Tenaculum for use with occlusion devices

Abstract

Devices, systems and methods for grasping, manipulating and retaining tissue are provided. In different aspects, devices, systems and methods for locating tissue; for guiding instruments to tissue; for grasping tissue; and for retaining and manipulating tissue are provided. Such tissue may include the cervix of a female patient. A device may have a distal portion having a sound configured to enter a cervical os without causing undue trauma or discomfort to the patient, and a retention element such as a spike configured to engage and retain a patient's cervix. Devices may include a proximal portion, such as a handle. Devices may be configured to co-operate with other instruments. Cooperation with other instruments may include serving as a mount for instruments and guiding instruments. Such devices may aid in the placement and operation of instruments for therapeutic and diagnostic procedures, such as, for example, treating uterine disorders and conditions.

What is claimed is:  
     
         1 . A hand-held device for use with medical instruments and for manipulating tissue of a female patient having a cervix and a cervical os, comprising: 
 an elongated shaft with a proximal portion and a distal portion defining a longitudinal direction along a longitudinal axis, said distal portion having a distal tip configured for atraumatic entry into said cervical os;    a tissue retention element operatively attached to said elongated shaft and configured to grip tissue when said shaft distal tip is disposed within said cervical os; and    a guide rail portion of said device configured to engage a medical instrument.    
     
     
         2 . The tissue manipulating device of  claim 1 , wherein said elongated shaft distal tip comprises a rounded tip.  
     
     
         3 . The tissue manipulating device of  claim 1 , wherein said distal portion of said elongated shaft comprises a malleable material.  
     
     
         4 . The tissue manipulating device of  claim 3 , wherein said malleable material comprises a soft metal.  
     
     
         5 . The tissue manipulating device of  claim 4 , wherein said soft metal comprises silver.  
     
     
         6 . The tissue manipulating device of  claim 1 , wherein said tissue retention element comprises an elongated arm, and wherein said operative attachment comprises a flexible connection between said elongated arm and said elongated shaft.  
     
     
         7 . The tissue manipulating device of  claim 6 , further comprising a closure element configured to press said elongated arm towards said elongated shaft.  
     
     
         8 . The tissue manipulating device of  claim 7 , wherein said closure element is configured to move longitudinally along said elongated shaft effective to press said elongated arm towards said elongated shaft.  
     
     
         9 . The tissue manipulating device of  claim 6 , wherein said elongated arm comprises a flexible portion, and said operative attachment comprises a fixed attachment between said elongated arm and said elongated shaft.  
     
     
         10 . The tissue manipulating device of  claim 6 , wherein said operative attachment comprises a pivot.  
     
     
         11 . The tissue manipulating device of  claim 1 , further comprising a securing element configured to secure said retention element so as to maintain the retention element in contact with tissue when said distal tip is disposed within said cervical os.  
     
     
         12 . The tissue manipulating device of  claim 1 , wherein said retention element comprises a sharp point.  
     
     
         13 . The tissue manipulation device of  claim 6 , wherein said guide rail portion is configured to receive a slidable coupling element attached to a medical device, said slidable coupling element being configured to move in a longitudinal direction along said guide rail portion effective to guide the motion of said medical device.  
     
     
         14 . The tissue manipulating device of  claim 6 , further comprising a collar configured to move in a longitudinal direction along said guide rail portion.  
     
     
         15 . The tissue manipulating device of  claim 14 , wherein said guide rail portion and said collar each comprise complementary threads configured to operatively engage with each other effective that engagement of said threads and rotation of said collar around said longitudinal axis is effective to provide longitudinal movement of said collar along said guide rail portion.  
     
     
         16 . The tissue manipulating device of  claim 15 , wherein said collar is configured to contact said slidable coupling element effective that longitudinal movement of said collar towards said slidable coupling element when said collar is in contact with said slidable coupling element is effective to effect longitudinal movement of said slidable coupling element.  
     
     
         17 . The tissue manipulating device of  claim 1 , further comprising a handle.  
     
     
         18 . The tissue manipulating device of  claim 17 , wherein said handle comprises two pivotally-connected portions configured for engagement by a human hand.  
     
     
         19 . The tissue manipulating device of  claim 17 , wherein said handle comprises a substantially cylindrical shaft.  
     
     
         20 . The tissue manipulating device of  claim 19 , wherein said handle comprises a proximal portion of said elongated shaft.  
     
     
         21 . The tissue manipulating device of  claim 1 , comprising a proximal portion and a distal portion, wherein said distal portion of said elongated shaft is configured to separate from said proximal portion of said device.  
     
     
         22 . The tissue manipulating device of  claim 21 , wherein said distal portion is configured to be retained in tissue when said portions are separated following engagement of said retention element with tissue.  
     
     
         23 . A system for manipulating tissue of a female patient having a cervix and a cervical os, comprising: 
 a) a hand-held device for use with medical instruments and for manipulating tissue of a female patient having a cervix and a cervical os, comprising: 
 an elongated shaft with a proximal portion and a distal portion defining a longitudinal direction along a longitudinal axis, said distal portion having a distal tip configured for atraumatic entry into said cervical os;  
 a tissue retention element operatively attached to said elongated shaft and configured to grip tissue when said shaft distal tip is disposed within said cervical os;  
 and a guide rail portion of said device configured to engage a medical instrument; and  
   b) a medical instrument having a slidable coupling element configured to engage said guide rail portion of said device.    
     
     
         24 . The system for manipulating tissue of a female patient of  claim 23 , wherein said slidable coupling element is configured to move along said longitudinal direction.  
     
     
         25 . A hand-held device for use with a medical instrument and for manipulating tissue of a female patient having a cervix and a cervical os, comprising: 
 a positioning means for atraumatic positioning of said device adjacent said cervical os;    a tissue retention means configured to grip tissue; and    a guide means configured to engage a medical instrument.    
     
     
         26 . The device of  claim 1 , wherein said distal portion having a distal tip configured for atraumatic entry into said cervical os comprises a length of between about 1 inch and about 5 inches.  
     
     
         27 . The device of  claim 26 , wherein said distal portion having a distal tip configured for atraumatic entry into said cervical os comprises a length of between about 1.5 inches and about 2.5 inches.  
     
     
         28 . The device of  claim 1 , wherein said guide rail comprises a length of between about 1 inch and about 12 inches.  
     
     
         29 . The device of  claim 28 , wherein said guide rail comprises a length of between about 3 inches and about 6 inches.  
     
     
         30 . The device of  claim 1 , wherein said guide rail comprises a diameter of between about 0.125 inch and about 0.25 inch.  
     
     
         31 . The device of  claim 6 , wherein said elongated arm comprises a length of between about 1 inch and about 4 inches.  
     
     
         32 . The device of  claim 31 , wherein said elongated arm comprises a length of between about 2 inches and about 3 inches.