BACKGROUND
1. Field of the Disclosure
The present disclosure generally relates to endoscopes, and more particularly to a system and method for maintaining a clean endoscope during a procedure.
2. Discussion of the Related Art
An endoscope is a medical device utilized for medical procedures requiring the visualization of internal organs in a non-surgical manner generally referred to as a minimally invasive procedure. A physician may utilize an endoscope to make a diagnosis and/or to gain access to internal organs for treatment. The endoscope may be introduced into a patient's body via a natural orifice or through a small surgical incision.
An endoscope generally comprises three systems; namely, the endoscope system, the imaging system and the illumination system. All three systems must work together to give the physician the entire, and clear picture. More specifically, in order to achieve optimal results, the physician must be able to have a clear view from insertion of the endoscope, traveling to the organ site and during the entire procedure. In order to do this, the lens of the endoscope must be maintained free and clear of any obstructing material, including smears, residue, debris and condensation without the need to remove the device from the body. Minimally Invasive Devices, Inc. has developed the FloShield™ system that directs carbon dioxide gas to the tip of the scope to clear the lens from condensation, debris and smoke. CIPHER SURGICAL has developed the OpClear® device which utilizes a gas-powered saline delivery system to clean the scope lens during a procedure.
While the above-referenced devices do function to clean endoscopes, these devices require additional components and are fairly complex in design and use thereof. For example, these devices comprise additional sleeves which are sized for particular endoscopes. For each endoscope, there is a sleeve and if a physician changes endoscopes during a procedure, which is a common occurrence, a new sleeve must also be utilized. In addition, these devices are fully manual device/systems which required the physician to perform additional steps and thus divert his or her attention from the primary task.
Accordingly, there exists a need for a simple, efficient and easy to utilize system and method for maintaining a clean scope lens and field of view.
SUMMARY OF THE DISCLOSURE
The present disclosure relates to a trocar for an intraoperative endoscope cleaning system. The trocar may comprise a main body comprising an elongate hollow tube portion extending terminating at a distal end, wherein the tube portion defines a cavity configured to receive an endoscope; a wash orifice disposed in the tube portion of the main body and configured to allow the wash solution to flow toward the cavity; a first gas orifice disposed in the tube portion of the main body between the wash orifice and the distal end of the main body, and configured to allow the pressurized gas to flow toward the cavity; and a second gas orifice disposed in the tube portion of the main body adjacent the wash orifice, and configured to allow the pressurized gas to flow toward the cavity and to atomize at least a portion of the wash solution in the cavity.
The present disclosure relates to a trocar for an intraoperative endoscope cleaning system. The trocar may comprise a main body comprising an elongate hollow tube portion extending terminating at a distal end, wherein the tube portion defines a cavity configured to receive an endoscope; a wash orifice disposed in the tube portion of the main body and configured to allow the wash solution to flow toward the cavity; a gas orifice disposed in the tube portion of the main body between the wash orifice and the distal end of the main body, and configured to allow the pressurized gas to flow toward the cavity; and a suction orifice disposed in the tube portion of the main body adjacent the wash orifice and configured to receive fluid from the cavity.
The present disclosure relates to a method for cleaning an endoscope during a procedure, the method comprising utilizing a trocar comprising a main body defining a cavity for receiving an endoscope, a wash orifice disposed in the main body and configured allow a flow of wash solution into the cavity, and a gas orifice disposed between the distal end of the main body and the wash orifice, the gas orifice configured allow a flow of gas into the cavity, the method comprising: washing the endoscope; drying the endoscope; and managing residual fluids on the endoscope or in the cavity, or both.
As a non-limiting example, the present disclosure describes improvements to the invention described in US20190125176A1 (prior art) for an endoscope cleaning system integrated into a trocar. The present disclosure describes solutions to a variety of problems that arise when the trocar design is reduced to practice and used in real world applications.
BRIEF DESCRIPTION OF THE DRAWINGS
The foregoing and other features and advantages of the disclosure will be apparent from the following, more particular description of preferred embodiments of the disclosure, as illustrated in the accompanying drawings.
