WO2023026118A1

WO2023026118A1 - In-situ scope cleaner

Info

Publication number: WO2023026118A1
Application number: PCT/IB2022/057244
Authority: WO
Inventors: Henry E. Holsten
Original assignee: Covidien Lp
Priority date: 2021-08-26
Filing date: 2022-08-04
Publication date: 2023-03-02

Abstract

A surgical kit includes a cannula assembly, a sleeve, and an endoscope. The cannula assembly includes a housing including an insufflation port and a cannula defining a first lumen in communication with the insufflation port. The sleeve includes an elongate shaft and a diffusing cap. The elongate shaft defines a second lumen. The elongate shaft includes a seal forming a fluid-tight seal against the cannula. The elongate shaft defines a bore in communication with the second lumen. The endoscope includes a housing, a shaft extending from the housing, and a lens. The shaft is configured to be received in the second lumen of the sleeve. When the sleeve is received through the first lumen of the cannula assembly, the second lumen of the sleeve is in communication with the insufflation port of the housing of the cannula assembly and the diffusing cap of the sleeve.

Description

IN- SITU SCOPE CLEANER

TECHNICAL FIELD

[0001] The disclosure relates to a minimally invasive viewing instrument and, more particularly, to an in-situ endoscope cleaning assembly for removing debris from a lens of the endoscope.

BACKGROUND

[0002] Minimally invasive surgery eliminates the need to make a large incision in a patient, thereby reducing discomfort, recovery time, and many of the deleterious side effects associated with traditional open surgery. Minimally invasive viewing instruments such as, e.g., laparoscopes and endoscopes, provide viewing of internal tissues and/or organs during the minimally invasive surgery.

[0003] Laparoscopic surgery involves the placement of a laparoscope in a small incision in the abdominal wall of a patient, to view the surgical site. Endoscopic surgery involves the placement of an endoscope in a naturally occurring orifice, e.g., mouth, nose, anus, urethra, or vagina, to view the surgical site. Other minimally invasive surgical procedures include video assisted thoracic surgery and cardiovascular surgery conducted through small incisions between the ribs. These procedures also utilize scopes to view the surgical site.

[0004] A typical minimally invasive viewing instrument, e.g., a laparoscope or an endoscope, includes a housing, an elongate lens shaft extending from one end of the housing, and a lens that is provided in a distal end of the elongate lens shaft. A camera viewfinder extends from the other end of the housing. A camera is connected to the housing and transmits images sighted through the lens to an external monitor on which the images are displayed. During a surgical procedure, the distal end portion of the elongate lens shaft is extended into the patient, while the proximal end portion of the elongate lens shaft, the housing and the camera viewfinder remain outside the patient. In this manner, the laparoscope/ endoscope is positioned and adjusted to view particular anatomical structures in the surgical field on the monitor. [0005] During insertion of an endoscope or a laparoscope into the body and during the surgical procedure, debris, e.g., organic matter and/or moisture, may be deposited on the lens of the scope. The buildup of debris and condensation on the lens impairs visualization of the surgical site, and often necessitates cleaning of the lens.

SUMMARY

[0006] The disclosure describes a cleaning assembly of use with an endoscope that demonstrates a practical approach to meeting the performance requirements and overcoming usability challenges associated with cleaning a lens of an endoscope during a surgical procedure. [0007] In accordance with the disclosure, a surgical kit includes a cannula assembly, a sleeve, and an endoscope. The cannula assembly includes a housing including an insufflation port and a cannula defining a first lumen in fluid communication with the insufflation port. The sleeve includes an elongate shaft and a diffusing cap disposed at a distal portion of the elongate shaft. The elongate shaft defines a second lumen. The elongate shaft is dimensioned to be received in the first lumen of the cannula of the cannula assembly. The elongate shaft includes a seal configured to form a fluid-tight seal against the cannula of the cannula assembly. The elongate shaft defines a bore in communication with the second lumen. The endoscope includes a housing, a shaft extending from the housing, and a lens disposed at a distal end portion of the shaft. The shaft is configured to be received in the second lumen of the sleeve such that the lens of the endoscope is disposed adjacent the diffusing cap. When the sleeve is received through the first lumen of the cannula assembly, the second lumen of the sleeve is in communication with the insufflation port of the housing of the cannula assembly and the diffusing cap of the sleeve.

