Method of dissecting tissue from a vagina

Abstract

A method of dissecting tissue from a vagina includes preparing a patient for surgery, and providing a vaginal manipulator having a head attached to a shaft and a door that is hinged to the head. The method includes inserting the head of the vaginal manipulator into a natural opening of a vagina of the patient, pivoting the door relative to the hinge, and displacing a posterior wall of the vagina for access by a surgeon. The method includes dissecting recto-vaginal tissue away from an exterior surface of the posterior wall of the vagina.

What is claimed is: 
     
         1 . A method of dissecting tissue from a vagina, the method comprising:
 preparing a patient for surgery;   providing a vaginal manipulator having a head attached to a shaft and a door that is hinged to the head;   inserting the head of the vaginal manipulator into a natural opening of a vagina of the patient;   pivoting the door relative to the hinge, moving an end of the door away from the head and into contact with an interior surface of the vagina, and displacing a posterior wall of the vagina for access by a surgeon; and   dissecting recto-vaginal tissue away from an exterior surface of the posterior wall of the vagina.   
     
     
         2 . The method of  claim 1 , wherein the head includes an index feature, and the method further comprises measuring a distance from an apex of the vagina to the index feature and dissecting the recto-vaginal tissue away from the exterior surface of the posterior wall of the vagina at a location of the index feature. 
     
     
         3 . The method of  claim 1 , wherein the shaft includes a knob, and the method further comprises rotating the knob and pivoting the door relative to the hinge. 
     
     
         4 . The method of  claim 1 , wherein the shaft includes an actuator, and the method further comprises sliding the actuator and pivoting the door relative to the hinge. 
     
     
         5 . The method of  claim 1 , further comprising:
 using the shaft as a lever and orienting the vagina V for visualization by the surgeon with a camera.   
     
     
         6 . The method of  claim 1 , further comprising:
 dissecting vesico-vaginal tissue away from the exterior surface of the vagina.   
     
     
         7 . The method of  claim 1 , further comprising:
 dissecting tissue away from the exterior surface of the vagina between a bladder and the vagina.   
     
     
         8 . The method of  claim 1 , further comprising:
 relieving a uterosacral ligament and accessing connective tissues attached between the vagina and another organ.   
     
     
         9 . The method of  claim 1 , further comprising:
 attaching a support to the vagina.   
     
     
         10 . The method of  claim 1 , comprising preparing the patient for a laparoscopic surgical procedure including forming a first trocar port for providing access for surgical tools and a second trocar for providing access for an optical camera. 
     
     
         11 . The method of  claim 1 , wherein the head includes an anterior side opposite a posterior side, a core fixed to the shaft, and a sleeve coupled in a sliding relationship to the core, and the method further comprises moving the door independently of the sleeve. 
     
     
         12 . The method of  claim 1 , comprising moving the sleeve in a distal direction and displacing the end of the door away from the core. 
     
     
         13 . A method of dissecting tissue from a vagina, the method comprising:
 preparing a patient for a laparoscopic surgical procedure including forming a first trocar port for providing access for surgical tools and a second trocar port for providing access for an optical camera;   providing a vaginal manipulator having a head attached to a shaft and a door that is hinged to the head;   inserting the head of the vaginal manipulator into a natural opening of a vagina of the patient;   pivoting the door relative to the hinge and displacing a posterior wall of the vagina;   viewing an exterior surface of the posterior wall of the vagina with the camera; and   dissecting recto-vaginal tissue away from the exterior surface of the posterior wall of the vagina.   
     
     
         14 . The method of  claim 13 , wherein the shaft includes a knob, and the method further comprises rotating the knob and pivoting the door relative to the hinge. 
     
     
         15 . The method of  claim 13 , wherein the shaft includes an actuator, and the method further comprises sliding the actuator and pivoting the door relative to the hinge.