Uterine manipulator with cutting head

Abstract

A uterine manipulator can include a shaft including a first end, a second end, and embodiments of a cutting head configured and arranged to receive a cervix. The cutting head can be configured and adapted to be used to cut the tissue joining the vaginal wall to the cervix and uterus to facilitate removal of the uterus in a minimally invasive manner.

What is claimed is: 
     
         1 . A method of separating a uterus from a vagina of a patient, comprising:
 providing a uterine manipulator having an elongate body with a cup configured to receive a cervix, a cutting head attached to the distal end of the shaft adapted to cut a tissue segment to separate a vagina from a cervix and uterus, the cutting head including a cutting wire coupled to the cup via an aperture in the cup such that a portion of the cutting wire extends radially away from an exterior surface of the cup and is urged along a longitudinal direction by a projection coupled to the uterine manipulator as the cutting wire is advanced out of the uterine manipulator;   engaging a cervix of the patient with the cup;   advancing the cutting wire relative to the cup to deploy the distal portion of the cutting wire through the tissue of the vagina outwardly into an abdominal cavity of the patient; and   rotating the cup about a longitudinal axis of the uterine manipulator to separate the uterus from the vagina.   
     
     
         2 . The method of  claim 1 , further comprising visualizing the cutting wire in the abdominal cavity through a laparoscopic procedure including insufflating the abdominal cavity of the patient, and visually locating a portion of the cutting wire extending into the abdominal cavity. 
     
     
         3 . The method of  claim 1 , wherein the cutting is accomplished without application of electrical current to the uterine manipulator. 
     
     
         4 . The method of  claim 1 , wherein the cutting is accomplished with application of electrical current to the uterine manipulator. 
     
     
         5 . The method of  claim 4 , wherein the cutting is accomplished with application of monopolar electrical current to the uterine manipulator. 
     
     
         6 . The method of  claim 4 , wherein the cutting is accomplished with application of bipolar electrical current to the uterine manipulator. 
     
     
         7 . The method of  claim 1 , wherein the uterine manipulator further includes an inflatable triangular balloon at a distal end of the manipulator having a light source disposed within the triangular balloon, and the method include introducing the triangular balloon into the patient's uterus prior to separating the uterus from the vagina, inflating the triangular balloon, and illuminating the light source to illuminate the patient's uterus. 
     
     
         8 . The method of  claim 7 , further comprising viewing an inner surface of the uterus using an optic to examine the endometrial lining of the uterus under illumination from the light source. 
     
     
         9 . The method of  claim 8 , further comprising inspecting the patient's uterus externally to search for fibroids, wherein the light source is of sufficient intensity to illuminate the uterus internally. 
     
     
         10 . The method of  claim 7 , further comprising directing fluid out of two distal tips of the triangular balloon toward the fallopian tubes of a patient. 
     
     
         11 . The method of  claim 10 , further comprising conducting a chromppertubation procedure, wherein the fluid includes at least one of methylene blue and indigo carmine.