Surgical gas delivery device with internal gas-tight sealing module and tube assembly with filter for the same

Abstract

System for performing an endoscopic surgical procedure in a patient's surgical cavity comprising a gas delivery device configured to deliver a pressurized gas flow to a gas delivery lumen extending therefrom, a gas sealing module communicating with a distal end of the gas delivery lumen and configured to generate a gas seal within a gas-sealed lumen extending therefrom, and an access port communicating with a distal end of the gas-sealed lumen to provide sealed access to instruments in the surgical cavity and maintain stable pressure within the surgical cavity.

Description

Surgical gas delivery device with internal gas-tight sealing module and tube assembly with filter for the same Cross-reference to related application

[0001] This application claims the benefit of priority of U.S. patent application serial number 16 / 015462, filed on June 22, 2018. Background of the invention Field of invention

[0002] The present invention relates to endoscopic surgery, and more particularly to a surgical gas delivery device for use in endoscopic surgical procedures that includes an internal or remote gas-tight sealing module to generate a gas-tight seal in a lumen extending from it and communicating with a mechanically sealed surgical access port to maintain stable pressure in a surgical cavity. Description of the related state of the art

[0003] The use of pneumatically sealed trocars or surgical access devices, such as those disclosed in U.S. Patent Nos. 7,854,724 and 8,795,223, granted to the same applicant, in combination with a multimodal gas delivery device, such as those disclosed in U.S. Patent Nos. 8,715,219, 8,961,451, 9,295,490, and 9,375,539, granted to the same applicant, has been shown to have numerous advantages. Some of these advantages include valveless access to a surgical cavity (e.g., the abdominal or thoracic cavity), facilitating smoke evacuation and maintaining stable pressure in the surgical cavity, as well as a number of medical and clinical benefits.

[0004] The combination of these devices forms a surgical system that relies on the presence of an annular jet unit housed in the trocar to receive pressurized gas from the gas delivery device to generate a gas-tight seal zone in the trocar body. This annular jet unit is disclosed in U.S. Patent No. 9,907,569, granted to the same applicant, and is designed to provide a static nozzle-like mechanism that directs the pressurized gas into a narrower channel, thereby increasing the gas velocity to generate the gas-tight seal zone.

[0005] In U.S. Patent Nos. 9,387,295 and 9,387,296, granted to the same applicant, as well as in U.S. Patent Application No. 2016 / 0287817, granted to the same applicant, it was proposed to move the location of the annular jet unit (or a similar nozzle design) from the trocar device and into the filter cartridge housing of a related filter tube assembly that is configured to be operatively associated with the gas delivery device. This allowed the use of more conventional, commercially available access devices instead of the pneumatically sealed trocars described above.

[0006] It has now been determined that additional advantages can be achieved by moving the location of the annular jet unit (or a similar nozzle design) either inside the tubing of a filtered tubing set or inside the housing of a proprietary multimodal gas delivery device. This would make the technology compatible with a wide variety of new end effectors and access devices, both proprietary and commercially available. Indeed, in certain surgical contexts, it may be necessary for all access ports used in a procedure to be of the same type. For example, these may include robotically assisted surgical procedures that are only compatible with a specific type or brand of reusable cannula.

[0007] Another advantage of the gas management systems of the present invention would be determined by the market or cost, since some hospitals have policies to use disposable cannulas of a particular brand (e.g., due to a cost-cutting contract) or reusable cannulas to save money. In these examples, the systems of the present invention would enable a surgeon to obtain pressure stability and smoke evacuation without needing to replace one of their access ports at a lower cost. In the U.S. patent... U.S. Patent 2016 / 220769A1 discloses a filter cartridge with an integrated gas seal for a multimodal surgical gas delivery system. U.S. Patent 2016 / 106952A1 discloses an assembly of branched, multi-lumen tubing for laparoscopic surgical procedures involving smoke evacuation. Summary of the description

[0008] The invention is defined by claim 1. Further embodiments of the invention are defined by the dependent claims.

[0009] This description refers to a useful and novel system for performing an endoscopic surgical procedure in a surgical cavity, comprising a gas delivery device configured to supply a pressurized gas flow to a gas supply lumen extending therefrom, a gas-tight sealing module communicating with a distal end of the gas supply lumen and configured to generate a gas-tight seal in a gas-tight sealed lumen extending therefrom, and an access port communicating with a distal end of the gas-tight sealed lumen to provide mechanically sealed access of an instrument to the surgical cavity and maintain stable pressure in the surgical cavity. The access port includes a valve-sealed proximal housing to provide mechanically sealed access of an instrument to the surgical cavity.

[0010] The system also includes a gas return light that extends from the gas-tight sealing module back to the gas management device. The gas management device includes a pump to supply pressurized gas to the gas supply light and to draw gas from the gas return light. The gas supply light and the gas return light communicate with a filter unit that is sized and configured to be received by the gas management device.

