Electrosurgical smoke evacuation for surgical procedures

Abstract

Various examples of the disclosed subject matter include systems and methods of controlling a flow rate of a smoke evacuation system. In one example, the smoke evacuation system includes an electrosurgical unit (ESU) to provide power to an electrosurgical tool within a surgical site. A monitoring device measures one or more electrical parameters from the electrosurgical tool, and a controller estimates an amount of smoke generated within the surgical site based on the electrical parameters. The controller sets a flow rate of a suction device to remove gases within the surgical site. The flow rate of the generated gases removed is based on the estimated amount of smoke generated. The controller also controls a flow rate of insufflation gases generated by an insufflation device, where the flow rate of the insufflation gases is substantially equal to the flow rate of the gases generated by the suction device. Other systems and methods are disclosed.

Description

[0001] CLAIM OF PRIORITY

[0002] This application claims priority to U.S. Patent Application Serial No. 62 / 953,079, filed December 23, 2019, entitled “ELECTROSURGICAL SMOKE EVACUATION FOR SURGICAL PROCEDURES,” the entirety of which is incorporated herein by reference. TECHNICAL FIELD

[0003] The disclosed subject matter relates generally to the field of minimally invasive surgery. More specifically, the disclosed subject matter relates to estimating an expected amount of electrosurgically-induced smoke and vapor (or the like) within a surgical site and evacuating the smoke from the surgical site. BACKGROUND

[0004] Surgical procedures can be performed in a minimally invasive manner using a teleoperated surgical system (e.g., a teleoperated robotic system). The benefits of minimally invasive surgery are well known when compared to traditional open incision surgery and include less patient trauma, less blood loss, and faster recovery times. In addition, it is known to use robotic surgical systems (e.g., teleoperated robotic systems that provide telepresence), such as the da Vinci® Surgical System (commercialized by Intuitive Surgical, Inc. of Sunnyvale, California, USA). Such robotic surgical systems allow surgeons to operate with intuitive control and greater precision when compared to alternative minimally invasive surgical approaches.

[0005] In one aspect of a minimally invasive surgical system, a procedure is performed by a surgeon controlling a robot. The robot includes one or more instruments coupled to a mechanical arm. The instruments enter the surgical site through small incisions in the patient’s skin. A cannula is inserted into each incision, and a shaft of an instrument can be inserted through the cannula to enter the surgical site.

[0006] Surgical smoke evacuators are configured to evacuate smoke (including particulate matter and water vapor or steam generated) as well as fluids (e.g., gases) from a surgical site. For example, during a surgical procedure involving an energy-generating device, smoke can be generated at or within the surgical site. The smoke and vapor generated by electrosurgery in minimally invasive surgery obscures the surgical field from the surgeon. Active insufflation devices pressurize and inflate the working volume and allow for exchange of gases at or near the surgical site by a suction device to remove the smoke and vapor. Another common method of minimizing loss of visualization is for the surgeon to ask the patient-side assistant to suction out the smoke with a suction irrigator.

[0007] ​Continuous high flow suction irrigation, as used in some prior art systems, is undesirable because suction reduces insufflation pressure and / or increases the amount of insufflation gas exchange required, potentially leading to excessive gas circulation (e.g., through continuous suction), which can cause excessive drying of surrounding tissue. Excessively dry tissue can lead to tissue damage and patient pain. In other prior art systems that use a gas flow (e.g., C02) as an insufflation mechanism, the gas flow rate is manually adjusted as needed to maintain adequate working volume and / or good visualization.

[0008] In a typical case with a standalone electrosurgical unit (ESU) and an active insufflator, the insufflator is unaware of the actual power delivery to the tissue. That is, the insufflator operates as an open loop system and continues to provide a constant flow rate of gas regardless of the actual amount of smoke or vapor generated within the body cavity.

