US20060129128A1 - Method and system for drug delivery - Google Patents

Abstract

A medical device and procedure for delivering a drug into a uterus are described. In one implementation, the medical device includes a first elongate member, a second elongate member and a stopper device. The first elongate member is configured for transcervical insertion into the uterus and includes a lumen extending therethrough. The second elongate member is positioned within said lumen and also includes a lumen therethrough. The second elongate member is positionable in a retracted or an extended position. A distal end of the second elongate member is configured to extend beyond a distal end of the first elongate member and penetrate uterine tissue when in the extended position. A proximal end of the second elongate member is configured to receive a drug for delivery through the lumen of the second elongate member. The stopper device controls movement of the second elongate member within the first elongate member.

Description

CROSS REFERENCE TO RELATED APPLICATION
• This application claims priority to pending U.S. Provisional Application Ser. No. 60/627,684, entitled “Method and Apparatus for Local Anesthesia Delivery”, filed on Nov. 15, 2004, the entire contents of which are hereby incorporated by reference.
TECHNICAL FIELD
• This invention relates to a medical device and procedure.
BACKGROUND
• Endometrial ablation and other transcervical procedures have historically been performed in an ASC (Ambulatory Surgery Center) or hospital operating room setting, where intravenous sedation or general anesthesia is readily available. As medical procedures migrate to the physician's office, these forms of sedation are less desirable. A local anesthesia is most desirable, since no anesthesiologist is needed. However, with respect to transcervical procedures, a para-cervical block (PCB) or intra-cervical block (ICB) can adequately anesthetize the cervix and most of the uterine corpus, but typically does not reach the fundus of the uterus. Various formulations of topical anesthetics have been instilled into the uterine cavity, but their absorption, for example into the endo-myometrial tissue, can be inadequate.
SUMMARY
• This invention relates to a medical device and procedure. In general, in one aspect, the invention features a medical device for drug delivery. The medical device includes a first elongate member, a second elongate member and a stopper device. The first elongate member is configured for transcervical insertion into a uterine cavity and includes a proximal end, a distal end and a lumen extending therethrough. The second elongate member is positioned within the lumen of the first elongate member and includes a proximal end, a distal end and lumen therethrough. The second elongate member is positionable in a retracted or an extended position relative to the first elongate member. The distal end of the second elongate member is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position. The proximal end of the second elongate member is configured to receive a drug for delivery through the lumen of the second elongate member. The stopper device is configured to control movement of the second elongate member within the first elongate member, thereby defining the retracted and extended positions of the second elongate member.
• Implementations of the invention may include one or more of the following features. The stopper device can include a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position. In another implementation, the stopper device includes a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.
• The first elongate member can further include a second lumen extending therethrough, the second lumen including light fibers, and a third lumen extending therethrough, the third lumen including a micro-endoscope. A light post coupler can be coupled to the light fibers and configured to couple to a light source, and a camera adapter can be coupled to the micro-endoscope and configured to couple to a camera. A first connector can be coupled to the proximal end of the second elongate member and configured to couple to a drug source, and a second connector can be coupled to the proximal end of the second elongate member and configured to couple to a distension medium source. In one implementation, the drug delivered through the medical device is a local anesthetic.
• In general, in another aspect, the invention features a system for drug delivery including a hysteroscope including a working channel and a medical device configured to position within the working channel of the hysteroscope. The medical device includes a first elongate member, a second elongate member and a stopper device. The first elongate member is configured for transcervical insertion into a uterine cavity and includes a proximal end, a distal end and a lumen extending therethrough. The second elongate member is positioned within the lumen of the first elongate member and includes a proximal end, a distal end and lumen therethrough. The second elongate member is positionable in a retracted or an extended position relative to the first elongate member. The distal end of the second elongate member is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position. The proximal end of the second elongate member is configured to receive a drug for delivery through the lumen of the second elongate member. The stopper device is configured to control movement of the second elongate member within the first elongate member, thereby defining the retracted and extended positions of the second elongate member.
