JP2008515531A - Device and method for delivering drug to the abdomen - Google Patents

Abstract

An apparatus for treating a gas to be delivered to a body cavity, body space, or body surface of an animal is provided.
An apparatus according to the present invention includes a housing defining a chamber having an inlet and an outlet. One or more drugs are entrained in a gas stream flowing through the chamber, and the drug is carried to the animal by the gas stream. Also used is a drug chamber coupled to at least one structure that defines at least one liquid flow path that forms at least part of the path between the air delivery device and the body cavity, body space or body surface. be able to.
[Selection] Figure 1

Description

  The present invention relates to the treatment of gas delivered to the body cavity, body space and body surface of an animal, and in particular, the gas is treated with one or more agents such that the agent is delivered to the animal by a gas stream. It relates to an apparatus and a method for

  It is well known to inject gas into a patient's body for various purposes. The gas is infused into a body cavity such as the abdomen to inflate a soft surface or generate pressure for a specific purpose. Once gas is injected to inflate the abdomen to form the pneumoperitoneum, space is provided for examination, treatment, removal and surgical procedures. The space formed by gas injection is a basic element of laparoscopic surgery. Within the body space formed by the gas flow and pressure, tissue surfaces and organs can be safely exposed, and devices used for diagnostic and therapeutic purposes are inserted into the space. Examples of the purpose include, but are not limited to, coagulation, incision, grasping, fixing, suturing, stapling, movement, degeneration, and shredding removal. The nature of the gas stream can be modified and adjusted by filtration, heating and humidification. U.S. Pat. No. 5,411,474 and the aforementioned U.S. patent application disclose methods for adjusting gas by such methods.

  However, there is room for further improvement and progress. Addition of pharmacologically active or inactive organic or inorganic agents when injecting gas into the body cavity, body space or body surface, improving tissue healing, reducing infection, reducing adhesion formation, Modulation of the immune response, treatment of tumors, treatment of specific disease processes, pain relief, and diagnostic assistance can be performed. Therefore, there is a need for an apparatus and method suitable for treating a gas by the above method.

  Briefly described, the present invention relates to a method and apparatus for treating a gas delivered to a body cavity, body space or body surface with one or more agents. The gas is supplied to the device from a gas source. The apparatus comprises a housing defining at least one chamber having an inlet (an inlet through which gas flow is supplied from the gas source) and an outlet. A predetermined amount of one or more drugs is released into the chamber. The released drug is mixed with the gas stream delivered to the animal by the delivery device. The gas stream is optionally humidified and / or heated within the housing.

  The above and other objects and advantages of the present invention will be apparent from the following description with reference to the accompanying drawings.

  <Definition>

  In this specification and in the claims, the singular includes the plural.

  As used herein, “predetermined temperature” or “predetermined temperature range” is a temperature during a procedure preset or programmed by a user. For example, a desirable temperature range is the body's physiological temperature, ie, about 35-40 ° C. As described below, the temperature of the gas is adjusted by a “dial” type or other type of regulator.

  As used herein, the term “humidified solution” refers to water, saline, lactated Ringer's solution, any buffered liquid or solution, aqueous solution, non-aqueous solution, aqueous or non-aqueous solution and other substances. A combination or gel material containing an aqueous or non-aqueous solution and other materials is meant.

  As used herein, the term “drug” is effective in promoting or healing tissue, reducing infection, reducing adhesion formation, modifying an immune response, treating a particular disease process, Any organic, inorganic, biologically inert or active substance that relieves pain or is used for other therapeutic or diagnostic purposes. These include solid phase, liquid phase or gas phase materials, aqueous, colloidal and non-colloidal materials, suspensions, mixtures, solutions, hydrogels, lyophilized materials, hydrophobic, hydrophilic, anionic , Cationic and surface active substances, surgical adjuvants, anticoagulants, antibiotics, immunostimulants, immunosuppressants, growth inhibitors, growth promoters, diagnostic substances, anesthetics and analgesics. In addition, these substances may be used as they are or are not limited thereto, but may be dissolved in other substances such as alcohol, ether, ester, lipid and solvent.

  The drug may be dried, for example, in powder form. Any agent that can be delivered into a body cavity or body surface by a gas stream for therapeutic or diagnostic purposes can be delivered by the present invention. However, the present invention is not limited to the examples of the drugs described above. Furthermore, the gas stream can be treated with any type or combination of agents according to the present invention. Examples include treatment with humidified solutions that humidify the gas stream to prevent drying, antibiotics that reduce infection, anti-inflammatory drugs that reduce inflammation, and anti-adhesives that prevent adhesion and improve healing. it can. Examples of the adhesion inhibitor include Adept (registered trademark) manufactured by ML Laboratories, Adcon (registered trademark) manufactured by Gliatech, and Atrisol (registered trademark) manufactured by Atrix Laboratories.

  As used herein, the term “gas” means any gas, or gas mixture in any ratio, that is naturally occurring or manufactured, or placed or created in a container.

  The term “treatment” as used in connection with the treatment of a gas stream refers to the gas stream for a liquid phase drug, such that the gas stream is a fume or dust for a solid phase drug. Means injecting or releasing one or more drugs into the gas stream to become a mist or spray. In certain embodiments, since the drug is in liquid form, the drug is taken in or removed from the container. In other embodiments, the drug is injected or released into the gas stream. In general, humidification is also performed on gas streams that are treated with one or more agents.

  The term “cavity” or “space” refers to any body cavity, such as, for example, a thoracic cavity, pericardium, peritoneal cavity or abdomen, multiple cavities, knee space, shoulder space, eyeball, stomach, and lung. It means space.

  The term “aerosol” means a liquid or solid particle diffused into a gas.

  The term “spray” means a jet of liquid ejected from a nebulizer.

  The term “mist” means a particulate liquid diffused in a gas.

  The term “mist” means vapor condensed liquid fine particles diffused into a gas.

  The term “vapor” means a gas in which substance molecules are diffused.

  The basic idea of the present invention is that one gas stream is such that the drug is actively or passively injected into the gas stream and forms part of the gas stream as a result of flow dynamics, vapor pressure and / or evaporation rate. Or it is processing with several chemical | medical agents. Thus, the gas flow is adjusted to include the additive desired by the user in the gas flow, for example to improve the results obtained by gas delivery associated with a particular treatment, diagnosis or prevention method.

  The term “body surface” means any surface of the body, either inside or outside the body, or originally exposed or exposed by a surgical procedure.

  Referring to FIG. 1, reference numeral 100 indicates an apparatus for treating or regulating a gas. The apparatus 100 is configured to receive gas (eg, at high pressure or low pressure, at high flow rate or low flow rate) from a gas regulator 10 such as an injector. The apparatus 100 includes a gas processing unit 120, an optional filter 110, and an optional control module 140. The various components of the device 100 are connected to each other by a tube. In particular, the first tube 160 connects the outlet of the gas regulator 10 and the inlet of the filter 110 via a male luer lock 166 (or other suitable adapter compatible with the outlet of the gas regulator 10). . The second tube 162 connects the outlet of the filter 110 and the inlet of the gas processing unit 120. The third tube 164 connects the outlet of the gas processing unit 120 and a gas delivery device (not shown) via a male luer lock 168 (or other appropriate connection adapter). Examples of the gas delivery device include a trocar, a Veres needle, an endoscope, or a tube that is placed in a body cavity or space, and injects the treated gas into the body of an animal. Moreover, when delivering gas to a body surface, the said gas delivery apparatus is shape | molded, formed or comprised so that a flow of gas (gas flow) may be guide | induced to a body surface, or may be spread | diffused.

  The tubes 160, 162, 164 are flexible and flexible so that the gas regulator 10 and the control module 140 can be placed in a convenient location away from the animal when performing procedures requiring gas delivery. It is preferable to have a sufficient length. Since the temperature during delivery of the gas stream should be within the required range, when using the device 100, it is preferable to place the gas processor 120 in the immediate vicinity of where the gas is delivered.

  The filter 110 is an optional component, and its pore size preferably excludes all solid particulates and bacterial or fungal material generated within the gas supply cylinder or gas regulator 10. It consists of a high performance hydrophobic filter (eg Gelman Sciences Metricel M5PU025) that is as small as possible (ie 0.5 microns or less, preferably about 0.3 microns). Preferred filters include hydrophobic filters such as, for example, glass fiber type filters (eg, Metrigard by Gelman Sciences or Porous Media Ultraphobic filter, Model DDDF 4700 M02K-GB). Other suitable filters include, for example, polysulfone (Supor, HT Tuffrin, Gelman Sciences) and mixed fiber esters (GN-6 Metricel, Gelman Sciences). When the pore size of the filter 110 is 0.1 microns or less, the pressure loss of the gas increases and the flow rate is significantly reduced. If the procedure being performed requires delivery of a relatively high pressure and / or high flow rate gas to the animal (eg, for laparoscopy), the pore size should not be less than 0.2 microns. Is preferred. Hydrophobic filters are less likely to tear due to water pressure resulting from incorrect suction or wicking of ascites or wash water. Therefore, it is preferable to use a hydrophobic filter rather than a hydrophilic filter.

  In some applications, it may be desirable to place the gas regulator 120 in the immediate vicinity of the gas delivery device so that the gas transfer distance from the outlet of the gas regulator 120 to the internal conduit or connection of the animal is minimized. The purpose of this arrangement is to maintain the temperature and moisture content of the gas delivered to the animal at a temperature sufficiently close to the physiological temperature of the body or other body surface. That is, in certain applications, the device according to the present invention is equipped with a high-performance processing chamber that is extremely small and can be placed in close proximity to the animal, so that the gas is heated before it is delivered to the animal. Prevents mechanical cooling.

  The control module 140 is housed inside the electrical housing 210 and connected to the gas regulator 120 by several pairs of wires contained within an insulated electrical cable 170. In particular, one end of the electric cable 170 is provided with a connector 172 that is electrically connected to the circuit connector 212 of the electric housing 210 for the control module 140. The other end of the electric cable 170 is electrically connected to the gas processing unit 120 by a sealed electric connection terminal 174. The electrical cable 170 is attached to the second tube 162 by a plastic tape or clip 176. Alternatively, the electric cable 170 is attached to the second tube 162 by heat fusion, extrusion, ultrasonic welding, or an adhesive, or is inserted into the second tube 162.

  The components in the control module 140 and the associated gas regulator 120 are preferably powered by the AC / DC converter 180. The AC / DC converter 180 has an output terminal connected to a power outlet 214 of a circuit in the control module 140 by a plug connector 182. The AC / DC converter 180 also has a standard AC power output plug 184 that can be connected to a standard AC power output terminal. For example, the AC / DC converter 180 is connected to an AC power cord that is also used in other devices in the operating room. Alternatively, the power of the apparatus 100 is supplied from a battery or a solar power source. As another method, there is a method of providing a circuit that operates with an AC signal instead of a DC signal inside the control module 140. In this case, the control module 140 can be directly driven by the AC output. Details of the control module 140 and the heating and humidification elements inside the gas processing unit 120 will be described later.