[0009] Other prior art devices attempt to improve a manually controlled insufflation device by sensing when an electrosurgical procedure is activated (when electrosurgery at the surgical site begins) and using the activation information to turn on a smoke evacuation function of a separate smoke evacuation device. However, while synchronizing smoke evacuation with activation of an electrosurgical procedure is an improvement, the prior art systems fail to consider refining the control algorithm within the insufflation device to increase the gas flow rate only during the period of the electrosurgical procedure when smoke and vapor are most likely to be generated.

[0010] The information in this section is presented to provide the ordinary skilled artisan with a background to the following disclosed subject matter and should not be construed as admitted prior art. SUMMARY

[0011] In various embodiments, the disclosed subject matter includes a surgical insufflation and smoke evacuation system including an electrosurgical unit (ESU) having a power generation unit to provide electrical power to an electrosurgical tool; a power monitoring device coupled to the ESU to measure at least one parameter from the electrosurgical tool; a controller coupled to the ESU to estimate an amount of generated smoke based on one or more parameters related to a surgical procedure; an insufflation device coupled to and controlled by the controller to deliver insufflation gas during the surgical procedure, a flow rate of the insufflation device based on the estimated amount of generated smoke; and a suction device coupled to the controller to remove one or more gases within a volume proximate to the surgical procedure.

[0012] In various embodiments, the disclosed subject matter includes a surgical insufflation and smoke evacuation system including a controller coupled to an electrosurgical unit (ESU) to estimate an amount of smoke generated based on one or more parameters related to a surgical procedure, the one or more parameters including at least one parameter including an electrical impedance of a target site (e.g., human tissue (as well as other types of mammalian and other tissue types)) to which energy is applied during the surgical procedure, an electrical power delivered to an electrosurgical tool substantially during a time period in which the surgical procedure is being performed, and an electrical current delivered to the electrosurgical tool substantially during the time period in which the surgical procedure is being performed; an insufflation device coupled to the controller to deliver an insufflation gas during the surgical procedure, a flow rate of the insufflation device based on the one or more parameters; and a suction device coupled to the controller to control a flow rate of one or more gases within a suction tube during the surgical procedure.

[0013] In various embodiments, the disclosed subject matter includes a method of performing insufflation and smoke evacuation from a surgical site during a surgical procedure. The method includes determining an estimated amount of smoke present within a volume proximate to the surgical site; and setting an insufflator device flow rate based on the estimated amount of smoke. BRIEF DESCRIPTION OF DRAWINGS

[0014] Figure 1 An exemplary embodiment of an electrosurgical smoke evacuation system according to the disclosed subject matter is shown;

[0015] Figure 2 Another exemplary embodiment of an electrosurgical smoke evacuation system with a central control unit according to the disclosed subject matter is shown;

[0016] Figure 3 An example of a simplified flowchart of estimating an amount of smoke and vapor generated and a generated insufflator flow rate for removing at least a portion of the generated smoke and vapor is shown;

[0017] Figure 4 An exemplary embodiment of an electrosurgical smoke evacuation system with an active smoke evacuator according to the disclosed subject matter is shown; and

[0018] Figure 5 Another exemplary embodiment of an electrosurgical smoke evacuation system with an active smoke evacuator and a central control unit according to the disclosed subject matter is shown. DETAILED DESCRIPTION

[0019] Electrosurgery involves the use of electricity to generate heat within biological tissue to cause thermal tissue effects, resulting in sealing or incision and removal of tissue through one or more of, for example, desiccation, coagulation, or vaporization. Insufflation instruments provide an enlarged volume within a body cavity proximate to where an electrosurgical procedure is being performed.

