Patent Application
20210251654
The present disclosure relates to humidifier systems and components of humidifier systems configured to supply gases to a patient, in particular to venting of surgical gases and/or smoke from a body cavity in a patient.
Various medical procedures require the provision of gases (for example, heated gases), typically carbon dioxide, to a patient during the medical procedure, for example, closed type medical procedures and open type medical procedures.
In closed type medical procedures, an insufflator is arranged to deliver gases to a body cavity of the patient to inflate the body cavity and/or to resist collapse of the body cavity during the medical procedure. Examples of such medical procedures include laparoscopy and endoscopy, although an insufflator may be used with any other type of medical procedure as required. Endoscopic procedures enable a medical practitioner to visualize a body cavity by inserting an endoscope or the like through natural openings or small puncture(s) to generate an image of the body cavity. In laparoscopy procedures, a medical practitioner typically inserts a surgical instrument through one or more natural openings, small puncture(s), or incision(s) to perform a medical procedure in the body cavity. In some cases an initial endoscopic procedure may be carried out to assess the body cavity, and then a subsequent laparoscopy carried out to operate on the body cavity. Such procedures are widely used, for example, within the peritoneal cavity, or during a thoracoscopy, colonoscopy, gastroscopy or bronchoscopy.
In open type medical procedures, for example, open surgeries, gases are used to fill a surgical cavity, with excess gases spilling outward from the opening. The gases can also be used to provide a layer of gases over exposed body parts, for example, including internal body parts, where there is no discernible cavity. For these procedures, rather than serving to inflate a cavity, the gases can be used to prevent or reduce desiccation and infection by covering exposed internal body parts with a layer of heated, humidified, sterile gases.
An apparatus for delivering gases during these medical procedures can include an insufflator arranged to be connected to a remote source of pressurized gases, for example, an insufflation fluid (for example, gases) supply system in a hospital. The apparatus can be operative to control the pressure and/or flow of the gases from the gases source to a level suitable for delivery into the body cavity, usually via a cannula or needle connected to the apparatus and inserted into the body cavity, or via a diffuser arranged to diffuse gases over and into the wound or surgical cavity. In many cases, a humidifier is operatively coupled to the insufflator. A controller of the apparatus can energize a heater of the humidifier located in the gases flow path to deliver humidification fluid (for example, water vapor) to the insufflation fluid (for example, gases) stream prior to entering the patient's body cavity. The humidified insufflation fluid can be delivered to the patient via further tubing which may also be heated. The insufflator and humidifier can be located in separate housings that are connected together via suitable tubing and/or electrical connections, or located in a common housing arranged to be connected to a remote gas supply via suitable tubing.
The internal body temperature of a human patient is typically around 37° C. It can be desirable to match the temperature of the gases delivered from the apparatus as closely as possible to the typical human body temperature. It can also be desirable to deliver gases above or below internal body temperature, such as, for example, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 15 degrees above or below internal body temperature for example, or ranges including any two of the foregoing values. It can also be desirable to deliver gases of a desired fixed or variable humidity and/or a desired fixed or variable gas temperature (which may also be referred to herein as standard), such as dry cold gas, dry hot gas, humidified cold gas, or humidified hot gas for example. Further, the gases delivered into the patient's body can be relatively dry, which can cause damage to the body cavity, including cell death or adhesions or cell desiccation. In many cases, a humidifier is operatively coupled to the insufflator. A controller of the apparatus can energize a heater of the humidifier located in the gases flow path to deliver humidification fluid to the insufflation fluid (for example, gases) stream prior to entering the patient's body cavity.
The humidified gas can be delivered to the patient via further tubing which may also be heated. The insufflator and humidifier can be located in separate housings that are connected together via suitable tubing and/or electrical connections, or located in a common housing arranged to be connected to a remote gas supply via suitable tubing.
During certain surgical procedures (for example, laparoscopic surgery, or other procedures disclosed herein), electrosurgery, electrocautery, energy and laser cutting and/or cauterizing, among others, is used to cause cutting and/or coagulation of tissue (including other organs, anatomical structures, and/or the like) and/or blood vessels within the surgical cavity (for example, a pneumoperitoneum). Smoke can be produced by electrosurgery, electrocautery, energy and laser cutting and/or cauterizing, among others. The concentration of smoke can increase over time, particularly in a sealed and pressurized surgical cavity and/or when there are no significant gases leaks, suction, and/or irrigation. The smoke plume rises and can block vision. Further the smoke plume may contact or deposit particles on the scope. The smoke plume contacting the scope can also cause fogging or condensation on the scope. Condensation can occur on various surfaces on a medical instrument. When condensation forms on a viewing surface of a medical instrument, this is observed as a fogging effect which manifests as an impairment of visibility through a lens or any other viewing surface of a medical instrument (such as, for example, a mirror or transparent or translucent window). When condensation forms on various surfaces of a medical instrument, the condensation can coalesce into water droplets. This can occur directly on the viewing surface or other surfaces which can then migrate to or be deposited on the viewing surface. Accordingly, as used herein condensation and/or fogging means condensation generally and in some instances, specifically with respect to condensation on a viewing surface (i.e. fogging).
The smoke can impede vision, for example, vision of a surgeon or other medical personnel participating in the medical procedure (for example, surgery) when the medical personnel views the surgical space via a camera inserted through the cannula. Without the use of venting or suction, the medical personnel need to release the gases and/or smoke from inside the surgical cavity through deflation and re-insufflation of the surgical cavity.
In some embodiments, systems and methods can advantageously filter to remove harmful chemicals & bio-particles from the gas being vented into the operation room. A growing concern in surgical environments is hazards to surgical staff (and patients) from the smoke produced during electrosurgery, electrocautery, laser and other energy-based cutting and/or cauterizing, among others. Surgical smoke may contribute to o cancers or other health issues, and contains many chemicals and bio-particles that can be hazardous for human inhalation. In some embodiments, systems and methods as disclosed herein can advantageously vent gas (and smoke plumes created during electrosurgery, electrocautery, laser and other energy-based cutting and/or cauterizing, among others) from inside the pneumoperitoneum which achieves at least two advantages: it can dilute the smoke concentration inside the pneumoperitoneum to improve visibility, and it can also ensure a constant flow of CO2 from the insufflator which creates an airflow of “clean” CO2 gas across/over the viewing area which carries or pushes away smoke that is hindering vision in the area between the camera and operating area. The venting flow rate may be related to the delivered flow rate. In one example, the venting rate (i.e. venting flow rate) may be set to achieve a specified pressure within the surgical site. Explained another way, the venting rate is such that a surgical cavity is maintained at a predetermined pressure rate. In some embodiments, venting flow rate may be a predetermined flow rate. For example, the flow rate may be set by the user. The venting element used may be constructed or tuned to achieve the predetermined flow rate. However, there can be a trade-off when venting in terms of negatively affecting stability and pressure of the pneumoperitoneum.
The present disclosure provides examples of venting attachments and/or leak devices (for example, for attaching to or used in combination with a cannula) for venting surgical smoke and/or gases from a surgical cavity. The venting attachment examples disclosed herein can be used with a directed flow cannula, or within a system that includes a supplementary gases source and the directed flow cannula to help with visualization.
The directed flow cannula can include a guiding element that guides the medical device (for example, a scope) in the cannula such that gases surround the scope at and beyond the outlet of the cannula. The guiding element can prevent flow non-uniformity and can prevent the scope from resting against the wall of the cannula outlet. This prevents flow non-uniformity (which may also be referred to as stagnation zones).
