US20160220768A1 - Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode - Google Patents
Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode Download PDFInfo
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- US20160220768A1 US20160220768A1 US14/609,952 US201514609952A US2016220768A1 US 20160220768 A1 US20160220768 A1 US 20160220768A1 US 201514609952 A US201514609952 A US 201514609952A US 2016220768 A1 US2016220768 A1 US 2016220768A1
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- 239000000779 smoke Substances 0.000 title claims abstract description 15
- 230000003750 conditioning effect Effects 0.000 claims abstract description 112
- 210000000683 abdominal cavity Anatomy 0.000 claims abstract description 56
- 238000012830 laparoscopic surgical procedure Methods 0.000 claims abstract description 9
- 239000012530 fluid Substances 0.000 claims description 36
- 230000004888 barrier function Effects 0.000 claims description 18
- 238000001914 filtration Methods 0.000 claims description 14
- 238000012546 transfer Methods 0.000 claims description 12
- 238000009530 blood pressure measurement Methods 0.000 claims description 11
- 230000029058 respiratory gaseous exchange Effects 0.000 claims description 11
- 238000007789 sealing Methods 0.000 claims description 9
- 230000003068 static effect Effects 0.000 claims description 8
- 238000004891 communication Methods 0.000 claims description 5
- 230000000737 periodic effect Effects 0.000 claims description 5
- 239000007789 gas Substances 0.000 description 176
- 238000000034 method Methods 0.000 description 10
- 208000005646 Pneumoperitoneum Diseases 0.000 description 9
- 239000003570 air Substances 0.000 description 5
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 230000003187 abdominal effect Effects 0.000 description 3
- 230000001143 conditioned effect Effects 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 230000007246 mechanism Effects 0.000 description 3
- 239000004743 Polypropylene Substances 0.000 description 2
- 229910002092 carbon dioxide Inorganic materials 0.000 description 2
- 239000001569 carbon dioxide Substances 0.000 description 2
- 239000011248 coating agent Substances 0.000 description 2
- 238000000576 coating method Methods 0.000 description 2
- 238000002357 laparoscopic surgery Methods 0.000 description 2
- 239000004033 plastic Substances 0.000 description 2
- -1 polypropylene Polymers 0.000 description 2
- 229920001155 polypropylene Polymers 0.000 description 2
- 206010019909 Hernia Diseases 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 239000012080 ambient air Substances 0.000 description 1
- 238000007486 appendectomy Methods 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 238000002192 cholecystectomy Methods 0.000 description 1
- 230000008878 coupling Effects 0.000 description 1
- 238000010168 coupling process Methods 0.000 description 1
- 238000005859 coupling reaction Methods 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000013059 nephrectomy Methods 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
- A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
- A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
- A61M13/006—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing with gas recirculation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/165—Filtering accessories, e.g. blood filters, filters for infusion liquids
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D46/00—Filters or filtering processes specially modified for separating dispersed particles from gases or vapours
- B01D46/0002—Casings; Housings; Frame constructions
- B01D46/0005—Mounting of filtering elements within casings, housings or frames
- B01D46/0008—Two or more filter elements not fluidly connected positioned in the same housing
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D46/00—Filters or filtering processes specially modified for separating dispersed particles from gases or vapours
- B01D46/52—Particle separators, e.g. dust precipitators, using filters embodying folded corrugated or wound sheet material
- B01D46/521—Particle separators, e.g. dust precipitators, using filters embodying folded corrugated or wound sheet material using folded, pleated material
- B01D46/525—Particle separators, e.g. dust precipitators, using filters embodying folded corrugated or wound sheet material using folded, pleated material which comprises flutes
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D46/00—Filters or filtering processes specially modified for separating dispersed particles from gases or vapours
- B01D46/56—Filters or filtering processes specially modified for separating dispersed particles from gases or vapours with multiple filtering elements, characterised by their mutual disposition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3474—Insufflating needles, e.g. Veress needles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/007—Aspiration
- A61B2218/008—Aspiration for smoke evacuation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/02—Gases
- A61M2202/0225—Carbon oxides, e.g. Carbon dioxide
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/75—General characteristics of the apparatus with filters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/10—Trunk
- A61M2210/1021—Abdominal cavity
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B01—PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
- B01D—SEPARATION
- B01D51/00—Auxiliary pretreatment of gases or vapours to be cleaned
- B01D51/10—Conditioning the gas to be cleaned
Abstract
Description
- 1. Field of the Invention
- The subject invention is directed to laparoscopic surgery, and more particularly, to a disposable filter cartridge with an internal gaseous seal for use with a multimodal gas delivery system employed during laparoscopic surgical procedures requiring smoke evacuation from the abdominal cavity of a patient.
- 2. Description of Related Art
- Laparoscopic or “minimally invasive” surgical techniques are becoming commonplace in the performance of procedures such as cholecystectomies, appendectomies, hernia repair and nephrectomies. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.
