CA2085990A1 - Device for controlled irrigation of natural body cavities - Google Patents
Device for controlled irrigation of natural body cavitiesInfo
- Publication number
- CA2085990A1 CA2085990A1 CA002085990A CA2085990A CA2085990A1 CA 2085990 A1 CA2085990 A1 CA 2085990A1 CA 002085990 A CA002085990 A CA 002085990A CA 2085990 A CA2085990 A CA 2085990A CA 2085990 A1 CA2085990 A1 CA 2085990A1
- Authority
- CA
- Canada
- Prior art keywords
- irrigation
- circuit
- suction
- pressure
- channels
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 230000002262 irrigation Effects 0.000 title claims abstract description 42
- 238000003973 irrigation Methods 0.000 title claims abstract description 42
- 239000007788 liquid Substances 0.000 claims abstract description 16
- 238000005303 weighing Methods 0.000 claims description 9
- 238000005259 measurement Methods 0.000 claims description 8
- 239000002245 particle Substances 0.000 claims description 5
- 239000007787 solid Substances 0.000 claims description 5
- 210000004369 blood Anatomy 0.000 claims description 4
- 239000008280 blood Substances 0.000 claims description 4
- 239000012530 fluid Substances 0.000 claims description 3
- 239000003814 drug Substances 0.000 abstract 1
- 210000000056 organ Anatomy 0.000 description 7
- 230000003187 abdominal effect Effects 0.000 description 3
- 206010059484 Haemodilution Diseases 0.000 description 2
- 238000011088 calibration curve Methods 0.000 description 2
- 150000001768 cations Chemical class 0.000 description 2
- 238000012937 correction Methods 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 210000003743 erythrocyte Anatomy 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000004458 analytical method Methods 0.000 description 1
- 230000000052 comparative effect Effects 0.000 description 1
- 238000002477 conductometry Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 230000001276 controlling effect Effects 0.000 description 1
- 238000001595 flow curve Methods 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000010926 purge Methods 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 238000012795 verification Methods 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02042—Determining blood loss or bleeding, e.g. during a surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/77—Suction-irrigation systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/77—Suction-irrigation systems
- A61M1/777—Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
- A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
- A61M3/0208—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity before use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
- A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
- A61M3/0212—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity after use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
- A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
- A61M3/0216—Pressure
-
- G—PHYSICS
- G05—CONTROLLING; REGULATING
- G05D—SYSTEMS FOR CONTROLLING OR REGULATING NON-ELECTRIC VARIABLES
- G05D16/00—Control of fluid pressure
- G05D16/20—Control of fluid pressure characterised by the use of electric means
- G05D16/2006—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means
- G05D16/2066—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means using controlling means acting on the pressure source
- G05D16/2073—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means using controlling means acting on the pressure source with a plurality of pressure sources
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3317—Electromagnetic, inductive or dielectric measuring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
- A61M3/0202—Enemata; Irrigators with electronic control means or interfaces
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
- A61M3/0233—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs
- A61M3/0254—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs the liquid being pumped
- A61M3/0258—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs the liquid being pumped by means of electric pumps
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Pulmonology (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Physiology (AREA)
- Cardiology (AREA)
- General Physics & Mathematics (AREA)
- Automation & Control Theory (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Fluid Mechanics (AREA)
- Endoscopes (AREA)
Abstract
Abrégé Appareil d'irrigation contrôlée des cavités naturelles du corps La présente invention concerne un appareil d'irrigation contrôlée de cavités naturelles du corps humain, notamment pour endoscopes et en particulier pour endoscopes urologiques, gynécologiques et arthrosco-piques. L'appareil d'irrigation comporte au moins deux canaux respectivement pour injecter d'une façon continue un liquide d'irrigation dans une de ces cavités et pour évacuer de façon continue ce liquide d'irrigation de cette cavité, cet appareil comportant un circuit d'irrigation couplé à l'un desdits canaux et un circuit d'aspiration couplé à l'autre des canaux. Le circuit d'irrigation (11) et le circuit d'aspiration (14) comportent chacun une pompe, un capteur de pression et des moyens pour comparer les pressions mesurées par chacun de ces capteurs et pour commander les pompes en fonction des différences de pression constatées. Appareil destiné spécialement à la médecine. Figure 1.Abstract Apparatus for controlled irrigation of natural cavities of the body The present invention relates to an apparatus for controlled irrigation of natural cavities of the human body, in particular for endoscopes and in particular for urological, gynecological and arthroscopic endoscopes. The irrigation device comprises at least two channels respectively for continuously injecting an irrigation liquid into one of these cavities and for continuously evacuating this irrigation liquid from this cavity, this device comprising a circuit of irrigation coupled to one of said channels and a suction circuit coupled to the other of the channels. The irrigation circuit (11) and the suction circuit (14) each comprise a pump, a pressure sensor and means for comparing the pressures measured by each of these sensors and for controlling the pumps as a function of pressure differences observed. Device specially designed for medicine. Figure 1.