[0020] Generally, insufflation instruments introduce a flow of gas into a body cavity. In various exemplary embodiments disclosed herein, an insufflation instrument provides, for example, carbon dioxide (C02) or other gas within a body cavity in which an electrosurgical procedure is being performed. The C02gas serves to pressurize and inflate the working volume and allows for the exchange of gas proximate to the surgical site to remove smoke and vapor, both of which can result from the electrosurgical procedure process. Those of ordinary skill in the art will recognize that although various embodiments disclosed herein relate to carbon dioxide or C02gas, the disclosed subject matter is not limited to providing only C02gas and can be substituted with other gases. One goal of the disclosed subject matter is to reduce or minimize the overall flow of carbon dioxide while removing smoke and vapor that can obscure the visual field. Those of skill in the art will further recognize that the terms "smoke" and "vapor" as used herein can also refer to any type of visual obscuring gas or particulate, or other contaminant or byproduct, formed by the electrosurgical procedure process.

[0021] During a typical electrosurgical procedure, a surgeon encounters a variety of tissue types and compositions, each of which has a different degree of hydration level and electrical impedance value. Generally, well-vascularized tissue has a lower electrical impedance. If there is little to no hydration (moisture) in the tissue, the impedance of the tissue is much higher. The effect of applying sufficient radiofrequency (RF) energy to well-vascularized tissue is that, for example, during cutting and / or coagulation applications (e.g., prior to tissue vaporization, where fluid content can be converted to gas), the water content is vaporized. This condition can result in the generation of smoke and vapor. Since generator settings and / or tissue impedance affect the electrosurgical current and power delivered to the tissue, at least some of these electrical parameters (e.g., impedance, power, and current) can be used to determine when visualization within the procedural volume can be obscured or reduced.

[0022] In a typical case of a standalone electrosurgical unit (ESU) and an active insufflator, the insufflator is not given feedback on the actual power delivery to the tissue and thus operates as an open loop system as described above. The disclosed subject matter is applicable to integrated systems, such as the da Vinci® Surgical System, which includes an ESU and an insufflator. A surgical robot or other minimally invasive surgical system configured to include communication between the ESU and insufflator or each unit and a control system that can send commands based on information about the current state, parameters, and settings of each unit.

[0023] Specifically, the disclosed subject matter uses parameters including, for example, electrical impedance, electrical power, and electrical current delivered to tissue by an electrosurgical generator to estimate the amount of smoke and vapor being produced and adjust the insufflator flow rate accordingly. Using at least one of the above parameters from the ESU, such as impedance, power, and current, controls the activation of the insufflator and the magnitude of the gas flow rate produced by the insufflator while still enabling a balance between the inflow (e.g., gas provided by the insufflator) and outflow (smoke evacuation or suction) components. Thus, the insufflation system can remove smoke, fluids (e.g., gas and vapor), and particulate from the surgical site without over-drying the tissue due to the gas flow rate being too high. The flow rate of the insufflator is then increased or decreased as needed to eliminate the smoke and vapor produced at or near the surgical volume. The calculations for smoke estimation, flow rate, and setting adjustment can be performed in the ESU, the insufflator, or some other component of the system. The calculation and estimation of the amount of smoke and vapor produced can be optionally stored in a lookup table, produced by an algorithm, and / or stored in, for example, a table or relational database. Thus, various embodiments of the system provide for reduced or minimal flow rates needed to remove smoke and vapor that can obscure the view.

[0024] As described in detail below, various embodiments of the electrosurgical smoke evacuation system (also referred to herein as a surgical smoke evacuation system) can also optionally include an adjustable flow rate setting that allows the surgeon to adjust the sensitivity of the system in relation to the flow rate produced by the insufflator. For surgical situations that are particularly susceptible to excessive flow rates, the surgeon can set the flow rate control to a low setting to prevent the control system from increasing the flow rate substantially. For situations where there is a greater need for visualization, a higher flow rate setting can be used. In the second case, the result will be good visualization with a higher flow rate than the first case, but without excessive flow rates due to the need for visualization. As previously mentioned, high flow rates can dry out or over-dry tissue too quickly.

[0025] Thus, the disclosed subject matter uses parameters of impedance, power, and / or current delivered to tissue by an electrosurgical generator to estimate the amount of smoke and vapor being produced and adjust the insufflator flow rate. Thus, the system can provide a minimal flow rate to remove the produced smoke and vapor that can obscure the view. As used herein, the term flow rate can be considered to be either a volumetric flow rate or a mass flow rate as understood by those skilled in the art.