[0008] In an aspect, the diffusing cap may define first slots in communication with the second lumen of the sleeve.

[0009] In another aspect, the elongate shaft of the sleeve may define a fluid channel coupled to a fluid source. The fluid channel may extend along a length of the elongate shaft.

[00010] In yet another aspect, the diffusing cap may further define a second slot in communication with the fluid channel of the elongate shaft of the sleeve.

[00011] In still yet another aspect, the elongate shaft may include splines extending along a length of the elongate shaft such that adjacent splines define a groove therebetween. [00012] In still yet another aspect, when the endoscope is received in the second lumen of the sleeve, each groove may define a conduit between the diffusing cap and the bores of the sleeve. [00013] In still yet another aspect, the elongate shaft of the sleeve may further include an Ciring disposed at a position along a length of the elongate shaft.

[00014] In accordance with another aspect of the disclosure, a surgical kit includes a cannula assembly, a sleeve, and an endoscope. The cannula assembly includes a housing defining passage and including an insufflation port coupled to an insufflation gas supply to receive an insufflation gas and a cannula extending from the housing. The cannula includes an inner surface and defines a first lumen in communication with the passage. The sleeve includes a head portion, an elongate shaft extending from the head portion, and a diffusing cap disposed at a distal portion of the elongate shaft. The elongate shaft includes inner and outer surfaces and defines a second lumen. A portion of the elongate shaft forms a fluid-tight seal against the cannula of the cannula assembly when the sleeve is received in the first lumen of the cannula. The elongate shaft defines a bore in communication with the second lumen. The endoscope includes a housing, a shaft extending from the housing, and a lens at a distal end portion of the shaft. When the sleeve is received through the first lumen of the cannula assembly, the inner surface of the cannula and the outer surface of the elongate shaft of the sleeve define a first gap in communication with the second lumen of the sleeve. When the endoscope is received in the second lumen of the sleeve, the inner surface of the sleeve and an outer surface of the endoscope define a second gap in communication with the diffusing cap of the sleeve.

[00015] In an aspect, the elongate shaft of the sleeve may include an O-ring to form the fluid- tight seal against the cannula of the cannula assembly. The bore of the elongate shaft of the sleeve may be proximal of the O-ring.

[00016] In another aspect, the diffusing cap of the sleeve may define first slots in communication with the second gap.

[00017] In yet another aspect, the first slots of the diffusing cap may be circumferentially arranged.

[00018] In still yet another aspect, the elongate shaft may define a fluid channel extending along a length of the elongate shaft. [00019] In still yet another aspect, the head portion of the sleeve may have a fluid port coupled to a fluid source. The fluid port may be in communication with the fluid channel of the elongate shaft of the sleeve.

[00020] In still yet another aspect, the diffusing cap of the sleeve may define a second slot in communication with the fluid channel of the elongate shaft of the sleeve.

[00021] In still yet another aspect, the head portion of the sleeve may have a support defining a cutout configured to detachably support a connector of the endoscope.

[00022] In still yet another aspect, the head portion of the sleeve may include a proximal cap including a seal forming a fluid-tight seal against the endoscope.

[00023] In still yet another aspect, when the endoscope is received in the second lumen of the sleeve, the lens of the endoscope may be proximal of the diffusing cap.

[00024] In accordance with yet another aspect of the disclosure, a sleeve for use with an endoscope includes a head portion defining a passage to receive a shaft of an endoscope, an elongate shaft extending from the head portion and defining a lumen and a lateral bore in communication with the lumen, and a diffusing cap disposed at a distal portion of the elongate shaft. The elongate shaft includes a circumferential seal distal of the bore. The diffusing cap defines a first slot in communication with the lumen of the elongate shaft.