Description
o APPAREIL D'IRRIGATION CONTROLEE DES CAVITES NATURELLES
DU CORPS
La présente invention concerne un appareil d' irrigation contrôlée de cavités naturelles du corps humain, notamment pour endoscopes et en particulier pour endoscopes urologiques, gynécologiques et arthros-copiques, comportant au moins deux canaux respectivement pour injecter d' une façon continue un liquide d' irrigation dans une de ces cavités et pour évacuer de façon continue ce liquide d' irrigation de cette cavité, cet appareil comportant un circuit d' irrigation couplé à
l'un desdits canaux et un circuit d'aspiration couplé à l'autre des canaux .
On connaît déjà des appareils de ce type, notamment celui décrit dans le brevet européen publié sous le N 224 487 . Cet appareil décrit en particulier des moyens de correction destinés à pondérer le signal de mesure représentatif de la pression en fonction de certains paramètres tels que la perte de charge, les différences de niveau entre le capteur et la zone d'intervention, afin de déterminer par le calcul la valeur exacte de la pression régnant à l' intérieur d' une cavité dans laquelle a lieu l' intervention endoscopique .
La présente invention se propose de compléter cette réalisation pour améliorer la sécurité d'utilisation de l'appareil en contrôlant d'une manière permanente les différents paramètres tels que le volume de liquide d'irrigation et sa pression dans les circuits d'entrée et de sortie, lorsque l'on opère en irrigation continue.
A cet effet, l'appareil d'irrigation selon l'invention est caractérisé en ce que le circuit d' irrigation et le circuit d' aspiration comportent chacun une pompe, un capteur de pression et des moyens pour comparer les pressions mesurées par chacun de ces capteurs et pour commander les pompes en fonction des différences de pression 3 5 constatées .
~C~3~990 Selon un mode de réalisation préféré, chacun des deux circuits est équipé d'un dispositif de pesée, et ces deux dispositifs de pesée sont associés à des moyens pour comparer les résultats des mesures de chacun de ces dispositifs.
Selon un mode de réalisation particulièrement avantageux, le circuit d' aspiration comporte un capteur conductimétrique pour déterminer les pertes de sang contenues dans le liquide d' irrigation à la sortie de la cavité.
De préférence, l'appareil comporte un capteur de pression de réfé-rence qui est couplé auxdits moyens pour comparer les pressions mesurées par les capteurs disposés respectivement sur le circuit d' irrigation et le circuit d' aspiration .
De façon avantageuse, le circuit d'aspiration de l'appareil peut être équipé d' un filtre à particules solides .
La présente invention sera mieux comprise en référence à la 20 description d'un exemple de réalisation et du dessin annexé dans lequel:
la figure 1 représente une vue schématique d'un appareil d'irrigation selon l' invention, la figure 2 représente un diagramme illustrant la courbe pres-sion/volume au cours d' une intervention au moyen de l' appareil d' irrigation contrôlée selon l' invention, et 30 la figure 3 représente un diagramme illustrant les courbes de débit d'irrigation et d'aspiration en fonction du temps au cours d'une intervention au moyen de l'appareil d'irrigation selon l'invention.