[0026] Referring now to Figure 1 , an exemplary embodiment of an electrosurgical smoke evacuation system 100 according to the disclosed subject matter is shown. Figure 1is shown to include an electrosurgical unit (ESU) 110 and a powered insufflator unit 120. The ESU 110 includes an ESU controller 111, an ESU communication device 113, a power generation device 115, and a power monitoring device 117. The powered insufflator unit 120 includes an insufflator communication device 121, an insufflator controller 123, a filter 125, a suction device 127, and an insufflation device 129.

[0027] Figure 1 is also shown to include an example of a minimally invasive surgical site 130 (e.g., an abdomen of a mammalian body). An electrosurgical handpiece cord 101 is coupled to an electrosurgical tool 131. The electrosurgical tool 131 enters the minimally invasive surgical site 130 through a cannula 133 known in the art. Power is delivered from the power generation device 115 to the electrosurgical tool 131 through the electrosurgical handpiece cord 101. The power variables (e.g., frequency of the signal, amplitude of the signal, and amount of current supplied to the signal) output by the power generation device 115 from the power generation device 115 are monitored by the power monitoring device 117. In addition, the power monitoring device 117 can measure the impedance of tissue proximate to the volume undergoing the surgical procedure through signals received from the electrosurgical tool 131. In some embodiments, the power monitoring device 117 can include, for example, an analog or digital display indicating a single power value (amplitude and amount of current supplied to the signal), one or more power variables, or other information related to the power output from the power generation device 115 and displayed for the convenience of the surgeon. In other embodiments, only one of the above-mentioned parameters can be optionally displayed, for example, the amount of power delivered.

[0028] The ESU controller 111 can be operated automatically or manually by the surgeon. In various embodiments, in either automatic or manual operation, the ESU controller 111 provides a desired (or calculated) input level of, for example, the above-mentioned power variables to the power generation device 115. The power monitoring device 117 can optionally display the power output variables in question, and can also optionally display the number of input power variables to the power generation device 115 received from the ESU controller 111. All power output variables from the ESU controller 111 are communicated from the ESU communication device 113 to the insufflator communication device 121. The insufflator controller 123 can control the parameters of the suction from the suction device 127 and the flow rate of the C02 delivered to the minimally invasive surgical site 130 through the insufflation device 129. The filter 125 removes most or all of the particulate, effluent, and other fluid or solid material (e.g., fluid and solid contaminants) removed from 130 by the suction device 127 before the contaminants are released to the environment. In various embodiments, the filter 125 or the output of the filter 125 can also optionally be directed through, for example, a water reservoir component to remove or reduce the amount of carcinogenic substances produced.

[0029] With continued reference to Figure 1 The suction tube 103 and insufflation tube 105 enter the minimally invasive surgical site 130 through the second cannula 135. Gas is supplied to the insufflation device 129 by the CO2 supply 107. The insufflation device 129 can include a pump (e.g., a peristaltic pump) or similar device known in the art. The insufflation device 129 is controlled to supply a flow of gas that is measured by, for example, a volumetric or mass flow meter (not shown but known in the art). The flow rate control of the insufflation device 129 can be achieved by, for example, electrical control or pneumatic control provided as input to the insufflation device 129 from the insufflator controller 123. The insufflator controller 123 also provides an input signal to the suction device 127 so that the suction device 127 and the insufflation device 129 are balanced. That is, the pressure of the flow rate of gas and other fluid or particulate matter extracted from the minimally invasive surgical site 130 by the suction device 127 is approximately equal to or slightly less than (e.g., approximately equal to or approximately less than 10%) the pressure created by the flow rate of gas supplied into the minimally invasive surgical site 130 by the insufflation device 129. Thus, the suction device 127 does not exhaust so much gas as to collapse the minimally invasive surgical site 130 that is insufflated by the insufflation device 129 (and further, for example, accounting for fluctuations in insufflation pressure). In embodiments, fluctuations in insufflation pressure are substantially avoided. Thus, a substantially equal pressure is maintained so that there is pressure stability between the insufflation device and the suction device. In these embodiments, the flow rate of gas supplied by the insufflator is monitored (at least up to a maximum gas flow rate that the insufflation device can produce) to compensate for the rate of gas lost due to the suction device.