FIGS. 1A-1B are illustrations of an example trocar comprising a gas port (e.g., gas orifice) to atomize wash solution.
FIG. 1C is an illustration of an example trocar comprising a gas port (e.g., gas orifice) to atomize wash solution.
FIG. 1D is an illustration of an example trocar comprising a plurality of gas ports (e.g., gas orifice) to atomize wash solution.
FIG. 1E is an illustration of an example trocar without a recess adjacent the wash orifice and gas orifice.
FIGS. 2A-2B illustrate example trocars showing residual fluid.
FIGS. 2C-2D illustrate example trocars comprising raised gas ports to prevent saline washing over the port and the generation of a mist during drying.
FIGS. 3A-3C illustrates an example problem of residual moisture and the resultant effect on the scope.
FIG. 4 illustrates an example trocar comprising physical seals to mitigate against residual moisture.
FIG. 5 illustrates an example trocar comprising suction to mitigate against residual moisture.
FIGS. 6A-6B illustrate an example trocar comprising rear gas pressure to mitigate against residual moisture.
FIG. 7 illustrates an example trocar comprising a rear gas seal to mitigate against residual moisture.
FIGS. 8A-8C illustrate an example trocar comprising vents to mitigate against residual moisture.
FIG. 9A-9D illustrate an example trocar comprising drains and ribs to mitigate against residual moisture.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present disclosure is directed to a method and system for improving the efficiency of the spray at cleaning the scope. In the prior art the spray is created by delivering pressurized saline through an orifice. At low saline flow rates the spray energy reduces significantly to the point that the saline flows out of the nozzle in a stream rather than a spray. To overcome this and to enable the use of low flow rates the pressure of the saline can be increased, and the orifice diameter reduced however this adds complication to the system.
FIGS. 1A-1B illustrate an example trocar 100 for an intraoperative endoscope cleaning system. As shown, the trocar 100 may comprise a main body having an elongate hollow tube portion extending terminating at a distal end. The tube portion defines a cavity configured to receive an endoscope 114. A gas inlet port may be disposed through the main body and configured to selectively receive a pressurized gas (e.g., 002). A fluid inlet port may be disposed through the main body and configured to selectively receive a wash solution. A wash orifice 104 may be disposed in the tube portion of the main body and in fluid communication with the fluid inlet port to receive the wash solution and to allow the wash solution to flow toward the cavity. A first gas orifice 102 may be disposed in the tube portion of the main body between the wash orifice 104 and the distal end of the main body, and in fluid communication with the gas inlet port to receive the pressurized and to allow the pressurized gas to flow toward the cavity. A second gas orifice 106 may be disposed in the tube portion of the main body adjacent the wash orifice 104, and in fluid communication with the gas inlet port to receive the pressurized gas and to allow the pressurized gas to flow toward the cavity and to atomize at least a portion of the wash solution in the cavity. A fluid channel 110 may be coupled between the fluid inlet port and the wash orifice 104 to provide fluid communication therebetween. A fluid channel 112 may be coupled between the gas inlet port and one or more of the first gas orifice 102 or the second gas orifice 106 to provide fluid communication therebetween.
Additionally or alternatively, and for the example purpose of controlling the delivery of the wash solution from the wash orifice 104 to the second gas orifice 106 it may be beneficial to create a recess or channel 108 connecting both ports 104, 106. In this way the solution from the wash orifice 104 is preferentially channeled to the gas orifice 106 for atomization into a spray. As shown in FIG. 1E, the trocar need not include the recess 108 shown in FIG. 1A.
In use, the endoscope 114A may be in a wash position and may be subjected to a spray of wash solution 105, which may be at least partially atomized by flow of gas 107. The endoscope 114B may be in a drying position and may be subjected to a burst of gas 103 for drying.
As shown in FIG. 1C, a wash channel 110 may be coupled between the fluid inlet port and the wash orifice 104 to provide fluid communication therebetween and a gas channel 112 may be coupled between the gas inlet port and one or more of the first gas orifice 102 or the second gas orifice 106 to provide fluid communication therebetween, wherein at least a portion of the gas channel 112 is parallel to a portion of the wash channel 110. A recess 108′ may have various shapes and may be formed adjacent or about one or more of the orifices 104, 106.