Alternatively, the venting attachment is coupled to a separate cannula that is used as a venting cannula. The venting cannula is standard cannula with the venting attachment attached thereto. The venting attachment is spaced apart and separate from a cannula that delivers gases into the surgical cavity.
In some configurations, the venting attachment can include a flow control structure. The flow control structure is shaped and dimensioned in order to control the venting flow rate in order to maintain pressure within the surgical cavity.
In some configurations, the leak device can control a venting flow rate. The venting rate is controlled by an active venting device or be a passive venting rate. In some configurations, the venting rate can match the delivered flow rate. Alternatively, the venting rate can exceed or be less than an insufflation fluid flow rate. The leak device is configured to vent at a rate such that over-pressurization of the surgical cavity is reduced and/or prevented. Preferably the leak device can prevent over-pressurization of surgical cavity, for example, the pneumoperitoneum.
The venting can dilute the smoke concentration inside the surgical cavity to improve visibility and promote a substantially constant flow of carbon dioxide (or other insufflation fluid) from the insufflator, which can produce a flow of cleaner gases across and over the viewing area to push and/or carry away surgical smoke in the area between the camera lens and the operating area.
In some configurations, the venting attachments and/or leak devices disclosed herein can reduce smoke concentration within the surgical cavity while maintaining a substantially stable surgical cavity, for example, by maintaining a substantially stable pressure within the surgical cavity.
In some configurations, the venting attachment and/or leak devices can include a smoke filter so that the vented gases and/or smoke can contain less potentially hazardous particles and/or chemicals.
In some configurations, the leak device examples disclosed herein can include a heating element to heat the vented gases and/or the filter so as to reduce and/or prevent condensation or clogging in the filter, which can improve the lifetime and efficiency of the filter.
In some configurations, the vented gases paths in the leak device examples can include valves to control a leak rate.
In some configurations, the venting attachment is used with a cannula that includes one or more heater elements. The venting attachment may also include a heating element. The heat can prevent condensation of the vented gases.
In some configurations, the venting attachment can include a connector that includes a flow control device. The flow control device is configured to control the venting flow rate. The flow control device may be structured to allow a venting rate that maintains a predetermined pressure within the surgical cavity.
In some configurations, an example leak device or venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity can include a cannula connecting component configured to connect to a portion of the surgical cannula inserted into the surgical cavity. The venting attachment can also include a venting component configured to vent gases and/or smoke from the surgical cavity at a predetermined rate. The venting attachment can also include a venting gases pathway extending from the cannula or the surgical cavity to the venting component. The venting attachment can also include a filter component configured to filter the gases and/or smoke before leaving the venting component, wherein the filter component is located in the venting gases pathway and adjacent the venting component.
In some configurations, an example venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity is provided, wherein the surgical cannula can comprise a gases port. The venting attachment can include a cannula connecting component configured to connect to a portion of the surgical cannula inserted into the surgical cavity. The venting attachment can also include a venting component configured to vent gases and/or smoke from the surgical cavity at a predetermined rate, an orifice of the cannula connecting component having a size that allows the venting at the predetermined rate. The venting attachment can also include a venting gases pathway extending from the cannula or the surgical cavity to the venting component. The venting attachment can also include a filter component configured to filter the gases and/or smoke before leaving the venting component, wherein the filter component is located in the venting gases pathway and adjacent the venting component.
In some configurations, the filter component can comprise an ULPA filter.
In some configurations, the filter component can further comprise a carbon filter.
In some configurations, the filter component can comprise a filter housing configured to reduce or absorb humidity or condensation in the filters.
In some configurations, the filter housing can comprise water traps and/or a desiccant.
In some configurations, the venting attachment can comprise a heating element.
In some configurations, the heating element is configured to heat the gases and/or the filter to reduce condensation and/or clogging of the filter component.
In some configurations, the heating element can be configured to heat the gases and/or the filter to reduce and/or prevent condensation and/or clogging of the filter component.
In some configurations, the heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, or conductive ink. In some configurations, the heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, conductive ink, or conductive polymer.
In some configurations, the heating element is in electrical communication with and powered by a controller of an insufflator or a humidifier unit. In some configurations, the heating element is in electrical communication with and powered by an external controller.
In some configurations, the venting component can comprise small orifices.
In some configurations, the venting component can comprise one or more valves in the venting gases pathway.
In some configurations, the one or more valves are mechanically actuated. In some configurations, the one or more valves are electrically actuated.
In some configurations, the one or more valves can comprise a solenoid valve.
In some configurations, the one or more valves are in electrical communication with a controller of an insufflator or a humidifier unit. In some configurations, the one or more valves are in electrical communication with an external controller.
In some configurations, the one or more valves are selectively opened or closed to control a vent rate.
In some configurations, the venting component is configured to vent the gases and/or smoke at a rate that is greater than or equal to a gases delivery flow rate. In some configurations, the venting component is configured to vent the gases and/or smoke at a rate that is equal to the gases delivery rate. In some configurations, the venting component is configured to vent the gases and/or smoke at a rate that is less than the gases delivery rate.
In some configurations, the venting component is configured to maintain pressure inside the surgical cavity at or below 50 mmHg.
In some configurations, the leak device or venting attachment can comprise a flow and/or smoke sensor located in the venting gases pathway.
In some configurations, the cannula connecting component is configured to be connected to a gases port of the cannula.
In some configurations, the venting component can comprise a leak device including a flow restriction. The flow restriction is shaped and dimensioned to define a venting flow rate.
In some configurations, the venting component can comprise a shape that increases in cross-sectional dimension distally with respect to proximally. In some configurations, the venting component can comprise the cross-sectional diameter greater at a distal end than at a proximal end. In some configurations, the venting component can comprise an elongate and flexible shape. In some configurations, the venting component can comprise a housing. In some configurations, the housing can be rectangular, round, curved, elliptical, or polygonal.
In some configurations, the venting component can comprise a user display configured to display a vent rate and/or gases composition.
In some configurations, the venting component can comprise a suction port. In some configurations, the venting component can comprise a manual pump.
In some configurations, the venting attachment is configured to receive gases from the cannula.
In some configurations, the cannula connecting component is configured to be connected to at least a portion of an elongate shaft of the cannula.
In some configurations, the cannula connecting component can comprise a sleeve or seal configured to be coupled near a distal end of the cannula. In some configurations, the cannula connecting component can comprise a sleeve extending along substantially an entire length of the elongate shaft.
In some configurations, the leak device or venting attachment can comprise at least one distal opening and at least one proximal opening. When in use, the at least one distal opening is located inside the surgical cavity and the at least one proximal opening is located outside the surgical cavity.
In some configurations, the cannula connecting component is configured to be connected to an upper housing of the cannula.
In some configurations, the cannula connecting component can comprise a sleeve cap configured to be coupled to the upper housing and enclose the gases port with a gases impermeable lining.
In some configurations, the cannula connecting component can comprise a sleeve portion and the venting component comprises a base coupled to the sleeve portion.
In some configurations, the base is above the upper housing of the cannula when the attachment is coupled to the cannula.
In some configurations, the sleeve portion can comprise at least one opening configured to allow insufflation gases received from the gases port to enter a lumen of the cannula.
In some configurations, the cannula connecting component can comprise a hinged device including two halves connected by a hinge mechanism. The hinged device is configured to clamp around a portion of the upper housing of the cannula.