- Additionally, such procedures commonly involve filling or “insufflating” the abdominal (peritoneal) cavity with a pressurized fluid, such as carbon dioxide, to create what is referred to as a pneumoperitoneum. The insufflation can be carried out by a surgical access device (sometimes referred to as a “cannula” or “trocar”) equipped to deliver insufflation fluid, or by a separate insufflation device, such as an insufflation (veress) needle. Introduction of surgical instruments into the pneumoperitoneum without a substantial loss of insufflation gas is desirable, in order to maintain the pneumoperitoneum.
- During typical laparoscopic procedures, a surgeon makes three to four small incisions, usually no larger than about twelve millimeters each, which are typically made with the surgical access devices themselves, typically using a separate inserter or obturator placed therein. Following insertion, the inserter is removed, and the trocar allows access for instruments to be inserted into the abdominal cavity. Typical trocars often provide means to insufflate the abdominal cavity, so that the surgeon has an open interior space in which to work.
- The trocar must provide a means to maintain the pressure within the cavity by sealing between the trocar and the surgical instrument being used, while still allowing at least a minimum freedom of movement of the surgical instruments. Such instruments can include, for example, scissors, grasping instruments, and occluding instruments, cauterizing units, cameras, light sources and other surgical instruments. Sealing elements or mechanisms are typically provided on trocars to prevent the escape of insufflation gas. Sealing elements or mechanisms typically include a duckbill-type valve made of a relatively pliable material, to seal around an outer surface of surgical instruments passing through the trocar.
- Further, in laparoscopic surgery, electrocautery and other techniques (e.g. harmonic scalpels) create smoke and other debris in the surgical cavity, reducing visibility by fogging the view from, and coating surfaces of endoscopes and the like. A variety of surgical smoke evacuation systems are known in the art.
- Additionally, SurgiQuest, Inc., Milford, Conn. USA has developed unique surgical access devices that permit ready access to an insufflated surgical cavity without the need for conventional mechanical seals, and it has developed related gas delivery systems for providing sufficient pressure and flow rates to such access devices, as described in whole or in part in U.S. Pat. No. 7,854,724.
- The present invention relates to a multimodal gas delivery system and related devices for performing multiple surgical gas delivery functions, including insufflation, smoke evacuation, recirculation and filtration of insufflation fluids and gases. The use of a single multimodal system reduces operating costs by requiring the purchase of only one system while achieving multiple functions, and also thereby reduces the amount of equipment needed in an operating room, thus reducing clutter and allowing space for other necessary equipment.
- The subject invention is directed to a new and useful system for delivering gas during a laparoscopic surgical procedure performed within a patient's abdominal cavity. The system includes, among other things, a gas delivery device having a housing with a port for receiving insufflating gas from a gas source. The gas delivery device includes a pump assembly for circulating pressurized gas throughout the system. The system further includes a disposable gas conditioning unit or cartridge configured for operative association with the gas delivery device.
- The gas conditioning system includes a first internal flow path for receiving pressurized gas delivered from the pump, a second internal flow path for delivering insufflating gas to the abdominal cavity at a desired flow rate and pressure and for facilitating periodic static pressure measurements from the abdominal cavity, and a third internal flow path for returning pressurized gas to the pump.
- In accordance with a preferred embodiment of the subject invention, the first internal flow path includes a nozzle assembly configured to accelerate the pressurized gas delivered by the pump and thereby generate a continuous pressure barrier contained within the gas conditioning unit. The pressure barrier or working zone that inhibits the egress of insufflating gas from the abdominal cavity and functions to maintain a stable pneumoperitoneum during a surgical procedure.
- The gas conditioning unit includes a generally cylindrical housing having an inlet end and an opposed outlet end. The gas delivery device includes an engagement port for detachably receiving the gas conditioning unit. The outlet end of the gas conditioning unit includes an outlet cover having a first outlet port corresponding to the first internal flow path, a second outlet port corresponding to the second internal flow path and a third outlet port corresponding to the third internal flow path.
- The inlet end of the gas conditioning unit includes an inlet cover having a first inlet port corresponding to the first internal flow path which communicates with a first conduit, a second inlet port corresponding to the second internal flow path which communicates with a second conduit and a third inlet port corresponding to the third internal flow path which communicates with a third conduit.
- The housing of the gas conditioning unit includes a pressure chamber located within the first internal flow path and communicating with the first outlet. The housing of the gas conditioning unit further includes a central nozzle chamber having a cylindrical wall supporting the nozzle assembly. The central nozzle chamber communicates with the pressure chamber through an internal delivery port.
- The nozzle assembly includes a cylindrical jet set having a pair of axially spaced apart outer sealing rings for sealingly isolating the nozzle assembly within the central nozzle chamber. The central nozzle chamber includes a plurality of circumferentially disposed spaced apart axial fins or vanes located distal to the cylindrical jet set of the nozzle assembly for directing gas flow away from the working zone. The central nozzle chamber communicates with a breathing tube proximal to the cylindrical jet set that is open to atmosphere to facilitate entrainment of air into the gas delivery system under certain operating conditions.