• Implementations of the invention may include one or more of the following features. The system may further include a drug source coupled to the proximal end of the second elongate member and/or a distension medium source coupled to the proximal end of the second elongate member. The stopper device can include a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position. In another implementation, the stopper device can include a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.
• The first elongate member can further include a second lumen extending therethrough, the second lumen including light fibers and/or a third lumen extending therethrough, the third lumen including a micro-endoscope. A light post coupler can be coupled to the light fibers and configured to couple to a light source. A camera adapter can be coupled to the micro-endoscope and configured to couple to a camera. The medical device may further include a first connector coupled to the proximal end of the second elongate member and configured to couple to a drug source and/or a second connector coupled to the proximal end of the second elongate member and configured to couple to a distension medium source. In one implementation, the drug delivered by the system is a local anesthetic.
• In general, in another aspect, the invention features a method of delivering a drug to a uterus. The method includes transcervically positioning a delivery device within a uterine cavity until a distal end of the delivery device is near or contacting the fundus. The delivery device includes a second elongate member included in a lumen of a first elongate member and a stopper device configured to define a retracted position and an extended position of the second elongate member relative to the first elongate member. The second elongate member is translated within the lumen of the first elongate member toward the distal end of the delivery device and from a retracted position to an extended position. The tissue at or near the fundus is penetrated with a distal tip of the second elongate member, the second elongate member including a lumen filled with a drug. At least some of the drug is purged from the lumen of the second elongate member into the tissue at approximately the fundus.
• Implementations of the invention can include one or more of the following features. The method can further include translating the second elongate member within the lumen of the first elongate member toward a proximal end of the delivery device and from the extended position to the retracted position, and withdrawing the delivery device from the uterine cavity.
• The second elongate member can be coupled to a distension medium source, and the distension medium can be delivered to the uterine cavity through the lumen and distal tip of the second elongate member. Translating the second elongate member from a retracted position to an extended position can include engaging a retainer clip included a proximal end of the second elongate member with a locator included in a proximal end of the first elongate member. Translating the second elongate member from a retracted position to an extended position can include advancing a second finger grip included at a proximal end of the second elongate member toward and into contact with a first finger grip included at a proximal end of the first elongate member.
• Transcervically positioning a delivery device within a uterine cavity can include transcervically positioning a hysteroscope within a uterine cavity, where the delivery device is included in a working channel of the hysteroscope. In one implementation, the drug delivered is a local anesthetic.
• In general, in one aspect, the invention features a medical device for local anesthesia delivery. The medical device includes a first elongate member, a second elongate member and a stopper device. The first elongate member is configured for transcervical insertion into a uterine cavity and includes a proximal end, a distal end and a lumen extending therethrough. The second elongate member is positioned within the lumen of the first elongate member and includes a proximal end, a distal end and lumen therethrough. The second elongate member is positionable in a retracted or an extended position relative to the first elongate member. The distal end of the second elongate member is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position. The proximal end of the second elongate member is configured to receive a local anesthesia for delivery through the lumen of the second elongate member. The stopper device is configured to control movement of the second elongate member within the first elongate member, thereby defining the retracted and extended positions of the second elongate member.
• Implementations of the invention may include one or more of the following features. The stopper device can include a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position. In another implementation, the stopper device includes a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.
