
     
         18 . The general uterine manipulator system according to  claim 17  wherein the second end portion is of a tubular configuration and has a second outer diameter that is different to the first outer diameter. 
     
     
         19 . The general uterine manipulator system according to  claim 17  wherein the second end portion is of a frusto conical configuration. 
     
     
         20 . The general uterine manipulator system according to  claim 16  wherein the first end portion is of a frusto conical configuration and has a first outer diameter, and the second end portion is of a frusto conical configuration and has a second outer diameter that is different to the first outer diameter. 
     
     
         21 . The general uterine manipulator system according to  claim 6  comprising an illumination device arranged to enable the emission of light from an end of the tubular portion. 
     
     
         22 . The general uterine manipulator system according to  claim 11  comprising an illumination device arranged to enable the emission of light from an end of the cervical funnel. 
     
     
         23 . The general uterine manipulator system according to  claim 22  wherein cervical funnel has a frusto conical portion and a large diameter end of the conical portion has an outwardly flared lip that extends for a part of the circumference of the conical portion. 
     
     
         24 . The general uterine manipulator system according to  claim 23  wherein a through hole is formed in the lip. 
     
     
         25 . The general uterine manipulator system according to  claim 24  wherein the illumination device is arranged to illuminate the through hole. 
     
     
         26 . The general uterine manipulator system according to  claim 25  wherein the illumination device comprised an annular light guide surrounding the through hole. 
     
     
         27 . The general uterine manipulator system according to  claim 11  wherein the cervical funnel comprises a tubular shaft extending coaxially form a small diameter end of the conical portion, wherein an outer surface of the tubular shaft is profiled to mechanically engage a motor to facilitate rotation of the cervical funnel. 
     
     
         28 . The general uterine manipulator system according to  claim 27  wherein the outer surface of the tube is provided with gear teeth to arranged to enable mechanical engagement with the motor.