En référence à la figure 1, l'appareil d'irrigation contrôlée 10 repré-3 5 senté schématiquement par cette figure, comporte un circuit d'irrigation 11 connecté à un des canaux 12 d'un endoscope 13 à
9~0 deux voies et un circuit d'aspiration 14 connecté à l'autre canal 15 de cet endoscope. Le circuit d'irrigation 11 comprend essentiellement une première pompe 16 et un premier capteur de pression 17 et le circuit d' aspiration 14 comprend essentiellement une seconde pompe 18 et un 5 second capteur de pression 19. Ces pompes et ces capteurs de pres-sion sont connectés à une unité centrale de gestion 20 dont la fonction consiste à gérer les paramètres de fonctionnement de la l'appareil, à savoir notamment le volume et le débit de liquide à
injecter dans la cavité où a lieu l' intervention et de celui qui est 10 aspiré hors de cette cavité, en tenant compte en particulier des valeurs des pressions mesurées par lesdits capteurs. Les deux circuits d'irrigation et d'aspiration comportent par ailleurs, respecti-vement un premier dispositif de pesée 21 et un second dispositif de pesée 22. Enfin, le circuit d' aspiration 14 est équipé d' un instrument 15 de mesure conductimétrique 23 dont le rôle sera défini par la suite.
Un troisième capteur de pression 24, dit capteur de référence est également connecté à l' unité centrale de gestion 20.
On notera que le circuit d'irrigation 11 est directement connecté au 20 canal correspondant 12 de l'endoscope 13 alors que sur le circuit d'aspiration 14, un filtre à particules solides 25 est interposé entre le canal correspondant 15 de l' endoscope 13 et les autres composants de ce circuit notamment la pompe 18.
25 A partir des informations transmises par le dispositif de pesée 21 et la mesure de la pression fournie par le capteur de pression 17, l'unité centrale de gestion 20 qui contient une horloge interne, peut déterminer en temps réel, le poids, le volume et la pression du liquide d'irrigation ainsi que le débit de la pompe 16. Cette unité est 30 par ailleurs conçue pour mémoriser la pression de référence fournie par le capteur 24 et la durée de fonctionnement de 1' appareil .
En ce qui concerne le circuit d'aspiration 14, les mêmes mesures de poids sont effectuées au moyen du dispositif de pesée 22, et de 35 pression au moyen du capteur de pression 19 et les valeurs corres-pondantes sont transmises à 1' unité centrale de gestion. Une mesure 9~o supplémentaire de conductimétrie permet de calculer les pertes de sang, c' est-à-dire la quantité de globules rouges contenue dans le liquide aspiré de la cavité dans laquelle s' effectue l' intervention .
Connaissant le poids de liquide injecté et de liquide aspiré et la 5 conductimétrie du liquide qui a été modifié à l'aspiration en raison de la présence de globules rouges t on peut déterminer l' hémodilution, c'est-à-dire le volume d'eau qui est rentré dans le circuit sanguin.
L' unité centrale de gestion est pilotée par un logiciel qui permet 10 d'effectuer une gestion globale automatique de l'appareil. Elle est notamment conçue pour mettre en mémoire des caractéristiques de pertes de charge correspondant à différents types d' endoscopes, ce qui permet de réduire considérablement le temps de calibrage. La valeur des pressions mesurées par les capteurs 17 et 19 est corrigée 15 par l' unité centrale de gestion en tenant compte notamment des pertes de charge correspondant à chaque endoscope utilisé.
L' unité centrale de gestion est conçue pour activer l' appareil selon trois modes qui correspondent respectivement au programme purge, o APPARATUS FOR CONTROLLED IRRIGATION OF NATURAL CAVITIES
FROM THE BODY
The present invention relates to an apparatus for controlled irrigation of natural cavities of the human body, especially for endoscopes and especially for urological, gynecological and arthroscopic endoscopes copics, comprising at least two channels respectively for continuously inject an irrigation liquid into one of these cavities and to continuously evacuate this irrigation liquid from this cavity, this apparatus comprising an irrigation circuit coupled to one of said channels and a suction circuit coupled to the other of canals .
Devices of this type are already known, in particular that described in the European patent published under N 224 487. This device describes in particular correction means intended to weight the measurement signal representative of the pressure as a function of certain parameters such as pressure drop, level differences between the sensor and the intervention zone, in order to determine by the calculates the exact value of the pressure prevailing inside a cavity in which the endoscopic intervention takes place.
The present invention proposes to complete this embodiment for improve the safety of use of the device by controlling permanently different parameters such as the volume of irrigation liquid and its pressure in the inlet and outlet circuits outlet, when operating in continuous irrigation.
To this end, the irrigation device according to the invention is characterized in what the irrigation circuit and the suction circuit include each a pump, a pressure sensor and means for compare the pressures measured by each of these sensors and to control pumps according to pressure differences 3 5 observed.