[0011] The system further includes an insufflator in the gas delivery device to supply insufflation gas to a second access port via an insufflation lumen. The second access port includes a mechanically sealed proximal housing to provide sealed instrument access to the surgical cavity.

[0012] Preferably, the gas-tight sealing module includes a housing in which a jet unit is mounted to receive pressurized gas from the gas supply lumen to generate the gas-tight seal, and wherein the gas expended in generating the gas-tight seal is drawn through the gas return lumen back to the pump in the gas delivery device. In one embodiment of the present description, the gas-tight sealing module includes a vented housing to facilitate the intake of air from the atmosphere into the surgical cavity and the release of gas to the atmosphere from the surgical cavity. The gas-tight sealing module is also provided to be able to communicate with a bidirectional filtration element to filter the intake air and / or the gas released to the atmosphere from the surgical cavity.

[0013] In one embodiment, the housing of the gas-tight sealing module is configured such that the connections for the gas supply light and the gas return light are arranged perpendicular to the connection for the gas-tight seal light. In another embodiment, the housing of the gas-tight sealing module is configured such that the connections for the gas supply light and the gas return light are arranged in line with the connection for the gas-tight seal light. In yet another embodiment, the housing of the gas-tight sealing module is configured such that the connections for the gas supply light and the gas return light are arranged parallel to the connection for the gas-tight seal light.

[0014] In these embodiments, the gas supply lumen and the gas return lumen are provided to interface with the gas-tight sealing module housing in either a parallel or concentric configuration. Alternatively, the gas-tight sealing module could include a two-part housing unit having a proximal subunit connected to the gas supply lumen and the gas return lumen, and a distal subunit connected to the gas-tight sealing lumen.

[0015] This description also refers to a system for performing an endoscopic surgical procedure in a body cavity, which includes a gas delivery device having a pump for supplying pressurized gas to a gas supply lumen extending therefrom and having an insufflator for supplying insufflation gas to an insufflation lumen extending therefrom. A gas-tight sealing module communicates with a distal end of the gas supply lumen, located outside the gas delivery device, and is configured to generate a gas-tight seal in a gas-tight seal lumen extending therefrom.A gas-tight sheath having a proximal terminal portion that communicates with a distal terminal portion of the gas-tight lumen, and a tubular access port configured for coaxial installation in the gas-tight sheath and having a valve-sealed proximal housing that provides mechanically sealed access of an instrument to the surgical cavity that communicates with a distal end of the insufflation lumen.

[0016] An annular channel is formed between an inner surface of the sheath and an outer surface of the access port such that the gas-tight lumen communicates with the surgical cavity to maintain stable pressure within the surgical cavity. A sealing ring is associated with the proximal end portion of the gas-tight sheath to seal the proximal end of the annular channel, and a plurality of circumferentially arranged and spaced flow channels are formed in the distal end portion of the gas-tight sheath to facilitate communication between the annular channel and the surgical cavity. The system further includes a gas return lumen extending from the gas-tight sealing module back to the pump in the gas delivery device.The gas supply light and the gas return light communicate with a filter unit that is sized and configured to be received by the gas management device.

[0017] This description also refers to a novel method for accessing a patient's surgical cavity, which includes the following steps: providing a gas-tight sheath; installing a valve-sealed trocar inside the gas-tight sheath; and introducing the gas-tight sheath, along with the installed valve-sealed trocar, into the patient's surgical cavity. The method further comprises the steps of connecting the sheath to a gas-tight lumen adapted for bidirectional gas flow to and from the sheath, and connecting the trocar to an insufflation and detection lumen.

[0018] This description also refers to a system for performing an endoscopic surgical procedure in a surgical cavity, which includes a gas delivery device housing a pump configured to deliver pressurized gas to an internal gas supply lumen extending from the pump. A gas-tight sealing module is housed in the gas delivery device, in communication with the gas supply lumen, and configured to generate a gas-tight seal on an internal gas-tight sealing tube extending from it.The gas-tight tube is adapted and configured to communicate with a gas-tight lumen extending externally from the gas delivery device, and a valve-sealed access port that communicates with a distal end of the gas-tight lumen to provide mechanically sealed access of an instrument to the surgical cavity and maintain stable pressure in the surgical cavity.

[0019] The system also includes an internal gas return lumen extending from the gas-tight seal module to recirculate used gas for gas-tight seal generation back to the pump in the gas management device. The gas management device also includes an insufflator to supply insufflation gas to a second valve-sealed access port via an insufflation lumen.

[0020] In this embodiment of the present description, the gas-tight sealing module preferably includes an integral unit formed by a metal disc with at least one inwardly inclined radial nozzle formed thereto to generate the gas-tight seal and a cylindrical orifice to accommodate inward air entrainment and gas release from the gas-tight seal.

[0021] It is anticipated that the inwardly inclined radial nozzle or nozzles may be radially separated from the cylindrical bore, which may be offset from a central axis of the disc. Alternatively, the disc may have a plurality of inwardly inclined radial nozzles formed therein, which would be radially separated from the cylindrical bore, which may be offset from a central axis of the disc. Alternatively, the disc may have a plurality of inwardly inclined radial nozzles formed therein, surrounding the cylindrical bore, which may be aligned with a central axis of the disc.