[00025] In an aspect, the head portion may include a fluid port coupled to a fluid source and the elongate shaft may define a fluid channel.

[00026] In another aspect, the elongate shaft may include splines to define a channel to direct a fluid to the first slot of the diffusing cap.

BRIEF DESCRIPTION OF DRAWINGS

[00027] The above and other aspects and features of this disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements.

[00028] FIG. 1 is a perspective view of a sleeve for use with an endoscope in accordance with the disclosure;

[00029] FIG. 2 is an exploded perspective view of the sleeve of FIG. 1 with parts separated;

[00030] FIG. 3 is a partial perspective view of the sleeve of FIG. 1; [00031] FIG. 4 is an enlarged view of the indicated area of detail of FIG. 1;

[00032] FIG. 5 is an enlarged view of the indicated area of detail of FIG. 1;

[00033] FIG. 6 is a partial perspective view of a distal portion of the sleeve of FIG. 1 with a diffusing cap separated from an elongate shaft of the sleeve;

[00034] FIG. 7 is a cutaway view of the sleeve of FIG. 4 taken along section line of 7-7 of FIG.

4;

[00035] FIG. 8 is a cross-sectional view of the sleeve of FIG. 1 taken along section line of 8-8 of FIG. 1;

[00036] FIG. 9 is a perspective view of a surgical kit including a cannula assembly, an endoscope, and the sleeve of FIG. 1;

[00037] FIG. 10 is a perspective view of the surgical kit of FIG. 9, illustrating use thereof;

[00038] FIG. 11 is an enlarged view of the indicated area of detail of FIG. 10;

[00039] FIG. 12 is a cross-sectional view of the surgical kit of FIG. 10 taken along section line 12-12 of FIG. 10;

[00040] FIG. 13 is an enlarged view of the indicated area of detail of FIG. 12; and

[00041] FIG. 14 is an enlarged view of the indicated area of detail of FIG. 12.

DETAILED DESCRIPTION

[00042] The endoscope cleaning assembly disclosed herein is described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views.

[00043] As used herein, the term "distal" refers to the portion that is being described which is farther from a user, while the term "proximal" refers to the portion that is being described which is closer to a user. In addition, the terms parallel and perpendicular are understood to include relative configurations that are substantially parallel and substantially perpendicular up to about + or - 10 degrees from true parallel and true perpendicular. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.

[00044] In FIG. 1, an exemplary in situ lens cleaning assembly in accordance with the disclosure is shown generally as a sleeve 100. The sleeve 100 is configured for use with a conventional cannula assembly 70 (FIG. 9) that provides access to a body cavity and supplies an insufflation gas to a body cavity. The sleeve 100 enables cleaning of a lens 18 (FIG. 9) of an endoscope 10 during a surgical procedure to maintain a clear image without having to remove the endoscope 10 from the patient's body by utilizing the insufflation gas supplied by the cannula assembly 70. Specifically, the sleeve 100 directs the insufflation gas from the cannula assembly 70 to the lens 18 of the endoscope 10 to remove debris, e.g., organic matter and/or moisture, on the lens 18, as will be described. The sleeve 100 includes a head portion 200, an elongate shaft 300 extending distally from the head portion 200, and a diffusing cap 500 disposed in a distal portion 300b of the elongate shaft 300. The elongate shaft 300 defines a lumen 302 to receive the endoscope 10 therein such that the lens 18 of the endoscope 10 is disposed adjacent or proximal of the diffusing cap 500 of the sleeve 100. Further, the sleeve 100 is configured to be received through a lumen 75 (FIG. 9) of the cannula assembly 70 to enable flow of the insufflation gas to clean the lens 18 of the endoscope 10 that is obscured by debris, e.g., organic matter and/or moisture, as will be described.