• The first elongate member can further include a second lumen extending therethrough, the second lumen including light fibers, and a third lumen extending therethrough, the third lumen including a micro-endoscope. A light post coupler can be coupled to the light fibers and configured to couple to a light source, and a camera adapter can be coupled to the micro-endoscope and configured to couple to a camera. A first connector can be coupled to the proximal end of the second elongate member and configured to couple to a drug source, and a second connector can be coupled to the proximal end of the second elongate member and configured to couple to a distension medium source.
• Implementations of the invention can realize one or more of the following advantages. A method or system for providing a controlled amount of local anesthesia to a particular location in uterine tissue is provided. Medical procedures that require anesthesia, yet are able to be performed in a physician's office using local anesthesia only, often can be performed without requiring the presence of an anesthesiologist. Additionally, the procedure can be performed without subjecting the patient to a general anesthesia, thereby avoiding possible side effects or complications associated therewith. A patient is able to recover from the procedure and be released from the medical office or hospital where the procedure was performed more quickly.
• The details of one or more embodiments of the invention are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the invention will be apparent from the description and drawings, and from the claims.
DESCRIPTION OF DRAWINGS
• FIG. 1 is a top view of a drug delivery device.
• FIG. 2 is a side view of the drug delivery device ofFIG. 1.
• FIG. 3 is an enlarged, cross-sectional view of the distal end of the drug delivery device ofFIG. 1.
• FIG. 4 is a side view of a portion of the proximal end of the drug delivery device ofFIG. 1.
• FIG. 5 is a flowchart showing a process for intrauterine delivery of a local anesthetic.
• FIG. 6 is a top, partial cross-sectional view of an alternative implementation of a drug delivery device.
• FIG. 7 is an enlarged, cross-sectional view of a distal end of the drug delivery device ofFIG. 5.
• FIG. 8 is a top, partial cross-sectional view of an alternative implementation of a drug delivery device.
• FIG. 9 is an end view of a distal end of the alternative implementation of the drug delivery device ofFIG. 8.
• Like reference symbols in the various drawings indicate like elements.
DETAILED DESCRIPTION
• A medical device and technique for drug delivery to a uterus is described. A drug delivery device includes a first elongate member configured for transcervical insertion into a uterine cavity. The first elongate member includes a proximal end, a distal end and a lumen extending therethrough. A second elongate member is positioned within the lumen of the first elongate member and includes a proximal end, a distal end and lumen therethrough. The second elongate member is positionable in a retracted or an extended position. The distal end of the second elongate member is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position. The proximal end of the second elongate member extends from the proximal end of the first elongate member and is configured to receive a drug for delivery through the lumen of the second elongate member. The device further includes a stopper device configured to control movement of the second elongate member within the first elongate member thereby defining the retracted and extended positions of the second elongate member.
• In one implementation, the drug delivery device can be used to deliver a local anesthesia. However, other drugs can be delivered into the uterine tissue, and a local anesthesia is merely one example. Any suitable drug, e.g., in a liquid or gel state, can be delivered either into the uterine cavity or the uterine tissue using the apparatus and processes described herein. For illustrative purposes, the apparatus and processes are described in reference to delivery of a local anesthetic, but it should be understood that this selection of drug is exemplary and not limiting.
• Referring toFIG. 1, one implementation of adrug delivery device100 is shown. Thedelivery device100 includes a first elongate member, orouter shaft102. Theouter shaft102 includes adistal end104 and aproximal end106. A lumen108 (seeFIG. 3) extends the length of theouter shaft102. Theouter shaft102 can be configured to be straight or curved. In the curved implementation, theouter shaft102 can be curved similarly to a conventional uterine sound to approximate the curvature of the uterine cavity. Near theproximal end106 of theouter shaft102 is aposition locator110. Thelocator110 can be configured in any convenient manner, including, for example, a detent, groove or slot. In one implementation, thedistal end104 of theouter shaft102 can be configured to prevent damage to the uterine tissue during tactile placement, for example, thedistal end104 can be rounded.