[0022] The present description also refers to a set of tubes for use with a gas delivery device in performing an endoscopic surgical procedure in a surgical cavity, which includes a filter cartridge unit having first and second flowways formed therein, a first lumen extending from the filter cartridge and communicating with the first flowway to communicate with the surgical cavity in order to maintain stable pressure therein and facilitate smoke evacuation, and a second lumen extending from the filter cartridge and communicating with the second flowway to supply insufflation gas to the surgical cavity and detect pressure in the cavity.

[0023] A fitting is operatively associated with a distal end of the first lumen for connection to a first mechanically sealed access port, and a fitting is operatively associated with a distal end of the second lumen for connection to a second mechanically sealed access port. There may be at least one filter element disposed in the first flow path of the filter cartridge and / or at least one filter element disposed in the second flow path of the filter cartridge.

[0024] These and other features of the gas circulation system and the system of the present description and invention will become more obvious to those skilled in the art to which the present description and invention pertains in the detailed description of the preferred embodiments taken together with the following brief description of the drawings. Brief description of the drawings

[0025] To enable those skilled in the art to easily understand how to manufacture and use the gas circulation system and gas-tight surgical access devices of the present description and invention without having to perform improper experiments, the preferred embodiments of these will be described in detail below with reference to the figures, where: Figure 1 illustrates the gas delivery system during an endoscopic surgical procedure performed in a patient's abdominal cavity, wherein the system includes a gas delivery device, gas supply and return lines extending between the gas delivery device and a remote gas-tight seal module, a first valve-sealed access port communicating with the gas-tight seal lumen attached to the gas-tight seal module, and an insufflation and sensing line extending between the gas delivery device and a second valve-sealed access port. Figure 2 shows a perspective view of the filter tube assembly, the remote gas-tight sealing module, and the valve-sealed access ports of the gas management system illustrated in Figure 1. Figure 3 shows an exploded perspective view of a portion of the gas management system in Figure 1, illustrating the connections between the gas supply and return lines, the remote gas-tight seal module, the gas-tight seal light, and the first valve-sealed access port. Figure 4 shows an exploded perspective view of the gas-tight sealing module of the gas management system shown in Figure 1, with the parts separated for ease of illustration. Figures 5 and 6 show perspective views of the top and bottom of the nozzle tube element that is part of the gas-tight sealing module shown in Figure 4. Figures 7 and 8 show cross-sectional views of the gas-tight sealing module taken along lines 7-7 and 8-8 of Figure 3. Figure 9 illustrates another embodiment of a filter tube assembly for use with the gas management device shown in Figure 1, which includes gas supply and return lines extending between a filter cartridge configured to be received in the gas management device, a remote gas-tight seal module having a two-part housing, a valve-sealed access port communicating with the gas-tight seal light attached to the gas-tight seal module, and an insufflation and detection light communicating with another valve-sealed access port. Figure 10 shows an enlarged perspective view of a portion of the gas management system in Figure 9, illustrating the gas-tight seal light extending between the gas-tight seal module and a first valve-sealed access port, and the insufflation and detection light and the second valve-sealed access port. Figure 11 shows an enlarged perspective view of the remote gas-tight sealing module shown in Figure 9. Figure 12 shows an exploded perspective view of the remote gas-tight sealing module shown in Figure 9, with the parts separated for ease of illustration, including the annular jet unit for generating a gas-tight seal in the gas-tight seal light extending from it. Figure 13 shows an exploded perspective view of the annular jet unit housed in the gas-tight sealing module of Figure 12. Figure 14 illustrates another embodiment of a filter tube assembly for use with the gas management device shown in Figure 1, which includes gas supply and return lines extending between a filter cartridge configured to be received in the gas management device, a remote gas-tight seal module, a valve-sealed access port communicating with the gas-tight seal light attached to the gas-tight seal module, and an insufflation and detection light communicating with another valve-sealed access port. Figure 15 shows an enlarged perspective view of a portion of the gas management system from Figure 14, illustrating the gas-tight light extending between the gas-tight sealing module and a first valve-sealed access port, and the insufflation light, detection light, and second valve-sealed access port. Figure 15a shows a localized view of the connector for the gas supply and return lines disconnected from the fitting on the gas-tight sealing module. Figures 16 and 17 show a cross-sectional view taken along line 16-16 of Figure 15, illustrating the interior of the remote gas-tight sealing module and the connection point for the gas supply and gas return lights. Figure 18 shows a perspective view of a surgical access unit constructed according to a preferred embodiment of the present description that includes a gas-tight sheath having a proximal terminal portion communicating with a distal terminal portion of a gas-tight lumen, and a valve-sealed tubular access port configured to be received coaxially in the sheath. Figure 19 shows an exploded perspective view of the surgical access unit shown in Figure 18, with the valve-sealed tubular access port separated from the gas-tight sheath. Figure 20 shows a perspective view of the filter tube assembly from Figure 14 together with the surgical access unit from Figure 18. Figure 21 shows an exploded perspective view of the filter tube assembly shown in Figure 20, with the parts separated for clarity. Figure 22 shows a cross-sectional view taken along line 22-22 of Figure 18. Figure 23 shows a localized plan view of the distal terminal portion of the surgical access unit shown in Figure 18. Figure 24 shows an illustration of another gas management system constructed according to a preferred embodiment of the present invention, wherein the gas management device includes an internal gas-tight sealed module communicating with a gas-tight sealed light extending from a filter cartridge to a valve-sealed access port, and also includes an insufflation and detection light extending from the filter cartridge to a second valve-sealed access port. Figure 25 shows a perspective view of the filter tube assembly used with the gas management device of Figure 24, with the valve-sealed access ports associated with it. Figure 26 shows a localized perspective view of the interior of the gas delivery device shown in Figure 24. Figure 27 shows a cross-sectional view taken along line 27-27 of Figure 24. Figure 28 shows an exploded perspective view of the internal gas-tight sealing module located in the gas delivery device shown in Figure 24, with the parts separated for ease of illustration. Figure 29 shows a schematic representation of the gas management device in Figure 24, illustrating the gas flow paths associated with it. Figures 30-37 illustrate four different embodiments of a one-piece nozzle disc for generating a gas-tight seal using the internal gas-tight sealing module shown in Figure 28. Detailed description of preferred embodiments