In some configurations, the venting attachment or leak device can further comprise a rubber seal configured to seal around the gases port of the cannula. The rubber seal can comprise a gases path configured to guide the venting gases and/or smoke to the filter.
In some configurations, the cannula is configured to deliver insufflation gases to the surgical cavity and/or to remove the gases from the surgical cavity.
In some configurations, the cannula connecting component can comprise a Luer lock connector that forms a seal around an outer surface of a gases port of the surgical cannula when the cannula connecting component and the gases port are coupled.
In some configurations, the seal between the cannula connecting component and the gases port can be the only seal between the cannula connecting component and the gases port.
In some configurations, the cannula connecting component can be configured to receive and guide the gases port during insertion into the cannula connecting component.
In some configurations, the cannula connecting component can comprise an opening, a neck region, and/or a confined area.
In some configurations, the neck region can be immediately adjacent the opening and the confined area.
In some configurations, the neck region can be configured to deform to allow passage of the gases port.
In some configurations, the gases port can comprise a flanged end portion and the neck region is configured to deform to allow passage of the flanged end portion.
In some configurations, the confined area can be configured to receive and retain the gases port when the cannula connecting component and the gases port are coupled.
In some configurations, the gases port can comprise a flanged end portion and the confined area is configured to receive and retain the flanged end portion when the cannula connecting component and the gases port are coupled.
In some configurations, the neck region can conform around an outer surface of the gases port to form the seal when the cannula connecting component and the gases port are coupled.
In some configurations, the seal can be formed only between the neck region and the outer surface of the gases port.
In some configurations, the gases port can comprise a shaft portion and the neck region conforms around an outer surface of the shaft portion to form the seal when the cannula connecting component and the gases port are coupled.
In some configurations, the seal can be provided along a length of the shaft portion.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate between 1 L/min and 10 L/min.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate between 5 L/min and 7 L/min.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate of 4 L/min.
In some configurations, a venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity can comprise a venting component configured to vent gases and/or smoke from the surgical cavity at a predetermined rate; a venting gases pathway extending from the cannula or the surgical cavity to the venting component; and a filter component configured to filter the gases and/or smoke before leaving the venting component, wherein the filter component can be located in the venting gases pathway and adjacent the venting component, wherein the venting component can be at least partially inserted through a surgical opening leading to the surgical cavity.
In some configurations, the venting attachment can comprise a cannula connecting component configured to connect to a portion of the surgical cannula inserted into the surgical cavity through the surgical opening.
In some configurations, the cannula connecting component can be configured to be connected to a gases port of the cannula.
In some configurations, the filter component can comprise an ULPA filter.
In some configurations, the filter component further can comprise a carbon filter.
In some configurations, the filter component can comprise a filter housing configured to reduce or absorb humidity or condensation in the filter.
In some configurations, the filter housing can comprise water traps and/or a desiccant.
In some configurations, the venting attachment can comprise a heating element.
In some configurations, the heating element can be configured to heat the gases and/or the filter to reduce and/or prevent condensation and/or clogging of the filter component.
In some configurations, the heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, conductive ink, or conductive polymers.
In some configurations, the heating element can be in electrical communication with and powered by a controller of an insufflator or a humidifier unit or an external controller.
In some configurations, the venting component can comprise small orifices.
In some configurations, the venting component can comprise one or more valves in the venting gases pathway.
In some configurations, the one or more valves can be mechanically actuated.
In some configurations, the one or more valves can be electrically actuated.
In some configurations, the one or more valves can comprise a solenoid valve.
In some configurations, the one or more valves can be in electrical communication with a controller of an insufflator or a humidifier unit or an external controller.
In some configurations, the one or more valves can be selectively opened or closed to control a vent rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is greater than or equal to a gases delivery flow rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is less than or equal to the gases delivery rate.
In some configurations, the venting component can be configured to maintain pressure inside the surgical cavity at or below 50 mmHg.
In some configurations, the venting component can comprise a leak device including a flow restriction, the flow restriction shaped and dimensioned to define a venting flow rate.
In some configurations, the venting component can comprise an elongate shape.
In some configurations, the venting attachment can comprise a flow and/or smoke sensor located in the venting gases pathway.
In some configurations, a venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity can be provided, wherein the surgical cannula can comprise a gases port and an inlet. The venting attachment can comprise a venting component configured to be inserted through the inlet of the surgical cannula, the venting component configured to vent gases and/or smoke from the surgical cavity at a predetermined rate; a venting gases pathway extending from the cannula or the surgical cavity to the venting component; and a filter component configured to filter the gases and/or smoke before leaving the venting component, wherein the filter component can be located in the venting gases pathway.
In some configurations, the venting gases pathway can extend from a distal end of the cannula or the surgical cavity to the inlet of the cannula.
In some configurations, the venting component can be configured to allow passage of insufflation gases into the surgical cavity.
In some configurations, the venting component can be configured to allow passage of one or more medical instruments.
In some configurations, the venting component can be coupled to an upper housing of the surgical cannula.
In some configurations, the venting component can be removably coupled to an upper housing of the surgical cannula.
In some configurations, the venting component can comprise a sleeve portion and a base coupled to the sleeve portion.
In some configurations, the base can be above the upper housing of the surgical cannula when the venting component is coupled to the surgical cannula.
In some configurations, the sleeve portion can comprise at least one opening configured to allow insufflation gases received from the gases port to enter a lumen of the cannula.
In some configurations, the filter component can comprise an ULPA filter.
In some configurations, the filter component further can comprise a carbon filter.
In some configurations, the filter component can comprise a filter housing configured to reduce or absorb humidity or condensation in the filters.
In some configurations, the filter housing can comprise water traps and/or a desiccant.
In some configurations, the venting component can comprise one or more valves in the venting gases pathway.
In some configurations, the one or more valves can be mechanically actuated.
In some configurations, the one or more valves can be electrically actuated.
In some configurations, the one or more valves can comprise a solenoid valve.
In some configurations, the one or more valves can be in electrical communication with a controller of an insufflator or a humidifier unit or an external controller.
In some configurations, the one or more valves can be selectively opened or closed to control a vent rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is greater than or equal to a gases delivery flow rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is less than or equal to the gases delivery rate.
In some configurations, the venting component can be configured to maintain pressure inside the surgical cavity at or below 50 mmHg.
In some configurations, a venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity can be provided, wherein the surgical cannula can comprise a gases port, the surgical cannula further having a proximal end and a distal end, the proximal end including an inlet and the distal end of the surgical cannula configured to be inserted into the surgical cavity. The venting attachment can comprise a cannula connecting component configured to connect to the gases port or an inlet of the surgical cannula; a venting component configured to vent gases and/or smoke from the surgical cavity at a predetermined rate; a venting gases pathway extending from the cannula or the surgical cavity to the venting component; and a filter component configured to filter the gases and/or smoke before leaving the venting component, wherein the filter component can be located in the venting gases pathway and adjacent the venting component, wherein the venting component can at least partially surround the proximal end of the surgical cannula.
In some configurations, the filter component can comprise an ULPA filter.
In some configurations, the filter component further can comprise a carbon filter.
In some configurations, the filter component can comprise a filter housing configured to reduce or absorb humidity or condensation in the filters.
In some configurations, the filter housing can comprise water traps and/or a desiccant.
In some configurations, the cannula connecting component can comprise a hinged device including two components connected by a hinge mechanism.