- A first filter element is disposed within the pressure chamber for filtering pressurized gas delivered from the pump. The housing of the gas conditioning unit includes a diverter plate which interacts with the outlet cover to define a conditioning cavity disposed in the second internal flow path and configured to support a second filter element for filtering insufflating gas from the gas source.
- The housing of the gas conditioning unit also includes a vacuum chamber located within the third internal flow path. The vacuum chamber communicates with the nozzle chamber through a plurality of gas transfer ports to permit spent gas from the nozzle assembly to return to the pump for repressurization and circulation. A third filter element is disposed within the vacuum chamber for filtering gas returning to the pump from the patient's abdominal cavity.
- The housing of the gas conditioning unit further includes a reservoir chamber located within the third internal flow path, downstream from and in fluid communication with the vacuum chamber through a fluid transfer port. The reservoir chamber will accommodate fluid and debris drawn into the housing of the gas conditioning unit by the suction of the pump. A fluid level sensor is arranged within the reservoir for detecting a predetermined fluid level therein, and alarm set points are associated with these sensors.
- The first conduit includes a fitting for communicating with a first surgical access port, and the first surgical access port includes a mechanical valve or seal associated with a central lumen thereof for accommodating the introduction of surgical instruments into the abdominal cavity. The second conduit includes a fitting for communicating with a second surgical access port responsible for insufflation of and pressure measurement from the abdominal cavity. The third conduit includes a fitting for communicating with a third surgical access port responsible for smoke evacuation from the abdominal cavity.
- The subject invention is also directed to a gas conditioning unit for use with gas delivery device during a laparoscopic surgical procedure performed within a patient's abdominal cavity. The unit includes a housing having an inlet end configured for engagement with the gas delivery device and an opposed outlet end, a first filtered flow path within the housing for receiving pressurized gas from a pump within the gas delivery device, a second filtered flow path within the housing for delivering insufflating gas to the abdominal cavity and for periodically sensing static pressure through a second conduit connected to the outlet end of the housing, and a third filtered flow path for returning pressurized gas to the pump.
- Preferably, the first filtered flow path includes an annular nozzle assembly with a plurality of jets that are dimensioned and configured to accelerate the pressurized gas delivered by the pump and thereby generate a continuous pressure barrier or working zone contained within the gas conditioning unit that inhibits egress of insufflation gas from the abdominal cavity, while maintaining a stable pneumoperitoneum.
- The outlet end of the conditioning unit or cartridge includes an outlet cover having a first outlet port corresponding to the first filtered flow path, a second outlet port corresponding to the second filtered flow path and a third outlet port corresponding to the third filtered flow path.
- The inlet end of the gas conditioning unit includes an inlet cover having a first inlet port corresponding to the first filtered flow path which communicates with the first conduit, a second inlet port corresponding to the second filtered flow path which communicates with the second conduit and a third inlet port corresponding to the third filtered flow path which communicates with the third conduit. The housing of the gas conditioning unit includes a pressure chamber located within the first flow path and communicating with the first outlet.
- The housing of the gas conditioning unit also includes a central nozzle chamber having a cylindrical wall supporting the annular nozzle assembly. The central nozzle chamber communicates with the pressure chamber through an internal delivery port. The annular nozzle assembly includes a cylindrical jet set having a pair of axially spaced apart outer sealing rings for sealingly isolating the nozzle assembly within the central nozzle chamber. The central nozzle chamber includes a plurality of circumferentially disposed spaced apart axial fins distal to the cylindrical jet set for directing gas flow. The central nozzle chamber communicates with a breathing tube proximal to the cylindrical jet set that is open to atmosphere for air entrainment.
- A first filter element is disposed within the pressure chamber for filtering pressurized gas from the pump. The housing of the gas conditioning unit includes a diverter plate which interacts with the outlet cover to define a conditioning cavity disposed in the second filtered flow path and configured to support a second filter element for filtering insufflation gas from the gas source.
- The housing of the gas conditioning unit also includes a vacuum chamber located within the third filtered gas path. The vacuum chamber communicates with the nozzle chamber through a plurality of gas transfer ports to permit spent gas from the nozzle assembly to return to the pump for repressurization and circulation. A third filter element is disposed within the vacuum chamber for filtering gas returning to the pump from the patient's abdominal cavity.
- The housing of the gas conditioning unit further includes a reservoir chamber located within the third filtered flow path, downstream from and in fluid communication with the vacuum chamber through a fluid transfer port, for accommodating any fluid or debris drawn into the housing of the gas conditioning unit by the suction of the pump. A fluid level sensor is arranged within the reservoir for detecting a predetermined fluid level therein. An alarm is operatively associated with these sensors.