[0026] With reference now to the drawings, in which the same reference numbers are used to identify similar structural features and elements of the present description, Figure 1 illustrates a gas circulation system for performing an endoscopic surgical procedure in a patient's surgical cavity, and more particularly, for performing a laparoscopic surgical procedure in a patient's abdominal cavity, constructed according to a preferred embodiment of the present description and generally designated by reference number 10. Those skilled in the art will readily appreciate that the gas circulation system 10 of the present description can be used to perform thoracoscopic surgical procedures in a patient's thoracic cavity, and also endoluminal surgical procedures, such as transanal and transesophageal surgical procedures.

[0027] With reference to Figure 1, the gas circulation system 10 herein is specifically designed to cooperate with a programmable multimodal gas delivery device 12. The gas delivery system 12 is of the type described, for example, in U.S. Patent No. 9,375,539, granted to the same applicant. The gas delivery device 12 includes a graphical user interface 14 for configuring operating parameters and a pump 16 for facilitating the circulation / recirculation of pressurized gas in relation to the surgical cavity 18 of a patient 20. The gas delivery device 12 is connected to a portable surgical gas source 22 to deliver insufflation gas to the surgical cavity 18 of the patient 20 by means of an internal insufflator 15. Alternatively, the gas could be supplied to the gas delivery device 12 from a permanent source.

[0028] With continued reference to Figure 1 together with Figure 2, the system 10 further includes a filter tube assembly 30 that is operatively associated with the gas delivery device 12. The filter tube assembly 30 includes a disposable filter cartridge 32 of the type described in U.S. Patent No. 9,526,849, granted to the same applicant. A gas supply light 34 and a gas return light 36 extend between the filter cartridge 32 and a remote gas-tight seal module 40, which will be described in more detail below. A first valve-sealed access port 42 communicates with the gas-tight seal module 40 through a gas-tight seal light 44, and an insufflation and detection line 46 extends between the filter cartridge 32 and a second valve-sealed access port 48.A connector 43 is associated with a distal end of the gas-tight light 44 to couple to a fitting in the first access port 42, and a connector 47 is associated with a distal end of the insufflation and detection line 46 to couple to a fitting in the second access port 48.

[0029] Referring now to Figure 3, the remote gas-tight seal module 40 (i.e., located away from the access port 42 and the gas delivery device 12) is shown together with the gas supply and return lumens 34 and 36, the gas-tight seal lumen 44, and the first valve-sealed access port 42. In general, the remote gas-tight seal module 40 is adapted and configured to generate a gas-tight seal that extends through the gas-tight seal lumen 44 to the first valve-sealed access port 42 to maintain stable pressure and facilitate smoke evacuation in the surgical cavity 18 of patient 20 during an endoscopic surgical procedure.

[0030] With reference to Figure 4, the remote gas-tight sealing module 40 includes a generally cylindrical proximal housing portion 50 and an elongated tubular stem portion 52 extending axially from the proximal housing portion 50. The proximal housing portion 50 is associated with an end cap 55 having an axially offset inlet port 54 to communicate with the gas supply lumen 34 and an adjacent axially offset outlet port 56 to communicate with the gas return lumen 36.