In some configurations, the hinged device can be configured to clamp around a portion of the proximal end of the surgical cannula.
In some configurations, the venting attachment can further comprise a rubber seal configured to seal around the gases port of the cannula, the rubber seal comprising a gases path configured to guide the venting gases and/or smoke to the filter.
In some configurations, the venting attachment can comprise a heating element.
In some configurations, the heating element can be configured to heat the gases and/or the filter to reduce and/or prevent condensation and/or clogging of the filter component.
In some configurations, the heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, conductive ink, or conductive polymers.
In some configurations, the heating element can be in electrical communication with and powered by a controller of an insufflator or a humidifier unit or an external controller.
In some configurations, the venting component can comprise small orifices.
In some configurations, the venting component can comprise one or more valves in the venting gases pathway.
In some configurations, the one or more valves can be mechanically actuated.
In some configurations, the one or more valves can be electrically actuated.
In some configurations, the one or more valves can comprise a solenoid valve.
In some configurations, the one or more valves can be in electrical communication with a controller of an insufflator or a humidifier unit or an external controller.
In some configurations, the one or more valves can be selectively opened or closed to control a vent rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is greater than or equal to a gases delivery flow rate.
In some configurations, the venting component can be configured to vent the gases and/or smoke at a rate that is less than or equal to the gases delivery rate.
In some configurations, the venting component can be configured to maintain pressure inside the surgical cavity at or below 50 mmHg.
In some configurations, the venting component can be a permeable or selectively permeable membrane to the filtered gases.
In some configurations, an example venting attachment to a surgical cannula for venting gases and/or smoke from a surgical cavity can comprise a leak device including a flow restriction within a passage of the leak device. The flow restriction is shaped and dimensioned to control a venting flow rate such that the venting flow rate is equal to or less than the flow rate of gases delivered into the surgical cavity. The leak device can further comprise a cannula connector.
In some configurations, an example surgical cannula for providing insufflation gases to a surgical cavity and venting from the surgical cavity can comprise an upper housing including an opening. The cannula can comprise an elongate shaft extending from the upper housing. The cannula can comprise a first lumen in the elongate shaft configured to receive the insufflation gases from a gases source. The cannula can comprise a second lumen in the elongate shaft configured to vent gases from the surgical cavity. The first and second lumens is in fluidic communication with the opening. The cannula can comprise a leak device. The leak device can comprise a cannula connecting component configured to connect to a portion of the cannula. The leak device can comprise a venting component configured to allow gases and/or smoke to exit the surgical cavity. The leak device can comprise a venting gases pathway extending from the cannula to the venting component. The venting gases pathway is in fluidic communication with the second lumen. The leak device can comprise a filter component configured to filter the gases and/or smoke before leaving the venting end. The filter component is located in the venting gases pathway and adjacent the venting component.
In some configurations, the filter component can comprise an ULPA filter.
In some configurations, the filter component can further comprise a carbon filter.
In some configurations, the filter component can comprise a filter housing configured to reduce or absorb humidity or condensation in the filters.
In some configurations, the filter housing can comprise water traps and/or a desiccant.
In some configurations, the cannula can comprise at least one heating element.
In some configurations, the at least one heating element is configured to heat the insufflation gases received from the gases source.
In some configurations, the at least one heating element is located in the leak device. In some configurations, the at least one heating element is located along or within a portion of the upper housing or elongate shaft.
In some configurations, the at least one heating element is configured to heat the vented gases and/or the filter.
In some configurations, the at least one heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, or conductive ink. In some configurations, the at least one heating element can comprise a flexible PCB heater, a PCB heater, a heater wire, multiple heater wires, conductive ink, or conductive polymers.
In some configurations, the first and second lumens is offset from each other. In some embodiments, the first and second lumens is concentric.
In some configurations, the first and second lumens is of the same diameter. In some configurations, the first and second lumens is of different diameters.
In some configurations, the second lumen can have a smaller diameter than the first lumen.
In some configurations, an example method of venting gases from a body cavity can comprise inserting a cannula into the body cavity, the cannula comprising a venting attachment, wherein the body cavity is configured to receive an insufflation gas from said cannula or another cannula; filtering the insufflation gases and/or surgical smoke through a filter within the venting attachment; and venting the filtered insufflation gases and/or surgical smoke from the body cavity through the venting attachment.
In some configurations, the method can further comprise heating the gases and/or surgical smoke and/or the filter using a heating element disposed on or within the venting attachment.
In some configurations, the venting is at a rate that is greater than or equal to a gases delivery flow rate.
In some configurations, the venting is at a rate that is equal to the gases delivery rate.
In some configurations, the venting is at a rate that is less than the gases delivery rate.
In some configurations, the venting is configured to maintain pressure inside the surgical cavity at or below 50 mmHg.
These and other features, aspects, and advantages of the present disclosure are described with reference to the drawings of certain embodiments, which are intended to schematically illustrate certain embodiments and not to limit the disclosure. In some cases, a “slice” has been shown for clarity purposes for some sectional and cross-sectional views of a three dimensional cannula. A person reasonably skilled in the art would be able to appreciate from the disclosure herein that these figures illustrate a slice of a three dimensional cannula. Certain features may not be shown in the slices, for example, any projected surfaces including but not limited to hole surface projections. A person reasonably skilled in the art would be able to appreciate from the disclosure herein that the three dimensional cannula with such slices can include those features.
Although certain embodiments and examples are described below, those of skill in the art will appreciate that the disclosure extends beyond the specifically disclosed embodiments and/or uses and obvious modifications and equivalents thereof. Thus, it is intended that the scope of the disclosure herein disclosed should not be limited by any particular embodiments described below.
Gases can be introduced to a surgical cavity, for example, the peritoneal cavity via a cannula inserted through an incision made in patient's body (for example, the abdominal wall). The cannula can be coupled to an insufflator. The gases flow from the insufflator can be increased to inflate the surgical cavity (for example, to maintain a pneumoperitoneum, which is a cavity filled with gas within the abdomen). The introduced gases can inflate the surgical cavity. A medical instrument can be inserted through the cannula into the inflated surgical cavity. For example, an endoscope, another scope, or camera unit can be inserted into the cavity and visibility in the cavity can be assisted by insertion of gases, which can be air or carbon dioxide. After initial insufflation and insertion of the instrument (for example, a laparoscope) through the primary cannula, additional cannulas can be placed in the surgical cavity under laparoscopic observation. Gases and/or surgical smoke can be vented from the surgical cavity using a venting attachment on one of the cannulas placed in the surgical cavity. At the end of the operating procedure, all instruments and cannulas are removed from the surgical cavity, the gases are expelled, and each incision is closed. For thoracoscopy, colonoscopy, sigmoidoscopy, gastroscopy, bronchoscopy, and/or others, the same or substantially similar procedure for introducing gases to a surgical cavity can be followed. The quantity and flow of gases can be controlled by the clinician performing the examination and/or automatically by the surgical system. The surgical system can be an insufflation system. The insufflator may deliver intermittent or continuous flow. The insufflator can control flow to ensure that the pressure in the surgical cavity is maintained at or around a predetermined range. The pressure allows for the surgical cavity to be inflated to a predetermined amount.
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The insufflation fluid supply 9 can provide one or more insufflation fluid, for example, carbon dioxide, to the humidifier chamber 5. The gases can be humidified as they are passed through the humidifier chamber 5, which can contain a volume of humidification fluid 8, such as water for example.