[00045] FIGS. 2 and 3 illustrate the elongate shaft 300 of the sleeve 100 including proximal and distal portions 300a, 300b. The proximal portion 300a of the elongate shaft 300 is coupled to the head portion 200. The head portion 200 is configured to detachably secure the endoscope 10 (FIG. 9) thereto. In an aspect, the head portion 200 includes a base portion 210 including a fluid port 220 and an adapter portion 230 that is configured to be coupled to the proximal portion 300a of the elongate shaft 300. In addition, the base portion 210 defines a bore 202 in communication with the lumen 302 of the elongate shaft 300 and the fluid port 220. The head portion 200 further includes a support 250 extending proximally from the base portion 210. The support 250 defines a cutout 252 configured to support a connector 20 (FIG. 9) of the endoscope 10. The head portion 200 further includes a proximal cap 270 defining a bore 271 therethrough. The bore 271 of the proximal cap 270 is in communication with the lumen 302 of the elongate shaft 300. The proximal cap 270 is disposed on the base portion 210 to facilitate securement of the endoscope 10 in the elongate shaft 300. In addition, the proximal cap 200 of the sleeve 100 includes a seal 272 to form a fluid- tight seal against a tubular shaft 14 (FIG. 9) of the endoscope 10. Further, the proximal cap 200 supports the housing 12 (FIG. 9) of the endoscope 10 and serves as a stop, which in turn, positions the lens 18 of the endoscope 10 adjacent or proximal of the diffusing cap 500. [00046] FIGS. 3-5 illustrate the elongate shaft 300 of the sleeve 100 defining the lumen 302 extending therethrough and bores 310 in communication with the lumen 302. The bores 310 are defined along a length of the elongate shaft 300. In addition, the elongate shaft 300 further defines a circumferential groove 320 (FIG. 2) configured to support an O-ring 350. The circumferential groove 320 is distal of the bores 310. In particular, the O-ring 350 is formed of a sealing material to form a fluid-tight seal against an inner wall of the cannula assembly 70 (FIG. 9) when the sleeve 100 is received in the cannula assembly 70. The O-ring 350 inhibits passage of the insufflation gas distally when the insufflation gas is supplied between an outer surface 301 of the elongate shaft 300 and the inner surface of the cannula assembly 70. Under such a configuration, the insufflation gas supplied to the cannula assembly 70 (FIG. 9) flows into the lumen 302 of the elongate shaft 300 of the sleeve 100 through the bores 310 of the elongate shaft 300 and out towards the lens 18 of the endoscope 10, as will be described. The diffusing cap 500 is secured to the distal portion 300b of the elongate shaft 300 of the sleeve 100. The diffusing cap 500 includes an inner surface 502 defining first slots 510 and a second slot 520. The first slots 510 may be circumferentially arranged about the diffusing cap 500. The first slots 510 are in communication with the lumen 302 as will be described. The second slot 520 is in communication with the fluid port 220 of the head portion 200 of the sleeve 100 to supply a cleaning fluid such as, e.g., saline, towards the lens 18 of the endoscope 10, as will be described.