• A second elongate member, orneedle112, is positioned coaxially within thelumen108 of theouter shaft102. Theneedle112 includes adistal end114 configured to penetrate uterine tissue, e.g., tissue at the fundus of the uterus. Theneedle112 further includes aproximal end116 that protrudes from the proximal end of theouter shaft102. In this implementation, theproximal end116 includes aleur connector118. Theleur connector118 can couple to a drug-filled syringe to fill the lumen of theneedle112 with the drug, e.g., an anesthetic. Other connectors can be used in place of theleur connector118, which is one exemplary configuration. Alternatively, theproximal end116 of theneedle112 can include a drug source, e.g., can include an integrated syringe.
• A stopper device is included in the proximal region of theneedle112. The stopper device in the implementation shown is aretainer clip120 that can engage with a slot-type locator110 located on theproximal end106 of theouter shaft102. However, other configurations of stopper device can be used, and the configuration shown is exemplary. When theneedle112 is in the retracted position, theretainer clip120 is in a position A. When theneedle112 is advanced through thelumen108 of theouter shaft102 into the extended position, theretainer clip120 is in a position B. Position B of theretainer clip120 corresponds to theretainer clip120 engaging thelocator110, which prevents the retainer clip, and therefore theneedle112, from any further advancement. The distance thedistal end114 of theneedle112 translates into the fundus tissue can thereby be controlled. That is, the difference in distance between position A (retracted position;FIGS. 2 and 3) and position B (extended position;FIGS. 3 and 4), which is shown inFIGS. 2 and 3 aslength122, can be set by a physician to control how far thedistal end114 of theneedle112 extends from thedistal end104 of theouter shaft102. For example, thedistal end114 may extend in the range of approximately 1 to 10 mm, or approximately 5 mm, depending on the application.
• In one implementation, position A of theretainer clip120 is adjustable by a user to adjust the travel distance of theretainer clip120 and therefore adjust the extended position of the distal end of theneedle112. In another implementation, position A of theretainer clip120 is fixed, thereby providing a fixed extended position of the distal end of theneedle112.
• Thedelivery device100 can be inserted into the uterine cavity along the mid-plane of the uterus, or can be turned to either side to come into contact with the regions of the cornua. The distance thedistal end114 of theneedle112 protrudes from the distal end ofouter shaft102 can be adjusted as a function of the location of the desired injection. For example, the extension distance for a drug injection at the midline of the fundus may be set deeper, e.g., approximately 10 mm, than the extension distance set for injection into the cornua, e.g., approximately 5 mm.
• Referring toFIG. 5, a flowchart is shown illustrating aprocess200 for using a drug delivery device to deliver a local anesthetic to the fundus tissue. For illustrative purposes the process shall be described in reference to the implementation of thedelivery device100 shown inFIG. 1. However, it should be understood that other implementations of the delivery device can be used to carry out the process, and that the steps of the process can be carried out in a different sequence, while still achieving the desired results.
• Theneedle112 is positioned within thelumen108 of the outer shaft102 (step202). Theproximal end116 of the needle is fluidly coupled to a source of anesthetic (step204). For example, in the implementation being described, an anesthetic filled syringe is connected to theleur connector118. Any fluid or gas contained within the needle112 (e.g., air), is purged and the substantially the entire lumen of theneedle112 is filled with the anesthetic (step206). Thedrug delivery device100 is transcervically inserted into the uterine cavity (step208) and the fundus is located with thedistal end104 of the outer shaft102 (step210). A physician or other medical person using the device can detect theouter shaft102 has reached the fundus by tactile feedback. Theneedle112 is moved within thelumen108 of theouter shaft102 until theneedle112 can move no further, due to the stopper device, e.g., the retainingclip120, ceasing translation of the needle. Thedistal end114 of the needle—during the movement—pierces and enters the tissue at the fundus of the uterus (step212). The desired amount of anesthetic is delivered into the tissue, e.g., by pushing the plunger of the syringe attached to the needle112 (step214). Thedistal end114 of the needle is then retracted and withdrawn from the tissue (step216). Thedelivery device100 is then transcervically retracted and removed from the uterine cavity and the patient's body (step218). The above procedure is described in the context of delivering a local anesthetic to uterine tissue, however, as previously mentioned, a local anesthetic is just one example of a drug that can be delivered using the device and procedure described herein.