A humidifier that incorporates the humidifier chamber 5 can be any type of humidifier. The humidifier chamber 5 can include a plastic formed chamber having a metal or otherwise conductive base 14 sealed thereto. The base can be in contact with the heater plate 16 during use. The volume of humidification fluid 8 contained in the chamber 5 can be heated by a heater plate 16, which can be under the control of a controller or control means 21 of the humidifier. The volume of humidification fluid 8 within the chamber 5 can be heated such that it evaporates, mixing humidification fluid vapor with the insufflation fluid flowing through the chamber 5 to heat and humidify the insufflation fluid. The humidification fluid may be water.
The controller or control means 21 can be housed in a humidifier base unit 3, which can also house the heater plate 16. The heater plate 16 can have an electric heating element therein or in thermal contact therewith. One or more insulation layers can be located between in the heater plate 16 and the heater element. The heater element can be a base element (or a former) with a wire wound around the base element. The wire can be a nichrome wire (or a nickel-chrome wire). The heater element can also include a multi-layer substrate with heating tracks electrodeposited thereon or etched therein. The controller or control means 21 can include electronic circuitry, which can include a microprocessor for controlling the supply of energy to the heating element. The humidifier base unit 3 and/or the heater plate 16 can be removably engageable with the humidifier chamber 5. The humidifier chamber 5 can also alternatively or additionally include an integral heater. The controller or control means can be housed in the insufflator, the cannula, the humidifier, and/or be external to the aforementioned components.
The heater plate 16 can include a temperature sensor, for example, a temperature transducer or otherwise, which can be in electrical connection with the controller 21. The heater plate temperature sensor can be located within the humidifier base unit 3. The controller 21 can monitor the temperature of the heater plate 16, which can approximate a temperature of the humidification fluid 8. The humidification fluid may be water.
A temperature sensor can also be located at the or near the outlet 11 to monitor a temperature of the humidified gases leaving the humidifier chamber 5 from the outlet 11. The temperature sensor can also be connected to the controller 21 (for example, with a cable or wirelessly). Additional sensors can also optionally be incorporated, for example, for sensing characteristics of the gases (for example, temperature, humidity, flow, or others) at a patient end of the gases delivery conduit 13.
The gases can exit out through the humidifier's outlet 11 and into the gases delivery conduit 13. The gases can move through the gases delivery conduit 13 into the surgical cavity of the patient 2 via the cannula 15, thereby inflating and maintaining the pressure within the cavity. Preferably, the gases leaving the outlet 11 of the humidifier chamber 5 can have a relative humidity of, for example, up to around 100%, for example at 100%. As the gases travel along the gases delivery conduit 13, further condensation can occur so that humidification fluid vapor (water vapor, for example) can condense on a wall of the gases delivery conduit 13. Further condensation can have undesirable effects, for example, detrimentally reducing the humidification fluid content of the gases delivered to the patient. In order to reduce and/or minimize or prevent the occurrence of condensation within the gases delivery conduit 13, a heating element, such as, for example, a heater wire 14 can be provided within, throughout, or around the gases delivery conduit 13. The heater wire 14 can be electronically connected to the humidifier base unit 3, for example by an electrical cable 19 to power the heater wire. In some embodiments, other heating elements could be included in addition or alternatively, e.g., a conductive ink, conductive polymers, or a flexible PCB. In some embodiments, other heating elements could be included in addition or alternatively. In some cases, the PCB could be flexible, or rigid and pre-shaped to an arcuate shape for example. In some embodiments, the heating element could be, for example, discrete Positive Temperature Coefficient (“PTC”) heaters, or heaters including conductive plastic/polymer. Optionally, the heating element can include an inductive heating element. Optionally, the heating element can include a chemical heating element, for example, silica beads. Optionally, the cannula can be pre-heated prior to insertion.
The heater wire 14 can include an insulated copper alloy resistance wire, other types of resistance wire, or other heater element, and/or be made of any other appropriate material. The heater wire can be a straight wire or a helically wound element. An electrical circuit including the heater wire 14 can be located within walls of the gases delivery tube 13. The gases delivery tube 13 can be a spiral wound tube. Alternatively, the gases delivery tube 13 can include a non-helical or straight tube. Optionally, the gases delivery tube 13 can be corrugated or non-corrugated. The heater wire 14 can be spirally wound around an insulating core of the gases delivery conduit 13. The insulating coating around the heater wire 14 can include a thermoplastics material which, when heated to a predetermined temperature, can enter a state in which its shape can be altered and the new shape can be substantially elastically retained upon cooling. The heater wire 14 can be wound in a single or double helix. Measurements by the temperature sensor and/or the additional sensor(s) at the patient end of the conduit 13 can provide feedback to the controller 21 so that the controller 21 can optionally energize the heater wire to increases and/or maintain the temperature of the gases within the gases delivery conduit 13 (for example, between approximately 35° C. and 45° C.) so that the gases delivered to the patient can be at or close to 37° C. or any other suitable temperature, including but not limited to temperatures above or below the internal body temperature (for example, approximately 5, 10, or 15 degrees above or below 37° C.). Alternatively or additionally the system can include additional sensors configured to measure one or more parameters, e.g., ambient temperature and ambient humidity sensors; and/or flow sensors, and/or pressure sensors configured to determine flow rate or pressure of flow or determine the pressure within a cavity or in the tube. Additionally or alternatively the system may also include additional sensors. The sensors can be located upstream, downstream, and/or within the humidifier. The sensors may be configured to determine a parameter of the insufflation fluid or one or more parameters of the patient/surgical cavity. Each of the sensors can provide feedback information to one or more controllers which in turn can provide closed loop feedback to keep humidity, temperature, flow, pressure, or other parameters within desired parameters, e.g., a preset range.
The controller or control means 21 can, for example, include the microprocessor or logic circuit with associated memory or storage means, which can hold a software program. When executed by the control means 21, the software can control the operation of the surgical system 1 in accordance with instructions set in the software and/or in response to external inputs. The surgical system can be an insufflation system. For example, the controller or control means 21 can be provided with input from the heater plate 16 so that the controller or control means 21 can be provided with information on the temperature and/or power usage of the heater plate 16. The controller or control means 21 can be provided with inputs of temperature of the gases flow. For example, the temperature sensor can provide input to indicate the temperature of the humidified gases flow as the gases leave the outlet 11 of the humidifier chamber 5. A flow sensor can also be provided in the same position as or near the temperature sensor or at other appropriate location within the surgical system 1. The controller 21 can control a flow regulator which regulates the flow rate of gases through the system 1. The regulator can include a flow inducer and/or inhibiter for example, a motorized fan or pump. Valves and/or vents can additionally or alternatively be used to control the gases flow rate.
A patient input 18 located on the humidifier base unit 3 can allow a user (for example, a surgeon or nurse) to set a desired gases temperature and/or gases humidity level to be delivered. Other functions can also optionally be controlled by the user input 18, for example, control of the heating delivered by the heater wire 14. The controller 21 can control the system 1, and in particular to control the flow rate, temperature, and/or humidity of gas delivered to the patient, to be appropriate for the type of medical procedure for which the system 1 is being used.
The humidifier base unit 3 can also include a display for displaying to the user the characteristics of the gas flow being delivered to the patient 2.
