Method and device for distending a gynecological cavity

Abstract

Method and device for distending a gynecological cavity. According to one embodiment, a mechanical, non-fluid device is used to distend the gynecological cavity. Such devices include, for example, self-expanding members, such as resilient baskets, coils, whisks, prongs, and loops, or mechanically expanded members, such as inflatable balloons, mechanically-expanded cages and loops, and scissor jacks. The device may serve a purpose in addition to distension, such as illumination, imaging, irrigation, drug delivery, resection and cauterization.

1 - 12 . (canceled) 
     
     
         13 . A system for performing a transcervical surgical procedure in a uterus, comprising:
 a deployment tool;   an expandable support structure detachably attached to the deployment tool, the expandable support structure configured to be transcervically introduced and positioned within a uterus using the deployment tool, and thereafter expanded within the uterus and detached from the deployment tool, wherein the deployment tool is configured to be removed from the uterus after detachment of the expanded support structure therein, and   wherein the expanded support structure comprises a three-dimensional configuration including an upper portion and a lower portion spaced apart from the upper portion, the support structure being configured so that expanding the support structure delivers an expansion force against opposing walls of the uterus to thereby create a three-dimensional working space between the upper and lower portions of the expanded support structure through non-fluid mechanical distention of the uterus; and   a surgical instrument configured to be transcervically inserted into the uterus after insertion and expansion of the support structure, so that a distal end of the surgical instrument may be positioned within the three-dimensional working space created by the expanded support structure and the surgical instrument is further configured to remove uterine wall tissue while the expanded support structure distends the uterus through non-fluid mechanical distention.   
     
     
         14 . The system of  claim 13 , wherein the surgical instrument is configured to extend through an opening between the upper and lower portions of the expanded support structure for removing uterine wall tissue through the opening. 
     
     
         15 . The system of claim  1 , wherein the support structure is configured to be introduced into the uterus through a lumen of the deployment tool; 
     
     
         16 . The system of claim  1 , wherein the support structure is further configured to be collapsed and transcervically removed from the uterus. 
     
     
         17 . The system of  claim 16 , further comprising a removal tool configured to be transcervically introduced into the uterus, coupled to the expanded support structure within the uterus, and for collapsing and removing the support structure from the uterus. 
     
     
         18 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus delivers an expansion force of at least about 0.5 lbs to mechanically distend the uterus. 
     
     
         19 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus delivers an expansion force of at least about 1.0 lbs to mechanically distend the uterus. 
     
     
         20 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus delivers an expansion force of at least about 5.0 lbs to mechanically distend the uterus. 
     
     
         21 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus achieves an equivalent distension of the uterus to that achieved by introduction of a liquid distension media at a pressure of at least about 40 mm Hg. 
     
     
         22 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus achieves an equivalent distension of the uterus to that achieved by introduction of a liquid distension media at a pressure of about 70 mm Hg. 
     
     
         23 . The system of  claim 13 , the support structure configured such that expanding the support structure within the uterus contacts a fundus of the uterus. 
     
     
         24 . A system for performing a transcervical surgical procedure in a uterus, comprising:
 a deployment tool;   an expandable support structure detachably attached to the deployment tool, the expandable support structure configured to be transcervically introduced and positioned within a uterus using the deployment tool, and thereafter expanded within the uterus and detached from the deployment tool, wherein the deployment tool is configured to be removed from the uterus after detachment of the expanded support structure therein, and   wherein the expanded support structure comprises a three-dimensional array of filaments, with adjacent filaments of the array defining windows there between, the array of filaments being configured so that expanding the support structure delivers an expansion force against opposing walls of the uterus, the expanded filament array defining a three-dimensional volume comprising a three-dimensional working space within the uterus through non-fluid mechanical distention of the uterus; and   a surgical instrument configured to be transcervically inserted into the uterus after insertion and expansion of the support structure, so that a distal end of the surgical instrument may be positioned within the three-dimensional working space created by the expanded support structure and to remove uterine wall tissue through one or more windows defined by adjacent filaments of the expanded support structure while the support structure distends the uterus through non-fluid mechanical distention.   
     
     
         25 . The system of  claim 24 , wherein the support structure is configured to be introduced into the uterus through a lumen of the deployment tool. 
     
     
         26 . The system of  claim 24 , wherein the support structure is further configured to be collapsed and transcervically removed from the uterus. 
     
     
         27 . The system of  claim 26 , further comprising a removal tool configured to be transcervically introduced into the uterus, coupled to the expanded support structure within the uterus, and for collapsing and removing the support structure from the uterus. 
     
     
         28 . The system of  claim 24 , the support structure configured such that expanding the support structure within the uterus delivers an expansion force of at least about 0.5 lbs to mechanically distend the uterus. 
     
     
         29 . The system of  claim 24 , the support structure configured such that expanding the support structure within the uterus achieves an equivalent distension of the uterus to that achieved by introduction of a liquid distension media at a pressure of at least about 40 mm Hg. 
     
     
         30 . The system of  claim 24 , the support structure configured such that expanding the support structure within the uterus contacts a fundus of the uterus.