~ C ~ 3 ~ 990 According to a preferred embodiment, each of the two circuits is equipped with a weighing device, and these two weighing devices are associated with means for comparing the results of the measurement of each of these devices.
According to a particularly advantageous embodiment, the circuit suction device has a conductimetric sensor to determine the blood loss contained in the irrigation fluid at the outlet of the cavity.
Preferably, the apparatus includes a reference pressure sensor which is coupled to said means for comparing the pressures measured by the sensors arranged respectively on the circuit irrigation system and the suction circuit.
Advantageously, the suction circuit of the device can be fitted with a solid particle filter.
The present invention will be better understood with reference to the 20 description of an exemplary embodiment and the attached drawing in which:
Figure 1 shows a schematic view of an irrigation device according to the invention, FIG. 2 represents a diagram illustrating the curve sion / volume during an intervention using the device controlled irrigation according to the invention, and FIG. 3 represents a diagram illustrating the flow curves of irrigation and aspiration as a function of time during a intervention by means of the irrigation device according to the invention.
Referring to Figure 1, the controlled irrigation apparatus 10 shows 3 5 schematically felt by this figure, has a circuit irrigation system 11 connected to one of the channels 12 of an endoscope 13 to 9 ~ 0 two channels and a suction circuit 14 connected to the other channel 15 of this endoscope. The irrigation circuit 11 essentially comprises a first pump 16 and a first pressure sensor 17 and the circuit suction 14 essentially comprises a second pump 18 and a 5 second pressure sensor 19. These pumps and pressure sensors sion are connected to a central management unit 20 whose function is to manage the operating parameters of the the device, namely in particular the volume and the flow rate of liquid to inject into the cavity where the intervention takes place and of the one that is 10 sucked out of this cavity, taking into account in particular the values of the pressures measured by said sensors. Both irrigation and aspiration circuits also include, respectively, a first weighing device 21 and a second weighing device weighing 22. Finally, the suction circuit 14 is equipped with an instrument 15 of conductimetric measurement 23 whose role will be defined later.
A third pressure sensor 24, called the reference sensor, is also connected to the central management unit 20.
It will be noted that the irrigation circuit 11 is directly connected to the 20 corresponding channel 12 of the endoscope 13 while on the circuit suction 14, a solid particle filter 25 is interposed between the corresponding channel 15 of the endoscope 13 and the other components of this circuit, in particular the pump 18.
25 From the information transmitted by the weighing device 21 and measuring the pressure supplied by the pressure sensor 17, the central management unit 20 which contains an internal clock, can determine in real time the weight, volume and pressure of the irrigation liquid as well as the pump flow 16. This unit is 30 furthermore designed to memorize the reference pressure supplied by sensor 24 and the operating time of one device.
With regard to the suction circuit 14, the same measurements of weights are carried out by means of the weighing device 22, and 35 pressure by means of the pressure sensor 19 and the corresponding values supporting documents are transmitted to the central management unit. A measurement 9 ~ o additional conductimetry calculates the losses of blood, that is the amount of red blood cells in the liquid drawn from the cavity in which the intervention is carried out.
Knowing the weight of injected liquid and aspirated liquid and the 5 conductivity of the liquid which was modified at the suction due to the presence of red blood cells t hemodilution can be determined, that is, the volume of water that has entered the bloodstream.
The central management unit is controlled by software which allows 10 to perform an automatic global management of the device. She is especially designed to store characteristics of pressure losses corresponding to different types of endoscopes, which considerably reduces the calibration time. The value of pressures measured by sensors 17 and 19 is corrected 15 by the central management unit, taking particular account of losses load corresponding to each endoscope used.
The central management unit is designed to activate the device according to three modes which correspond respectively to the purge program,
2 0 au programme calibrage et au programme utilisation . Au cours du programme purge, les tubulures d' irrigation et d' aspiration sont reliées entre elles et un liquide de purge traverse les canalisations pour les nettoyer.
25 Au cours du programme calibrage, on raccorde les tubulures d'irrigation et d'aspiration à l'endoscope, on purge l'endoscope et on effectue des corrections de pertes de charge des deux circuits, ces pertes de charge pouvant être de 0 à 700 ml/mn. On rnémorise les données correspondant à deux courbes de calibrage et, le cas 2 0 to the calibration program and to the use program. During the purge program, the irrigation and suction pipes are interconnected and a purge liquid passes through the pipes to clean them.