[00047] FIGS. 6 and 7 illustrate the elongate shaft 300 of the sleeve 100 that includes an inner wall 304 having splines 308 extending along a length of the elongate shaft 300. The splines 308 are circumferentially arranged about the lumen 302 of the elongate shaft 300. In particular, adjacent splines 308 define a groove 313 that serve as a conduit to supply the insufflation gas to the diffusing cap 500 to provide fluid communication therebetween. As best shown in FIG. 7, the grooves 313 are aligned with the first slots 510 of the diffusing cap 500. As shown in FIG. 8, the inner wall 304 of the elongate shaft 300 further defines a fluid channel 340 in communication with the fluid port 220 (FIG. 2) of the head portion 200 such that the cleaning fluid such as, e.g., saline, from a fluid source "FS" connected to the fluid port 220 (FIG. 2) is directed towards the lens 18 (FIG. 9) of the endoscope 10. The fluid channel 340 is aligned with the second slot 520 of the diffusing cap 500 to provide fluid communication therebetween. [00048] The sleeve 100 is used in conjunction with the cannula assembly 70 (FIG. 9) providing access and an insufflation gas to a body cavity "BC" (FIG. 10), thereby utilizing the insufflation gas to clean the lens 18 of the endoscope 10 (FIG. 9). FIG. 9 illustrates the sleeve 100 separated from the cannula assembly 70 and the endoscope 10 prior to use. The endoscope 10 includes the housing 12 and the elongate tubular shaft 14 extending distally from the housing 12 and terminating in the lens 18. A distal tip portion 16 of the endoscope 10 includes a number of optical components that produce images of the patient's tissues as known by one skilled in the art. The optical components generally include a window or front element of a lens assembly that is positioned in front of an image sensor (not shown) or in front of a fiber optic imaging guide that transfers an image to the proximal end of the endoscope 10. Illumination sources such as, e.g., light-emitting diodes, fiber optic or illumination guides, may also be provided. The elongate tubular shaft 14 may be rigid, semi-rigid, or flexible. The housing 12 includes a connector 20 configured to receive, e.g., a cable, therethrough, and a viewfinder 17 adapted to sight images of a surgical field in the patient, e.g., an abdominal cavity, thoracic cavity, etc., as the position of the endoscope 10 is adjusted to view a particular anatomical structure in the surgical field. A camera is adapted to receive images of the surgical field sighted through the lens 18 and transmit the images to, e.g., an external monitor, on which the images of the surgical field are displayed. That is, a visual display device converts the optical signal into a video signal to produce a video image on the monitor (or for storage on select media). Accordingly, the monitor enables a clinician to view the anatomical structure in the surgical field inside the patient as the surgical procedure is carried out using minimally invasive or endoscopic surgical instruments. Throughout the surgical procedure, condensation, smoke particles, and biological tissue or matter have a tendency to contact and build up on the lens 18 of the endoscope 10. This tends to obscure the images of the surgical field as they are displayed on the monitor. To this end, the sleeve 100 that enables cleaning of the lens 18 during the surgical procedure to maintain a clear image without having to remove the endoscope 10 from the patient's body may be utilized with the endoscope 10, as will be described hereinbelow.

[00049] FIG. 9 further illustrates a surgical access assembly in the form of the cannula assembly 70. The cannula assembly 70 may be utilized during minimally invasive surgery, e.g., laparoscopic surgery, to provide sealed access of surgical instruments into an insufflated body cavity, such as the abdominal cavity. The cannula assembly 70 includes a cannula 72 and a housing 78. The cannula 72 defines a lumen 75 extending therethrough. The housing 78 may be secured with or integrally formed with the cannula 72. The housing 78 is configured to support a seal assembly 79 (FIG. 13) including a plurality of seals 79a, 79b including, e.g., a duckbill seal. The housing 78 defines a longitudinal passage for receipt of a surgical instrument. The seal assembly 79 is supported within the housing 78 and is configured to provide sealed passage of the surgical instrument through the cannula assembly 70. The housing 78 includes an insufflation port 77 connected to an insufflation source "IS".

[00050] FIG. 10 illustrates the cannula assembly 70 placed through an incision in tissue "T" and placed within a body cavity "BC." The sleeve 100 is inserted through the cannula assembly 70 and the endoscope 10 is received through the lumen 302 of the sleeve 100. The connector 20 of the endoscope 10 is detachably secured to the cutout 252 of the sleeve 100. In this manner, the sleeve 100 extends through the lumen 75 of the cannula assembly 70 and the lens 18 of the endoscope 10 is disposed adjacent the diffusing cap 500 of the sleeve 100. Under such a configuration, an outer surface of the endoscope 10 and the grooves 313 (FIG. 6) of the sleeve 100 define respective conduits to direct the insufflation gas to the diffusing cap 500 and out through the first slots 510 of the diffusing cap 500 towards the lens 18 of the endoscope 10. In addition, the cleaning fluid may be provided to the lens 18 by supplying the cleaning fluid to the fluid port 220 of the sleeve 100. The cleaning fluid flows through the fluid channel 340 (FIG. 7) of the sleeve 100 and out of the second slot 520 of the diffusing cap 500 towards the lens 18.