  In some embodiments, the gas processor 120 has a fill port 190 that can receive a supply of a drug and / or a humidified solution. For example, a syringe 200 filled with a predetermined amount of liquid medicine is inserted into the filling port 190, and the gas treatment section 120 is initially filled or refilled with the liquid medicine. The apparatus 100 can be sold in a state where the gas processing unit 120 is pre-filled with a drug and / or a humidifying solution so that the first filling is not necessary.

  The gas processing unit 120 will be described in detail with reference to FIG. The gas processing unit 120 includes a housing 122 having a gas inlet 124 and a gas outlet 126. The housing 122 defines a chamber 128. The chamber 128 includes a processing subchamber for processing the gas supplied from the inlet 124 with a drug. Also, in some embodiments, the chamber 128 detects components that perform heating and humidification substantially simultaneously, and temperature detection means 136 that detects the temperature of the gas as it is exhausted from the chamber 128 and relative humidity. Relative humidity detecting means 138.

  In particular, in the embodiment shown in FIG. 2, the chamber 128 is provided with a sub-chamber comprising one or more layers 130, 131, 132 that retain liquid or absorb drug. As a matter of course, the number, interval, and absorption capacity of the liquid holding layers 130, 131, and 132 differ depending on purposes. These three layers are shown as an example only. The layer 130, 131, 132 material may be any suitable liquid holding or absorbing material such as rayon / polyester (eg, NU GAUZE ™ manufactured and sold by Johnson & Johnson Medical, Inc). Can do. The pore size of the selected material must be selected in consideration of the balance between liquid holding capacity and pressure loss. Increasing the pore size increases the liquid holding capacity for contacting the gas to aerosolize it.

  Another form of processing subchamber consists of a hollow chamber with a subcontainer or subcontainer in which liquid is placed in a chamber 128 (without an absorbent layer) having a semi-permeable membrane for the passage of gas at the opposite end. A chamber is provided. The drug in the chamber is optionally heated by a heating jacket placed around the chamber.

  The heating means provided inside the gas processing unit 120 includes at least one heating element 134. The heating element 134 is installed inside the housing 122, for example, between the absorption layers 130 and 131. The heating element 134 is, for example, an electric resistance wire. The heating element 134 is preferably disposed between a plurality of absorbent layers, or enmeshed within the material (fibers) of the absorbent layer. The heating element 134 heats the gas supplied from the inlet 124 under the control of the heating control signal transmitted from the control module 140. The heating is performed substantially simultaneously with the processing of the gas as it passes through the chamber 128. Further heating elements can also be placed in the chamber.

  A temperature sensor 136 and a relative humidity sensor 138 are installed to detect the temperature and humidity of the gas when discharged from the gas processing unit 120. The temperature sensor 136 can be disposed at any location in the gas flow path in the chamber 128, but is preferably disposed between the plurality of liquid holding layers downstream of the heating element 134. The temperature sensor 136 is a thermistor (eg, Thermometrics MA100 Seres chip thermistor or Thermometrics Series BR23, Thermometrics, Inc., Edison, New Jersey). The error range of the temperature sensor 136 is preferably about 0.2 ° C. In the present invention, the temperature change when processing the gas at that location of the device is corrected and offset with the enthalpy change, so the gas temperature is after processing the gas (and optionally after being humidified). It is preferable to detect.

  The humidity sensor 138 is disposed on the flow path of the gas discharged from the chamber 128. The humidity sensor 138 is preferably disposed between the plurality of liquid holding layers downstream of the heating element 134 or in the vicinity of the outlet 126 of the housing 122 downstream of the absorption layer. The humidity sensor 138 is preferably not in contact with the layer. In the embodiment shown in FIG. 2, the humidity sensor 138 is located on the terminal end side of the plurality of absorption layers and is separated from the liquid holding layer 132 by a porous mesh (plastic or metal) layer 133 extending inside the housing 122. ing. The humidity sensor 138 is not actually in contact with the porous mesh layer 133 and is sufficiently spaced from the layer 133.

  In one embodiment, the humidity sensor 138 is a humidity-sensitive capacitance sensor (eg, a capacitance humidity sensor manufactured by Philips Corporation) whose capacitance changes in response to changes in humidity. The humidity sensor 138 monitors the gas humidity and detects the amount of humidified solution remaining in the gas processor 120 (i.e., layers 130, 131 and 132) as the gas as it passes through the chamber 128. Measure the relative humidity. As described below, in one embodiment, the humidity sensor 138 is connected to a timekeeping / dividing integrated circuit (IC) 145 (see FIG. 5). The integrated circuit IC 145 is preferably located in the housing 122 at substantially the same location as the humidity sensor 138. Other measuring means for measuring the humidity of the gas are also within the scope of the present invention.

  As one method for treating a gas with one or a plurality of drugs using the gas processing unit shown in FIG. 2, a liquid drug is injected from the syringe 200 into the chamber 128 through the injection port 190. Thus, there is a method in which one of the layers 130 to 132 is absorbed. As the gas stream passes through layers 130-132, the gas stream is treated with the agent. As a result, the medicine can be transported from the gas processing unit 120 to the animal. The amount of drug that can be introduced into the chamber 128 depends on the size and type of absorbent pad used. Further, by increasing the size of the chamber 128 to accommodate a large-sized absorbent pad, the drug introduction capability can be enhanced.

  Several other embodiments of the present invention will be described with reference to FIGS. 3-9 and 12-15. In these embodiments, a differently structured housing 122 is shown that is effective for treating a gas stream passing through the housing 122 of the gas treatment section 120 with one or more agents. Also, in these embodiments, different types of containers are shown for containing the drug and releasing the drug into the gas flow in the chamber of the gas processing unit 120.

  3 and 4 illustrate a housing 122 having a plurality of chambers, such as three chambers 128A, 128B, and 128C that extend to a particular length of the housing 122 (which need not extend the entire length of the housing). An embodiment is shown. These chambers are separated by walls or partitions 202, 204 and 206. The chambers 128A, 128B, and 128C are provided with filling ports 190A, 190B, and 190C, respectively, that receive supply of medicines from respective sources such as an external bag and a syringe. The drug is delivered under pressure to each chamber through the filling port or from a small opening in the bag inserted into the chamber from the filling port (FIGS. 5 and 6). In another embodiment, each chamber 128A, 128B, and 128C has one or more absorbent pads or layers therein that absorb a predetermined amount of drug, similar to the embodiment shown in FIG. In yet another embodiment, each chamber filled with a different drug is provided with a semipermeable separation membrane.

  Each chamber can be filled with a different type of drug. For example, the chamber 128A can be filled with a humidified solution, the chamber 128B can be filled with the drug A, and the chamber 128C can be filled with the drug B. Although not shown in FIGS. 3 and 4, the housing embodiment shown in FIGS. 3 and 4 optionally includes the heating element, temperature sensor, and relative humidity sensor shown in FIG. 2 in various arrangements. it can. In the embodiment of FIGS. 3 and 4, as the gas stream passes through the housing 122, the gas stream takes in or removes the humidified solution from the chamber 128A, is mixed with the drug A from the chamber 128B, and the drug B from the chamber 128C. Mixed. Thus, the gas stream exiting the housing 120 for delivery to the animal is humidified and treated with the drug.

  Figures 5 and 6 show another embodiment in which the drug carried by the gas stream is contained in a bag. FIG. 5 shows, for example, two bags 220 and 230 each containing a predetermined amount of medicine. The device can be shipped with a predetermined amount of drug pre-loaded or filled into bags 220 and 230, or can be filled with a predetermined amount of drug prior to use. Bags 220 and 230 are made from a flexible material, such as, for example, polyethylene or other similar material. In certain embodiments, the bags 220 and 230 are formed from a semi-permeable membrane material such that the drug contained therein is entrained by the gas flow through the housing 122 through the bag surface. In other embodiments, one end of the bag 220, 230 in the housing 122 is respectively a restriction orifice, nozzle or hole 222 and 232 (a spray hole or atomization for mixing the drug in contact with the gas stream. Hole). The other end of the bag 220, 230 is an optional filling port 224 and 234 that allows the introduction of a predetermined amount of drug into the bag 220 and 230, respectively. The housing 122 is provided with an opening for allowing the entire length of the bags 220 and 230 to enter the chamber.

  When the bag is filled, the bag is inflated inside the chamber 128. The pressure of a predetermined amount of drug filled in the bags 220 and 230 and / or capillary action at the holes 222 and 232 causes the drug to drip out of the holes 222 and 232. Thereby, the drug is taken in or taken out by the gas flow passing through the chamber 128 and carried out from the outlet port of the housing 122. In embodiments where bags 220 and 230 are formed from a semi-permeable membrane material, the pressure of a predetermined amount of drug filled in the bag facilitates the drug being taken up through the membrane. Bags 220 and 230 are positioned within chamber 128 so that when they are filled and inflated, they remain substantially within a predetermined area of the chamber and do not interfere with gas flow through the other bags. For example, the heating coil 124 or absorbent pad can be used to separate the bags 220 and 230 within the chamber 128.

  Although FIG. 5 illustrates only two bags 220 and 230, it will be appreciated that one or more bags may be used, depending on the number of types of medications carried by the gas stream.

  FIG. 6 shows a modification of the embodiment of FIG. In the embodiment of FIG. 6, the bags 220 and 230 are located outside or outside the housing 122. In this embodiment, an opening is provided in the housing 122 and the bag holes 222 and 232 are located just inside the opening in the housing 122. The drug is continuously delivered through holes 222 and 232 and taken into or out of the gas stream passing through chamber 128. Furthermore, the drug in the bags 220 and 230 has a natural tendency to be taken into the gas stream from the holes 222 and 232 due to changes in vapor pressure. The reason is that the gas stream is relatively dry, but the drugs in the bags 220 and 230 contain some moisture, so that trying to achieve vapor pressure equilibrium will result in a wet drug containing moisture. This is because a natural mechanism of taking in from the bag occurs. The faster the flow rate of the gas stream, the less drug is taken into the gas stream from the bags 220 and 230. The same theory of operation applies to the embodiment of FIG.

  When placed outside the housing 122, the bags 220 and 230 can be filled through the respective filling ports 224 and 234 in the same manner as described with reference to FIG. The number of bags can be varied depending on the particular application. Figures 5 and 6 show only two bags as an example. All other functions related to heating, humidification and detection of the housing 122 can be applied to the embodiment shown in FIGS.

  A further variation of the embodiment shown in FIGS. 5 and 6 includes an optional tube member 250 that extends from the bag to an optional absorbent pad 130 disposed within the housing 122.