[0031] With continued reference to Figure 4 together with Figures 5 and 6, the gas-tight sealing module 40 further includes a nozzle body 60 located between the proximal housing portion 50 and the end cap 55, which delimits the crescent-shaped inlet chamber 62a for conveying pressurized gas from the pump 16 of the gas delivery device 12 to the gas supply lumen 34 and the inlet 54 in the end cap 55 used to generate a gas-tight seal in the gas-tight sealing module 40, and the crescent-shaped outlet chamber 62b for receiving the spent gas that has been used to generate the gas-tight seal in the gas-tight sealing module 40 through the outlet 56 for return to the pump 16 by means of the gas return lumen 36. The crescent-shaped chambers 62a and 62b have respective crescent-shaped gas conduits 63a and 63b.

[0032] The nozzle body 60 of the gas-tight sealing module 40 further includes a central gas transfer chamber 64, which is open to the atmosphere at both ends and is located between the inlet chambers 62a and 62b. The nozzle body 60 also includes a nozzle tube extending distally 65 and communicating with the gas transfer chamber 64. The nozzle tube 65 has a central orifice 70 that communicates with the gas transfer chamber 64 to define a bidirectional ventilation path that facilitates gas exchange to and from the gas-tight seal 44, including, but not limited to, the entrainment of air from the atmosphere into the surgical cavity 18 and the release of gas to the atmosphere from the surgical cavity 18 to relieve overpressure.The outer periphery of the nozzle tube 65 includes a plurality of protruding zones 66 arranged in a circumference and separated from each other, which delimit a series of recessed gas jets 68 arranged in a circumference and separated from each other to accelerate the pressurized gas supplied to the gas-tight sealing module 40 from the gas supply light 34 to generate a gas-tight seal in the gas-tight sealing light 44.

[0033] With continued reference to Figure 4 together with Figures 7 and 8, the proximal housing portion 50 of the gas-tight sealing module 40 includes a central cylindrical chamber zone 72 in communication with the gas inlet channels 63a of the inlet chamber 62a of the nozzle body 60, and a surrounding annular chamber zone 74 in communication with the gas return channel 63b of the gas return chamber 62b. The annular chamber zone 74 includes a plurality of gas return ports 75 arranged in a circumference and spaced apart from each other.

[0034] A nozzle orifice 76 is formed in the central chamber area 72, as best seen in Figures 7 and 8, the nozzle tube 65 of the nozzle body 60 is dimensioned and configured to fit into the nozzle orifice 76 in order to form the radial outer limits of the jets 68 arranged in a circumference and separated from each other, recessed into the outer peripheral surface of the nozzle tube 65, as described above.

[0035] With reference to Figure 4 together with Figures 7 and 8, the elongated tubular stem portion 52 extending axially from the proximal housing portion 50 of the gas-tight sealing module 40 includes a proximal flange portion 80 housing a plurality of circumferentially arranged and spaced fins 82 configured to guide the spent gas used to generate the gas-tight seal back to the annular chamber area 74 by means of the return gas ports 75. The tubular stem portion 52 further includes an intermediate throat section 84, which delimits the inner area 85 of the gas-tight sealing module 40 where the gas-tight seal is generated by the circumferentially arranged and spaced jets 68.The stem portion 52 also includes a distal tube fitting 86 that is sized and configured to connect to the gas-tight lumen 44, as best seen in Figure 3.

[0036] Referring now to Figures 9 to 12, another set of filter tubes constructed according to a preferred embodiment of the present description is illustrated, which is generally designated by reference number 130 and includes a remote gas-tight seal module 140 that differs from the remote gas-tight seal module 40 described above, in that the gas-tight seal supply and return lights are offset and arranged parallel to the gas-tight seal light.

[0037] More particularly, the tube assembly 130 includes a filter cartridge 132, a gas supply light 134 and a gas return light 136 extending between the filter cartridge 132 and the gas-tight sealing module 140, a gas-tight sealing light 144 extending from the gas-tight sealing module 140 to a first valve-sealed access port 142, and an insufflation and detection light 146 extending from the filter cartridge 132 to a second valve-sealed access port 148. In this embodiment, the gas-tight sealing module 140 is configured such that the connection for the gas supply light 134 and the gas return light 136 are arranged in parallel and offset with respect to the connection for the gas-tight sealing light 144.

[0038] Referring now to Figures 11 and 12, the remote gas-tight sealing module 140 includes a mechanically interconnected two-part housing unit 145 consisting of a first component 152 and a subunit 157. The first component 152 is connected to, and communicates with, the gas supply light 134 and the gas return light 136. The subunit 157 is connected to, and communicates with, the gas-tight sealing light 144.

[0039] More particularly, component 152 of the two-part housing 145 has an inlet port 154 for direct communication with the gas supply light 134 and an adjacent outlet port 156 for direct communication with the gas return light 136. Subunit 157 of the two-part housing 145 includes a body portion 155 that delimits an internal chamber 159 and a distally extending tube fitting 186 that is sized and configured to connect to the gas-tight light 144.

