# US 11,998,267 B2 · Uterine manipulator with neutral return electrode

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- Number: US 11,998,267 B2
- Document ID: US11998267B2
- Status: Granted
- Kind: B2
- Application number: 17/493,437
- Filed: 2021-10-04
- Published: 2022-04-14
- Granted: 2024-06-04
- Earliest claimed: 2020-10-08
- Assignees: Gyrus ACMI, Inc.
- Applicants: Gyrus Acmi, Inc.
- Inventors: Judy L. Walish; Dennis G. Lamser
- Web page: https://patentgrep.com/patent/US11998267B2

## CPC

- A61B 18/1485: {having a short rigid shaft for accessing the inner body through natural openings}
- A61B 18/16: Indifferent or passive electrodes for grounding
- A61B 17/42: Gynaecological or obstetrical instruments or methods {(ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708)}
- A61B 18/1206: {Generators therefor}
- A61B 18/1482: {having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy}
- A61B 34/70: {Manipulators specially adapted for use in surgery}
- A61B 2017/4225: {Cervix uteri}
- A61B 2018/00202: {rotating}
- A61B 2018/00273: {Anchoring means for temporary attachment of a device to tissue}
- A61B 2018/00559: {Female reproductive organs}
- A61B 2018/00601: {Cutting}
- A61B 2018/00773: {Sensed parameters}
- A61B 2018/00827: {Current}
- A61B 2018/00869: {Phase}
- A61B 2018/00875: {Resistance or impedance}
- A61B 2018/00892: {Voltage}
- A61B 2018/162: {located on the probe body}
- A61B 2018/165: {Multiple indifferent electrodes}
- A61B 2090/065: {for measuring contact or contact pressure}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A uterine manipulator including an elongate shaft having a distal portion configured to be inserted into a uterus through a lumen of a cervix, and a return electrode coupled to the elongate shaft. The return electrode is configured to be electrically coupled to an electrosurgical generator.

## Claims

### Claim 1

A uterine manipulator comprising:
an elongate shaft including a distal portion configured to be inserted into a uterus through a lumen of a cervix; and
a colpotomy cup coupled to the elongate shaft and comprising an outer wall portion, a base portion, and a protrusion extending distally away from the base portion,
wherein:
the protrusion is configured to be inserted into the lumen of the cervix;
the protrusion includes a return electrode that is configured to be electrically connected to an electrosurgical generator, to receive an electrical signal from an active electrode via the cervix, and to return the electrical signal to the electrosurgical generator; and
the elongate shaft is configured to pass through the protrusion.

### Claim 2 (depends on 1)

The uterine manipulator of claim 1, wherein the return electrode is configured for use with the electrosurgical generator to sense when the elongate shaft is located in a treatment position.

### Claim 3 (depends on 1)

The uterine manipulator of claim 1, wherein the return electrode is a split return electrode that comprises a first electrode and a second electrode, and wherein the second electrode is located proximal of the first electrode.

### Claim 4 (depends on 1)

The uterine manipulator of claim 1, wherein the return electrode is a split return electrode that comprises a first electrode and a second electrode, and wherein the first electrode has a first surface area and the second electrode has a second surface area, wherein the first surface area is larger than the second surface area.

### Claim 5 (depends on 1)

The uterine manipulator of claim 1, wherein the return electrode is a split return electrode that comprises a first electrode located distal of a second electrode, and wherein the first electrode has a first longitudinal length extending along a longitudinal path of the elongate shaft, and wherein the second electrode has a second longitudinal length extending along the longitudinal path, and wherein the first longitudinal length is greater than the second longitudinal length.

### Claim 6 (depends on 1)

The uterine manipulator of claim 1, further comprising a cutting device including the active electrode, the cutting device configured to be electrically connected to the electrosurgical generator.

### Claim 7 (depends on 6)

The uterine manipulator of claim 6, wherein the colpotomy cup is configured to be delivered vaginally to delineate a first surface of a target tissue and the cutting device is configured to be delivered laparoscopically to a second surface of the target tissue opposite the first surface.

### Claim 8 (depends on 6)

The uterine manipulator of claim 6, wherein the colpotomy cup is configured to be delivered vaginally to delineate a target tissue and the cutting device is coupled to the colpotomy cup and is actuatable to move along a periphery of the colpotomy cup to treat the target tissue.

### Claim 9

A tissue resection system comprising:
a uterine manipulator including an elongate shaft having a distal portion configured to be inserted into a uterus through a lumen of a cervix;
a colpotomy cup coupled to the elongate shaft, the colpotomy cup configured to be positioned in-situ around a cervix, wherein a distal portion of the colpotomy cup is configured to delineate a target tissue to be treated, the colpotomy cup having a protrusion extending distally away from a base portion thereof, wherein the elongate shaft passes through the protrusion and the protrusion comprises a split return electrode comprising a first electrode and a second electrode, the split return electrode configured to be electrically connected to an electrosurgical generator; and
a cutting device including an active electrode to treat the target tissue, the cutting device configured to be electrically connected to an output of the electrosurgical generator.

### Claim 10 (depends on 9)

The tissue resection system of claim 9, wherein the colpotomy cup is configured to be delivered vaginally to a first surface of the target tissue and the cutting device is configured to be delivered laparoscopically to a second surface of the target tissue opposite the first surface.

### Claim 11 (depends on 9)

The tissue resection system of claim 9, wherein the cutting device is coupled to the colpotomy cup and is actuatable to move along a periphery of the colpotomy cup to treat the target tissue.

### Claim 12 (depends on 9)

The tissue resection system of claim 9, further comprising the electrosurgical generator, wherein the electrosurgical generator is configured to:
issue a monitoring signal to the split return electrode; and
receive at least a portion of the issued monitoring signal from the split return electrode; and
a controller configured to:
monitor an electrical property of the split return electrode based on the issued monitoring signal and the received at least a portion of the issued monitoring signal to determine if a threshold has been traversed; and
based at least in part on the threshold being traversed, permitting delivery of therapeutic energy to the active electrode.