Apparatus for repositioning the vagina, cervix, uterus and pelvic floor and method for securing same

Abstract

This invention relates to the pelvic floor and vagina manipulator probes and related systems and methods. In certain aspects of the invention, a vaginal manipulator probe assembly is comprised of an intravaginal body curved along its long axis and with an adjustable pelvic floor ring. The probe assembly can be configured as an apparatus for insertion into a vagina for repositioning the vagina, cervix, uterus and pelvic floor and method for securing same. In certain aspects, the curved intravaginal probe can be configured to receive a cervix. In certain implementations, the vaginal manipulator probe facilitates surgical visibility, dissection, and graft placement, is a device to elevate, support, and expose the pelvic floor and perineal body during surgical repair, is a device to set the proper vaginal insertion depth, is a device to assist with proper tensioning of the repositioned pelvic floor structures, and is a device to facilitate shortening of the anterior or posterior vaginal wall.

What is claimed is: 
     
         1 . A surgical device comprising:
 an elongated arcuate shaft assembly that is includes a mounting interface at one end; and   a vaginal manipulator probe that is removably securable at its proximal end to the elongated arcuate shaft assembly via the mounting interface, the vaginal manipulator probe having a cylindrical cross-sectional shape at its proximal end that becomes a flattened oval cross-sectional shape toward its distal end, the vaginal manipulator probe having a rounded tip at its distal end, the vaginal manipulator probe having a recess proximate its distal end for accommodating a cervix.   
     
     
         2 . The surgical device of  claim 1 , further comprising:
 a robotic arm, wherein the elongated arcuate shaft assembly is removably securable to a robotic arm.   
     
     
         3 . The surgical device of  claim 1 , further comprising:
 a disk that is movable along at least one portion of a length of the vaginal manipulator probe to limit vaginal insertion of the vaginal manipulator probe and/or escape of insufflation gas.   
     
     
         4 . The surgical device of  claim 3 , further comprising:
 a nut that rotates about threads on the vaginal manipulator probe to limit movement of the disk; and   a locking mechanism to removably secure the nut at one or more positions along a length of the vaginal manipulator probe.   
     
     
         5 . The surgical device of  claim 4 , further comprising:
 one or more measurement markings disposed along at least one portion of a length of the vaginal manipulator probe.   
     
     
         6 . The surgical device of  claim 1 , wherein the vaginal manipulator probe has a cylindrical cross-sectional shape at its proximal end that becomes a flattened oval cross-sectional shape toward its distal end such that the widest portion of the flattened oval cross-sectional shape is approximately in a transverse plane when inserted into a vagina. 
     
     
         7 . The surgical device of  claim 1 , wherein the vaginal manipulator probe includes a surface coloration that contrasts with tissue. 
     
     
         8 . The surgical device of  claim 1 , wherein the elongated arcuate shaft assembly includes an insertion tip as the mounting interface at one end, which insertion tip is configured for insertion into a recess in the proximal end of the vaginal manipulator probe. 
     
     
         9 . The surgical device of  claim 1 , wherein the vaginal manipulator probe is straight along its long axis. 
     
     
         10 . The surgical device of  claim 1 , wherein the vaginal manipulator probe includes at least one curved portion along its long axis. 
     
     
         11 . The surgical device of  claim 1 , wherein the elongated arcuate shaft assembly is rotatable relative to the vaginal manipulator probe. 
     
     
         12 . The surgical device of  claim 11 , wherein the elongated arcuate shaft assembly is lockable at one or more designated rotational positions. 
     
     
         13 . The surgical device of  claim 1 , wherein the vaginal manipulator probe has a slotted recess proximate its distal end for accommodating a cervix. 
     
     
         14 . The surgical device of  claim 13 , wherein the distal end of the vaginal manipulator probe having the slotted recess is rotatable. 
     
     
         15 . The surgical device of  claim 1 , further comprising:
 a handle that is removably couplable to the elongated arcuate shaft assembly.   
     
     
         16 . The surgical device of  claim 1 , wherein the elongated arcuate shaft assembly includes a handle portion. 
     
     
         17 . The surgical device of  claim 1 , wherein the vaginal manipulator probe has a smooth, flat, and rounded tip at its distal end. 
     
     
         18 . The surgical device of  claim 1 , wherein the device is configured for insertion into a vagina to (i) facilitate surgical visibility, dissection, and graft placement; (ii) elevate, support, and expose the pelvic floor and perineal body during surgical repair; (iii) properly tension repositioned tissue; (iv) substantially inhibit escape of abdominal insufflation gas via the vagina during laparoscopy; and (v) provide a backstop support for placement of sutures. 
     
     
         19 . A surgical device comprising:
 an elongated arcuate shaft assembly that is includes an insertion tip at one end; and   a vaginal manipulator probe that includes a recess at its proximal end to removably receive the insertion tip of the elongated arcuate shaft assembly, the vaginal manipulator probe having a cylindrical cross-sectional shape at its proximal end that becomes a flattened oval cross-sectional shape toward its distal end such that the widest portion of the flattened oval cross-sectional shape is approximately in a transverse plane when inserted into a vagina, the vaginal manipulator probe being straight along its long axis and having a smooth, flat, and rounded tip at its distal end, the vaginal manipulator probe having a recess proximate its distal end for accommodating a cervix,   wherein the device is configured for insertion into a vagina to any one of facilitate surgical visibility, dissection, and graft placement; elevate, support, and expose the pelvic floor and perineal body during surgical repair; properly tension repositioned tissue; substantially inhibit escape of abdominal insufflation gas via the vagina during laparoscopy; and provide a backstop support for placement of sutures.   
     
     
         20 . A surgical device comprising:
 an elongated arcuate shaft assembly that is includes an insertion tip at one end;   a vaginal manipulator probe that includes a recess at its proximal end to removably receive the insertion tip of the elongated arcuate shaft assembly to lock the elongated arcuate shaft assembly to the vaginal manipulator probe at a selected rotational position, the vaginal manipulator probe having a cylindrical cross-sectional shape at its proximal end that becomes a flattened oval cross-sectional shape toward its distal end such that the widest portion of the flattened oval cross-sectional shape is approximately in a transverse plane when inserted into a vagina, the vaginal manipulator probe being straight along its long axis and having a smooth, flat, and rounded tip at its distal end, the vaginal manipulator probe having a recess proximate its distal end for accommodating a cervix, and the vaginal manipulator probe including a surface coloration that contrasts with tissue; and   a handle that is removably couplable to the elongated arcuate shaft assembly,   wherein the device is configured for insertion into a vagina to any one of facilitate surgical visibility, dissection, and graft placement; elevate, support, and expose the pelvic floor and perineal body during surgical repair; properly tension repositioned tissue; substantially inhibit escape of abdominal insufflation gas via the vagina during laparoscopy; and provide a backstop support for placement of sutures.