The subject invention is directed to endoscopic surgery, and more particularly, to a surgical gas circulation system that is adapted and configured for multi-modal operation including insufflation, recirculation and smoke evacuation using a filtered tube set having five separate lumens.
Endoscopic surgical techniques are well known. Indeed, laparoscopic surgical procedures performed in the abdominal cavity, such as such as cholecystectomies, appendectomies, hernia repair and nephrectomies have become commonplace. Benefits of such minimally invasive procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.
Endoscopic surgical procedures performed in other surgical cavities or areas of the body include thoracoscopic surgical procedures performed in the thoracic cavity of a patient, as well as, endo-luminal surgical procedures, such as trans-anal and trans-esophageal surgical procedures.
Endoscopic surgical procedures commonly involve filling or “insufflating” the surgical cavity with a pressurized fluid, such as carbon dioxide, to create an operating space. In the case of laparoscopy in the abdominal cavity, this is referred to as a pneumoperitoneum. Insufflation can be carried out by a surgical access device, such as a trocar, equipped to deliver insufflation fluid, or by a separate insufflation device, such as an insufflation (veress) needle.
The trocar must also provide a way to maintain the pressure within the surgical cavity by sealing between the trocar and the surgical instrument being used, while still allowing at least a minimum amount of freedom of movement for the surgical instruments. Mechanical seals are typically provided on trocars to prevent the escape of insufflation gas from the surgical cavity. These seals often comprise a duckbill-type valve made of a relatively pliable material, which seals around an outer surface of a surgical instrument passing through the trocar.
SurgiQuest, Inc., a wholly owned subsidiary of ConMed Corporation has developed unique gas sealed surgical access devices that permit ready access to an insufflated surgical cavity without the need for conventional mechanical seals, as described, for example, in U.S. Pat. Nos. 8,795,223 and 9,907,569, the disclosures of which are herein incorporated by reference in their entireties. These gas sealed devices have an inner tubular body portion that defines a central lumen for introducing surgical instruments to the surgical cavity and an outer tubular body portion that defines an annular outer lumen surrounding the inner tubular body portion for delivering insufflation gas to the surgical cavity and for facilitating periodic sensing of cavity pressure. During use, pressurized gas is delivered to the access device, where it is accelerated by internal jet nozzles to create a gaseous sealing zone within the central lumen of the access device. Gas that has been used to generate the gaseous sealing zone is carried away from the access device by way of a suction line.
These dual-lumen gas sealed access devices are designed for use with a unique multi-modal surgical gas delivery device, as described in commonly assigned U.S. Pat. Nos. 9,067,030 and 9,526,849, the disclosures of which are herein incorporated by reference. This gas delivery device includes an insufflation subunit for delivering insufflation gas to the outer annular lumen of the access device, and for taking period pressure readings from the surgical cavity. The gas delivery device further incudes a gas circulation pump for delivering pressurized gas to the nozzle jets located within in the access device and for carrying away spent gas from the access device, thereby forming a gas recirculation path between the pump and the access port.
Those skilled in the art will readily appreciate that electrocautery devices are regularly used during endoscopic surgical procedures. These devices are used to cut and/or coagulate tissue, and typically give off smoke during this process. The smoke can cloud the vision of the endoscopic camera, leading to delays in surgery or requiring the surgical team to evacuate that smoke from the surgical cavity.
It is known to utilize a dual-lumen gas sealed access device in conjunction with a multi-modal gas delivery device to remove smoke filled gas from a surgical cavity, while maintaining a gaseous seal within the access device. In this mode of operation, smoke removal is conducted by way of the gas recirculation path used to generate the gaseous seal in the access device, which is filtered on both the input and output legs of the path. Moreover, smoke filled gas will flow up through the central lumen of the access device and into the gas recirculation path by way of a “chimney” effect, where it will be filtered within the suction line.
While this method of smoke evacuation has been somewhat effective, it has certain shortcomings. First, the smoke evacuation mode of the current multi-modal gas delivery device described in U.S. Pat. Nos. 9,067,030 and 9,526,849 does not operate continuously. Rather, it toggles on and off, because the addition of insufflation gas through the outer annular lumen of the access device must be interrupted so that the insufflation subunit within the gas delivery device can accurately sense cavity pressure. Second, some of the smoke filled gas flows up through the central lumen of the gas sealed access device can find its way out of the open end of the access device, where it is released into the operating room, creating undesirable odors.