[00051] In use, as shown in FIGS. 11-14, the endoscope 10 is received within the lumen 302 (FIG. 2) of the sleeve 100 such that the lens 18 of the endoscope 10 is disposed adjacent the diffusing cap 500 of the sleeve 100. The sleeve 100 extends through the lumen 75 (FIG. 9) of the cannula assembly 70. The insufflation port 77 of the cannula assembly 70 is coupled to an insufflation source "IS" and is supplied with an insufflation gas to insufflate the surgical site or the body cavity "BC" (FIG. 10). The seal assembly 79 of the cannula assembly 70 forms a fluid-tight seal against the elongate shaft 300 of the sleeve 100 and the insufflation gas flows distally in the direction of an arrow "S" between the elongate shaft 300 of the sleeve 100 and the inner wall of the cannula assembly 70. The O-ring 350 of the elongate shaft 300 of the sleeve 100 forms a fluid- tight seal against the inner surface of the cannula 72 and directs the insufflation gas through the bores 310 of the sleeve 100. The insufflation gas then flows through the conduits defined between the tubular shaft 14 of the endoscope 10 and the inner surface of the elongate shaft 300 of the sleeve 100 towards the diffusing cap 500. The diffusing cap 500 directs the insufflation gas toward the lens 18 of the endoscope 10 through the first slots 510 to remove any debris, e.g., organic matter and/or moisture, on the lens 18. In addition, the cleaning fluid such as, e.g., saline, may be supplied through the fluid port 220 of the sleeve 100. The fluid port 220 is in fluid communication with the fluid channel 340 of the inner wall 304 of the elongate shaft 300 of the sleeve 100. The cleaning fluid flowing through the fluid channel 340 of the sleeve 100 is directed towards the diffusing cap 500 and is applied to the lens 18 of the endoscope 10 via the second slot 520 (FIG. 4) of the diffusing cap 500. In this manner, the cleaning fluid may further facilitate or enhance removal of the debris on the lens 18 of the endoscope 10.

[00052] While illustrated as being used in an in-situ endoscope cleaning assembly, it is contemplated, and within the scope of the present disclosure for the in-situ endoscope cleaning assembly to be configured for use with various electromechanical and/or electrosurgical instruments and systems. For example, the in-situ endoscope cleaning assembly may be utilized in robotic surgical systems, such as the robotic surgical system shown and described in U.S. Patent 8,828,023, the entire content of which is incorporated herein by reference.

[00053] While the disclosure has been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims

WHAT IS CLAIMED IS:

1. A surgical kit comprising: a cannula assembly including: a housing including an insufflation port; and a cannula defining a first lumen in fluid communication with the insufflation port; a sleeve including an elongate shaft and a diffusing cap disposed at a distal portion of the elongate shaft, the elongate shaft defining a second lumen, the elongate shaft dimensioned to be received in the first lumen of the cannula of the cannula assembly, the elongate shaft including a seal configured to form a fluid-tight seal against the cannula of the cannula assembly, the elongate shaft defining a bore in communication with the second lumen; and an endoscope including a housing, a shaft extending from the housing, and a lens disposed at a distal end portion of the shaft, the shaft configured to be received in the second lumen of the sleeve such that the lens of the endoscope is disposed adjacent the diffusing cap, wherein when the sleeve is received through the first lumen of the cannula assembly, the second lumen of the sleeve is in communication with the insufflation port of the housing of the cannula assembly and the diffusing cap of the sleeve.

2. The surgical kit according to claim 1, wherein the diffusing cap defines first slots in communication with the second lumen of the sleeve.