  Further embodiments for releasing one or more drugs into the gas stream are shown in FIGS. In FIG. 7, an elongated tube member 300 is disposed in the chamber 128 of the housing 122. The tube member 300 is very long and meanders throughout the chamber 128 (the illustration is simplified in FIG. 7). As the tube member 300, for example, a polyamide tube product manufactured by MicroLumen (Tampa, Florida) can be used. An important feature of the tube member is that the wall thickness of the tube member 300 has been made as thin as possible in order to maximize the amount of drug that the tube member 300 can carry. The tip or end of the tube member 300 is a restrictive orifice or hole 310 that continuously delivers or discharges the drug into the gas stream. A plurality of tube members, each containing different types of medicines, are installed. Further, in order to supply a predetermined amount of medicine to the tube member 300, a filling port 312 is provided at the proximal end of the tube member 300 located just outside the housing 122.

  FIG. 8 shows a modification of the embodiment shown in FIG. The embodiment of FIG. 8 includes a tube member 400 formed along its length with one or more holes or perforations 410 that release the drug into the chamber 128. The gas stream passing through the chamber 128 takes in or removes the drug from the hole 410 and carries the drug by the gas flow. The tube member 400 has a filling port 412 similar to the filling port 312 of the tube member 300. In addition, a plurality of tube members 400 may be provided in the chamber in order to release a plurality of types of drugs into the gas flow. The length of each tube member 400, as well as the number and size of the holes 412, are selected to control the rate of different drugs from different tube members 400 that are taken into or removed from the gas stream passing through the chamber 128.

  In the embodiment shown in FIGS. 2 to 8, the size of the chamber 128 of the housing 122 of the gas processing unit is changed according to the purpose of use, the gas flow, the type of medicine, the presence / absence of an absorption pad, the number of absorption pads, and the like. Can do. The size of the chamber for practicing the present invention is not limited and is not limited to being relatively small or relatively large.

  FIG. 9 shows yet another embodiment. The inkjet printhead cartridge 500 included in the embodiment of FIG. 9 is used to release vapor bubbles containing one or more predetermined amounts of drug into the chamber 128 of the housing 122. The ink jet print head cartridge 500 is a well-known ink jet print head used in an ink jet printer sold by Hewlett-Packard Company, Canon Inc. or the like.

  As is well known in the art, the inkjet printhead cartridge 500 includes a reservoir 510, a printhead 520, and a plurality of contact pads 530. The conductive wiring of the cartridge 500 is terminated by a contact pad 530. Contact pad 530 is generally designed to interconnect with a printer. Then, the contact pad 530 comes into contact with the electrode of the printer and supplies ink generated on the paper by supplying an externally generated energization signal to the print head 520. Thermal ink jet print heads generate vapor bubbles by raising the ink temperature to the superheat limit on the surface of a plurality of heaters. This same method can be used to generate vapor bubbles of one or more drugs. The print head 520 has a plurality of nozzles 522. When a voltage is applied to the heater and a predetermined amount of medicine stored in the storage container is heated, vapor bubbles are released from the nozzle 522.

  In the present invention, the ink jet print head cartridge 500 is connected to the control circuit 600 via a connector 610 having contacts compatible with the contact pads 530. The control circuit 600 can be included within the control module 140 shown in FIG. 1 and is connected to the cartridge 500 by one or more conductors included in the electrical cable 170. The storage container 510 is filled with one or more predetermined amounts of medicine that is released into the chamber 128. For example, a color inkjet printhead cartridge includes a plurality of chambers or reservoirs for each of the three colors of ink. Using this same type of device, the ink jet printhead cartridge can contain a predetermined amount of a plurality of different types of drugs that are delivered to the chamber individually or simultaneously in controlled amounts. A control circuit 600 connected to the cartridge 500 via the connector 610 is suitable for driving a heater in the print head 520 and for releasing one or more drug vapor bubbles from the nozzle 522 into the chamber. Generate a control signal.

  As the drug or drugs are released into the chamber 128, a gas stream passing through the chamber unloads the drug from the outlet port of the housing 122 and carries it to the animal. Each individual drug can be released into the chamber 128 at a different rate or amount. In addition, each separate sub-chamber in chamber 128 can be provided with a different ink jet printhead cartridge to prevent the drug from being mixed for a predetermined period before delivery to the animal.

  Referring to FIG. 2 again, the electrical connection of the gas processing unit 120 to the components inside the housing 122 is as follows. The temperature sensor 136, the heating element 134, the relative humidity sensor 138, and the clock / divider 145 are connected to a ground or a current-carrying conductor (not shown). The wire 175 (plus-side conductor) is electrically connected to the heating element 134, and the wire 176 (plus-side conductor) is electrically connected to the temperature sensor 136. Further, the three wires 177A, 177B, and 177C are electrically connected to the relative humidity sensor 138 / timer / divider circuit. The wire 177A supplies DC power to the timer / divider 145, the wire 177B supplies an enable signal to the timer / divider 145, and the wire 177C carries an output signal (data) from the timer / divider 145. All wires are supplied from the insulated cable 170 into the connection terminal 174 and enter the chamber 128 through a small hole in the housing 122. The connection terminal 174 is sealed at the opening 178 around the cable 170.

  The filling port 190 is attached to the side extension 139 of the housing 122. Fill port 190 includes a cylindrical body 192 having a resealable member 194. A syringe or similar device can be inserted into the resealable member 194 with the outer periphery of its tip sealed. As a result, a predetermined amount of liquid medicine or humidified solution can be delivered into the chamber 128 without releasing the liquid already filled in the syringe or the like. As the resealable member 194, for example, Baxter InterLink (registered trademark) injection site, 2N3379 manufactured by Baxter can be used. As the filling port, a one-way valve, a sealable port, a screw cap, a grooved cap or the like into which a syringe or a similar device can be inserted can be used. Examples of the similar device include Safeline (registered trademark) injection site manufactured by B. Braun Medical, part number NF9100, or other cover material capable of inserting a syringe and preventing backflow of contained liquid or gas. Or there is a member. When the humidity of the gas processed by the gas processing unit 120 falls below a predetermined or user-programmed relative humidity, the control module 140 issues a warning (details will be described later).

  In another form, or in addition to the detection and monitoring functions described above, auxiliary or pre-feed containers for liquid medication and / or humidifying solutions are provided. Referring again to FIG. 1, one form of auxiliary supply container is a container 800 that hangs down from the device 100. Container 800 is connected to fill port 190 by access tube 810. The container 800 is a bag such as an intravenous infusion bag, and the access tube 810 is an intravenous injection type tube.

  Another form of auxiliary supply container is a container 850 that is attached to a portion of the apparatus 100. The container 850 is, for example, a tubular container, a bag, a syringe, or a tank. The container 850 is attached to the tube 162 or fixed with a strap in the vicinity of the gas processing unit 120. In another form, the container 850 is fixed to the outside of the housing 122 of the gas processing unit 120 with a strap. The container 850 is connected to the filling port 190 by the access tube 860 as in the case of the access tube 810 described above.

  The access tubes 810 and 860 have a permeable membrane (not shown) at their tips, pass through the filling port 190, and are connected to the chamber 128 of the housing 122 of the gas processing unit 120. Further, instead of the access tube 860, a tip member similar to the tip member of the syringe 200 is provided at the end of the container 850 on the side close to the filling port 190, and the filling port 190 is inserted directly into the filling port 190. It can also be penetrated.

  Containers 800 and 850 can be pre-filled or filled prior to use using techniques well known in the art. For example, the container 850 has an injection site 862 for injecting liquid into the container 850.

  The access tube 810 or 860 (or penetrating tip integral with the container 850) of the auxiliary supply containers 800 and 850 allows the liquid in the container to be released to one of the layers 130-132 by capillary force. It is preferred that it extend sufficiently long through the fill port 190 so that it can contact one of .about.132. Further, the length of the access tube 810 or 860 (or the penetrating tip integrated with the container 850) is set to the length before the layers 130 to 132, and the pressure difference generated by the gas flow passing through the housing 122 The gas treatment may be performed by discharging the liquid medicine and / or the humidifying solution from the ends of these members.

  In another variation shown in FIG. 2, the extension tube 870 extends from the fill port 190 where the access tube 810 or 860 (or the penetrating tip integral with the container 850) terminates to the processing subchamber inside the chamber 128. Guided and in contact with one or more layers 130-132. Liquid drug and / or humidifying solution is continuously released from the end of the extension tube 870 to one of the layers 130-132.

  The basic principle of any form of auxiliary supply container is the same. The auxiliary supply container is connected to the processing sub-chamber in the chamber 128 via the filling port 190, and always supplies the processing sub-chamber (for example, one or more layers 130, 131 or 132). The treatment subchamber has an initial amount of liquid drug and / or humidification solution pre-filled or filled prior to use. Then, since the auxiliary supply from the auxiliary supply container is always supplied to the processing sub-chamber by the gas flow passing through the chamber, the processing sub-chamber is always filled. As such, the total time required for sufficient humidification and / or processing of the gas is extended to a lifetime that is compatible with all or nearly all gas delivery applications. As a result, it is not necessary to consider a decrease in the humidity of the delivered gas. The auxiliary supply container serves an auxiliary function to provide humidification and / or treatment of gases throughout the entire procedure. Thus, some forms of device 100 need not include the humidity and temperature detection and monitoring functions or recharge alarms described herein. It is also possible to provide another type of assistance that may be useful for a particular application instead of or in addition to the auxiliary supply container.

  The desired width and diameter of the gas treatment section is intended for use, the speed of the gas flow from the gas generation source, and the pressure to be maintained (which is more greatly influenced by the diameter of the chamber 128 than the length of the chamber 128), etc. Determined by a plurality of factors. Those skilled in the art will readily be able to determine the appropriate dimensions of the chamber 128 from the teachings and illustrations provided herein without undue experimentation. However, when starting the device or changing the device requirements (eg flow rate or pressure), the lag time for detecting the gas temperature and adjusting the heating element to achieve the appropriate gas temperature or desired temperature is Note that there are only a few tenths of a second. Such a fast start-up time is extremely beneficial.

  FIG. 10 shows details of the heating element 134. The heating element 134 is an electric resistance wire having a coaxial coil structure having a plurality of turns (for example, 6 to 8 turns), and is disposed in the housing 128. Alternatively, a second heating element 134 'is provided. The heating element 134 ′ is arranged such that its coil is offset relative to the coil of the first heating element 134 in the direction of gas flow through the chamber. When two or more heating elements are used, it is preferred that they are spaced apart from each other by a distance of about 3-4 mm in the chamber of the gas treatment section. The winding directions of the first heating element 134 and the second heating element 134 'can be opposite to each other. In this way, contact between the gas flow through the chamber and the heating element is maximized. The heating element 134 may use another structure that does not use a coil.