• Other implementations of the delivery device are possible. Referring toFIG. 6, an alternative implementation of adelivery device300 is shown. Thedelivery device300 is configured as a catheter with adiameter302 sufficiently small so as to be compatible with the working channel of a hysteroscope. Thedelivery device300 can be inserted into a uterine cavity either alone or can be used in conjunction with a conventional hysteroscope for use under direct visualization. Thedelivery device300, having adistal end304 and aproximal end306, includes anexternal sheath308 extending between the distal and proximal ends, with afirst finger grip310 located at theproximal end306. Theexternal sheath308 includes alumen310 extending the length of theexternal sheath308. Aneedle312 is positioned within thelumen310. Theneedle312 includes adistal tip314 configured to penetrate tissue, and aproximal end316 with asecond finger grip318 attached. Theneedle312 includes a lumen320 extending the length of theneedle312, including extending through thesecond finger grip318. The lumen320 is fluidly coupled to an anesthetic source. In this implementation,tubing322 and astandard leur connector324 included at theproximal end316 of theneedle312 fluidly couple the lumen320 to an anesthetic filled syringe that can be connected to theleur connector324.
• Thefirst finger grip310 attached to theexternal sheath308 and thesecond finger grip318 at the proximal end of theneedle312, together form a stopper device. In use, thedelivery device300 can be inserted into the uterine cavity and thedistal end304 of theexternal sheath308 advanced to the fundus. Adistance326 between thefirst finger grip310 and thesecond finger grip318 corresponds to a controlled travel distance of theneedle312. Referring toFIG. 7, an enlarged view of the distal region of theneedle312 is shown. Thedistal tip314 of theneedle312 travels thesame distance326 as thesecond finger grip318 travels to come into contact with thefirst finger grip310. Therefore, the protrusion of thedistal tip314 from thedistal end304 of theexternal sheath308 is controllable to a predetermined distance. As such, the penetration of thedistal tip314 into the uterine tissue is also controllable.
• Referring now toFIG. 8, another implementation of adelivery device400 is shown. Thedelivery device400 is similar to the implementation shown inFIG. 6, but includes atriple lumen sheath402. This implementation is configured for direct visualization during device and needle placement.FIG. 9 shows an end view of thedelivery device400. Thesheath402 includes acentral lumen404 andadditional lumens406 and408.Lumen406 includes light fibers andlumen408 includes a micro-endoscope. Alight post coupler410 is coupled to the light fibers withinlumen406 and is configured to connect to a light cable, providing a light source to the fibers. Acamera adapter412 is coupled to the micro-endoscope included inlumen408 and is configured to connect to a digital camera.
• Thedelivery device400 includes aneedle414 positioned coaxially within thecentral lumen404 and including adistal tip416 configured to pierce uterine tissue. Afirst finger grip418 is included at the proximal end420 of thetriple lumen sheath402. Asecond finger grip422 is included at the proximal end of theneedle414. As explained above in reference to the implementation shown inFIG. 6, the first and second finger grips418,422 together form a stopper device and can be used to control the distance thedistal tip416 of theneedle414 extends from the distal end of thetriple lumen sheath402. Other configurations of stopper device can be used, including, for example, the configuration shown inFIG. 1 (i e., a retainer clip and locator).
• Astandard leur connector424 is coupled to the proximal end of theneedle414 and configured to connect to a drug source, e.g., a syringe. Other configurations of connector can be used. In the implementation shown, a secondstandard leur connector426 is also included and coupled to the proximal end of theneedle414. Thesecond leur connector426 can be fluidly coupled to a distension medium, for example, a saline solution. Some uses of thedelivery device400 may require the uterine cavity be distended prior to or after delivery of the drug. A distension medium can be delivered into the uterine cavity using thesame needle414 as used to delivery the drug into the uterine tissue.
• In another implementation, the second leur connector can be included in a delivery device, such as that shown inFIG. 1 or6, including a single lumen in the external sheath. Other configurations are possible, including different combinations of configurations of stopper device, numbers of lumens, and numbers of leur connectors and types of connectors. The implementations described are exemplary.
• In any of the implementations of the delivery device, including thedelivery devices100,300 and400 discussed above, the first elongate member (i.e., the outer shaft, external sheath or triple lumen sheath) can be formed using any suitable material, including for example, an extruded thermoplastic elastomer. The second elongate member (i.e., the needle) can be formed from any suitable material, including for example, a stainless steel tubing hypotube.
• A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. For example, the steps shown inFIG. 5 can be performed in a different order and still achieve desirous results. Additionally, as noted above, the delivery device can be used to deliver drugs other than an anesthetic to the uterine cavity or uterine tissue, and the invention described herein is not limited to delivery of a local anesthetic. Accordingly, other embodiments are within the scope of the following claims.

