Methods for evaluating the integrity of a uterine cavity

Abstract

Methods, systems and devices for evaluating the integrity of a uterine cavity. A method comprises introducing transcervically a probe into a patient's uterine cavity, providing a flow of a fluid (e.g., CO2) through the probe into the uterine cavity and monitoring the rate of the flow to characterize the uterine cavity as perforated or non-perforated based on a change in the flow rate. If the flow rate drops to zero or close to zero, this indicates that the uterine cavity is intact and not perforated. If the flow rate does not drop to zero or close to zero, this indicates that a fluid flow is leaking through a perforation in the uterine cavity into the uterine cavity or escaping around an occlusion balloon that occludes the cervical canal.

What is claimed is: 
     
         1 . A method for evaluating a patient's uterus, comprising:
 introducing a probe through a cervical canal into a uterine cavity of the patient;   expanding first and second expandable structures carried by the probe;   introducing a flow of a fluid into the uterine cavity through the probe, wherein the fluid comprises a gas; and   measuring a flow rate of the fluid being introduced, wherein a measured flow rate which drops to a level below a predetermined minimum level indicates that the uterus is non-perforated.   
     
     
         2 . The method of  claim 1 , wherein the first expandable structure has a fluid-tight wall. 
     
     
         3 . The method of  claim 1 , wherein the second expandable structure has a fluid-tight wall. 
     
     
         4 . The method of  claim 1 , wherein the expanding step expands the first and second expandable structures independently. 
     
     
         5 . The method of  claim 1 , further comprising generating a signal responsive to the flow rate not dropping or dropping below the predetermined level to thereby characterize the uterine cavity as perforated or non-perforated, respectively. 
     
     
         6 . The method of  claim 5 , wherein the predetermined level is 0.05 slpm. 
     
     
         7 . The method of  claim 1 , wherein measuring comprises measuring the flow rate over a predetermined first time interval after initiation of the flow. 
     
     
         8 . The method of  claim 7 , wherein the first time interval is in a range from 1 second to 60 seconds. 
     
     
         9 . A method for performing a procedure relating to uterine ablation, comprising:
 introducing an ablation device through a cervical canal into a uterine cavity of a patient;   expanding at least one expandable structure carried by the probe;   introducing a flow of a fluid into the uterine cavity wherein an expanded structure confines the fluid about a distal end portion of the device in the uterine cavity; and   measuring a flow rate of the fluid being introduced, wherein a measured flow rate which drops to a level below a predetermined minimum level indicates that the uterus is non-perforated.   
     
     
         10 . The method of  claim 1 , wherein each expandable structure has a fluid-tight wall. 
     
     
         11 . The method of  claim 10 , wherein an expandable structure is configured to contact tissue in the cervical canal. 
     
     
         12 . The method of  claim 10 , wherein an expandable structure is configured to contact tissue in the uterine cavity. 
     
     
         13 . The method of  claim 1 , further comprising generating a signal responsive to the flow rate not dropping or dropping below the predetermined level to thereby characterize the uterine cavity as perforated or non-perforated, respectively. 
     
     
         14 . The method of  claim 5 , wherein the predetermined level is 0.05 slpm. 
     
     
         15 . The method of  claim 9 , further comprising, responsive to the uterine cavity being characterized as non-perforated, automatically delivering energy to the uterine cavity with the ablation device. 
     
     
         16 . The method of  claim 9 , further comprising, responsive to the uterine cavity being characterized as perforated, automatically disabling energy delivery from the ablation device. 
     
     
         17 . A method for performing a procedure relating to uterine ablation, comprising:
 introducing an ablation device through a cervical canal into a uterine cavity of a patient;   expanding at least one expandable structure carried by the device to occupy at least one of the cervical canal and uterine cavity;   introducing a flow of a fluid into the uterine cavity into a space around the portion of the device in the uterine cavity; and   measuring a flow rate of the fluid being introduced, wherein a measured flow rate which drops to a level below a predetermined minimum level indicates that the uterus is non-perforated.   
     
     
         18 . The method of  claim 1 , further comprising generating a signal responsive to the flow rate not dropping or dropping below the predetermined level to thereby characterize the uterine cavity as perforated or non-perforated, respectively. 
     
     
         19 . The method of  claim 17 , further comprising, responsive to the uterine cavity being characterized as non-perforated, automatically delivering energy to the uterine cavity with the ablation device. 
     
     
         20 . The method of  claim 17 , further comprising, responsive to the uterine cavity being characterized as perforated, automatically disabling energy delivery from the ablation device.