  FIG. 11 shows another form of the gas processing unit 120. The inlet and / or outlet of the housing 122 is provided with a grooved surface 123 for facilitating diffusion of the gas supplied to the gas processing unit 120 throughout. The grooved surface 123 improves the dynamics of the gas flow through the chamber 128 so that the gas flow is uniformly heated and humidified as it passes through the chamber 128.

  Figures 12 and 13 show an embodiment of an apparatus for treating a gas stream with a solid phase drug. FIG. 12 shows a container 700 for a solid phase drug. The container 700 is, for example, a built-in power type, and is disposed in the chamber 128 of the housing 122 of the gas processing unit. The container 700 includes a check valve 710 and a pressurizer (such as a carbon dioxide cartridge) 720. When the pressurizer 720 is activated, the pressure inside the container 700 increases, and the urging of the check valve 710 is suppressed and the medicine is released into the chamber 128. A button 730 provided on the outside of the housing 122 is connected to the pressurizer 720 by a wire or other means, and activates the pressurizer by remote control.

  FIG. 13 shows a case where the solid-phase drug container 700 is disposed outside the housing 122. The check valve 710 of the container 700 is connected to the inside of the chamber 128 through an opening provided in the housing 122. A button 730 for activating the pressurizer is optionally disposed outside the container 700. The operation of the structure shown in FIG. 13 is the same as the operation of the structure shown in FIG.

  In the embodiment shown in FIGS. 12 and 13, the rate at which the solid phase drug is released into the chamber 128 depends on the pressure generated in the container 700 by the pressurizer 720 and the size of the check valve 710. It may be desirable to deliver the solid phase drug to the gas stream at once, or to deliver the solid phase drug continuously to the gas stream. If necessary, a separate pressure assisted source can be connected to the vessel 700 to process the gas stream for an extended period of time. In either case, the gas stream passing through the housing 122 carries the solid phase drug out of the outlet port.

  FIG. 14 shows details of the control module 140. The control module 140 includes a monitoring circuit and a control circuit for the device 100. Of course, some forms of device 100 need not include humidity (and heating) detection, monitoring, temperature control, and recharge alarm functions. The control module 140 includes a voltage regulator 141, a microcontroller 142, an A / D converter 143, a dual operational amplifier (hereinafter referred to as “op-amp”), a module 144, and a clock / divider 145. The monitoring circuit unit of the control module 140 is composed of a combination of a microcontroller 142 and a timer / divider 145. The control circuit unit of the control module 140 includes a microcontroller 142, an A / D converter 143, and an operational amplifier module 144. The monitoring circuit monitors the relative humidity of the gas exhausted from the chamber based on the signal generated by the timer / divider 145. The control circuit monitors the temperature of the gas discharged from the chamber, controls the power to the heating element based on the monitoring result, and adjusts the temperature of the gas to a user-programmed or predetermined temperature or temperature range. The temperature of the gas exhausted from the chamber is actively controlled, but the relative humidity of the gas in the chamber is not actively controlled. Instead, the relative humidity is monitored, an alarm is issued when the relative humidity falls below a predetermined threshold value, and appropriate measures such as replenishing the gas processing unit 120 with a liquid medicine or a humidifying solution are performed.

  As shown in FIG. 14, the plurality of components are preferably arranged inside the electric housing 210 (see FIG. 1), and the other components are arranged inside the housing of the gas processing unit 120 (see FIG. 2). In particular, the timer / divider 145 and the associated resistors R4 and R5 are preferably disposed within the housing 122 of the gas processor 120, with a relative humidity sensor 138 housed within the circuit package. Relative humidity sensor 138 is exposed on one or more surfaces of the circuit package. More specifically, the timer / divider 145 is disposed at the same position as the relative humidity sensor 138. This structure can minimize timing errors due to stray wire inductance and stray capacitance (the sensor is close to the active circuit of the timer / divider 145). Furthermore, placing the clock / divider 145 and the relative humidity sensor 138 in the same position eliminates the need for wire interconnections, thereby preventing unwanted signal radiation.

  The voltage regulator 141 receives from the AC / DC converter 180 (FIG. 1) as input a DC output suitable for use in the analog components of the control module (eg, DC 9V). The voltage regulator 141 adjusts the voltage to generate a low voltage (eg, DC 5V) that is used for the digital components of the control module. As is well known in the art, the capacitor C1 on the output side of the voltage regulator 141 serves to filter various AC components. Reference numeral 149 indicates that a suitable DC power source is provided from a battery or solar power source.

  The microcontroller 142 is a microcontroller IC, PIC16C84, and controls the operation of the system. The ceramic resonator 146 (4 MHz) supplies a raw clock signal used to generate a clock signal for a signal processing function to pins 15 and 16 of the microcontroller 142 (details will be described later).

The operational amplifier module 144 is connected through a wire 176 to a temperature sensor (thermistor) 136 attached to the housing of the gas processing unit. The operational amplifier module 144 is, for example, a low input offset voltage dual operational amplifier IC, LTC1013 having two operational amplifiers (hereinafter referred to as “operational amplifier A” and “operational amplifier B”). The non-inverting input of the operational amplifier A of the operational amplifier module 144 is pin 3 and the inverting input is pin 2. The output of operational amplifier A is pin 1. The operational amplifier A of the operational amplifier module 144 is used as a buffer for the output voltage of the voltage divider formed by the resistors R1 and R2. The buffer output voltage Vx is applied to the operational amplifier B of the operational amplifier module 144. The operational amplifier B is set as a non-inverting offset correction amplifier having a gain of 21.5. The operational amplifier B receives the output (voltage Vy) of the temperature sensor 136 adjusted by the resistor R3 as an input. The output voltage V _O of the operational amplifier B is pin 7. The output voltage V _O is equal to 21.5 Vy to 20.5 Vx, and is inversely proportional to the gas temperature in the housing of the gas processing unit. The range of the output voltage V _O is 0 to DC 5 V, and is determined by the gas temperature in the chamber.

The A / D converter 143 is an analog-digital conversion IC, ADC0831, and receives the output V _O of the operational amplifier module 144 as an input at pin 2. The A / D converter 143 generates a multi-bit digital language (for example, a digital language consisting of 8 bits) representing the output voltage V _O and supplies it as an output from the pin 6 to the I / O pin 8 of the microcontroller 142. . The microcontroller 142 instructs the A / D converter 143 to output a digital language by outputting a control signal from the I / O pin 10 to the chip selection pin 1 of the A / D converter 143. In addition, the microcontroller 142 controls the rate at which the A / D converter 143 outputs a digital language by outputting a series of pulses from the pin 9 to the clock input pin 7 of the A / D converter 143. The value of the “unbalanced bridge” of resistors R1, R2 and R3 is selected to produce a DC output of 0-5V in the gas temperature range of about 20-45 ° C. Since the reference voltage of the bridge and the A / D converter 143 is provided from the same DC 5 V generation source, it is possible to prevent errors due to various reference voltage changes.

The timer / divider 145 is, for example, a precision timer / divider IC, MC14541. Relative humidity sensor 138 is connected to pin 2 and resistors R4 and R5. The timer / divider 145 determines the value of the resistance R4, the capacitance of the relative humidity sensor 138 (the housing of the gas processing unit) according to the permission signal output from the pin 12 of the microcontroller 142 to the pin 6 of the timer / divider. And an output signal that oscillates at a speed determined by a predetermined division constant. The division constant is, for example, 256. Specifically, the output signal of the clock / divider 145 is a square wave, and has a frequency of approximately 1 / [256 * 2.3 * R4 _t * C _t ] Hz, from 0 V (“low”) to 5 V ( “High”). Here, R4 _t is, for example, 56 kilohms, and C _t is a capacitance at a certain time (t) of the relative humidity sensor 138 determined by the relative humidity of the gas in the chamber. The above-mentioned relative humidity sensor is manufactured by Phillips Electronics, for example, and can measure a range of 10 to 90% RH (relative humidity). Here, when the sensitivity of 0.4 +/- 0.5 pF per RH 1%, the _{C t} in 43% RH is 122pF (+/- 15%). The output signal of the timer / divider 145 is output from the pin 8 to the I / O pin 13 of the microcontroller 142. Therefore, the timer / divider 145 is essentially an oscillation circuit connected to the relative humidity sensor, and generates an output signal with a frequency corresponding to the capacitance of the relative humidity sensor. Various oscillator circuits that can generate as output the signal whose frequency is determined by the variable capacitance can be used for the timer / divider 145.

The microcontroller 142 performs measurement of the relative humidity of the gas in the housing of the gas processing unit by measuring or measuring the characteristics of the output signal of the timer / divider 145. Specifically, the microcontroller 142 measures the duration of one phase in the time / divider 145 output signal. For example, the “high” phase is approximately 1/2 * [256 * 2.3 * R4 _t * C _t ]. As described above, since the oscillation speed of the timer / divider is determined by the capacitance of the relative humidity sensor 138, the duration indicates the relative humidity of the gas in the chamber of the gas processing unit. For example, if the 10-50% and / or 50% RH changes to 90%, the duration of the “high” phase of the clock / divider output signal changes by 13%. The microcontroller 142 thus monitors the relative humidity of the gas exhausted from the chamber. When the relative humidity falls below a predetermined threshold (indicated by a predetermined change in the oscillation speed of the corresponding timer / divider 145), the microcontroller 142 generates a signal (recharge signal) for driving the transistor Q3. Generate and output from pin 17 to activate an acoustic alarm device such as buzzer 147. The buzzer 147 generates an audible sound indicating that the relative humidity of the gas in the gas processing unit is below a predetermined threshold value and that it is necessary to replenish the gas processing unit with liquid. The predetermined relative humidity threshold corresponds to the lowest level in the desired relative humidity range of the gas discharged from the gas processing unit, and may be 40%, for example. The predetermined relative humidity threshold is a parameter that is adjustable or programmable by the microcontroller 142. Optionally, the microcontroller 142 generates another alarm signal, such as causing the light emitting diode (LED) 148A to emit light, and outputs it from pin 7, indicating that the relative humidity in the gas processing section has fallen below a predetermined threshold and gas. It can also be displayed visually that the processing unit 120 needs to be replenished with liquid. Furthermore, the microcontroller 142 may detect when there is an “encoding failure” (very little occurrence) or when the relative humidity of the gas in the gas processing unit falls below a critical threshold (lower than a predetermined relative humidity threshold) (eg, 10%), an abnormal or alarm signal can be generated and output from pin 6 to drive LED 148B (eg, a different color than LED 148A). In either case, the power supply to the heating element 134 is cut off in response to the alarm signal.