As shown in FIG. 1D, a wash channel 110 may be coupled between the fluid inlet port and the wash orifice 104 to provide fluid communication therebetween and a gas channel 112′ coupled between the gas inlet port and one or more of the first gas orifice 102 or the second gas orifice 106 to provide fluid communication therebetween, wherein at least a portion of the gas channel 112′ is shaped to surround at least a portion of the wash channel 110. Additionally or alternatively, a plurality of gas orifices (ports) 106A, 106B, 106C mat be disposed adjacent the wash orifice 104.
The gas orifices 106 may be connected to the drying gas fluid channel 112 to receive a flow of pressurized gas, for example. If a gas drying port 102 is activated concurrently with a wash solution (e.g., saline, buffered biocompatible solution, etc.) flow the additional gas port(s) 106 may be highly effective at atomizing the wash solution into an energetic spray. This offers a practical solution to creating energetic sprays at low saline pressures and flow rates. Another embodiment of this design uses a dedicated gas channel independent of the existing gas channel design. This has multiple benefits as the gas can be activated independently of the drying gas and be configured for the optimal gas pressure and flow rate to optimize the spray however this comes at an increase in the complexity of the system.
In the prior art, it was observed that the wash spray coalesces inside the trocar and has the potential to flow over the lower gas port. This typically occurs at the end of the washing cycle and thus the solutions flows over the gas drying port during the drying process resulting in a spray. In the present disclosure there is the same opportunity for the wash solution to coalesce inside the trocar and flow past the gas port during drying. This causes a spray which can compromise the drying stage of the clean as the CO2 gas has to run for an extended period to remove all the saline wash before the gas can effectively dry the scope.
In the present disclosure a solution to the problem is detailed which prevents any saline within the trocar from being atomized during drying. FIGS. 2A-2D illustrate an example trocar 200 for an intraoperative endoscope cleaning system. As shown, the trocar 200 may comprise a main body having an elongate hollow tube portion extending terminating at a distal end. The tube portion defines a cavity configured to receive an endoscope. A wash orifice 204 may be disposed in the tube portion of the main body. A gas orifice 202 may be disposed in the tube portion of the main body between the wash orifice 204 and the distal end of the main body. A fluid channel 210 may be coupled between the fluid inlet port and the wash orifice 104 to provide fluid communication therebetween. A fluid channel 212 may be coupled between the gas inlet port and one or more of the gas orifice 202 to provide fluid communication therebetween. The gas orifice 202 may have a raised elevation 224 relative to a surface 222 of the main body defining the cavity to prevent residual fluid 201 such as wash solution from washing up on to the gas orifice 202. Alternatively or additionally, channels 220 may be disposed adjacent the gas orifice 202 to divert the wash solution away from the gas orifice 202. Additionally or alternatively, a hydrophobic coating may be applied to the gas orifice 202 area to prevent wash from wicking up onto the port.
FIGS. 3A-3C illustrate examples of residual moisture. During washing and drying there is a propensity for wash solution 304 and/or other fluids fouling the scope e.g. blood to be pushed up the trocar 300 between the scope 302 and the walls of the trocar driven by the spray impingement and the high-pressure drying gas. When the cleaning cycle has ended (OO2 gas turned off) the wash solution is under the influence of gravity and when the scope is tilted forward the solution runs down the scope and wets the scope window compromising the clean. Another cleaning cycle is then required to dry the scope.
Multiple solutions to the problem of residual moisture have been generated and evaluated.
One solution comprises the use of physical seals within the trocar to compartmentalize the cleaning process. FIG. 4 shows an example of such a system. As shown in FIG. 4, two seals 402 have been used in the washing zone to prevent wash solution from a) going up into the trocar during washing (e.g., endoscope 403 in wash position) and b) flowing out of the trocar during the drying process (e.g., endoscope 403 in drying position). This solution has been shown to be highly effective at addressing the problem of residual moisture enabling an effective washing and drying cycle. As an example, lip seals were found to offer the sealing with low stiction. As a further example, a lip seal 402 may comprise a body 402A disposed in a cavity 401 formed in the wall of the trocar 400. A lip 402B may protrude from the body 402A and may extend toward the endoscope. Various design of seal angles, lip shapes and materials may be used.