Claims (26)

1. A medical device for drug delivery, comprising:

a first elongate member configured for transcervical insertion into a uterine cavity, the first elongate member including a proximal end, a distal end and a lumen extending therethrough;

a second elongate member positioned within the lumen of the first elongate member and including a proximal end, a distal end and lumen therethrough, where:

the second elongate member is positionable in a retracted or an extended position relative to the first elongate member;

the distal end is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position;

the proximal end is configured to receive a drug for delivery through the lumen of the second elongate member; and

a stopper device configured to control movement of the second elongate member within the first elongate member thereby defining the retracted and extended positions of the second elongate member.

2. The medical device ofclaim 1, wherein the stopper device includes a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position.

3. The medical device ofclaim 1, wherein the stopper device includes a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.

4. The medical device ofclaim 1, where the first elongate member further includes:

a second lumen extending therethrough, the second lumen including light fibers;

a third lumen extending therethrough, the third lumen including a micro-endoscope;

a light post coupler coupled to the light fibers and configured to couple to a light source; and

a camera adapter coupled to the micro-endoscope and configured to couple to a camera.

5. The medical device ofclaim 1, further comprising:

a first connector coupled to the proximal end of the second elongate member and configured to couple to a drug source; and

a second connector coupled to the proximal end of the second elongate member and configured to couple to a distension medium source.

6. The medical device ofclaim 1, wherein the drug is a local anesthetic.

7. A system for drug delivery, comprising:

a hysteroscope including a working channel; and

a medical device configured to position within the working channel of the hysteroscope, the medical device including:

a first elongate member configured for transcervical insertion into a uterine cavity, the first elongate member including a proximal end, a distal end and a lumen extending therethrough;

a second elongate member positioned within the lumen of the first elongate member and including a proximal end, a distal end and lumen therethrough, where:

the second elongate member is positionable in a retracted or an extended position relative to the first elongate member;

the distal end is configured to extend beyond the distal end of the first elongate member and pierce uterine tissue when in the extended position;

the proximal end is configured to receive a drug for delivery through the lumen of the second elongate member; and

a stopper device configured to control movement of the second elongate member within the first elongate member thereby defining the retracted and extended positions of the second elongate member.

8. The system ofclaim 7, further comprising:

a drug source coupled to the proximal end of the second elongate member.

9. The system ofclaim 8, further comprising:

a distension medium source coupled to the proximal end of the second elongate member.

10. The system ofclaim 7, wherein the stopper device includes a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position.

11. The system ofclaim 7, wherein the stopper device includes a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.

12. The system ofclaim 7, wherein the first elongate member further includes:

a second lumen extending therethrough, the second lumen including light fibers;

a third lumen extending therethrough, the third lumen including a micro-endoscope;

a light post coupler coupled to the light fibers and configured to couple to a light source; and

a camera adapter coupled to the micro-endoscope and configured to couple to a camera.