25 During the calibration program, the pipes are connected endoscope irrigation and suction, the endoscope is purged and performs pressure drop corrections of the two circuits, these pressure losses can be from 0 to 700 ml / min. We remember data corresponding to two calibration curves and, if applicable
3 0 échéant, on imprime au moyen d' une imprimante appropriée, ces courbes de calibrage. L' endoscope couplé aux pompes est prêt à
l' utilisation Le troisième capteur de pression 24 est nécessaire pour mesurer une 35 pression de référence qui, en utilisation urologique ou gynécologique, pourra par exemple être la pression correspondant à la hauteur de la 359~
table sur laquelle est allongé le patient, ou la pression abdominale.
En urologie, la pression différentielle qui est en fait la pression vési-cale diminuée de la pression abdominale s'appelle Pression du Detrusor et permet de s'affranchir de toutes les modifications de 5 position de la table ou de contractions abdominales en cours d' intervention .
Lorsqu'on enclenche le programme utilisation, on règle les zéro des capteurs après avoir mis l'endoscope et le capteur de référence à la 10 hauteur de l'organe où se situe l'intervention. L'opérateur introduit l'endoscope et on effectue le remplissage de l'organe soit en com-mande manuelle, soit en commande automatique. On règle le débit, le volume, la prèssion maximale . On visualise au moyen d' un écran 26 couplé à 1' unité centrale de gestion 20 ou au moyen d' une imprimante 15 (non représentée), la courbe pression/volume qui fournit des indi-cations précises sur 1' état de "gonflement" de 1' organe . Cette courbe est représentée à titre d'exemple par la figure 2. Elle montre qu'au cours du remplissage de l'organe, qui est généralement une poche, la pression intérieure est soit constante, soit faiblement croissante 20 jusqu'au moment où la poche est pleine et que l'injection d'un volume supplémentaire de liquide engendre une dilatation de cette poche. A
ce moment, la dilatation des parois engendre une augmentation rapide et sensible de la pression.
25 L'opérateur peut déterminer sa zone de travail, c'est-à-dire les valeurs maximales et minimales des volumes de liquide physiologique à
injecter dans la cavité où a lieu 1' intervention en fonction des pressions maximales et minimales à ne pas dépasser. Pour rester dans cette zone de travail, on aspire 1' excédent de volume au moyen du 3 0 circuit d' aspiration .
La figure 3 illustre les courbes représentant le débit d' aspiration ( en traits interrompus) et le débit d'irrigation (en trait plein, ) en fonction du temps. Cette régulation de débit peut s'effectuer soit en 35 prévoyant un débit d'irrigation qui est égal au débit d'aspiration à
volume constant, soit en effectuant une régulation autour du volume o minimal et du volume maximal. C'est ce qui est représenté sur la figure 3 .
Pendant la durée de l' intervention, si la même pression mesurée par 5 les deux capteurs respectivement montés sur le circuit d' irrigation et sur le circuit d'aspiration est différente de plus de 10%, on inverse le sens de rotation de la pompe d'aspiration 18 pour injecter pendant une durée de quelques 5 secondes du liquide dans le circuit d'aspiration afin d'évacuer la particule solide qui obstrue le circuit 10 d'aspiration et qui est vraisemblablement à l'origine de cette diffé-rence de pression. Si le défaut persiste, les pompes sont arrêtées pour éviter une surpression excessive à l'intérieur de l'organe. Les deux pompes, qui sont agencées pour pouvoir fonctionner automatiquement ou en commande manuelle, peuvent être soit indé-15 pendantes, soit remplacées par une pompe double. Le circuitd'irrigation est vérifié en permanence par les mesures qui sont effec-tuées d' une manière continue ( volume, pression, débit ) . Ces mêmes mesures sont effectuées sur le circuit d'aspiration et en outre, une vérification comparative s'effectue sur les deux circuits.
Lorsque l'appareil est équipé d'une imprimante, le chirurgien dispose d'une courbe pression de travail/durée de l'intervention imprimée sur un document qui constitue, le cas échéant, une preuve médicolégale portant en outre l' indication du volume du travail minimal et du 2 5 volume maximal, le taux d' hémodilution et une indication précise concernant les pertes sanguines au cours de l' intervention . A la fin de cette intervention, une touche manuelle permet de vider l' organe .