FIG. 5 shows a solution using a suction port 516 located proximally to a washing port 504. In this embodiment, the suction is activated during washing (endoscope 503 in wash position) and drying step (endoscope 503 in dry position) in the cleaning process and is highly effective at extracting moisture within the trocar 500 and removing the residual moisture 501. This solution also has the added benefit that the suction flow rate can be matched to the gas flow rate such that there is no net effect of the gas flow into the body cavity.
FIGS. 6A-6B shows a solution using an additional gas port 602B located proximally to the washing port 604. As shown, a gas channel 612 may provide pressurized gas to one or more gas ports 602A, 602B. A fluid channel 610 may provide wash solution to the washing port 604. In this embodiment the rear gas (e.g., via port 602B) is activated during washing (endoscope 603 in wash position) and drying (endoscope 603 in dry position). The rear gas creates a back pressure within the trocar which acts as a barrier preventing the ingress of saline 601 up the trocar 600. In this embodiment the flow of rear gas must be tightly controlled: too low and it is ineffective at preventing saline ingress and too high and it fights against the washing process to blow the spray away from the scope reducing the effectiveness of the wash. This control can be achieved in multiple ways however the simplest embodiment is controlling the orifice diameter, reducing the diameter to reduce the flow rate and vice versa. A more flexible solution would use a dedicated lumen supplying this orifice such that the gas pressure and flow rate can be set independently of the gas drying port.
FIG. 7 shows a rear gas pressure design. As shown, one or more gas channels 712, 718 may provide pressurized gas to one or more gas ports 702, 716. A fluid channel 710 may provide wash solution to the washing port 704. In this embodiment a reduction in the internal diameter of the trocar 700 is created and the rear gas port 716 is created in a groove such that within this location in such as position that the gas flow distally is higher than proximally. In this manner a gas seal can be created to prevent saline ingress using low gas flow rates and low pressures such that it doesn't compromise the effectiveness of the saline wash. In this embodiment the rear gas (e.g., via port 716) may be activated during washing (endoscope 703 in wash position) and drying (endoscope 703 in dry position).
FIGS. 8A-8C show an additional or alternative approach to dealing with residual moisture 801. As shown, a gas channel 812 may provide pressurized gas to one or more gas ports 802. A fluid channel 810 may provide wash solution to the washing port 804. As shown, vents 816 are created proximally in the trocar 800 to allow any wash solution and gas that passes beyond the scope 803 to be vented into the body cavity thus when the drying gas is turned off at the end of the drying step there is minimal moisture remaining in the trocar.
FIGS. 9A-9D show an additional or alternative approach to dealing with residual moisture 901. As shown, a gas channel 912 may provide pressurized gas to one or more gas ports 902. A fluid channel 910 may provide wash solution to the washing port 904. Drains 916 are created at the distal end of the trocar 900. These are designed to allow any residual moisture 901 within the trocar 900 to drain out of the trocar 900 rather than run down the length of the scope 903 to wet the scope lens. It may be beneficial that the scope is prevented from coming into contact with the walls of the trocar 900 as this increases the likelihood of wash wicking between the trocar and scope. To prevent this, ribs 918 are created axially within the inner surface of the trocar to position the scope centrally within the trocar thus creating channels that are effective are directing the residual moisture 901 to the drain.
Although shown and described in what is believed to be the most practical and preferred embodiments, it is apparent that departures from specific designs and methods described and shown will suggest themselves to those skilled in the art and may be used without departing from the spirit and scope of the invention. The present invention is not restricted to the particular constructions described and illustrated but should be constructed to cohere with all modifications that may fall within the scope of the appended claims. It is also noted that many of the above solutions are complementary such that more than one solution may be used at the same time to provide a more effective solution.
Patent Application
20240293018