13. The system ofclaim 7, the medical device further comprising:

a first connector coupled to the proximal end of the second elongate member and configured to couple to a drug source; and

a second connector coupled to the proximal end of the second elongate member and configured to couple to a distension medium source.

14. The system ofclaim 7, wherein the drug is a local anesthetic.

15. A method of delivering a drug to a uterus, the method comprising:

transcervically positioning a delivery device within a uterine cavity until a distal end of the delivery device is near or contacting the fundus, where the delivery device includes a second elongate member included in a lumen of a first elongate member and a stopper device configured to define a retracted position and an extended position of the second elongate member relative to the first elongate member;

translating the second elongate member within the lumen of the first elongate member toward the distal end of the delivery device and from a retracted position to an extended position;

penetrating tissue at or near the fundus with a distal tip of the second elongate member, the second elongate member including a lumen filled with a drug; and

purging at least some of the drug from the lumen of the second elongate member into the tissue at approximately the fundus.

16. The method ofclaim 15, further comprising:

translating the second elongate member within the lumen of the first elongate member toward a proximal end of the delivery device and from the extended position to the retracted position; and

withdrawing the delivery device from the uterine cavity.

17. The method ofclaim 15, further comprising:

coupling the second elongate member to a distension medium source; and

delivering the distension medium to the uterine cavity through the lumen and distal tip of the second elongate member.

18. The method ofclaim 15, wherein translating the second elongate member from a retracted position to an extended position includes engaging a retainer clip included a proximal end of the second elongate member with a locator included in a proximal end of the first elongate member.

19. The method ofclaim 15, wherein translating the second elongate member from a retracted position to an extended position includes advancing a second finger grip included at a proximal end of the second elongate member toward and into contact with a first finger grip included at a proximal end of the first elongate member.

20. The method ofclaim 15, wherein transcervically positioning a delivery device within a uterine cavity includes:

transcervically positioning a hysteroscope within a uterine cavity, where the delivery device is included in a working channel of the hysteroscope.

21. The method ofclaim 15, wherein the drug is a local anesthetic.

22. A medical device for local anesthesia delivery, comprising:

a first elongate member configured for transcervical insertion into a uterine cavity, the first elongate member including a proximal end, a distal end and a lumen extending therethrough;

a second elongate member positioned within the lumen of the first elongate member and including a proximal end, a distal end and lumen therethrough, where:

the second elongate member is positionable in a retracted or an extended position relative to the first elongate member;

the distal end is configured to extend beyond the distal end of the first elongate member and penetrate uterine tissue when in the extended position;

the proximal end is configured to receive a local anesthesia for delivery through the lumen of the second elongate member; and

a stopper device configured to control movement of the second elongate member within the first elongate member thereby defining the retracted and extended positions of the second elongate member.

23. The medical device ofclaim 22, wherein the stopper device includes a groove formed in the proximal end of the first elongate member and a retainer clip connected to the proximal end of the second elongate member, where the retainer clip is configured to engage the groove when the second elongate member is in the extended position.

24. The medical device ofclaim 22, wherein the stopper device includes a first finger grip included at the proximal end of the first elongate member and a second finger grip included at the proximal end of the second elongate member, where the second finger grip is configured to contact the first finger grip when the second elongate member is in the extended position.

25. The medical device ofclaim 22, where the first elongate member further includes:

a second lumen extending therethrough, the second lumen including light fibers;

a third lumen extending therethrough, the third lumen including a micro-endoscope;

a light post coupler coupled to the light fibers and configured to couple to a light source; and

a camera adapter coupled to the micro-endoscope and configured to couple to a camera.

26. The medical device ofclaim 22, further comprising:

a first connector coupled to the proximal end of the second elongate member and configured to couple to a local anesthesia source; and

a second connector coupled to the proximal end of the second elongate member and configured to couple to a distension medium source.

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