- The first conduit includes a fitting for communicating with a first surgical access port, and the first surgical access port includes a mechanical valve associated with a central lumen thereof for accommodating the introduction of surgical instruments into the abdominal cavity. The second conduit includes a fitting for communicating with a second surgical access port responsible for insufflation and pressure measurement of the abdominal cavity. The third conduit includes a fitting for communicating with a third surgical access port responsible for smoke evacuation from the abdominal cavity.
- These and other features of the surgical gas delivery system and the gas conditioning device of the subject invention and the manner in which both are manufactured and employed will become more readily apparent to those having ordinary skill in the art from the following enabling description of the preferred embodiments of the subject invention taken in conjunction with the several drawings described below.
- So that those skilled in the art to which the subject invention appertains will readily understand how to make and use the gas delivery system of the subject invention without undue experimentation, preferred embodiments thereof will be described in detail herein below with reference to certain figures, wherein:
-
FIG. 1 is an illustration of the operating environment in which the gas delivery system of the subject invention is employed during a laparoscopic surgical procedure, which includes, among other things, a gas delivery device having a housing with a port for receiving insufflation gas from a gas source, a pump for circulating pressurized gas and a disposable gas conditioning unit; -
FIG. 2 is a perspective view of the gas delivery device and separate gas conditioning unit illustrated inFIG. 1 ; -
FIG. 3 is a perspective view of the gas conditioning unit of the subject invention as viewed from the front end of the unit, illustrating the three conduits extending therefrom; -
FIG. 4 is a perspective view of the gas conditioning unit of the subject invention as viewed from the rear end of unit, illustrating the three ports thereof; -
FIG. 5 is an exploded perspective view of the gas conditioning unit of the subject invention, with parts separated for ease of illustration; -
FIG. 6 is an exploded perspective view of the annular jet rings which form the internal nozzle assembly of the gas conditioning unit shown inFIG. 5 ; -
FIG. 7 is a cross-sectional perspective view of the gas conditioning unit of the subject invention taken along line 7-7 ofFIG. 3 , illustrating the location of the filter elements within the housing of the gas conditioning unit; -
FIG. 8 is a cross-sectional perspective view of the gas conditioning unit of the subject invention, taken along line 8-8 ofFIG. 3 , illustrating the internal features of the vacuum chamber within the housing of the unit; -
FIG. 9 is a cross-sectional view of the gas conditioning unit of the subject invention, with a wall broken away to show the liquid level sensing prisms in the reservoir; -
FIG. 10 is a cross-sectional view of the gas conditioning unit of the subject invention with a wall broken away to illustrate the insufflation/sensing path layout within the housing of the unit; -
FIG. 11 is a cross-sectional view of the gas conditioning unit of the subject invention with a wall broken away to illustrate the pressure path layout within the housing of the unit; -
FIG. 12 is a localized cross-sectional view of the central nozzle chamber within the housing, where the internal pressure barrier or working zone is formed by the nozzle assembly, remote from the surgical site; -
FIG. 13 is a cross-sectional view of the gas conditioning unit of the subject invention with a wall broken away to illustrate the vacuum path layout within the housing; -
FIG. 14 illustrates the manner in which the flexible conduits associated with the gas conditioning unit are connected to respective surgical access devices communicating directly with the abdominal cavity of a patient, which includes a conventional valved trocar for instrument access, a cannula for vacuum return associated with smoke evacuation and another cannula for insufflation and sensing; -
FIG. 15 is an enlarged localized perspective view of the conventional valved cannula shown inFIG. 14 ; and -
FIG. 16 is an exploded perspective view of the components of the coupling used to connect the pressurized gas supply conduit to the conventional trocar shown inFIG. 13 . - Referring now to the drawings wherein like reference numerals identify similar structural features or aspects of the subject invention, there is illustrated in
FIGS. 1 and 2 , a new and useful system for delivering and circulating medical gas (e.g., carbon dioxide) during a laparoscopic surgical procedure performed within a patient's abdominal cavity that involves the evacuation of smoke generated from an electrocautery device or other instrument (e.g., harmonic scalpels), which would otherwise reduce visibility within the cavity by fogging the view from, and coating surfaces of endoscopes and the like. - The gas delivery system, which is designated generally by
reference numeral 10 includes, among other things, agas delivery device 12 having ahousing 14 with a rear connector orport 16 for receiving pressurized insufflation gas from agas source 18. As shown, thegas source 18 is a portable supply canister. However, it is envisioned that the medical or insufflating gas could be supplied from another source, including for example, a remote storage tank (e.g., house gas) as is well known in the art. Apump assembly 20 is enclosed within thehousing 14 ofdelivery device 12 for circulating pressurized gas throughout thesystem 10 to maintain a stable pneumo-peritoneum during a surgical procedure. - A graphical user interface 25 with associated control circuitry is provided within the