Le circuit aspiration est fermé sur l' endoscope . On raccorde l' embout de la tubulure d' aspiration à l' embout principal de l' endoscope . Les 30 particules solides ou copeaux engendrés par l'intervention à
l' intérieur de 1' organe peuvent être récupérés en vue d' une analyse ultérieure .
Il est bien entendu que la présente invention n' est pas limitée aux 35 formes de réalisation décrites, mais peut subir différentes modifi-cations et se présenter sous diverses variantes évidentes pour1' homme de 1' art . 3 0 if necessary, a suitable printer is printed, these calibration curves. The endoscope coupled to the pumps is ready to use The third pressure sensor 24 is necessary to measure a 35 reference pressure which, in urological or gynecological use, could for example be the pressure corresponding to the height of the 359 ~
table on which the patient is lying, or abdominal pressure.
In urology, the differential pressure which is in fact the vesi-wedge less abdominal pressure is called Pressure of the Detrusor and allows to get rid of all the modifications of 5 table position or abdominal contractions in progress intervention.
When the user program is started, the zero points of the sensors after putting the endoscope and the reference sensor to the 10 height of the organ where the intervention is located. The operator introduces the endoscope and the organ is filled either by manual control, or automatic control. We regulate the flow, the volume, maximum pression. You can visualize by means of a screen 26 coupled to the central management unit 20 or by means of a printer 15 (not shown), the pressure / volume curve which provides indications precise cations on the state of "swelling" of the organ. This curve is shown by way of example in FIG. 2. It shows that at during the filling of the organ, which is usually a pocket, the internal pressure is either constant or slightly increasing 20 until the bag is full and the injection of a volume additional liquid causes this pocket to expand. AT
at this point, the expansion of the walls generates a rapid increase and pressure sensitive.
25 The operator can determine his working area, i.e. the maximum and minimum values of physiological fluid volumes to inject into the cavity where the intervention takes place depending on the maximum and minimum pressures not to be exceeded. To stay in this work area, we vacuum the excess volume by means of the 3 0 suction circuit.
Figure 3 illustrates the curves representing the suction flow (in broken lines) and the irrigation flow (solid line) in function of time. This flow regulation can be done either by 35 providing for an irrigation flow which is equal to the suction flow at constant volume, either by regulating around the volume o minimum and maximum volume. This is what is depicted on the figure 3.
During the intervention, if the same pressure measured by 5 the two sensors respectively mounted on the irrigation circuit and on the suction circuit is different by more than 10%, we reverse the direction of rotation of the suction pump 18 for injecting during a duration of some 5 seconds of the liquid in the circuit suction in order to evacuate the solid particle which obstructs the circuit 10 of suction and which is probably at the origin of this difference pressure pressure. If the fault persists, the pumps are stopped to avoid excessive pressure inside the organ. The two pumps, which are arranged to operate automatically or manually, can be either independent 15 pendants, or replaced by a double pump. The irrigation circuit is constantly checked by the measurements that are made killed continuously (volume, pressure, flow). These same measurements are carried out on the suction circuit and in addition, a comparative verification is carried out on the two circuits.
When the device is equipped with a printer, the surgeon has of a working pressure / intervention duration curve printed on a document which constitutes, where appropriate, forensic evidence also showing the minimum work volume and the 2 5 maximum volume, hemodilution rate and specific indication regarding blood loss during the procedure. At the end during this intervention, a manual key empties the organ.
The suction circuit is closed on the endoscope. We connect the nozzle from the suction tubing to the main endoscope tip. The 30 solid particles or shavings generated by the intervention at the interior of the organ can be recovered for analysis later.
It is understood that the present invention is not limited to 35 described embodiments, but may undergo different modifications cations and appear in various variants obvious to the man of the art.