[0030] Further, the suction device 127 is arranged to exhaust a sufficient level of gas, fluid (e.g., vapor or steam), and particulate matter to provide a sufficient visible volume proximate the surgical site. In various embodiments, the flow rate sufficient to provide the visible volume is based on predetermined parameters as described above. The predetermined parameters can include, for example, an estimated amount of vapor and particulate matter produced for a given input value of frequency, amplitude, and current supplied to the electrosurgical tool 131. Reference is made to the following Figure 3 This exhaust process is described in more detail.

[0031] In some embodiments, the ESU controller 111 can contain all of the lookup tables, algorithms, and / or databases discussed above that are used to provide information to operate the electrosurgical smoke evacuation system 100. In other embodiments, the lookup tables and / or databases can be contained in one or both of the other controllers 111, 123. Such lookup tables and / or databases can be stored on various types of hardware, firmware, and / or software devices or media known in the art, and are described in more detail below.

[0032] In various embodiments, the electrosurgical smoke evacuation system 100 can include a sensitivity control that allows the surgeon to adjust the system sensitivity related to the flow rate produced by the insufflator. The sensitivity control can be located, for example, on the ESU controller 111, on the insufflator controller 123, or on a central control system (e.g., a surgeon's console, not shown but readily understood by those skilled in the art) of a robotic system (also not shown) if used. In some embodiments, the sensitivity control can optionally be duplicated on both controllers 111, 123 for the surgeon's convenience. For example, for surgical cases that are particularly susceptible to excessive flow, the surgeon can set the sensitivity control to a low setting to prevent the electrosurgical smoke evacuation system 100 from increasing the flow rate (e.g., from one or both of the suction device 127 and the insufflation device 129) too much. For cases where good visualization is more needed and less sensitive to higher flow, the surgeon can use a higher sensitivity control setting. In the latter case, the result is good visualization with a higher flow rate than the first case, but without the need for excessive flow for visualization.

[0033] A parameter related to at least one of impedance, power, and / or current delivered into tissue in the surgical site is measured by the power monitoring device 117 based on electrical feedback delivered to or obtained from the electrosurgical tool 131. The parameter is delivered to one or both of the other controllers 111, 123. One or both of the other controllers 111, 123 uses the parameter to estimate the amount of smoke and vapor produced based on information saved to a storage area or calculated according to an algorithm as described above. An optimal or desired flow rate is based on the estimate, in combination with the surgeon's sensitivity setting as described above. One or both of the other controllers 111, 123 sends a command signal to the active insufflator unit 120 or within the active insufflator unit 120 to set the flow rates of the suction device 127 and the insufflation device 129 to the optimal or desired flow rate value.

[0034] Reference is made to Figure 2 FIG. 2 shows another exemplary embodiment of an electrosurgical smoke evacuation system 200 having a central control unit 230 in accordance with the disclosed subject matter. Figure 2 is shown to include an electrosurgical unit (ESU) 210 and an active insufflator unit 220. The ESU 210 includes an ESU controller 211, an ESU communication device 213, a power generation device 215, and a power monitoring device 217. The active insufflator unit 220 includes an insufflator communication device 221, an insufflator controller 223, a filter 225, a suction device 227, and an insufflation device 229. Gas is supplied by a CO2 supply 207 for the insufflation device 229. Each of these components is the same as or similar to the components shown and described above with reference to FIG. 1. Figure 1 ​