It would be beneficial therefore to separate the smoke evacuation function from the gas recirculation function of the gas sealed access port so that smoke evacuation can be performed continuously and so that smoke filled gas is not unnecessarily released into the operating room environment through the open end of the gas sealed access port.
The subject invention provides a beneficial solution to these problems by incorporating a second gas circulation pump into the multi-modal gas delivery device, which is dedicated to smoke evacuation, thereby separating smoke evacuation from the gas recirculation path used to create the gaseous sealing zone in a gas sealed access device.
The subject invention is directed to a new and useful system for performing an endoscopic surgical procedure in a surgical cavity, which includes a multi-modal gas delivery device including a primary gas circulation pump, a secondary gas circulation pump and an insufflation subunit, and an interface plate adapted and configured to engage with the multi-modal gas delivery device and including a connector and a filter seat corresponding to each of five separate and distinct lumens.
The first lumen is an insufflation and sensing lumen for delivering insufflation gas from the insufflation subunit to the surgical cavity and for facilitating sensing of surgical cavity pressure. The second lumen is a gas delivery lumen for delivering pressurized gas from the primary gas circulation pump to a gas sealed access device. The third lumen is a gas return lumen for returning gas used to generate a gaseous seal within the gas sealed access device back to the primary gas circulation pump. The fourth lumen is a smoke evacuation lumen for removing smoke filled gas from the surgical cavity by way of the secondary gas circulation pump. The fifth lumen is a recirculation supply lumen for returning filtered gas back to the surgical cavity from the secondary gas circulation pump.
In one embodiment of the subject invention, the insufflation and sensing lumen is attached to a respective connector of the interface plate, and a modular bi-directional filter canister is seated on the interface plate to communicate with the attached lumen. Furthermore, a distal end of the insufflation and sensing lumen has a coupling that is adapted and configured to connect with a valve sealed access device.
In another embodiment of the subject invention, the insufflation and sensing lumen, the gas delivery lumen and the gas return lumen are attached to respective connectors of the interface plate, and modular bi-directional filter canisters are seated on the interface plate to communicate with each of the attached lumens. Furthermore, distal ends of the insufflation and sensing lumen, the gas delivery lumen and the gas return lumen are attached to a tri-lumen coupling that is adapted and configured to connect with the gas sealed access device. Alternatively, distal ends of the gas delivery lumen and the gas return lumen are attached to a bi-lumen coupling that is adapted and configured to connect with the gas sealed access device, and a distal end of the insufflation and sensing lumen has a coupling that is adapted and configured to connect with a valve sealed access device.
In yet another embodiment of the subject invention, the smoke evacuation lumen and the recirculation supply lumen are attached to respective connectors of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens. Furthermore, a distal end of the smoke evacuation lumen has a coupling that is adapted and configured to connect with a first valve sealed access device and a distal end of the recirculation supply lumen has a coupling that is adapted and configured to connect with a second valve sealed access device.
In still another embodiment of the subject invention, the insufflation and sensing lumen, the smoke evacuation lumen and the recirculation supply lumen are attached to respective connectors of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens. Furthermore, a distal end of the insufflation and sensing lumen has a coupling that is adapted and configured to connect with a first valve sealed access device, a distal end of the smoke evacuation lumen has a coupling that is adapted and configured to connect with a second valve sealed access device and a distal end of the recirculation supply lumen has a coupling that is adapted and configured to connect with a third valve sealed access device.
In an ultimate embodiment of the subject invention, the insufflation and sensing lumen, the gas delivery lumen, the gas return lumen, the smoke evacuation lumen and the recirculation supply lumen are all attached to respective connectors of the interface plate, and modular filter canisters are seated on the interface plate to communicate with each of the attached lumens. Furthermore, distal ends of the insufflation and sensing lumen, the gas delivery lumen and the gas return lumen are attached to a tri-lumen coupling that is adapted and configured to connect with the gas sealed access device, a distal end of the smoke evacuation lumen has a coupling that is adapted and configured to connect with a first valve sealed access device and a distal end of the recirculation supply lumen has a coupling that is adapted and configured to connect with a second valve sealed access device.
Alternatively, distal ends of the gas delivery lumen and the gas return lumen are attached to a bi-lumen coupling that is adapted and configured to connect with the gas sealed access device, a distal end of the insufflation and sensing lumen has a coupling that is adapted and configured to connect with a first valve sealed access device, a distal end of the smoke evacuation lumen has a coupling that is adapted and configured to connect with a second valve sealed access device and a distal end of the recirculation supply lumen has a coupling that is adapted and configured to connect with a third valve sealed access device.