  The microcontroller 142 also controls the heating element 134 to adjust the temperature of the gas inside the gas processing unit. Therefore, the microcontroller 142 processes the digital language supplied from the A / D converter 143 and measures the temperature of the gas inside the housing of the gas processing unit. Depending on the measurement result, the microcontroller 142 generates a heating control signal for driving the transistor Q1 and outputs it from the output pin 11, thereby driving the MOSFET power transistor Q2 to supply a current to the heating element 134. The temperature of the gas inside the gas processing unit is adjusted by the microcontroller 142 so that the gas is discharged from the gas processing unit and delivered to the patient's body within a predetermined temperature range. The predetermined temperature range in which the gas is adjusted is about 35-40 ° C, preferably 37 ° C. As described above, when the relative humidity inside the gas processing unit measured by the monitoring circuit unit of the control module 140 falls below the critical threshold, the control circuit unit cuts off the power supply to the heating element 134 accordingly, Prevents dry warm gas from being delivered.

  The circuit for monitoring the relative humidity of the gas can also be implemented by other circuits known in the art. In addition, it has been described that the control module 140 controls a heating element to monitor a signal indicating the temperature and relative humidity of the gas discharged from the chamber and to control the temperature of the gas by one microcontroller 142. Of course, the monitoring and control functions can be performed individually by two or more microcontrollers. Further, the functionality of microcontroller 142 may be achieved by other circuits such as, for example, application specific integrated circuits (ASICs), digital logic circuits, microprocessors, or digital signal processors.

  FIG. 15 shows another embodiment for monitoring the relative humidity of a gas using a moisture sensitive resistor instead of the moisture sensitive capacitor 138. The humidity detection scheme uses a resistive relative humidity sensor that does not require the timekeeping / dividing circuit 145 shown in FIG. The moisture-sensitive resistor 900 is disposed at an appropriate position for detecting the relative humidity of the gas flow passing through the gas processing unit 120 inside the housing of the gas processing unit. A suitable moisture sensitive resistor is a resistor manufactured by Ohmic, model number UPS600 (about 30.7 kiloohms at 45% RH). The resistor R10 is connected to the moisture sensitive resistor 900 in the structure of the voltage distributor. The three pins of the microcontroller 142 connect to a voltage divider formed by a resistor R10 and a moisture sensitive resistor 900.

  Pin 910 of microcontroller 142 is connected to one terminal of resistor R10, pin 912 is connected to one terminal of moisture sensitive resistor 900, and pin 914 is connected to a terminal between resistor R10 and moisture sensitive resistor 900. To do. The moisture sensitive resistor 900 may be of a type that requires AC excitation. Accordingly, the microcontroller 142 excites the moisture sensitive resistor 900 by applying an alternating pulse (eg, 5V) to the pins 910 and 912, with the pin 912 being “high” and the pin 910 being “ Be low. As a result, the average excitation voltage to the moisture sensitive resistor 900 becomes zero. During the period when pin 910 is “high”, microcontroller 142 detects the humidity of the gas by determining whether the tap voltage is a logical value “0” or a logical value “1” at pin 914. . When the resistance of the moisture sensitive resistor 900 is low and the logical value is 0 (low voltage), it indicates that the relative humidity of the gas is still high. The resistance of the moisture-sensitive resistor 900 is high, and a logical value of 1 (high voltage) indicates that the relative humidity of the gas is low. The value of resistor R10 is selected to cause a change at pin 914 at the desired relative humidity threshold (eg, selected to transition 2.5V from low to high at 45% RH). The resistance of the resistor R10 is, for example, 30 kilohms. In one embodiment using a resistive relative humidity sensor, a suitable microcontroller is the PIC16C558 (replaces the above-mentioned model number microcontroller described with reference to FIG. 14). This detection scheme can be further simplified when using a DC-excitable relative humidity sensor. In this case, one pin of the microcontroller 142 is required for humidity detection.

  Resistive relative humidity sensors have various advantages over capacitive relative humidity sensors. The specific types of resistive relative humidity sensors described above have been found to be resistant to being immersed in water in the gas treatment unit 120 even if the user accidentally overfills the gas treatment unit 120 with water. Yes. Also, detection schemes using resistive sensors do not require relatively high frequency square wave signals that are undesirable in certain device usage environments. And a resistive sensor can detect relative humidity with higher precision in a certain use.

  Other changes or extensions can be made in the circuit shown in FIG. As the microcontroller, for example, a type incorporating the function of the A / D converter 143 such as PIC16C715 can be used. The microcontroller, PIC16C715, contains a multi-channel A / D converter. In addition, more feature rich microcontrollers can be used that can add displays such as liquid crystal displays (LCDs) or LED displays. The microcontroller can periodically generate information such as gas temperature and relative humidity and display it to the user. Further, the microcontroller may drive the alarm device directly rather than indirectly through the transistor as shown in FIG. These are modifications or variations that are possible depending on the type of microcontroller selected for use in the control module 140.

  The setting and operation of the apparatus 100 will be described with reference to FIGS. The AC / DC converter 180 is connected to a 110V AC power source such as a wall outlet or a power cord. The control module 140 is connected to the AC / DC converter 180. The device 100 can also receive power from a battery or a solar power source. By attaching one end of the tube 160 to the outlet of the injector 10 with a luer lock 166, the heater / humidification tube set is installed. The apparatus 100 may be sold with tubes 160, 162 and 164 pre-attached to the filter 110 and the gas processing unit 120. Cable 170 is attached to electrical housing 210 of control module 140 by connector 172.

  The gas processing unit 120 is filled by supplying a liquid drug and / or a humidified solution from the syringe 200. The syringe 200 is inserted into the filling port 190 and the needle or cannula of the syringe 200 penetrates the resealable member 194 (FIG. 2). Then, the liquid is injected from the penetrating needle or cannula into the gas processing unit 120 and absorbed by the absorption layer. The syringe 200 is then removed from the filling port 190 and the filling port 190 is sealed by itself. The free end of tube 164 is attached to the gas delivery device by luer lock 168 or other suitable connector. Moreover, when the gas processing part 120 is filled with the liquid beforehand, it is not necessary to fill before an action | operation.

  In the case of the embodiment of FIG. 5 or 6, the bags 220 and 230 are filled with a predetermined amount of one or more medicaments (unless they are pre-filled). Similarly, in the case of the embodiment of FIG. 7 or 8, the tube member 300 or the tube member 400 is filled with a predetermined amount of one or more drugs (except when they are pre-filled). In the embodiment of FIG. 9, the nozzles 522 of the print head 520 are aligned so as to coincide with the openings of the housing 122. And in the case of the embodiment of FIG. 12 or 13, the container 700 is prepared for use as described above with reference to FIGS.

  When the gas regulator 10 is activated, the gas regulator receives gas from the gas supply cylinder and regulates the pressure and flow rate of the gas. Both pressure and flow rate can be adjusted by the user. The pressure and volume flow rate are controlled by adjusting a control device (not shown) of the gas regulator 10. The gas flows through the tube 160 into the optional filter 110 and is filtered, and then flows through the tube 162 into the gas processing unit 120. The gas contacts the optional electric heating element 134 and optional humidified liquid holding layers 130 to 132 arranged in the gas flow path as shown in FIG.

  In the embodiment of FIGS. 2-9, 12 or 13, the gas stream is treated with a predetermined amount of one or more agents, depending on the gas processor used. Thereby, one or a plurality of medicines are carried out of the gas processing unit 120 and delivered to the animal. For certain applications and temperature range conditions, it may be desirable for the gas processor 120 to be placed in close proximity to where the processed gas is delivered.

  In addition, in a configuration where heating and humidification of the gas is desired and appropriate components are disposed within the gas processing section 120 and thus within the chamber 128, the gas adjusts the liquid capacity of the heating element 134 and layers 130-132. By simultaneous heating and humidification to an appropriate physiological range. The adjustment is such that the temperature of the gas exhausted from the chamber 128 is within a preselected physiological temperature range (preferably 35-40 ° C., however, various desired temperature ranges can be preselected. And within a pre-selected relative humidity range (preferably above 40% relative humidity, for example, 80-95% relative humidity). The user forgets to manually fill the liquid medication and / or humidifying solution before the start of operation, or the device is sold without prefilling the liquid (ie, in a dry state), and the gas treatment unit 120 is filled with the liquid medication and When the device is operated without being filled with either of the humidifying solutions, the measurement result of the relative humidity of the gas inside the chamber of the gas processing unit 120 is below a predetermined threshold value, so an alarm is issued and the gas processing is performed. The user is warned that the part 120 needs to be filled with liquid. The device automatically alerts the user that the gas treatment unit 120 needs to be filled with a liquid drug and / or humidifying solution, thereby further delivering unhumidified gas to the animal. To prevent.

  Referring to FIG. 5, the control module 140 monitors the relative humidity of the gas exhausted from the chamber and further adjusts the temperature of the gas in the chamber 128. In particular, when the relative humidity of the gas in the chamber falls below a predetermined relative humidity threshold, the microcontroller 142 generates a refill signal to indicate that the gas processor 120 needs to refill the liquid supply. The alarm sound emitted by the buzzer 147 and / or the visual alarm emitted by the LED 148A alerts the attending physician or user that the gas processor 120 needs to be refilled. The microcontroller 142 preferably continues the alarm until the gas processing unit 120 is refilled with liquid and the humidity in the chamber returns to a level above a predetermined relative humidity threshold. When the relative humidity level of the gas in the gas processing unit 120 falls below the critical relative humidity threshold, the microcontroller 142 issues a second alarm such as causing the LED 148B to emit light, and at that time, power is supplied to the heating element 134. To stop. Furthermore, the microcontroller 142 controls the temperature of the gas by controlling the power supplied to the heating element 134.

  In some cases, humidity control is more important than heating control. In such a case, the device comprises only components for treating the gas stream with one or more agents (based on the embodiments of FIGS. 7-13) and components for humidifying the gas stream. Further, in some cases, monitoring the humidity of the gas stream is also optional. For example, when treating a gas stream with a desiccant, heating or humidification is usually not required.

  The method and apparatus of the present invention can be used in a variety of medical procedures that require the supply of heated and humidified gas. Also, filtration is optionally performed depending on the sterility of the gas required for the medical procedure. The gas is selected depending on the medical procedure to be performed. The gas can be any medically useful gas such as carbon dioxide, oxygen, nitrous oxide, argon, helium, nitrogen, air and other inert gases. Desirable gases for use in endoscopy are carbon dioxide and nitrous oxide. A combination of the above gases can also be used (ie, it is not necessary to use 100% of a single gas). The medical procedure desirably includes endoscopy such as laparoscopy, colonoscopy, gastroscopy, bronchoscopy and thoracoscopy. However, the present invention can also be used to provide heated and humidified respiratory oxygen or any anesthetic gas or combination of these gases, or to provide anesthesia or respiratory therapy. In particular, since the present apparatus is small and portable, it is suitable for use in applications that require carrying. The gas delivery device that brings the gas into direct contact with the patient needs to be selected according to the medical procedure known in the art to be performed. The gas regulated by the device is regulated in pressure, volume or both.