[0035] Figure 2 Also shown is the inclusion of a central control unit 230. The central control unit 230 includes a central communication device 231 and a central controller 233. As shown, the central communication device 231 intervenes between all communications shared between the ESU 210 and the active blower unit 220. In addition, all control of the electrosurgical smoke evacuation system 200 can be centralized within the central controller 233. In this embodiment, the central controller 233 can provide commands to the ESU controller 211 and the blower controller 223. The commands are transmitted through the central communication device 231 and exchanged with or directed to the ESU communication device 213 and the blower communication device 221, respectively. Although all communications within the electrosurgical smoke evacuation system 200 are shown in FIG. 2 as being through hardwired signal paths, this is not intended to be limiting. For example, the communications can be through wireless signals, such as RF radio signals using a protocol such as Bluetooth®, or other wireless communication protocols known in the art. In addition, the communications can be through wireless signals with a backup of hardwired signal paths to maintain a high level of safety. Figure 2 Figure 2

[0036] In some embodiments, the central control unit 230 can also contain all of the lookup tables, algorithms, and / or databases discussed above that are used to provide information to the central controller 233 to operate the electrosurgical smoke evacuation system 200. In other embodiments, the lookup tables, algorithms, and / or databases can be contained in one or all of the controllers 211, 223, 233. Such lookup tables and / or databases can be stored in various types of hardware, firmware, and / or software devices or media known in the art and described in more detail below.

[0037] As discussed above with reference to FIG. 1, the electrosurgical smoke evacuation system 200 can optionally include a sensitivity control (not explicitly shown) that can be adjusted by the surgeon. The sensitivity control can be located on the ESU 210 or the active blower unit 220. The sensitivity control can also be located on the central control unit 230 instead of or in addition to being located on the ESU 210 and / or the active blower unit 220. Figure 1

[0038] In some embodiments, the central control unit 230 can also contain all of the lookup tables, algorithms, and / or databases discussed above that are used to provide information to the central controller 233 to operate the electrosurgical smoke evacuation system 200. In other embodiments, the lookup tables, algorithms, and / or databases can be contained in one or all of the controllers 211, 223, 233. Such lookup tables and / or databases can be stored in various types of hardware, firmware, and / or software devices or media known in the art and described in more detail below. Figure 1 ​​​​One or more parameters related to at least one of impedance, power, and / or current delivered to tissue in the surgical site are disclosed in a similar manner by the power monitoring device 217 based on electrical feedback measurements communicated to or obtained from the electrosurgical tool 131. The one or more parameters are communicated to the central control unit 230. The central control unit 230 uses the one or more parameters to estimate the amount of smoke and vapor generated based on information saved to a storage area or calculated according to an algorithm as described above. The central control unit 230 then calculates an optimal or desired flow rate based on the estimate and in combination with the surgeon sensitivity setting described above. The central control unit 230 sends a command signal to the active insufflator unit 220 through the communication devices 231, 221 to set the flow rates of the suction device 227 and the insufflation device 229 to the optimal or desired flow rate values.

[0039] Figure 3 An example of a simplified flowchart 300 is shown for estimating the amount of smoke and vapor generated and generating an insufflator flow rate to remove at least a portion of the generated smoke and vapor. At operation 301, it is determined whether the ESU (e.g., the ESU 110 of Figure 1 is active (e.g., whether the electrosurgical unit is activated and in use). If the ESU output is not active, the flowchart 300 continues to operation 309 where the insufflator flow rate (e.g., the insufflation device 129) can be set to zero or simply a function of the default insufflator settings (e.g., approximately 15 mm Hg insufflation pressure at a flow rate of about 20 SLPM). In some embodiments, a latency period is also included whereby the insufflator flow rate is not immediately reduced to zero. For example, if plume buildup (e.g., residual smoke accumulation) from a high energy application cannot be immediately evacuated upon stopping the provision of radio frequency energy, a longer predetermined time period can be used to run the smoke evacuation process to mitigate the plume buildup.