[0040] The internal chamber 159 of the body portion 155 is sized and configured to receive a two-part annular jet unit 190 of the type illustrated in Figure 13, which is described in further detail in U.S. Patent No. 9,907,569, granted to the same applicant. In general, as shown in Figure 13, the two-part annular jet unit 190 consists of an upper member 192 with an O-ring seal 193 and a lower annular member 194 with an O-ring seal 195.

[0041] The jet unit 190 receives pressurized gas through an inlet port 163 from the gas supply lumen 134, and operates to accelerate that gas in order to generate a gas-tight seal in the distal throat area 184 of the body portion 155 (see Figure 10). The gas-tight seal generated in the throat area 184 creates a stable pressure barrier that stabilizes the pressure along the entire gas-tight lumen 144 up to the access port 142 to maintain stable pressure and facilitate smoke evacuation in the surgical cavity 18 of a patient 20 during an endoscopic surgical procedure.

[0042] As best seen in Figure 12, the circumferentially arranged and spaced guide fins 182 are provided in the chamber 159 of the body portion 155 to guide the spent gas from the gas-tight seal in the throat area 184 back to the gas return lumen 136 by means of an outlet fitting 170. The component 152 also includes a vent 188 which facilitates gas exchange to and from the gas-tight lumen 144, including, but not limited to, the intake of air from the atmosphere into the surgical cavity 18 and the release of gas to the atmosphere from the surgical cavity 18 to relieve overpressure.

[0043] Referring now to Figures 14 to 17, another set of filter tubes constructed according to a preferred embodiment of the present description is illustrated, which is generally designated by reference number 230 and includes a remote gas-tight sealing module 240 that differs from each of the remote gas-tight sealing modules described above. More specifically, the tube assembly 230 includes a filter cartridge 232, a gas supply light 234 and a gas return light 236 extending between the filter cartridge 232 and the gas-tight sealing module 240, a gas-tight sealing light 244 extending from the gas-tight sealing module 240 to a first valve-sealed access port 242, and an insufflation and detection light 246 extending from the filter cartridge 232 to a second valve-sealed access port 248.

[0044] In this embodiment, the gas-tight sealing module 240 is configured so that the gas supply light 234 and the gas return light 236 are arranged perpendicular to the outlet of the gas-tight sealing light 244, and the gas supply light 234 and the gas return light 236 are arranged to form an interface with the housing 250 of the gas-tight sealing module 240 in a concentric configuration.

[0045] More particularly, the gas supply light 234 and the gas return light 236 are operatively associated with a rotating concentric two-light connector 235 that engages with a fitting 245 configured accordingly extending from the housing 250 of the gas-tight sealing module 240, in a direction perpendicular to the connection for the gas-tight sealing light 244, as best seen in Figure 15a. Some examples of such devices are disclosed in U.S. Patent Application No. 2017 / 0361084. The housing 250 of the gas-tight sealing module 240 further includes a louvered vent 280 that facilitates bidirectional gas exchange with the atmosphere (i.e., for air entrainment and overpressure relief through the light 244) and is arranged in line with the gas-tight sealing light 244, as best seen in Figures 16 and 17.

[0046] In this embodiment, the gas-tight sealing module 240 includes the two-part annular jet unit 290 of the type shown in Figure 13 and described in U.S. Patent No. 9,907,569, granted to the same applicant, for generating a gas-tight seal with the inner region 285 of the throat portion 284 of the housing 250, creating a stable pressure barrier that stabilizes the pressure along the entire gas-tight seal lumen 244 up to the access port 242 to maintain stable pressure and facilitate smoke evacuation in the surgical cavity 18 of a patient 20 during an endoscopic surgical procedure.

[0047] Referring now to Figures 18 to 23, a surgical access unit 300 is illustrated that is adapted and configured for use in conjunction with any of the filter tube assemblies previously described, such as, for example, the filter tube assembly 230 shown in Figure 14. The surgical access unit 300 mainly comprises a gas-tight tubular sheath 342 and a valve-sealed access port 348. The gas-tight tubular sheath 342 has a proximal terminal portion 343 that includes a fitting 347 for communication with a connector 247 on the distal terminal portion of the gas-tight lumen 244 of the tube assembly 230.The valve-sealed access port 348 is configured for coaxial installation in the tubular sheath 342 to provide mechanically sealed access of an instrument to the surgical cavity 18 and has a fitting 349 to communicate with a connector 249 at the distal end of the insufflation and sensing light 246 of the tube assembly 230.

[0048] As best seen in Figures 22 and 23, the access port 348 has a proximal housing 365 that accommodates a duckbill seal 367 to provide sealed access to the surgical cavity 18 up to the central lumen 369 of the access port 348. With reference specifically to Figure 22, the central lumen 369 provides an insufflation and detection pathway for the system 300, and the elongated annular channel 353 is formed between an inner peripheral surface of the gas-tight sheath 342 and an outer peripheral surface of the access port 348, such that the gas-tight lumen 244 communicates with the surgical cavity 18 to maintain stable pressure and facilitate smoke evacuation in the surgical cavity 18.