  In certain embodiments, it may be desirable to provide a number of drugs that are different from other drugs (the drugs described above) supplied to the heater / humidifier 120. Depending on the drug, it may be desirable to use a heater / humidifier to humidify and heat the insufflation gas and supply the drug separately. Alternatively, one or more medications can be delivered using a heater / humidifier. One or more additional medicaments can also be supplied separately to the insufflation gas.

  The drug can be delivered through the gas stream during, for example, laparoscopy, colonoscopy, gastroscopy and / or thoracoscopy, or other medical procedures that require inflation. As an example, currently, these medical procedures are performed during surgery under general anesthesia, for example, but not limited to administering a therapeutic amount of anesthesia to the abdomen. However, when performing surgery quickly and speeding up patient recovery, general anesthesia may be performed in small amounts or not at all. For example, appendectomy, cholecystectomy or fallopian tube ligation may be performed without general anesthesia.

  Any type of drug can be delivered using the present invention. Major examples of drugs that can be delivered in a gas stream during a medical procedure include anesthetics, analgesics, chemotherapeutic drugs, anti-infective drugs and anti-adhesives.

  Examples of the anesthetic include, but are not limited to, alcohol, bupivacaine, chloroprocaine hydrochloride, levobupivacaine, lidocaine, mepivacaine, procaine, ropivacaine, and tetracaine.

  Analgesics include, but are not limited to, respiratory drugs such as Excedrin, Tylenol, DayQuil, NyQuil, Duraclon and Ultram Centrally acting analgesics such as (Ultram), such as Carbatrol, Hyalgan, Lidoderm, Neuropin, Neurontin, Phenegran and Tegretol There are various analgesics and anesthetics such as Nubein, Darvocet, Dilaudid, Lortab, OxyContin, Percocet and Vicodin.

  Examples of chemotherapeutic drugs (also known as antitumor drugs) include, but are not limited to, the following. Artretamine, BCG, bleomycin sulfate, busulfan, carboplatin, carmustine, chlorambucil, cisplatin, cladribine, cyclophosphamide, cytarabine, dacarbazine imidazole carboxamide, dactinomycin, daunorubidine, daunomycin, dexamethasone, doxamethasone Epipodophyllotoxin, floxuridine, fluorouracil, fluoxymesterone, flutamide, fludarabine, goserelin, hydroxyurea, idarubicin, HCL, ifosfamide (isophosphamide), interferon alpha, interferon alpha 2a, interferon alpha n3, irinotecan, leucovorin calcium , Leuprolide, leva Zole, lomustine, megestrol, melphalan (L-phenylalanine mustard), L-sarcorycin, melphalan hydrochloride, MESNA, mechlorethamine, nitrogen mustard, methylprednisolone, methotrexate (amethopterin), mitomycin (mitomycin C), mitoxantrone , Mercaptopurine, paclitaxel, prikamycin (mitromycin), prednisone, procarbazine, streptozocin (streptozotocin), tamoxifen, 6-thioguanine, thiotepa (triethylenethiophosphoramide), vinblastine, vincristine, and vinorelbine tartrate.

  Anti-infective drugs include drugs classified as anthelmintic drugs and antibiotics. Antibiotics can be further classified into the following: Aminoglycosides, antifungal antibiotics, cephalosporins, b-lactam antibiotics, chloramphenicol, macrolides, penicillins, tetracyclines, various antibiotics, antituberculosis drugs, antiviral drugs, antiretroviral drugs, antimalarials Drugs, quinolones, sulfonamides, sulfones, urinary tract anti-infectives and various anti-infectives.

  Antiparasitic agents include, but are not limited to, for example, thiabendazole.

  Aminoglucosides include, but are not limited to, amikacin, gentamicin, neomycin, streptomycin and trabmycin.

  Examples of antifungal antibiotics include, but are not limited to, amphotericin B, lipid preparation T.I. E. Fluconazole, flucytosine, griseofulvin, itraconazole, ketoconazole, nystatin and terbinafine.

  Examples of cephalosporin include, but are not limited to, cefaclor, cefazolin, cefepime, cefixime, cefoniside, cefotaxim, cefpodoxime, cefprozil, ceftazidime, ceftriaxone, cefuroxime, cephalexin, and cefradine.

  B-lactam antibiotics include, but are not limited to, aztreonam, cefotetan, cefoxitin and imipenem / cilastatin.

  Examples of chloramphenicol include, but are not limited to, chloramphenicol, chloramphenicol palmitate, and chloramphenicol succinate.

  Macrolides include, but are not limited to, azithromycin, clarithromycin, erythromycin, erythromycin ethyl succinate and erythromycin lactobionate.

  Examples of tetracycline include, but are not limited to, demeclocycline, doxycycline, minocycline, and tetracycline.

  Various antibiotics include, but are not limited to, for example, bacitracin, clindamycin, polymyxin B, spectinomycin and vancomycin.

  Anti-tuberculosis drugs include, but are not limited to, ethambutol, isoniazid, pyrazinamide, rifabutin and rifampin.

  Antiviral agents include, but are not limited to, acyclovir, amantadine, famciclovir, foscanet, ganciclovir, ribavirin, valacyclovir, and valganciclovir.

  Antiretroviruses include, but are not limited to, for example, abacavir, amprenavir, didanosine, efavirenz, indinavir, lamivudine, lopinavir, nelfinavir, nevirapine, ritonavir, saquinavir, stavudine, zalcitabine and zidovudine is there.

  Antimalarials include, but are not limited to, chloroquine, hydroxychloroquine, pyrimethamine and quinine, for example.

  Examples of quinolones include, but are not limited to, gatifloxacin, lepofloxacin, and ofloxacin.

  Examples of sulfonamides include, but are not limited to, sulfadiazine, sulfamethoxazole, sulfasalazine, and sulfisoxazole.

  Examples of the sulfone include, but are not limited to, Dapson.

  Examples of urinary tract anti-infection include, but are not limited to, nitrofurantoin.

  Examples of various anti-infective agents include, but are not limited to, clofazamine, cotrimoxazole, metronidazole, and pentamidine.

  Examples of the anti-adhesive agent include, but are not limited to, the following. Aspirin, calcium channel blocker, carboxymethylcellulose, chondroitin sulfate, corticosteroid, chymase inhibitor, dextran, dialysate, diphenhydramine, fibrin glue, heparin, hyaluronic acid, L-arginine, methylene blue, mifepristone, mitomycin C , Non-steroidal anti-inflammatory drug (NSAID), octreotide acetate, pentoxifylline, peritoneal transplant, photopolymerized hydrogel, polyethylene glycol, polyoxamer, lactated Ringer's solution, sarin, surfactant, and tissue plasminogen activator .

  Also known are solutions or gels such as hyaluronic acid, hyaluronate / carboxymethylcellulose, carboxymethylcellulose, polyethylene glycol, dextran 70 and icodextrin 4%.

  Those skilled in the art will appreciate that the above are liquids, solutions or gels and can be used in the present invention. There are also commercially available anti-adhesion barriers such as hyaluronate / carboxymethylcellulose, oxidized regenerated cellulose, polyethylene oxide-oxidized regenerated cellulose, expanded polytetrafluoroethylene and pericardial patches. Are known.

  In order for the drug to be usable in the present invention, it would be necessary to crush, pulverize or grind the drug and then mix it with the liquid.

  The present invention also includes the use of the above types of drugs that have not yet been invented, as well as the use of drugs that are included in the above types but not described.

  FIGS. 16-20 illustrate embodiments of the present invention that are believed to be particularly useful in providing medication to a patient's abdomen via treated or untreated air delivery gas. The embodiment includes an air supply device, at least one structure including at least one liquid flow path that forms at least a portion of a path between the air supply device and a patient's abdomen, and the at least one structure. A chamber connected to the body and configured to supply a medicament to the interior of the abdomen via the at least one structure.

  FIG. 16 shows an insufflation device 915, such as the Stortz Model 26012 described above, or any other insufflation device that supplies insufflation gas to the surgical site. The air supply device 915 has an outlet 916 for supplying an air supply gas.

  A heater / humidifier 120 that is fluidly connected to the air supply device 915 is optionally provided downstream of the air supply device 915. The heater / humidifier 120 has an inlet 917 and an outlet 918. A first conduit 919 connects the outlet 916 of the air delivery device and the inlet 917 of the heater / humidifier 120. Thus, the air delivery device 915 is fluidly connected to the heater / humidifier 120.

  In the embodiments described herein, the conduit may be short or long and may be thick or thin. In some cases, conduits are separate parts from the device to which they are fluidly connected. In other cases, the conduits are integrated with the device to which they are fluidly connected. In some cases, the various devices are connected or coupled together without the use of conduits. In other cases, the various devices are configured as a single device having multiple chambers. All of these embodiments are within the scope of the present invention.

  Whether the insufflation gas is dry, humidified, heated or cold, it can be beneficial to add the drug to the gas stream delivered to the patient's abdomen. The scope of the present invention includes the addition of a drug under any condition. A preferred method is a method of heating and humidifying the air supply gas.

  One end 920A of the second conduit 920 is connected to the outlet 918 of the heater / humidifier 120 and the other end 920B is open. Either end may include one or more connectors, such as luer locks. During surgery, the second conduit 920 is fluidly connected to a trocar assembly 921 that is pre-installed on the abdomen 922 of the patient P. Thus, the heater / humidifier 120 is fluidly connected to the patient's abdomen. A Beres needle or other device can also be used to connect to the abdomen (without departing from the scope of the invention). The first conduit 919 or the second conduit 920 may have a filter connected to them.

  In this embodiment of the invention, a drug chamber 925 is provided spaced apart from the heater / humidifier 120. The drug chamber 925 has at least one outlet 926. One end 927A of the third conduit 927 is connected to the outlet 926 of the drug chamber. The other end 927B of the third conduit 927 is fluidly connected to the trocar assembly 921 (it can also be fluidly connected to the conduit 920 using a suitable connector).

  A trocar assembly 930 (FIG. 31) having two inlets can also be used. Alternatively, an improved trocar 933 (FIG. 32) can be used as necessary. Because the third conduit 927 is open to the atmosphere, some pressure source other than the insufflator 915 may be used to deliver the agent in the agent chamber 925 to the insufflation gas stream. An example of the pressure source will be described later.

  In order to deliver the drug to the abdomen 922 of the patient P in the form of aerosol spray, mist, mist, or vapor, a diffusion device 948 is used. The diffuser 948 is believed to increase the effectiveness of the drug.

  The arrangement of the diffuser 948 is determined according to the position and method of introducing the drug into the insufflation gas. If the drug chambers 925 are not connected in series, the diffuser 948 is placed anywhere within the third conduit 927 or trocar 921.