It is envisioned that each filter seat of the interface plate would be configured to receive a uniform or common modular filter canister that includes a pleated filter element for filtering gas flowing therethrough. Those skilled in the art will readily appreciate that the modularity and commonality of the filter canisters provides benefits and advantages in terms of decreased manufacturing costs, reduced inventory and ease of assembly. Each modular filter canister is preferably attached to a respective filter seat by conventional means known in the art such as, for example, an adhesive, ultrasonic welding, spin welding, and laser welding or by way of a threaded fit or an interference fit.
Preferably, the filter element in each canister is configured for bi-directional flow so that it can be utilized to filter a flow of clean pressurized gas coming from the outlet side of a gas circulation pump or an outlet flow of spent or smoke filled gas going to the suction side of a gas circulation pump. The bi-directional filter element within each canister is preferably selected from a group of filter media consisting of a pleated filter media, a woven polymer mesh filter media, a non-woven polymer mesh filter media, sintered metal filter media, a sintered polymer filter media, an activated carbon filter media, and a particulate filter media. Each filter canister also includes means for detected a fluid level within the filter canister. This can include an optical sensors or the like.
It is envisioned that the interface plate could include a permanent or integral filter canister operatively associated with the filter seat that communicates with the insufflation and sensing lumen, while the four other filter seats would each have the previously described modular filter canister associated therewith. This is because nearly every embodiment or version of the interface plate would likely include the insufflation and sensing lumen. It is the most often gas path used in the embodiment of the subject invention described herein.
It is also envisioned that the interface plate would include means for communicating information to a controller in the gas delivery device identifying which of the five lumens is attached to the interface plate. The information received from an interface plate of a tube set is preferably communicated to the gas delivery device by way of an RFID communication link, an NFC communication link, a Bluetooth communication link, a WiFi communication link or by way of microswitches.
The subject invention is also directed to an interface plate for a multi-modal gas delivery device used in performing an endoscopic surgical procedure in a surgical cavity. The interface plate includes a first connector for an insufflation and sensing lumen that delivers insufflation gas from an insufflation subunit in the gas delivery device to the surgical cavity and facilitates sensing of surgical cavity pressure, a second connector for a gas delivery lumen that delivers pressurized gas from a primary gas circulation pump in the gas delivery device to a gas sealed access device, a third connector for a gas return lumen that returns gas used to generate a gaseous seal within the gas sealed access device back to the primary gas circulation pump, a fourth connector for a smoke evacuation lumen that removes smoke filled gas from the surgical cavity by way of a secondary gas circulation pump in the gas delivery device, and a fifth connector for a recirculation supply lumen that returns filtered gas back to the surgical cavity from the secondary gas circulation pump.
The interface plate further includes a filter seat corresponding to each of the five connectors for receiving a respective filter canister. In one embodiment of the subject invention, an insufflation and sensing lumen is attached to the first connector of the interface plate, and a filter canister is seated on the interface plate to communicate with the attached lumen. In another embodiment of the subject invention, an insufflation and sensing lumen is attached to the first connector of the interface plate, a gas delivery lumen is attached to the second connector of the interface plate and a gas return lumen is attached to the third of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens.
In yet another embodiment of the subject invention, a smoke evacuation lumen is attached to the fourth connector of the interface plate and a recirculation supply lumen is attached to the fifth connector of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens. In still another embodiment of the subject invention, an insufflation and sensing lumen is attached to the first connector of the interface plate, a smoke evacuation lumen is attached to the fourth connector of the interface plate and a recirculation supply lumen is attached to the fifth connector of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens.
In an ultimate embodiment of the interface plate of the subject invention, an insufflation and sensing lumen is attached to the first connector of the interface plate, a gas delivery lumen is attached to the second connector of the interface plate, a gas return lumen is attached to the third connector of the interface plate, a smoke evacuation lumen is attached to the fourth connector of the interface plate and a recirculation supply lumen is attached to the fifth connector of the interface plate, and filter canisters are seated on the interface plate to communicate with each of the attached lumens.
The subject invention is also directed to a multi-modal gas delivery device for performing an endoscopic surgical procedure in a surgical cavity, which includes an insufflation subunit for delivering insufflation gas from a gas source to the surgical cavity and for sensing pressure within the surgical cavity, a primary gas circulation pump for delivering pressurized gas to a gas sealed access port so as to generate a gaseous seal therein and thereby maintain a stable pressure within the surgical cavity and for receiving gas returning from the gas sealed access port that was used to form the gaseous seal, and a secondary gas circulation pump for continuously evacuating smoke filled gas from the surgical cavity. The secondary pump can operate regardless of the sensed pressure within the surgical cavity. Preferably, the secondary gas circulation pump is further configured to return filtered gas to the surgical cavity.