housing 14 ofgas delivery device 12 for controlling the operation of thepump assembly 20, as well as the delivery of insufflating gas fromsupply source 18. The interface and associated circuitry enables a user to readily adjust flow rates and supply pressures relating to the delivery, circulation and recirculation of gas and fluid throughout the system. - The
gas delivery system 10 further includes a separate and preferably disposablegas conditioning unit 30, which is dimensioned and configured for operative association with thegas delivery device 12. As described in more detail below, thegas conditioning unit 30 is constructed in such a manner so that a continuous gaseous pressure barrier is generated within the housing of the unit itself, remote from the patient. This gaseous pressure barrier or working zone prevents the egress of insufflation gas from the abdominal cavity of the patient while maintaining a stable pneumoperitoneum within the abdominal cavity. This feature differs from the multi-modal gas delivery systems disclosed in commonly assigned U.S. Pat. No. 7,854,724, wherein the gaseous pressure barrier is generated within the housing of a specialized trocar at the surgical site. - The
gas conditioning unit 30 includes a number of internal flow paths configured to facilitate the periodic delivery of insufflating gas, as well as the continuous circulation and recirculation of pressurized gas. In particular, a first internal flow path (i.e., the pressure path shown inFIG. 11 ) is provided for receiving pressurized gas from thepump assembly 20 of thegas delivery device 12. The first internal flow path is associated with afirst conduit 32 that is connected to a first surgical access device or trocar 34. The trocar 34 is the primary path for introducing surgical instrumentation into the abdominal cavity during a surgical procedure, and it has a mechanical seal installed therein. The pressurized gas is used to create a pressure barrier within thegas conditioning unit 30 that prevents the egress of gas from the abdominal cavity by way ofconduit 32. In doing so, it also maintains a stable pneumoperitoneum within the abdominal cavity of thepatient 15. - The
gas conditioning unit 30 further includes a second internal flow path (i.e., the sense/insufflation path shown inFIG. 10 ) for delivering insufflating gas from thegas delivery device 12 to the abdominal cavity of thepatient 15 and for facilitating periodic static pressure measurements from the abdominal cavity by way of asecond conduit 36 connected to a second surgical access device orcannula 38. The duration of the insufflation interval between pressure measurements can vary, depending upon the patient and the operating environment. This flow and stop methodology for obtaining static pressure measurements from the abdominal cavity is well known in the art. - The
gas conditioning unit 30 also includes a third internal flow path (i.e., the vacuum path shown inFIG. 13 ) for returning pressurized gas to thepump assembly 20 of thegas delivery device 12 by way of athird conduit 40 connected to a second surgical access device orcannula 42. The gas returned to thepump assembly 20 comes from two locations or sources. This includes the pressurized gas that was used to create the pressure barrier within theconditioning unit 30 and gas from within the abdominal cavity of the patient 15 that may be carrying smoke and debris resulting from an electrocautery procedure or the like. - With continuing reference to
FIG. 2 , thegas conditioning unit 30 is adapted and configured for ready installation into and removal from thehousing 14 ofgas delivery device 12 by way of a interfitting lug arrangement. More particularly, as best seen inFIGS. 3 and 4 , the generallycylindrical housing 50 ofgas conditioning unit 30 includes a plurality of circumferentially spaced apart engagement lugs, including an L-shapedlug 52 and a square-shapedlug 54. A third lug 56 can be seen inFIG. 8 . The three engagement lugs 52, 54 and 56 are dimensioned and configured to interact with correspondingly shaped and positionedrecesses cartridge engagement port 60 formed in the front panel ofhousing 14, as shown inFIG. 2 . - With continuing reference to
FIGS. 3 and 4 , thehousing 50 ofgas conditioning unit 30 includes a front end cap orinlet cover 70 and a rear end cap orouter cover 90. Thefront end cap 70 has three conduit connection tubes associated therewith. These include a first or centralconduit connection tube 72 that extends through anaperture 75 in thefront end cap 70 and is operatively associated with thefirst conduit 32, shown inFIGS. 1 and 2 .Front end cap 70 also includes a secondconduit connection tube 76 operatively associated with thesecond conduit 36 and a thirdconduit connection tube 80 operatively associated with thethird conduit 40, which are also shown inFIGS. 1 and 2 . - The
rear end cap 90 includes three outlet ports, each having an associated sealing ring. Thefirst outlet port 92 communicates with the first internal flow path (i.e., the pressure path shown inFIG. 11 ) and ultimately withtube 72. Thesecond outlet port 94 communicates with the second internal flow path (i.e., the sense/insufflation path shown inFIG. 10 ) and ultimately withtube 80. Thethird outlet port 96 communicates with the third internal flow path (i.e., the vacuum path shown inFIG. 13 ) and ultimately withtube 96. - The