[0049] A sealing ring 355 is associated with the proximal terminal portion 343 of the sheath 342 to seal a proximal end of the annular channel 353, and a plurality of flow channels 357 arranged in a circumference and separated from each other are formed in the distal terminal portion 359 of the gas-tight sheath 342 to facilitate communication between the annular channel 353 and a patient's surgical cavity, as best seen in Figure 23, thereby maintaining stable pressure in the surgical cavity and facilitating smoke evacuation during an endoscopic surgical procedure.

[0050] While in use, to access the surgical cavity 18 with the access unit 300 during an endoscopic surgical procedure, the valve-sealed port 348 is first installed in the gas-tight sheath 342, and then the gas-tight sheath 342 together with the valve-sealed port 348 is introduced into the surgical cavity 18 of patient 20. The inclined distal edge 363 of the valve-sealed port 348 facilitates percutaneous introduction of the unit 300, which would be accomplished by means of a conventional obturator or introducer placed there, as is well known in the technique.

[0051] The method further includes the steps of connecting fitting 247 at the end of the gas-tight light 244 to fitting 347 of the sheath 342, which is adapted for bidirectional gas flow to and from the gas-tight sheath 342, and the step of connecting fitting 249 at the end of the insufflation and detection light 246 to fitting 349 of the valve-sealed port 348. If a metallic access device is used in this system, it is anticipated that the sheath 342 should be grounded to prevent electric shock from capacitive coupling.

[0052] Referring now to Figure 24, a unique gas delivery system 400 manufactured according to a preferred embodiment of the present invention is illustrated. The gas delivery system 400 includes a gas delivery device 412 having an internal gas-tight sealing module 440, as distinct from the remote external gas-tight sealing modules described above. The gas delivery device 412 also includes a graphical user interface 414 for configuring operating parameters, an internal insufflator 415 for receiving insufflation gas from a source and delivering that gas to the patient's surgical cavity, and a pump 416 for facilitating the circulation / recirculation of pressurized gas in relation to the internal gas-tight sealing module 440.The insufflator 415 and the gas-tight sealing module 440 communicate with a set of tubes with a unique filter 430, which is best seen in Figure 25.

[0053] With reference to Figure 25, the filter tube assembly 430 includes a filter cartridge 432 from which extend a gas-tight lumen 444 and an insufflation and detection lumen 446. The gas-tight lumen 444 extends from the filter cartridge 432 to a first valve-sealed access port 442, and the insufflation and detection lumen 446 extends to a second valve-sealed access port 448. The internal gas-tight sealing module 440 generates a gas-tight seal that creates a stable pressure barrier, stabilizing the pressure through the gas-tight lumen 444 to the first access port 442 to maintain stable pressure and facilitate smoke evacuation in a patient's surgical cavity during an endoscopic surgical procedure.

[0054] With reference to Figures 26 to 27 together with the schematic diagram in Figure 29, the interior of the housing 413 of the gas delivery device 412 is illustrated, which includes a receiving cavity 417 for releasably receiving the cartridge 432 of the filter tube assembly 430, which communicates with the internal gas-tight sealing module 440 by means of an internal gas-tight sealing tube 425. The filter cartridge 432 includes a first filter element 431 for filtering the insufflation gas flow to the insufflation conduit 446 and a second filter element 433 for filtering the gas flowing to and from the gas-tight sealing lumen 444.Although the filter cartridge 432 has been described as part of the replaceable and disposable tube assembly 430, it is foreseen and perfectly within the scope of the present description that either or both of the filter elements 431 and 433 could be in the form of a detachable filter element that is installed in an internal compartment in the housing 413 of the gas management device 412, as shown, for example, in Figure 29 (see, for example, the internal filter 457).

[0055] An internal insufflation tube 419 extends between the insufflator 415 and the receiving cavity 417. In addition, an internal gas supply conduit 421 extends from a high-pressure outlet side of the pump 416 to the inlet side of the gas-tight sealing module 440, and an internal gas return conduit 423 extends between the outlet side of the gas-tight sealing module 440 and the inlet or suction side of the pump 416.

[0056] With reference to Figure 26 in conjunction with Figure 28, the gas-tight sealing module 440 is mounted in the housing 413 of the gas management device 412 on a vertical support 427 that includes a louvered vent plate 429 to accommodate gas exchange, including, but not limited to, the entrainment of air from the atmosphere into the gas-tight sealing module 440 and the release of gas to the atmosphere from the gas-tight sealing module 440. As illustrated in Figure 29, one embodiment of the gas management device 412 includes an internal vent tube 455 extending from the housing 450 of the gas-tight sealing module 440 to an internal filter element 457. The internal filter 457 communicates with an outlet tube 459 extending from the housing 413 to the atmosphere to facilitate gas exchange.

[0057] The housing 450 of the gas-tight sealing module 440 is sized and configured to accept a pressurized gas nozzle unit 490, which is adapted and configured to accelerate the pressurized gas to generate a gas-tight seal in the throat section 484 extending from the housing 450 to the gas-tight seal tube 425. The nozzle unit 490 includes an upper ring component 492 having an associated O-ring seal 493 and a lower nozzle disc 494 having an associated O-ring seal 495. As explained in more detail below, the nozzle disc 494 includes one or more gas acceleration nozzles.