The gas delivery device further comprises a controller for initiating an operating mode from a group of operating modes including: i) an insufflation mode driven by the insufflation subunit; ii) an insufflation and gas circulation mode driven by the insufflation subunit and the primary gas circulation pump; iii) a smoke evacuation and gas return mode driven by the secondary gas circulation pump; iv) an insufflation and smoke evacuation mode driven by the insufflation subunit and the secondary gas circulation pump; v) an insufflation, smoke evacuation and gas return mode driven by the insufflation subunit and the secondary gas circulation pump; and vi) an insufflation and gas circulation mode driven by the insufflation subunit and the primary gas circulation pump, together with smoke evacuation and gas return driven by the secondary gas circulation pump.
Preferably, the controller is adapted and configured to determine which operating mode to initiate based upon information received from an interface plate of a tube set operatively associated therewith. The information received from an interface plate of a tube set is preferably communicated to the gas delivery device by way of an RFID communication link, an NFC communication link, a Bluetooth communication link, a WiFi communication link or by way of micro-switches.
These and other features of the gas circulation system of the subject invention will become more readily apparent to those having ordinary skill in the art to which the subject invention appertains from the detailed description of the preferred embodiments taken in conjunction with the following brief description of the drawings.
So that those skilled in the art will readily understand how to make and use the gas circulation system of the subject invention without undue experimentation, preferred embodiments thereof will be described in detail herein below with reference to the FIGS. wherein:
Referring now to the drawings wherein like reference numerals identify similar structural elements and features of the subject invention, there is illustrated in
Those skilled in the art will readily appreciate that the gas circulation system 10 of the subject invention can be used for performing other types of endoscopic procedures, aside from laparoscopic procedures. For example, this system 10 can be used in the performance of thoracoscopic surgical procedures in the thoracic cavity of a patient, as well as, the performance of endo-luminal surgical procedures, such as trans-anal and trans-esophageal surgical procedures.
Referring to
The gas delivery device 12 includes a graphical user interface 14 for setting operating parameters, and more particularly, for interacting with an internal controller 16 (see
More particularly, as explained in greater detail below, and with reference to
Referring once again to
The gas delivery system 10 of the subject invention further includes an interface plate 30 that is adapted and configured to engage with the multi-modal gas delivery device 12 and it is designed for connection with as many as five different lumens or tubes, each of which has a different functionality, depending upon a selectively or automatically activated mode of operation, as explained in more detail below. More particularly, the front face of the gas delivery device 12 has a complementary reception cavity 32 for receiving and engaging with the interface plate 30.
Referring now to
The front surface 34 of interface plate 30 also includes a second connector 44 for connecting with a gas delivery lumen for delivering pressurized gas from the primary gas circulation pump 18 to a gas sealed access device 300 or 400. The front surface 34 of interface plate 30 further includes a third connector 46 for connecting with a gas return lumen for returning gas used to generate a gaseous seal within the gas sealed access device 300 or 400 back to the primary gas circulation pump 18.
The front surface 34 of the interface plate 30 also includes a fourth connector 48 for connecting with a smoke evacuation lumen that removes smoke filled gas from the surgical cavity 20 by way of the secondary gas circulation pump 24 by way of a valve sealed access port 200. The front surface 34 of interface plate 30 further includes a fifth connector 50 for connection with a recirculation supply lumen for returning filtered gas back to the surgical cavity 20 from the secondary gas circulation pump 24 by way of a valve sealed access port 200.
As best seen in
As illustrated in
The modular canister 74 of filter unit 72 contains a filter element 76 for filtering gas flowing therethrough, and an elastomeric face seal 78 for sealing against a complementary sealing surface located within the reception cavity 32 of gas delivery device 12 (not shown).
While the filter element 76 of filter unit 72 is shown as a pleated filter element, it is envisioned that the filter element 76 can be selected from a group of different types of filter media including, for example, pleated filter media, woven polymer mesh filter media, non-woven polymer mesh filter media, sintered metal filter media, sintered polymer filter media, activated carbon filter media, particulate filter media and the like. Regardless of the material that is used within the filter unit, it will be a material that is configured to facilitate two-way, bi-directional gas flow. That is, the filter element 76 in each canister 74 is configured so that it can be readily utilized to filter a flow of clean pressurized gas coming from the outlet side of one of the gas circulation pumps 18, 24 or a flow of spent or smoke filled gas going to the suction side of one of the gas circulation pumps 18, 24.