first outlet port 92 includes a first O-ring seal 102, thesecond outlet port 94 includes a second O-ring seal 104 and thethird outlet port 96 includes a third O-ring seal 106. The three O-rings seals rear end cap 90 to cooperate with corresponding features within thecartridge engagement port 60 in the front panel ofhousing 14. - A similar co-planar arrangement of O-ring seals is disclosed in commonly assigned U.S. Patent Application Publication 2012/0138523, which is incorporated herein by reference in its entirety. In addition, the
rear end cap 90 includes acentral exhaust port 108, which permits the entrainment of air into the recirculation flow under certain operating conditions. This will be described in more detail hereinbelow. - Referring now to
FIG. 5 , there is illustrated thegas conditioning unit 30 with each of the components parts thereof separated from thecylindrical housing 50 for ease of illustration. Also shown are certain internal features of thehousing 50 ofconditioning unit 30. Starting there, thehousing 50 includes several internal cavities for supporting components and/or defining gas/fluid flow passages. At the front end ofhousing 50, there is avacuum chamber 110, which is located within the third internal flow path (i.e., the vacuum path shown inFIG. 13 ). - The
vacuum chamber 110 is dimensioned and configured to support a cylindrical pleated filter element 120 (see alsoFIG. 7 ). Thepleated filter element 120 is preferably made from a porous non-woven or melt-blown filter media fabricated from a plastic material such as polypropylene or the like.Filter element 120 has an offsetbore 122 to accommodate the passage of the centralconduit connection tube 72 therethrough, when theunit 30 is fully assembled. - As best seen in
FIGS. 7 and 9 , thehousing 50 ofgas conditioning unit 30 further includes areservoir chamber 130, which is also located within the third internal flow path, downstream from and in fluid communication with thevacuum chamber 110. More particularly, thereservoir chamber 130 communicates with thevacuum chamber 110 through afluid transfer port 132 formed in theinternal wall 135 ofhousing 50. Any fluid or debris drawn into thehousing 50 of thegas conditioning 30 unit by the suction ofpump 20 ingas delivery device 12 accumulates first within thevacuum chamber 110 until it reaches the level of thetransfer port 132, whereupon such fluid enters into thereservoir chamber 130. - Referring to
FIG. 9 , prism shapedfluid level sensors reservoir chamber 130 for detecting a predetermined fluid level therein. The structure and function of thefluid level sensors - With continuing reference to
FIG. 5 in conjunction withFIGS. 7 and 9 , thehousing 50 ofgas conditioning unit 30 further includes apressure chamber 140 located within the first internal flow path (i.e., the pressure path shown inFIG. 11 ).Pressure chamber 140 is dimensioned and configured to support a cylindrical pleated filter element 150 (see alsoFIG. 7 ).Pleated filter element 150 is preferably made from a porous non-woven or melt-blown filter media fabricated from a plastic material such as polypropylene or the like. -
Filter element 150 has acentral bore 152 to accommodate acylindrical breathing tube 165.Breathing tube 165 communicates with thecentral breathing port 108 in therear end cap 90 to facilitate the entrainment of ambient air into the system under certain operating conditions. As best seen inFIGS. 5 and 7 , anannular barrier wall 160 separates and fluidly isolates thereservoir chamber 130 from thepressure chamber 140. Thebarrier wall 160 is seated on anannular ledge 162 formed in the inner wall of thehousing 50. - The
housing 50 ofgas conditioning unit 30 also includes acentral nozzle chamber 170 defined primarily by acylindrical wall 172, which is surrounded bypleated filter 150. Thecentral nozzle chamber 170 communicates with thepressure chamber 140 through an internal delivery port 174 (seeFIGS. 5 and 11 ). Thecentral nozzle chamber 170 supports a two-partannular nozzle assembly 180, which is shown in a separated condition inFIG. 6 . Theannular nozzle assembly 180 is described in greater detail in commonly assigned U.S. Pat. No. 8,795,223, which is herein incorporated by reference in its entirety. - In general, the
annular nozzle assembly 180 includes upper and lowerring jet components lugs 182 a-182 d and 184 a-184 d. The upperring jet component 182 includes a centraltubular portion 183 having a set of circumferentially spaced apart recessed areas 185 forming a set of spaced apartland areas 187. The lowerring jet component 184 includes acontinuous seating surface 189 for intimately receiving thetubular portion 183 of upperring jet component 182. - When the two
ring jet components land areas 187 of thetubular portion 183 and thecontinuous seating surface 189. When pressurized air is delivered from thepressure chamber 140, through thedelivery port 174, into thenozzle chamber 170, and then through thenozzle 180 formed by the intimate engagement of thetubular portion 183 and thecontinuous seating surface 189, a pressure barrier or working zone is created within thehousing 50 ofconditioning unit 30 to prevent the egress of insufflation gas from the abdominal cavity of a patient by way ofconduit 32. This is best seen inFIG. 12 . - The
annular nozzle assembly 180 further includes a pair of axially spaced apart outer sealing rings 186 a, 186 b for sealingly isolating thenozzle assembly 180 within thecentral nozzle chamber 170, as best seen inFIG. 7 . Thecentral nozzle chamber 170 ofhousing 50 includes a plurality of circumferentially disposed spaced apart axial vanes orfins 190 located distal to thecylindrical jet set vanes 190 are adapted and configured to direct the flow of spent gas (i.e., pressurized gas that has lost its momentum after being delivered from the jet set nozzle assembly 180) away from the working zone. - The