Although not shown, the humidifier can also optionally be a passover or bypass humidifier, which can include the chamber with a volume of water or any other type of humidification fluid, but may not include a heater plate for heating the humidification fluid (for example, water). The chamber can be in fluid communication with the insufflation fluid supply such that the insufflation fluid(s) are humidified by the humidification fluid vapor (for example, water vapor) evaporated from the volume of humidification fluid as the insufflation fluid(s) pass over the volume of humidification fluid.
When in use, the humidifiers described above can be located outside an “operating sterile zone” and/or adjacent the insufflator. As a result, the medical personnel would not be required to touch the humidifier when moving the cannula during the operation to maneuver the medical instruments within the surgical cavity. The humidifier may not need to be sterilized to the same extent as the medical instruments. Furthermore, the humidifier being located outside the “operating sterile zone” can reduce obstructions to the medical personnel during the operating procedure that may restrict movements of the medical personnel and/or the medical instruments in the already crowded space.
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The present disclosure provides examples of a venting attachment or leak device configured to vent insufflation fluid and/or surgical smoke from the surgical cavity. The venting attachment or leak device may be connected to either the cannula 15 or cannula 22. The venting attachment or leak device may be connected to a cannula initially used for insufflation and the delivery of insufflation fluid can be subsequently performed by another cannula. The venting attachment can improve optical clarity and/or maintain a clearer field of vision (for example, by clearing camera lens fog, condensation and/or smoke), reduce and/or minimize surgical smoke caused by electrosurgery, electrocautery, energy and laser cutting and/or cauterizing, among others, aid in maintaining a substantially stable operating space within the surgical cavity (for example, by maintaining a substantially stable insufflation fluid pressure), and/or reduce operating time and/or post-operative complications (for example, pain and/or other side effects). In the present disclosure, features of the different examples of venting attachment or leak device can be incorporated into or combined with one another.
During these operations/procedures there is often also a smoke plume that is generated. The smoke plume can engulf the scope or move across the scope and restrict vision of the surgeon. Clearing the smoke as well as clearing the smoke plumes helps in improving optical clarity during surgery. This makes surgery safer, faster and more efficient. A high concentration of smoke in the insufflated cavity, and in the field of vision can severely impede the optical clarity when viewing the space inside the peritoneum or other site through a vision system, including but not limited to, a scope or a camera unit, inserted through a trocar. A trocar includes a cannula and an obturator. Without the use of venting or suction, surgeons generally have no option but to release all the gas from inside the pneumoperitoneum through deflation, then re-insufflation. The leak rate can be configured to balance the need to clear surgical smoke and the need to maintain substantial stability of the surgical cavity. The venting attachment and/or leak device can be dimensioned such that the leak device has a set venting flow rate. The venting flow rate may be greater than or equal to the delivery flow rate. A venting rate greater than or equal to a gases delivery flow rate can prevent the surgical cavity from over-inflating or over-pressuring and/or causing damage. In some configurations, the venting device can have a leak rate that does not exceed the delivery flow rate. The venting device can include structures that control the venting flow rate such that the venting flow rate is less than or equal to the delivery flow rate. A venting rate equal to or less than the gases delivery flow rate can assist in maintaining a more stable pressure in the surgical cavity. Preferably, the venting rate is equal to the gases delivery flow rate so as to maintain a more stable surgical cavity. The venting device can be configured such that it does not negatively affect the surgical cavity stability. In a configuration where the venting flow rate is greater than the gases delivery flow rate, the venting flow rate is limited such that it does not deflate the surgical cavity.
The venting attachment or leak device can also include one, two, or more filters configured to remove potentially hazardous chemicals and/or particles before releasing the gases and/or smoke into the atmosphere. The filter can be configured to filter particles as small as, for example, about 0.1 microns to about 0.2 microns, or about 0.12 microns. The filter can be configured to filter the particles with at least about 99% efficiency, or about 99.999% efficiency, or about 99.9995% efficiency. The filter can be an ultra-low particulate air (ULPA) filter. The filter can also include optionally a carbon filter to reduce odor. The filters could also be a high-efficiency particulate air (HEPA) filter. The filters can include multiple filter elements that can be positioned in series. For example, ULPA filters and carbon filters can be positioned in series. The filters throughout the disclosure can also include a filter housing which has features to reduce or absorb humidity or condensation in the filters, for example, with water (or other humidification fluid) traps, a desiccant, and/or the like.
The example venting attachments or leak devices can be attached to the insufflation cannula 15 or the venting cannula 22, or be used in a standalone manner. The cannula 15, 22 can have an upper housing 102 connected to an elongate shaft 104. The elongate shaft 104 can optionally have a square tip or a pointed end such that the cannula can function as a trocar for easier insertion of the cannula 100 into the surgical cavity. The upper housing 102 can have a greater cross-sectional dimension than the elongate shaft 104 for easier insertion of the medical instruments. As shown in
In some embodiments, a surgical cannula includes a housing, an elongate shaft extending from the housing, and at least one lumen within the elongate shaft. The cannula can include gripping features to grip against the surgical cavity. The housing can include one or more seals/valves disposed adjacent an instrument opening. The seals/valves are configured to seal against an instrument inserted through the instrument opening. A gases inlet is disposed on the housing or the shaft. The gases inlet can be in fluid communication with the lumen and receives gases from either a humidifier or an insufflator. The surgical cannula may include other features for example, external seals and may include either a flat (e.g., square) tip or an angled (e.g., beveled) tip. Any number of venting features as disclosed elsewhere herein can be incorporated into, or attached to cannulas as described.
More detailed examples of the leak devices are described below with reference to
Examples of a Leak Device Attached to the Gases Port of a Cannula
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The device 308 can include hand grip features 309 for ease of use when pushing or pulling the device 308. The venting flow control device 308 can include a resilient material, for example, rubber, elastomer or the like. The resilient material of the venting flow control device 308 can extend around a more rigid (for example, made of harder plastic) barb connector 310. For example, the resilient material of the venting flow control device 308 can be overmoulded onto the barb connector 310. The venting flow control device 308 can include a tapering 312 from a proximal opening of the venting flow control device 308 with a size of the opening decreasing toward a proximal end of barb connector 310. The venting flow control device 308 can include a flow restriction in a passage of the barb connector 310. The resilient material can encase the flow restriction and the barb connector 310. The flow restriction is shaped and dimensioned to define a venting flow rate, for example, to control the venting flow. The venting flow rate may be greater than or equal to the delivery flow rate. The venting flow rate can also be less than or equal to the delivery flow rate to prevent deflation of the surgical cavity. The tapering or restriction in the opening of the venting flow control device 308 can also aid in controlling a flow rate of the gases and/or smoke passing into a filter (see
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When in use, insufflation fluid and/or surgical smoke within the surgical cavity can enter into the lumen in the elongate shaft 104 of the cannula 22 and travel into the device 300 via the gases port 106. The gases and/or smoke can diffuse through the porous fabric filter material within the venting end 304. The gases and/or smoke can exit the membrane 318 at the venting end 304 after having been filtered by the particulate filter 320 and also optionally the odor filter 322.
The suspended filter device 300 can also be coupled to a gases port 109 of a double-lumen cannula 22. The gases port 109 can include a first entry in fluidic communication with an insufflation lumen 110 and a second entry in fluidic communication with an offset venting lumen 112. The device 300 can be coupled to the second entry, separate from the gases delivery tube, for example, the gases delivery conduit 13 describe above.
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In some embodiments, the one, two, or more sensors may provide feedback to a controller operably connected to a humidifier or an insufflation fluid supply (e.g. insufflator). The venting lumen may fluidly couple to a gas evacuation system e.g., a suction unit. The sensor outputs can control the gas evacuation system. Furthermore, the sensor output may control the output valves to control the venting rate in some embodiments.