As best seen in
Referring now to
Referring now to
Referring to
The distal end of the insufflation and sensing lumen 82 has a coupling 92 that is adapted and configured to connect with the connector 210 of a first valve sealed access device 200, the distal end of the smoke evacuation lumen 88 has a coupling 98 that is adapted and configured to connect with the connector 210 of a second valve sealed access device 200, and the distal end of the recirculation supply lumen 90 has a coupling 100 that is adapted and configured to connect with the connector 210 of a third valve sealed access device 200. As best seen in
While not explicitly illustrated herein, it is envisioned and well within the scope of the subject disclosure that an interface plate 30 could be adapted and configured for use only in a smoke evacuation mode, wherein the distal end of the smoke evacuation lumen 88 would be connected to a first valve sealed access device 200 and the distal end of the recirculation supply lumen 90 would be connected to a second valve sealed access device 200. In such an instance, a separate conventional insufflation unit, distinct from the gas supply device 12, could be used for insufflation and pressure sensing.
It is also envisioned and well within the scope of the subject disclosure that with respect to the configuration of the interface plate 30 shown in
Referring now to
Here, the insufflation and sensing lumen 82, the gas delivery lumen 84 and the gas return lumen 86 are ganged together, and their distal ends are all operatively associated with a tri-lumen coupling 95 of the type which is disclosed in commonly assigned U.S. Pat. No. 9,526,886, the disclosure of which is herein incorporated by reference. The tri-lumen coupling 95 is adapted and configured to connect with the connector 410 of a dual lumen gas sealed access device 400. In this embodiment, there are three filter units 72 associated with the rear surface 36 of interface plate 30, wherein one is associated with filter seat 52, a second is associated with filter seat 54 and the third is associated with filter seat 56.
Referring now to
Here, the distal end of the insufflation and sensing lumen 82 has a coupling 92 that is adapted and configured to connect with the connector 210 of a valve sealed access device 200, while the gas delivery lumen 84 and the gas return lumen 86 are ganged together, and their distal ends are all operatively associated with a bi-lumen coupling 97 of the type which is disclosed in commonly assigned U.S. Patent Application Publication No. 2017/0361084, the disclosure of which is herein incorporated by reference (see
The bi-lumen coupling 97 is adapted and configured to connect with the connector 310 of a single lumen gas sealed access device 300 shown in
Referring now to
Here, the insufflation and sensing lumen 82, the gas delivery lumen 84 and the gas return lumen 86 are ganged together, and their distal ends are all operatively associated with a tri-lumen coupling 95 for connecting with the tri-lumen connector 410 of a bi-lumen gas sealed access device 400, while the smoke evacuation lumen 88 and the recirculation supply lumen 90 have respective couplings 98 and 100 that are each adapted and configured to connect with the connectors 210 of respective valve sealed access devices 200. This embodiment of interface plate 30, with five lumens attached, is the configuration of the subject invention that is illustrated in
As shown in
Alternatively, with respect to the 5-lumen configuration of
It is also envisioned and well within the scope of the subject disclosure that the interface plate 30 of the subject invention would include a mechanism for communicating information to the controller 16 in the gas delivery device 12 identifying which of the five lumens and filters is attached to the interface plate 30, and thereby indicate which particular operational mode must be activated to perform a desired surgical procedure. This mechanism could be a mechanical feature, such as a micro-switch that would communicate with the controller 16 when the interface plate 30 is installed within the reception cavity 32 in the front face of gas delivery device 12. Alternatively, the mechanism could be wireless transmitter 35 on the rear surface 36 of interface plate 30, as shown in
Referring to
Referring to
As best seen in
A shroud 136 surrounds the entire periphery of the interface plate 130 and forms a mounting surface for a wireless transmitter 135, such as an RFID signal transmitter or NFC signal transmitter, identifying which of the five lumens is attached to the interface plate 130.
While the subject disclosure has been shown and described with reference to preferred embodiments, those skilled in the art will readily appreciate that changes or modifications may be made thereto without departing from the scope of the subject disclosure.
This Application is a Divisional of U.S. patent application Ser. No. 16/138,354 filed Sep. 21, 2018, now U.S. Pat. No. 11,027,078 issued Jun. 8, 2021, the entire contents of which is incorporated herein by reference in its entirety.
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Number | Date | Country | |
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Number | Date | Country | |
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Parent | 16138354 | Sep 2018 | US |
Child | 17323759 | US |