central nozzle chamber 170 communicates with thebreathing tube 165, which is located proximal to thenozzle assembly 180. Thebreathing tube 165 is open to atmosphere and permits the entrainment of air into the recirculation flow of the gas delivery system under certain operating conditions. Thebreathing tube 165 includes abase portion 167 that forms an end cap for thenozzle chamber 170. - Referring to
FIGS. 8 and 9 , thevacuum chamber 110 communicates withcentral nozzle chamber 170 through a plurality ofgas transfer ports 192 formed in theinternal wall 135 ofhousing 50. Thegas transfer ports 192 permit spent gas from thenozzle assembly 180 to return to thepump 20 for repressurization and circulation, as explained in more detail below. This is caused by suction created bypump 20. - Referring once again to
FIG. 5 , thehousing 50 of thegas conditioning unit 30 also includes adiverter plate 210 which interacts with theoutlet cover 90 to define, among other features, aconditioning cavity 212 therebetween. Theconditioning cavity 212 forms part of the second internal flow path, communicates withoutlet port 94 inend cap 90, and is configured to support aplanar filter element 220 made from a non-woven mesh or the like for filtering insufflation gas delivered from thegas source 18.Diverter plate 210 also includes a central aperture 215 to accommodate the passage ofbreathing tube 165. - Referring now to
FIG. 10 , during operation, insufflation gas is delivered from thegas source 18 into theconditioning cavity 212 through theinlet port 94 in therear end cap 90. The gas is conditioned or otherwise filtered as it passes throughplanar filter element 220. The filtered gas exists theconditioning cavity 212 through the crescent shapedside aperture 214 indiverter plate 210 and then flows into the internalside flow passage 216 ofhousing 50. The insufflating gas then exits from thehousing 50 by way ofconduit tube 80 in thefront end cap 70 for delivery to the patient 15 throughflexible conduit 36. - This same pathway shown in
FIG. 10 is used to periodically sense abdominal pressure. That is, the flow of insufflation gas fromgas source 18 is intermittently turned off by a valve (not shown) located in thehousing 14 ofgas delivery device 12. As a result, there are intervals of time in which there is no flow through the sensing path (e.g. throughpath 216 in housing 50). At such times, static pressure within the abdominal cavity can be measured by thegas delivery device 12 by way ofconduit 36. This pressure measurement is utilized to adjust the flow of gas to the abdominal cavity, for example. - Referring now to
FIG. 11 , during operation, pressurized gas is delivered from thepump 20 ingas delivery device 12 through theinlet port 92 in therear end cap 90. The pressurized gas then passes through the centrally offsetcircular aperture 218 indiverter plate 210 and then into thepressure chamber 140, where it is conditioned or otherwise filtered by passing throughpleated filter element 150. - The pressurized gas then travels to the
central nozzle chamber 170 by way ofinternal delivery port 174. In thecentral nozzle chamber 170, the pressurized gas is directed through thenozzle assembly 180 where it forms a pressure barrier within the upper region of centraltubular passage 280 that is operatively associated with theconduit tube 72, as best seen inFIG. 12 . This pressure barrier or working zone prohibits the egress of insufflation gas coming up from the abdominal cavity throughflexible conduit 32 andconduit tube 72, while maintaining a stable pneumoperitoneum within the abdominal cavity of thepatient 15. - Referring to
FIG. 13 , during operation, gas from the abdominal cavity of the patient is drawn into thehousing 50 throughconduit connection 76 ofend cap 70 under the suction created bypump 20. The gas that is drawn into thehousing 50 may include bodily fluids, smoke from cauterization procedures and/or other debris from the ongoing laparoscopic surgical procedure. That flow of fluid/gas/solids is filtered within thevacuum chamber 110 bypleated filter element 120. The filtered gas is drawn out ofvacuum chamber 110 through theside port 282 and into thelateral flow path 284 formed inhousing 50. That gas then flows through the crescent shapedside aperture 285 indiverter plate 210 and out of thehousing 50 throughexit port 96 in therear end cap 90. - The suction from
pump assembly 20 also draws the spent fluid/gas that had been used to develop the pressure barrier within the conditioning unit through theplural apertures 192 formed in the floor of thenozzle chamber 170. That spent fluid/gas enters into thevacuum chamber 110, flows through theside port 282 and into thelateral flow path 284. The spent fluid/gas along with the filtered gas from the abdomen exits thehousing 50 throughexit port 96 and returns to pump 20. The conditioned flow is repressurized by thepump 20 and recirculated back to thehousing 50 throughpressure aperture 92 for subsequent delivery to thenozzle assembly 180 innozzle chamber 170. - Referring now to