3. The surgical kit according to claim 1, wherein the elongate shaft of the sleeve defines a fluid channel coupled to a fluid source, the fluid channel extending along a length of the elongate shaft.

4. The surgical kit according to claim 3, wherein the diffusing cap further defines a second slot in communication with the fluid channel of the elongate shaft of the sleeve.

5. The surgical kit according to claim 1, wherein the elongate shaft includes splines extending along a length of the elongate shaft such that adjacent splines define a groove therebetween.

6. The surgical kit according to claim 5, wherein when the endoscope is received in the second lumen of the sleeve, each groove defines a conduit between the diffusing cap and the bores of the sleeve.

7. The surgical kit according to claim 1 , wherein the elongate shaft of the sleeve further includes an O-ring disposed at a position along a length of the elongate shaft.

8. A surgical kit comprising: a cannula assembly including: a housing defining passage and including an insufflation port coupled to an insufflation gas supply to receive an insufflation gas; and a cannula extending from the housing, the cannula including an inner surface and defining a first lumen in communication with the passage; a sleeve including a head portion, an elongate shaft extending from the head portion, and a diffusing cap disposed at a distal portion of the elongate shaft, the elongate shaft including inner and outer surfaces and defining a second lumen, a portion of the elongate shaft forming a fluid-tight seal against the cannula of the cannula assembly when the sleeve is received in the first lumen of the cannula, the elongate shaft defining a bore in communication with the second lumen; and an endoscope including a housing, a shaft extending from the housing, and a lens at a distal end portion of the shaft, wherein when the sleeve is received through the first lumen of the cannula assembly, the inner surface of the cannula and the outer surface of the elongate shaft of the sleeve define a first gap in communication with the second lumen of the sleeve, wherein when the endoscope is received in the second lumen of the sleeve, the inner surface of the sleeve and an outer surface of the endoscope define a second gap in communication with the diffusing cap of the sleeve.

9. The surgical kit according to claim 8, wherein the elongate shaft of the sleeve includes an O-ring to form the fluid-tight seal against the cannula of the cannula assembly, the bore of the elongate shaft of the sleeve being proximal of the O-ring.

10. The surgical kit according to claim 8, wherein the diffusing cap of the sleeve defines first slots in communication with the second gap.

11. The surgical kit according to claim 10, wherein the first slots of the diffusing cap are circumferentially arranged.

12. The surgical kit according to claim 8, wherein the elongate shaft defines a fluid channel extending along a length of the elongate shaft.

13. The surgical kit according to claim 12, wherein the head portion of the sleeve has a fluid port coupled to a fluid source, the fluid port in communication with the fluid channel of the elongate shaft of the sleeve.

14. The surgical kit according to claim 13, the diffusing cap of the sleeve defines a second slot in communication with the fluid channel of the elongate shaft of the sleeve.

15. The surgical kit according to claim 8, wherein the head portion of the sleeve has a support defining a cutout configured to detachably support a connector of the endoscope.

16. The surgical kit according to claim 8, wherein the head portion of the sleeve includes a proximal cap including a seal forming a fluid-tight seal against the endoscope.

17. The surgical kit according to claim 8, wherein when the endoscope is received in the second lumen of the sleeve, the lens of the endoscope is proximal of the diffusing cap.

18. A sleeve for use with an endoscope comprising: a head portion defining a passage to receive a shaft of an endoscope; an elongate shaft extending from the head portion and defining a lumen and a lateral bore in communication with the lumen, the elongate shaft including a circumferential seal distal of the bore; and a diffusing cap disposed at a distal portion of the elongate shaft, the diffusing cap defining a first slot in communication with the lumen of the elongate shaft.

19. The sleeve according to claim 18, wherein the head portion includes a fluid port coupled to a fluid source and the elongate shaft defines a fluid channel.

20. The sleeve according to claim 18, wherein the elongate shaft includes splines to define a channel to direct a fluid to the first slot of the diffusing cap.