  FIG. 17 shows a modification of the structure shown in FIG. In this embodiment, an air supply device 915 having an outlet 916 is provided again. An inlet 917 of the heater / humidifier 120 is connected to an outlet 916 of the air delivery device 915 via a first conduit 919. However, in this embodiment, a modified drug chamber 935 having an inlet 936 and an outlet 937 ("modified" is having an inlet and outlet) is placed in series with the heater / humidifier 120. Is done. The modified drug chamber 93 is connected to the heater / humidifier 120 via the second conduit 920. Thus, the pressure of the insufflation gas can be used as needed to deliver the drug. The term “modified drug chamber” is used for convenience and is not intended to define a special definition of “drug chamber” or “modified drug chamber” in the claims. The term “drug chamber” is intended to broadly mean any chamber that can contain a drug, as used in the claims.

  A fourth conduit 938 connects to the outlet 937 of the drug chamber 935. The fourth conduit 938 is used to fluidly connect the drug chamber 935 with the trocar assembly 921 in the abdomen 922 of the patient P during surgery. The diffusion device 948 can be installed anywhere downstream of the modified drug chamber 935 (eg, inserted or connected to the fourth conduit 938). As described above, a device other than the trocar 921 such as a Beres needle can be used for connection to the abdomen.

  Depending on the type of diffuser 948, the diffuser 948 can be installed inside the conduit (liquid flows in or around the diffuser 948) or surrounding the conduit (as one skilled in the art will know). Will understand). Also, depending on the application for a particular conduit, diffusion devices may be provided both inside and outside the conduit.

  In FIG. 18, the drug chamber 925 is connected upstream of the heater / humidifier 120. The drug chamber 925 is fluidly connected to the heater / humidifier 120 by a fifth conduit 940. The fifth conduit 940 is located anywhere between the outlet 916 of the air delivery device 915 and the inlet 917 of the heater / humidifier 120 to fluidly connect the drug chamber 925 with the heater / humidifier 120. Connected to. As above, the second conduit 920 is connected to the outlet 918 of the heater / humidifier 120 and fluidly connects the heater / humidifier 120 to the patient's abdomen via the trocar assembly 921. . As described above, an instrument other than the trocar 921 such as a Beres needle can be used for connection to the abdomen.

  Since the drug chamber 925 is connected in parallel with the insufflation device 915, the diffusion device 948 can be connected or placed anywhere downstream of the drug chamber 925 (eg, in the second conduit 920). .

  The embodiment shown in FIG. 19 is similar to the embodiment shown in FIG. 17 except that a modified drug chamber 935 having an inlet 936 and an outlet 937 is installed upstream rather than downstream of the heater / humidifier 120. It is. A first conduit 919 connects between the outlet 916 of the insufflator 915 and the inlet 936 of the modified drug chamber, and the modified drug chamber 935 is fluidly connected to the insufflator 915.

  A sixth conduit 941 connects the outlet 937 of the modified drug chamber 935 to the inlet 917 of the heater / humidifier 120. A seventh conduit 942 connects to the outlet 918 of the heater / humidifier 120. The seventh conduit 942 is placed in fluid communication with a trocar assembly 921 that is pre-placed on the abdomen 922 of the patient P during surgery. As described above, an instrument other than the trocar 921 such as a Beres needle can be used for connection to the abdomen. If gas is delivered from the insufflator 915 and the drug remains in the change chamber 935, the drug is delivered to the abdomen 922 of the patient P. Similar to the above case, the diffusion device 948 is installed anywhere downstream of the drug chamber (eg, inserted or connected to the seventh conduit 942).

  The embodiment shown in FIG. 20 is similar to the embodiment shown in FIG. 18 except that a drug chamber 925 having an outlet 926 is connected downstream rather than upstream of the heater / humidifier 120. A first conduit 919 connects between the outlet 916 of the air delivery device 915 and the heater / humidifier inlet 917, and the heater / humidifier 120 is fluidly connected to the air delivery device 915. ing.

  The second conduit 920 is connected to the outlet 918 of the heater / humidifier 120. As above, the second conduit 920 is placed in fluid connection with the trocar assembly 921 placed in the abdomen 922 of the patient P during surgery. As described above, an instrument other than the trocar 921 such as a Beres needle can be used for connection to the abdomen. An eighth conduit 943 is connected to the outlet 926 of the drug chamber 925. The other end of the eighth conduit 943 is fluidly connected to the gas stream delivered from the heater / humidifier 120 anywhere between the outlet 918 of the heater / humidifier 120 and the trocar assembly 921. The The diffusion device 948 may be installed anywhere downstream of the drug chamber 925 (eg, inserted or connected into the second conduit 920). When pressure is applied to the medicine in the medicine chamber 925, the medicine is supplied to the abdomen 922 of the patient P regardless of whether or not gas is sent from the air feeding device 915.

  Depending on the application, the structures shown in FIGS. 1 to 20 may be combined or provided in order to obtain the desired result. For example, when one or more drugs are introduced via the heater / humidifier 120, the one or more drugs are introduced via one or more drug chambers (925, 935). Also, any of the chambers shown here can be used singly or in multiple to add multiple drugs. The gas is heated and / or humidified as necessary. The chamber may be empty or may have various means for absorbing or adsorbing liquid.

  FIG. 21 illustrates one method of introducing a drug into the drug chamber (925, 935). Although a modified drug chamber 935 is shown in FIG. 21, it operates even in the case of the drug chamber 925. The modified drug chamber has an external port 950 that is provided with a closure member 968 for adjusting the flow rate therein. A syringe 951 filled with a desired amount of medicine is inserted into the external port 950. At an appropriate time, the surgeon, anesthesiologist or other medical personnel opens the closure 968, if present, and presses the plunger 952 of the syringe 951 to place the drug into the drug chamber (925, 935). inject. The drug is delivered to the patient's abdomen as described above.

  FIG. 22 illustrates another device that can be used to introduce a drug into the drug chamber (925, 935) in various embodiments of the present invention. In this embodiment, a pump 954 is used to deliver the drug to the drug chamber (925, 935). A port 950 is provided to which an externally peristaltic or other suitable type of pump 954 is connected. A closing member 968 for adjusting the flow rate to the port 950 is provided. Although not shown, a container containing at least a desired amount of drug is provided.

  At an appropriate time, the surgeon, anesthesiologist or other medical personnel will open the closure 968, if present, and activate the pump 954 to deliver the desired amount of drug to the drug chamber (925, 935). Supply. The drug is delivered to the patient's abdomen as described above. Note that in all embodiments, the closure member 968 may be an adjustable valve.

  FIG. 23 illustrates another device that can be used to introduce a desired amount of drug into the drug chamber (925, 935) in various embodiments of the invention. In this embodiment, a pressurized cylinder 956 that is pre-filled with a desired amount of drug is used to deliver the drug to the drug chambers (925, 935). An external port 950 to which a pressure cylinder 956 is connected is provided. A closing member 968 is installed between the cylinder 956 and the port 950. In addition to the desired amount of drug, the cylinder can be filled with a predetermined amount of pressurizing agent (such as an inert gas). It can also have a device (eg, an electronically controlled valve) that causes the release of the drug when desired. When appropriate, the surgeon, anesthesiologist or other medical personnel opens the closure 968, if present, and activates the release device to deliver the desired amount of drug to the drug chamber. The drug is delivered to the patient's abdomen as described above.

  FIG. 24 shows yet another device that can be used to introduce a drug into the drug chamber (925, 935). In this embodiment, a flexible bag 958 containing the desired amount of drug is connected to the external port 950 by a tube 959. Whether or not a device (for example, an adjustment valve) that adjusts the release of the drug from the flexible bag 958 is installed is determined depending on the application. The closing part 968 serves as a discharge device. When desired at the time of surgery, the flexible bag 958 is squeezed and the release device activates the release device if present and delivers the drug to the drug chamber (925, 935).

  Of course, all of the methods for introducing drugs into the drug chambers (925, 935) shown in FIGS. 21-24 can be used in all of the embodiments of the invention shown in FIGS. Furthermore, it will be appreciated that other methods of introducing drugs into the chambers (925, 935) can be used without departing from the scope of the present invention.

  Referring to FIGS. 25-28, if for some reason it is not desirable to use a separate drug chamber, a syringe 951, pump 954, pressurization may be used to deliver the drug to the embodiment shown in FIGS. A cylinder 956 and a flexible bag 958 may be used. A suitable external port or connector 965 is provided in series with a suitable conduit so that it is within the flow path of the insufflation gas. The operation of the various devices is as described with reference to FIGS.

  FIG. 29 shows a further device that can function as a drug chamber (925, 935) according to the present invention. The piezoelectric chamber 961 includes a hollow chamber 962 having an inlet 963 and an outlet 964. Piezoelectric chamber 961 is fluidly connected to a suitable conduit and air supply gas 970 flows through the chamber during operation of the air supply device. The hollow chamber 962 is filled with a desired amount of liquid medicine 966. The drug 966 is filled in the chamber together with the piezoelectric crystal 965. In order to activate the piezoelectric crystal 965, a voltage is then applied to the crystal 965. Activation of the crystals 965 causes the drug molecules to vibrate at such a high speed as to cause an agent fog 962. The drug mist 962 is entrained in the insufflation gas 970 and delivered to the patient's abdomen.

  FIG. 30 illustrates yet another embodiment that may be useful for administering the drug to the patient's abdomen. This embodiment includes the use of a modified syringe 971 used with the trocar 972. Trocar 972 has a tubular portion 973 and an enlarged upper portion 974. The change syringe 971 has a hollow body portion 978 of a normal size that receives the plunger 979 in a sealed state. The plunger 979 reciprocates in the main body 978. The main body portion 978 is connected to or integrated with a lower end portion 980 which is elongated, hollow and tubular and has a diffusion device 948 attached to the distal end thereof.

  During use, medication is drawn into the change syringe 971 through the needle or lower end 980. When not yet attached, the lower end 980 is attached. The change syringe 971 is then inserted into the trocar assembly 972 with the lower end 980 and the diffuser 948 slidably mating with the tubular portion of the trocar 972.

  The length of the elongated tubular lower end 980 of the change syringe 971 is such that the distal end 980A of the lower end 980 extends from the end of the tubular portion 973 of the trocar 972 when the change syringe 971 is inserted into the trocar 972. Should be of length. In this way, if it is desired to administer medication to the abdomen during surgery and the modified syringe 971 is fully inserted into the trocar 972, the diffuser 948 is actually present inside the pneumoperitoneum. obtain. Thus, when plunger 979 is depressed, drug already loaded into change syringe 971 passes through diffuser 948 and is in the state of aerosol, spray, mist, mist or vapor (as determined by diffuser 948 and drug). Delivered to the abdomen. There are also drugs that cannot be diffused in the above state.