[0058] As best seen in Figure 27, a gas inlet chamber 497 is formed between the lower surface of the upper ring component 492 and the upper surface of the lower nozzle disc 494 to receive pressurized gas from the internal gas supply duct 421. More particularly, the housing 450 includes an inlet port 451 to communicate with the gas supply duct 421 and an outlet port 453 to communicate with the gas return duct 423. The nozzle unit 490 defines a ventilation path 499 to facilitate bidirectional gas exchange with the atmosphere, relieved by means of the louvered vent plate 429.

[0059] Referring now to Figures 30-37, four different embodiments of a metallic nozzle disc are illustrated, each of which is adapted and configured to generate a gas-tight seal in the internal gas-tight sealing module 440 shown in Figure 28, as explained above. In these embodiments, each metal disc 594 is formed with at least one inwardly radially inclined nozzle 596 therefor formed to accelerate the pressurized gas received from the pump 416 in order to generate the gas-tight seal in the internal gas-tight sealing module 444 of the gas management device 412, a cylindrical bore 598 to accommodate the inward air entrainment and gas release from the gas-tight seal 444, and an O-ring seal 595 to isolate by sealing the high and low pressure sides of the disc 594 in the housing 450 of the module 440.

[0060] With reference first to Figures 30 and 31, one embodiment of the disc 594 includes an inwardly inclined radial nozzle 596 radially separated from the cylindrical bore 598, both being offset with respect to a central axis of the disc 594. An alternative embodiment of the disc 594 has a plurality of inwardly inclined radial nozzles 596 formed therein, which are radially separated from the cylindrical bore 598, all being offset with respect to a central axis of the disc, as illustrated in Figures 32 and 33.

[0061] In another embodiment, the disc 594 has a plurality of inwardly inclined radial jet nozzles 596 formed therein, surrounding the cylindrical orifice 598, which is axially aligned with a central axis of the disc 594, as illustrated in Figures 34 and 35. In yet another embodiment of the disc 594, there is an inwardly inclined radial nozzle 596 receiving pressurized gas through a radial inlet channel 597 extending from an outer periphery of the disc 594, and the cylindrical orifice 598 is axially aligned with a central axis of the disc 594, as illustrated in Figures 36 and 37.

[0062] In essence, the cylindrical orifice 598 in each of these metal discs 594 provides the same function as the center bore of an annular jet unit for a gas-tight access port (see U.S. Patent No. 8,795,223), which is centered to allow passage of the instrument. However, since the jet discs 594 are located inside the gas delivery device 412, and do not have to accommodate the passage of the instrument, the cylindrical orifice 598 in each disc 594 does not have to be as large and can be offset from the center. This is because it is not necessary to form a pneumatic seal around a cylindrical instrument passing through the access port. Although this orifice is cylindrical for ease of manufacture, it does not have to be.

[0063] Although the present description has been shown and described with reference to preferred embodiments, those skilled in the art will readily appreciate that changes or modifications can be made without departing from the scope of the present description.

[0064] The invention is defined by the following claims.

Claims

1. A filter tube assembly (430) with a gas delivery device (412) for performing an endoscopic surgical procedure in a surgical cavity (18), the filter tube assembly (30) comprising: a) a filter cartridge unit (432) having a first flow path and a second flow path formed therein; b) a first lumen (444) extending from the filter cartridge unit (432) and communicating with the first flow path to communicate with the surgical cavity in order to maintain a stable pressure value and facilitate smoke evacuation therein; wherein the stable pressure value is maintained by a gas-tight sealing module (440) mounted on the gas delivery device (412), wherein the gas delivery device (412) includes a receiving cavity (417) for releasably receiving the filter cartridge unit (432) of the filter tube assembly (430),which communicates with the internal gas-tight sealing module (440) by means of an internal gas-tight sealing tube (425). c) a second lumen (446) extending from the filter cartridge and communicating with the second flow path for administering insufflation gas to the surgical cavity (18) and sensing pressure in the cavity.

2. A filter tube assembly according to claim 1, wherein a fitting is operatively associated with a distal end of the first lumen (444) for connection to a first valve-sealed access port.

3. A filter tube assembly according to claim 1, wherein a fitting is operatively associated with a distal end of the second lumen (446) for connection to a second valve-sealed access port.

4. A filter tube assembly according to claim 1,wherein at least one filter element is disposed in the first filtered flow path of the filter cartridge (432).

5. A filtered tube assembly according to claim 1, wherein at least one filter element is disposed in the second filtered flow path of the filter cartridge (432).

6. A filtered tube assembly according to claim 1, wherein the first lumen (444) is configured for bidirectional gas flow in order to facilitate stable pressure in the surgical cavity and facilitate smoke evacuation from the surgical cavity.

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