Claims (5)
DROIT EXCLUSIF DE PROPRIÉTÉ OU DE PRIVILÉGES EST REVENDIQUE, SONT DÉFINIES COMME IL SUIT: THE EMBODIMENTS OF THE INVENTION, REGARDING WHICH A
EXCLUSIVE RIGHT OF OWNERSHIP OR PRIVILEGES IS CLAIMED, ARE DEFINED AS FOLLOWS:
la sortie de la cavité. 3. Apparatus according to claim 1, characterized in that the circuit suction (14) comprises a conductivity sensor (23) for determine the blood loss contained in the irrigation fluid at exit from the cavity.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR91/04969 | 1991-04-22 | ||
| FR9104969A FR2675367A1 (en) | 1991-04-22 | 1991-04-22 | APPARATUS FOR CONTROLLED IRRIGATION OF NATURAL BODY CAVITIES. |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2085990A1 true CA2085990A1 (en) | 1992-10-23 |
Family
ID=9412144
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002085990A Abandoned CA2085990A1 (en) | 1991-04-22 | 1992-04-22 | Device for controlled irrigation of natural body cavities |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP0535209A1 (en) |
| JP (1) | JPH06504221A (en) |
| CA (1) | CA2085990A1 (en) |
| FR (1) | FR2675367A1 (en) |
| WO (1) | WO1992018049A1 (en) |
Families Citing this family (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5709670A (en) * | 1994-05-03 | 1998-01-20 | Aquintel, Inc. | Surgical fluid and tissue loss monitor |
| FR2727847A1 (en) * | 1994-12-07 | 1996-06-14 | C & D Biomedical | Appts. for supply and extraction of clarifying liquid during surgery, e.g. bladder operations |
| US5830180A (en) * | 1996-07-17 | 1998-11-03 | Aquarius Medical Corporation | Fluid management system for arthroscopic surgery |
| US7857794B2 (en) | 2004-06-14 | 2010-12-28 | Alcon, Inc. | Handpiece tip |
| SE529738C2 (en) * | 2006-03-30 | 2007-11-06 | Medical Vision Res & Dev Ab | Device for flushing cavities in the body |
| US8465467B2 (en) * | 2006-09-14 | 2013-06-18 | Novartis Ag | Method of controlling an irrigation/aspiration system |
| US7967775B2 (en) | 2007-01-09 | 2011-06-28 | Alcon, Inc. | Irrigation/aspiration tip |
| US9314553B2 (en) | 2008-01-10 | 2016-04-19 | Alcon Research, Ltd. | Surgical system |
| AU2012348191C1 (en) | 2011-12-08 | 2017-04-20 | Alcon Inc. | Selectively moveable valve elements for aspiration and irrigation circuits |
| DE102012204680B4 (en) | 2012-03-23 | 2019-04-25 | Olympus Winter & Ibe Gmbh | Method and system for flushing solution supply during endoscopic procedures |
| US9549850B2 (en) | 2013-04-26 | 2017-01-24 | Novartis Ag | Partial venting system for occlusion surge mitigation |
| JP2017508484A (en) * | 2013-12-13 | 2017-03-30 | アカデミッシュ メディッシュ セントラム | Pericardial irrigation system |
| CN112220988B (en) * | 2020-12-17 | 2021-04-13 | 上海宇度医学科技股份有限公司 | Uterine cavity perfusion system |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3900022A (en) * | 1973-12-10 | 1975-08-19 | Jerrold Widran | Endoscope with uninterrupted flow purging system |
| DE2646079C3 (en) * | 1976-10-13 | 1980-12-04 | Richard Wolf Gmbh, 7134 Knittlingen | Device for determining blood loss during endoscopic interventions |
| US4562842A (en) * | 1984-02-21 | 1986-01-07 | Diane E. Morfeld | Blood-loss measurement apparatus |
| DE3570186D1 (en) * | 1984-08-31 | 1989-06-22 | Robert Burner | Apparatus for the controlled irrigation of natural conduits and cavities of the human body |
| FR2642297A1 (en) * | 1989-02-02 | 1990-08-03 | Sinergy Sa | APPARATUS FOR IRRIGATION AND SUCTION FOR USE IN ENDOSCOPIC SURGERY |
-
1991
- 1991-04-22 FR FR9104969A patent/FR2675367A1/en not_active Withdrawn
-
1992
- 1992-04-22 EP EP92910533A patent/EP0535209A1/en not_active Withdrawn
- 1992-04-22 WO PCT/FR1992/000362 patent/WO1992018049A1/en not_active Application Discontinuation
- 1992-04-22 JP JP4510448A patent/JPH06504221A/en active Pending
- 1992-04-22 CA CA002085990A patent/CA2085990A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| FR2675367A1 (en) | 1992-10-23 |
| WO1992018049A1 (en) | 1992-10-29 |
| JPH06504221A (en) | 1994-05-19 |
| EP0535209A1 (en) | 1993-04-07 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Discontinued | ||
| FZDE | Discontinued |
Effective date: 19980422 |
|
| FZDE | Discontinued |
Effective date: 19980422 |