  FIG. 31 shows a trocar 930 having two inlets. The trocar 930 having two inlets includes a tubular main body 975 having an enlarged upper portion 975A and a single inlet 976 into which an air supply gas supplied from the air supply device 915 is injected. , Similar to trocars well known in the art. A trocar 930 having two inlets having a second inlet 977 is desirable because it may be desirable to introduce a drug into the insufflation gas stream at the trocar. If desired, the insufflation gas stream enters the trocar 930 with two inlets via the first inlet 976 and the drug gas stream enters the trocar via the second inlet 977 (reverse) The same).

  FIG. 32 shows a modified trocar structure shown in FIG. A modified trocar 933 is shown. The modified trocar 933 has a tubular body 975 and an enlarged upper portion 974, similar to the trocar roll described above. The modified trocar 933 also has an inlet 976. However, the modified trocar 933 has a branched inlet 934 instead of the second inlet 977. The bifurcated inlet 934 branches from the inlet 976 to connect the drug flow directly to the modified trocar 933 rather than supplying the drug from a completely separate second inlet. An air delivery device 948 is optionally provided at the distal end of the bifurcated inlet 934. A closure member 968 is optionally provided.

  FIG. 33 shows yet another embodiment that is similar in some respects to the embodiment shown in FIG. This embodiment is almost the same as the structure shown in FIG. 32 and uses a modified trocar 933 having a tubular lower portion 975 and an enlarged upper portion 974 with a single inlet 976 and a branched inlet 934. In this modification, the bifurcated inlet 934 is sized and shaped to fit a pressurized aerosol spray can 981 filled with the desired amount of drug and high pressure gas.

  The pressurized container or spray can 981 has a nozzle 982. The nozzle 982 has an orifice for forming an aerosol spray, mist, mist or vapor. The orifice is selected depending on the drug used. The nozzle 982 is configured to be able to press fit into the branched inlet 934. The diffuser 948 can be omitted from this embodiment because the nozzle can produce the desired diffusion of the drug. Moreover, it can also be installed as needed.

  FIG. 34 is a flowchart illustrating a sequence of steps performed in various embodiments of the invention. In the first step 1000, the patient's P abdomen 922 is accessed. This can be done using any surgical technique known to those skilled in the surgical arts. The surgical technique generally includes surgically incising the patient's abdomen and inserting a trocar therein.

  In the next step 1010, a gas stream of insufflation gas is introduced into the patient's abdomen 922. This includes the steps of providing an air supply device 120, forming a flow path between the air supply device and the trocar, and initially inflating the patient's abdomen with about 2-3 liters of air supply gas. Including. After the patient's abdomen is initially inflated, the insufflation gas continues to flow into the abdomen at a desired rate, or the inflow is stopped depending on the particular situation.

  The drug or drug stream is then introduced into the pneumoperitone with the insufflation gas (step 1020). A predetermined concentration suitable for the particular treatment is selected.

  Once the desired concentration of drug for the surgical procedure to be performed is determined, as described above, there are several ways to introduce the drug into the pneumoperitoneum.

  Regardless of the method used, once the desired amount of drug has been introduced, the flow of drug or drug stream is blocked (step 1030).

  In this specification, various patent documents are referred to. These references have been referred to in order to more fully describe the prior art to which the present invention pertains (which is hereby incorporated by reference).

  As mentioned above, although various embodiment of this invention was described, these embodiment is an illustration and does not limit this invention. Therefore, the scope of the present invention is defined only by the claims and their equivalents.

1 is a schematic view of an apparatus according to the present invention. It is sectional drawing of the gas processing part contained in the apparatus which concerns on this invention. It is the schematic of other embodiment provided with a some chamber in the housing of a gas processing part. FIG. 4 is an end view of the housing of the gas processing unit in the embodiment of FIG. 3. FIG. 6 is an internal view of another embodiment with one or more bags inside the housing. FIG. 6 is an internal view of yet another embodiment with one or more bags outside the housing. FIG. 6 is an interior view of another embodiment comprising a tube member having a restriction opening at its distal end within the housing. It is an inner surface figure of another embodiment provided with the tube member in which the several hole was formed in the inside of a housing along the longitudinal direction. FIG. 6 is a schematic view of yet another embodiment comprising an inkjet printhead for controlled release of a predetermined amount of one or more agents into a gas processing chamber. It is the schematic of the heating element used for a gas processing part. It is sectional drawing of the chamber of a gas processing part, and has shown that the groove | channel was formed in the gas inlet_port | entrance and outlet of a chamber. It is an inner surface figure of the housing of a gas processing part, and has shown the container for releasing a predetermined amount of solid-phase chemical | medical agents. FIG. 13 is an internal view of the housing of the gas processing unit similar to FIG. 12, but the container is located outside the chamber. 1 is a schematic diagram of a circuit for controlling the temperature of a gas and for monitoring the humidity of the gas. FIG. FIG. 6 is a schematic diagram of another embodiment of a circuit for monitoring the humidity of a gas. 1 is a schematic diagram illustrating one embodiment of a device according to the present invention capable of delivering treated or untreated gas and drug to a body cavity, body space and body surface. FIG. 6 is a schematic diagram illustrating another embodiment of a device according to the present invention capable of delivering treated or untreated gas and drug to body cavities, body spaces and body surfaces. FIG. 6 is a schematic diagram illustrating another embodiment of a device according to the present invention capable of delivering treated or untreated gas and drug to a body cavity, body space and body surface. FIG. 6 is a schematic diagram illustrating yet another embodiment of a device according to the present invention capable of delivering treated or untreated gas and drug to body cavities, body spaces and body surfaces. FIG. 6 is a schematic diagram illustrating yet another embodiment of a device according to the present invention capable of delivering treated or untreated gas and drug to body cavities, body spaces and body surfaces. It is a front view which shows the method of introduce | transducing a chemical | medical agent into the chemical | medical agent chamber used by one embodiment of this invention. It is a front view which shows the other method of introduce | transducing a chemical | medical agent to a chemical | medical agent chamber. It is a front view which shows another method of introduce | transducing a chemical | medical agent to a chemical | medical agent chamber. FIG. 6 is a front view showing yet another method for introducing a drug into a drug chamber. It is a front view which shows the method of using a syringe as a chemical | medical agent chamber. It is a front view which shows the method of using a pump as a chemical | medical agent chamber. It is a front view which shows the method of using a pressurization chamber as a chemical | medical agent chamber. It is a front view which shows the method of using a bag as a chemical | medical agent chamber. It is a front view which shows the method of using a piezoelectric chamber as a chemical | medical agent chamber. FIG. 6 shows a further embodiment of the present invention. It is a front view which shows the trocar which has two injection holes which comprise a part of this invention. It is a modification of the structure shown in FIG. FIG. 32 is a further modification of the structure shown in FIG. 31. FIG. Figure 5 is a flow chart illustrating a series of steps performed in various embodiments of the present invention.

Claims (34)

A device for introducing a chemotherapeutic drug into a patient's abdomen,
a) an air supply device;
b) at least one structure defining at least one liquid flow path forming at least part of a path between the air delivery device and the abdomen;
c) a device connected to the at least one structure and configured to supply a chemotherapeutic agent to the interior of the abdomen via the at least one structure. The apparatus of claim 1, comprising:
The apparatus further comprising a diffusion device configured to cause diffusion of the chemotherapeutic agent. The apparatus of claim 1, comprising:
An apparatus characterized in that the chamber is pre-filled. The apparatus of claim 1, comprising:
The apparatus wherein the chamber has an external port for receiving a filling device. The apparatus according to claim 4, comprising:
The filling device is a syringe. The apparatus of claim 1, comprising:
The chamber is a syringe. The apparatus of claim 1, comprising:
The chamber is a bag. The apparatus of claim 1, comprising:
The chamber is a pump. The apparatus of claim 2, comprising:
The diffusion device generates an aerosol. The apparatus of claim 2, comprising:
The diffusing device produces a spray. The apparatus of claim 2, comprising:
The diffusion device generates mist. The apparatus of claim 2, comprising:
The diffusion device generates mist. The apparatus of claim 2, comprising:
The diffusion device generates steam. A chemotherapeutic drug delivery system for use with an insufflation device capable of supplying a gas flow to a patient's abdomen,
a) at least one structure defining at least one liquid flow path that forms at least part of a path between the air delivery device and the abdomen;
b) a system connected to the at least one structure and configured to deliver the chemotherapeutic agent to the interior of the abdomen via the at least one structure. 15. An apparatus according to claim 14, wherein
An apparatus comprising a diffusion device in fluid communication with the chamber downstream of the chamber. 15. An apparatus according to claim 14, wherein
An apparatus comprising a diffusion device disposed between the chamber and the trocar. 15. An apparatus according to claim 14, wherein
An apparatus characterized in that the chamber is pre-filled. 15. An apparatus according to claim 14, wherein
The apparatus wherein the chamber has an external port for receiving a filling device. The apparatus of claim 1, comprising:
The apparatus is characterized in that the chamber is a piezoelectric chamber. A first inlet for the insufflation gas;
A trocar having a second inlet for a chemotherapeutic agent that is separate from the first inlet. A first inlet for the insufflation gas;
A trocar having a branched inlet for a chemotherapeutic agent in fluid connection with the first inlet. A trocar according to claim 21, wherein
The trocar, wherein the aerosol includes a source of pressurized chemotherapeutic agent connected to the branched inlet. A method of administering a chemotherapeutic drug to a patient comprising:
a) supplying a gas stream from an air supply device;
b) injecting at least one chemotherapeutic drug into the gas stream to create a chemotherapeutic drug gas stream;
c) delivering the chemotherapeutic drug gas stream into the patient during an endoscopic procedure. 20. The method according to claim 19, comprising
A method wherein the chemotherapeutic agent is injected by passing the gas stream through a chamber containing an absorbent material that has absorbed at least one predetermined amount of the chemotherapeutic agent. The method of claim 20, comprising:
The chamber further comprises a port in fluid connection with the chamber. The method of claim 20, comprising:
Heating the gas stream in the chamber. The method of claim 20, comprising:
Heating and humidifying the gas stream in the chamber;
The method wherein the humidifying step is performed using a humidifying agent different from the chemotherapeutic agent. The method of claim 20, comprising:
Humidifying the gas stream in the chamber;
The method wherein the humidifying step is performed using a humidifying agent different from the chemotherapeutic agent. 20. The method according to claim 19, comprising
Heating the gas stream. 20. The method according to claim 19, comprising
Heating and humidifying the gas stream. 20. The method according to claim 19, comprising
A method comprising the step of humidifying the gas stream. 20. The method according to claim 19, comprising
Heating the chemotherapeutic drug gas stream. 20. The method according to claim 19, comprising
Heating and humidifying the chemotherapeutic drug gas stream. 20. The method according to claim 19, comprising
Humidifying the chemotherapeutic drug gas stream.

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