FIGS. 14 through 16 , as discussed above, the flexible conduits associated with thegas conditioning unit 30 are respectively connected to separate surgical access devices communicating directly with the abdominal cavity of a patient. These devices include a conventional valved trocar for enabling instrument access 34, as shown inFIG. 15 . That is, trocar 34 includes a mechanical valve such as a duckbill valve or the like designed to mechanically inhibit the egress of insufflating gas from the abdominal cavity by way of the access port, in combination with the pressure barrier or working zone formed withinconditioning unit 30 bynozzle assembly 180. The access devices further include a firstconventional cannula 38 for vacuum return associated with smoke evacuation procedures, and a secondconventional cannula 42 for facilitating insufflation of and static pressure sensing from theabdominal cavity 15. - Because a conventional trocar includes a standard leur-
type fitting 340, an adapter assembly 300 is provided to connect thelarge diameter conduit 32 to the fitting 340 of the trocar 34. The adapter assembly 300 includes a singlelumen tubing connector 320 having afirst end 322 dimensioned and configured to receive thelarge diameter conduit 32 and asecond end 324 of reduced sized for communicating with the trocar 34. - The
tubing connector 320 is supported within a rotatablegripping collar 330, and thegripping collar 330 interfits with a threadedmember 342. The threadedmember 342 connects directly with the leur fitting 340 on trocar 34. The threadedmember 342 includes a plurality of rearward facing ratchetfingers 344 for interacting with a series of steppedratchet pawls 346 formed within the interior of thegripping collar 330. This interaction allows for a specific torque to be applied to thecollar 330 when connecting theconduit 32 to trocar 34. A similar mechanism is disclosed in commonly assigned U.S. patent Application publication 2014/0171855, the disclosure of which is herein incorporated by reference in its entirety. - While the gas delivery device and associated gas conditioning unit of the subject invention have been shown and described with reference to a preferred embodiment, those skilled in the art will readily appreciate that various changes and/or modifications may be made thereto without departing from the spirit and scope of the subject invention as defined by the appended claims. For example, the locations and relative positions of each of the gas flow paths formed within the conditioning unit could vary, and the type and size of the filter elements used within the conditioning unit could also vary.
Claims (37)
Priority Applications (13)
Application Number | Priority Date | Filing Date | Title |
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US14/609,952 US9387295B1 (en) | 2015-01-30 | 2015-01-30 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
US14/628,711 US9387296B1 (en) | 2015-01-30 | 2015-02-23 | Filter cartridge with integrated gaseous seal for multimodal surgical gas delivery system |
CA2974906A CA2974906C (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
KR1020177024176A KR102092578B1 (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gas-phase seal for multi-mode surgical gas carrier with ventilation mode |
JP2017540769A JP6661650B2 (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gas seal used for a multi-mode surgical gas delivery system with a smoke evacuation mode |
PCT/US2016/015042 WO2016123173A1 (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
AU2016211651A AU2016211651B9 (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
EP16708229.6A EP3250274A1 (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
CN201680008124.1A CN107427755B (en) | 2015-01-30 | 2016-01-27 | Filter cartridge with internal gas seal for multi-mode surgical gas delivery system having smoke evacuation mode |
US15/177,532 US10159809B2 (en) | 2015-01-30 | 2016-06-09 | Multipath filter assembly with integrated gaseous seal for multimodal surgical gas delivery system |
US16/121,036 US10960150B2 (en) | 2015-01-30 | 2018-09-04 | Multipath filter assembly with integrated gaseous seal for multimodal surgical gas delivery system |
US16/120,957 US11202870B2 (en) | 2015-01-30 | 2018-09-04 | Multipath filter assembly with integrated gaseous seal for multimodal surgical gas delivery system |
US17/522,651 US20220062567A1 (en) | 2015-01-30 | 2021-11-09 | Multipath filter assembly with integrated gaseous seal for multimodal surgical gas delivery system |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US14/609,952 US9387295B1 (en) | 2015-01-30 | 2015-01-30 | Filter cartridge with internal gaseous seal for multimodal surgical gas delivery system having a smoke evacuation mode |
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US14/628,711 Continuation-In-Part US9387296B1 (en) | 2015-01-30 | 2015-02-23 | Filter cartridge with integrated gaseous seal for multimodal surgical gas delivery system |
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US9387295B1 US9387295B1 (en) | 2016-07-12 |
US20160220768A1 true US20160220768A1 (en) | 2016-08-04 |
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US (1) | US9387295B1 (en) |
EP (1) | EP3250274A1 (en) |
JP (1) | JP6661650B2 (en) |
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CN (1) | CN107427755B (en) |
AU (1) | AU2016211651B9 (en) |
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AU2016211651B9 (en) | 2020-11-05 |
JP2018503478A (en) | 2018-02-08 |
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CN107427755A (en) | 2017-12-01 |
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AU2016211651B2 (en) | 2020-07-02 |
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KR20170118765A (en) | 2017-10-25 |
CN107427755B (en) | 2020-07-03 |
WO2016123173A1 (en) | 2016-08-04 |
CA2974906C (en) | 2023-08-01 |
EP3250274A1 (en) | 2017-12-06 |
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