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In some configurations, valves can be configured in order to control the venting rate, e.g., the rate of gases being vented out of the cannula. The venting rate can be controlled to a predetermined rate such that smoke is cleared, that is, smoke plumes are cleared from the surgical cavity. The solenoid valves may be controlled by a controller, e.g. a controller in a humidifier, a controller in the insufflator, a controller in the cannula, or an external controller. A controller may be associated with both the gases source (e.g., insufflator) and the humidifier. The controller associated with the gases source and/or the humidifier may be external from the gases source and/or the humidifier. The controller may also be positioned internally within the cannula.
In some embodiments, a valve may be passive or active. Passive valves, e.g., spring valves or umbrella valves, are configured to vent at a predetermined pressure. The venting pressure corresponds to a pressure that can be used to maintain a constant pressure in the surgical cavity and provide a desired venting rate. Active valves are preferably actively controlled to achieve a constant pressure in the surgical cavity and vent smoke and smoke plumes and gases at a predetermined rate to achieve optical clarity. The passive openings, e.g. multiple openings or flow restricted openings, can be configured, e.g., shaped and structured to provide a desired venting rate.
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Examples of a Leak Device Attached to a Cannula Shaft
The sleeve leak device 900 can have an outer shape of generally a funnel. The leak device 900 can include a plurality of ridges 952 on an outer surface of the device 900. The ridges 952 can assist in retaining and repositioning the cannula 15 and/or sleeve leak device 900 within the surgical cavity. The ridges 952 can also help in retaining the cannula 15 in place. As described above, the sleeve leak device 900 can also act as a passage through the skin to allow manipulation of the cannula insertion depth.
The sleeve leak device 900 can include a lumen configured to slidably receive the elongate shaft 104 so that the sleeve leak device 900 circumferentially surrounds a portion of the elongate shaft 104, for example, near a distal end of the cannula 15. The sleeve leak device 900 can be securely attached to and/or repositioned on the elongate shaft 104 by a set screw 953, which can provide a radial pressure against the outer surface of the elongate shaft 104 when the screw 954 is tightened onto the elongate shaft 104. Other securement features can also be used to secure the sleeve leak device 900 to the shaft 104, such as shown in
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The sleeve leak device 900 can include one or more distal vents 948 and one or more proximal vents 950 to provide venting of the gases and/or surgical smoke, with a remainder of the sleeve leak device wall 916 being gases impermeable (for example, being made of plastic, for example, acrylonitrile butadiene styrene (ABS), polycarbonate (PC), and the like. In some examples, the wall 916 can have a thickness of about 0.1 mm to about 3 mm, or about 1 mm. The thickness of the wall 916 can vary. When in use, the leak device 900 can be partially inserted into the surgical cavity, with the distal vents 948 within the surgical cavity and the proximal vents 950 outside the patient's body. Gases and/or smoke in the surgical cavity can enter a space within the leak device 900 via the distal vents 948. The gases and/or smoke can diffuse upward through the particulate filter 920 and optionally the odor filter 922 before exiting through the proximal vents 950. The filter(s) can be located near a proximal end of the sleeve leak device 900, for example, adjacent the proximal vents 950 so that the gases and/or smoke are filtered before being released into the atmosphere. The leak device 900 can also optionally include one or more mechanical or passive venting valves (for example, an umbrella pressure relief valve described above) near a proximal end of the leak device 900 at a location after the gases and/or smoke have been filtered. The mechanical valves can be located at the small orifices, for example, at the proximal vents 950. Closing of the valve can restrict the orifice as described above. The valve(s) 938 can be selectively opened or closed (for example, to control the venting or leak rate).
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The heaters can be incorporated into the filter elements. Further heating elements can be included in a shaft or a gases pathway. The heating element can be configured to heat the vented gases in order to reduce and/or prevent condensation in the passage or filter. The heating elements may be a heater wire, for example, a spiral wound heater wire, a PCB heater, conductive ink, conductive polymers, or the like.
The shaft sleeve leak device 1200 can have a slim sleeve portion 1266 and an enlarged proximal portion 1268. The shaft sleeve leak device 1200 can include a lumen configured to slidably receive the elongate shaft 104 so that the shaft sleeve leak device 1200 circumferentially surrounds the elongate shaft 104 (for example, substantially along an entire length of the shaft 104). The enlarged proximal portion 1268 can be near or adjacent the upper housing of the cannula 15. A distal end of the slim sleeve portion 1266 can be near a distal end or outlet of the cannula 15.
The shaft sleeve leak device 1200 can include one or more distal vents 1248 and one or more proximal vents 1250 to provide venting of the gases and/or surgical smoke, with a remainder of the sleeve leak device wall being gases impermeable 1216 (for example, being made of plastic, for example, ABS and the like). When in use, the leak device 1200 can be partially inserted into the surgical cavity, with the distal vents 1248 within the surgical cavity and the proximal vents 1250 outside the patient's body.
Gases and/or smoke in the surgical cavity can enter a space within the leak device 1200 via the distal vents 1248. The gases and/or smoke can diffuse from the inside of the particulate filter 1220 to the outside of the particulate filter 1220, and optionally also through the odor filter 1222 before the filtered gases exit through the proximal vents 1250. The filter(s) can be located near a proximal end of the shaft sleeve leak device 1200, for example, adjacent the proximal vents 1250 and/or occupying substantially the proximal portion 1268, so that the gases and/or smoke are filtered before being vented. The proximal vents 1250 can include a plurality of small orifices, which can also optionally be used in combination with valves.
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In other configurations, the device 1300 can be coupled to the cannula shaft 104 using any suitable fastener.
Examples of a Leak Device Attached to a Cannula Upper Housing
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The sleeve portion 1466 can be made of a gases impermeable material (for example, being made of plastic, for example, ABS, PC, and the like). In some configurations, the material 1416 can have a thickness of about 0.4 mm to about 0.8 mm, or about 0.6 mm. The sleeve portion 1466 can have an open lumen 1448 and the enlarged proximal base 1468 can include one or more proximal vents 1450 to provide venting of the gases and/or surgical smoke. When in use, gases and/or smoke from within the surgical cavity can enter the open lumen 1448 of the sleeve portion 1466 and travel upward to the proximal vents 1450. The gases and/or smoke can diffuse through the particulate filter 1420 and optionally the odor filter 1422 (see
The lumen 1448 of the sleeve portion 1466 can also guide a medical instrument (for example, a scope) when inserted into the cannula 15. The insertable filter device 1400 can also include an instrument seal (for example, a duckbill seal) 1480 to provide sealing of the gases and/or smoke inside the insertable filter device 1400. The seal 1480 can conform around the medical instrument inserted into the cannula 15 via the insertable filter device 1400 to prevent gases from escaping in spaces surrounding the medical instrument.
The insertable filter device 1400 can optionally include one or more mechanical or passive venting valves in a gases pathway in the insertable filter device 1400, for example, to replace or be used in combination with the small orifices at the proximal vents 1450. As shown in
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The hinged device 1500 can clamp around a portion of the upper housing 102 of the cannula 22. The hinged leak device 1500 can include a lumen configured to receive a portion of the upper housing 102 and/or a portion of the elongate shaft 104 so that the leak device 1400 circumferentially surrounds a portion of the upper housing 102 and/or a portion of the elongate shaft 104. The hinged device 1500 can include two halves. A hinge mechanism 1588 can connect the two halves and allow the device 1500 to be opened and closed using a latch (for example, operated by spring) 1592 or other locking mechanisms to lock the two halves in place. The latch can be made of aluminum or other metals, or plastics.
The hinged leak device 1500 can include gases impermeable walls 1516 (for example, being made of plastic, for example, acrylonitrile butadiene styrene (ABS) and the like) with a plurality of vents 1518 configured to vent the gases. In some configurations, the curved inner 1517 and outer 1516 walls of the device 1500 can have a thickness of, for example, about 0.1 mm to about 3 mm, or about 1 mm to about 2 mm, or thinner. In some configurations, the curved inner 1517 and outer 1516 walls of the device 1500 can have a thickness of about 1 mm. The divider wall between the two halves can have a thickness of about 2 mm. As shown in
The device 1500 can optionally include one or more mechanical or passive venting valves in a gases pathway in the device 1500, for example, to replace and/or be used in combination with small orifices at the vents 1518. As shown in
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Additional Examples of a Venting Attachment
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In some configurations, a filter for example, those described and illustrated herein can comprise multiple filter elements. The multiple filter elements can be arranged in fluid communication with the venting passage/venting lumen. The filter elements can be placed within a venting gases path. The filter elements can be arranged in series such that the vented gases/smoke travels through two or more filter elements. Different types of filters can be used in the multi-filter elements. For example, a carbon filter and a UPLA filter can be used to filter out particulate matter and any potentially harmful substances in the vented gases.
In some configurations, a venting gases cannula for example, those described and illustrated herein may include one or more heating elements. The heating elements may be located within one, two, or more lumens. The heating elements may extend a partial length or the entire length of the lumens. The heating elements are configured to heat the gases being delivered to the surgical cavity to maintain the temperature of the cavity at a desired value. Further heating the gases prevents condensation of the insufflation fluid and vented gases. Further heating the gases can also reduce and/or prevent fogging and/or condensation on any instruments e.g., scopes. Furthermore, one or more heating elements can be in communication or in contact with one or more filter elements to heat the filter elements. Heating the filter elements prevents clogging and condensation in the filter. Additionally, the heating elements may also be structured and configured to heat one or more valves in order to heat the vents or valves. Heating these portions reduces and/or prevents condensation forming in the vents and clogging the vents.
Examples of medical gases delivery systems and associated components and methods have been described with reference to the figures. The figures show various systems and modules and connections between them. The various modules and systems can be combined in various configurations and connections between the various modules and systems can represent physical or logical links. The representations in the figures have been presented to clearly illustrate the principles and details regarding divisions of modules or systems have been provided for ease of description rather than attempting to delineate separate physical embodiments. The examples and figures are intended to illustrate and not to limit the scope of the inventions described herein. For example, the principles herein may be applied to a surgical humidifier as well as other types of humidification systems, including respiratory humidifiers. However, the humidification systems and methods may also optionally not involve a patient's respiratory system and may not be placed within a portion of the respiratory tract (for example, nose, mouth, trachea, and/or bronchi).
As used herein, the term “processor” refers broadly to any suitable device, logical block, module, circuit, or combination of elements for executing instructions. For example, the controller 8 can include any conventional general purpose single- or multi-chip microprocessor such as a Pentium® processor, a MIPS® processor, a Power PC® processor, AMD® processor, ARM® processor, or an ALPHA® processor. In addition, the controller 122 can include any conventional special purpose microprocessor such as a digital signal processor or a microcontroller. The various illustrative logical blocks, modules, and circuits described in connection with the embodiments disclosed herein can be implemented or performed with a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein, or can be a pure software in the main processor. For example, logic module can be a software-implemented function block which does not utilize any additional and/or specialized hardware elements. Controller can be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a combination of a microcontroller and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration.
Data storage can refer to electronic circuitry that allows data to be stored and retrieved by a processor. Data storage can refer to external devices or systems, for example, disk drives or solid state drives. Data storage can also refer to fast semiconductor storage (chips), for example, Random Access Memory (RAM) or various forms of Read Only Memory (ROM), which are directly connected to the communication bus or the controller. Other types of data storage include bubble memory and core memory. Data storage can be physical hardware configured to store data in a non-transitory medium.
Although certain embodiments and examples are disclosed herein, inventive subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses, and to modifications and equivalents thereof. Thus, the scope of the claims or embodiments appended hereto is not limited by any of the particular embodiments described herein. For example, in any method or process disclosed herein, the acts or operations of the method or process can be performed in any suitable sequence and are not necessarily limited to any particular disclosed sequence. Various operations can be described as multiple discrete operations in turn, in a manner that can be helpful in understanding certain embodiments; however, the order of description should not be construed to imply that these operations are order dependent. Additionally, the structures described herein can be embodied as integrated components or as separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not necessarily all such aspects or advantages are achieved by any particular embodiment. Thus, for example, various embodiments can be carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other aspects or advantages as can also be taught or suggested herein.
Conditional language used herein, such as, among others, “can,” “could,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more embodiments. As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having” or any other variation thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, article, or apparatus that comprises a list of elements is not necessarily limited to only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Conjunctive language such as the phrase “at least one of X, Y and Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to convey that an item, term, etc. may be either X, Y or Z. Thus, such conjunctive language is not generally intended to imply that certain embodiments require at least one of X, at least one of Y and at least one of Z each to be present. As used herein, the words “about” or “approximately” can mean a value is within ±10%, within ±5%, or within ±1% of the stated value.
Methods and processes described herein may be embodied in, and partially or fully automated via, software code modules executed by one or more general and/or special purpose computers. The word “module” refers to logic embodied in hardware and/or firmware, or to a collection of software instructions, possibly having entry and exit points, written in a programming language, such as, for example, C or C++. A software module may be compiled and linked into an executable program, installed in a dynamically linked library, or may be written in an interpreted programming language such as, for example, BASIC, Perl, or Python. It will be appreciated that software modules may be callable from other modules or from themselves, and/or may be invoked in response to detected events or interrupts. Software instructions may be embedded in firmware, such as an erasable programmable read-only memory (EPROM). It will be further appreciated that hardware modules may comprise connected logic units, such as gates and flip-flops, and/or may comprised programmable units, such as programmable gate arrays, application specific integrated circuits, and/or processors. The modules described herein can be implemented as software modules, but also may be represented in hardware and/or firmware. Moreover, although in some embodiments a module may be separately compiled, in other embodiments a module may represent a subset of instructions of a separately compiled program, and may not have an interface available to other logical program units.
In certain embodiments, code modules may be implemented and/or stored in any type of computer-readable medium or other computer storage device. In some systems, data (and/or metadata) input to the system, data generated by the system, and/or data used by the system can be stored in any type of computer data repository, such as a relational database and/or flat file system. Any of the systems, methods, and processes described herein may include an interface configured to permit interaction with users, operators, other systems, components, programs, and so forth.
It should be emphasized that many variations and modifications may be made to the embodiments described herein, the elements of which are to be understood as being among other acceptable examples. All such modifications and variations are intended to be included herein within the scope of this disclosure and protected by the following claims. Further, nothing in the foregoing disclosure is intended to imply that any particular component, characteristic or process step is necessary or essential.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/NZ2019/050103 | 8/21/2019 | WO | 00 |
| Number | Date | Country | |
|---|---|---|---|
| 62720687 | Aug 2018 | US |