[0040] At operation 301, if the ESU output is active, the flowchart 300 proceeds to operation 303, where a smoke and / or vapor estimate is made based on a function of at least one electrical parameter including impedance, power, and current. At operation 305, a blower flow rate is set according to the function of the smoke and vapor estimate, a surgeon-entered sensitivity control setting, and a blower setting (e.g., the level of electrical signal required for the blower to produce an optimized or desired flow rate). After operation 305 is completed, the flowchart 300 again loops back to operation 301 at 307 to verify whether the ESU is still active. In some embodiments, the time period for determining when the flowchart 300 should loop back to operation 301 at 307 can be determined based on the speed at which any of the above-mentioned parameters can be expected to change. In other embodiments, the time period can be confirmed based on a given procedure. One of ordinary skill in the art, upon reading and understanding the disclosed subject matter, will recognize how this confirmed or variable time period (e.g., duration) can be determined.

[0041] Each operation of the simplified flowchart 300 can be performed by one or more controllers (e.g., the central controller 233 of the Figure 2 or one of the other controllers 211, 223 of the Figure 2 .

[0042] In various embodiments, the disclosed subject matter can also apply to the case of a smoke evacuator that is separate from the blower. In this embodiment, the smoke evacuator would adjust the flow rate of suction based on the above-mentioned algorithms in the ESU, the smoke evacuator, or a central control system.

[0043] For example, Figure 4 Another example embodiment of an electrosurgical smoke evacuation system 400 having a separate smoke evacuator unit 430 in accordance with the disclosed subject matter is shown. Figure 4 Also shown is an electrosurgical unit (ESU) 410 and an active blower unit 440. The ESU 410 includes an ESU controller 411, an ESU communication device 413, a power generation device 415, and a power monitoring device 417. The separate smoke evacuator unit 430 includes a smoke evacuator communication device 431, a smoke evacuator controller 433, a smoke evacuator filter 435, and a smoke evacuator suction device 437. The active blower unit 440 includes a blower communication device 441, a blower controller 443, and a blowing device 445. Gas is supplied to the blowing device 445 by a CO2 supply 407. Except that the separate smoke evacuator unit 430 is a separate device, each of these components is the same as or similar to the components shown and described above with reference to Figure 1 . Furthermore, the operation of each component is similar or identical to the similar devices of Figure 1 .

[0044] For example, in some embodiments, any or all of the controllers 411, 433, 443 can contain all of the lookup tables, algorithms, and / or databases discussed above for providing information to the smoke evacuator suction device 437 and insufflation device 445 to operate the electrosurgical smoke evacuation system 400. Furthermore, to further enhance the safety of the electrosurgical smoke evacuation system 400, all of the control parameters can optionally be replicated onto each of the controllers 411, 433, 443. If one controller fails, one or both of the remaining controllers can control the operation of the electrosurgical smoke evacuation system 400. For example, if the insufflator controller 443 fails, the ESU controller 411 or the smoke evacuator controller 433 can take over all of the operations of the active insufflator unit 440 through the various ones of the communication devices 413, 431, 441. Furthermore, if two of the controllers fail, the only remaining controller can take over control of all aspects of the electrosurgical smoke evacuation system 400. Thus, in contrast to the electrosurgical smoke evacuation system 200 of Figure 2 the electrosurgical smoke evacuation system 400 of Figure 4 can be considered to have a triple redundant control system.

[0045] Furthermore, the sensitivity controls described above (not explicitly shown) can also be located in the smoke evacuator unit 430 instead of, or in addition to, being located on the ESU 410 and / or the active insufflator unit 440.

[0046] In a similar manner to the procedures disclosed above with respect to Figure 1 the electrosurgical smoke evacuation system 200, a parameter related to at least one of the impedance, power, and / or current delivered to the tissue in the surgical site is measured by the ESU 410 based on electrical feedback obtained from the electrosurgical tool 131. As described above, this parameter is communicated to at least one of the controllers. For example, the insufflator controller 443 uses the parameter to estimate the amount of smoke and vapor generated based on information saved to a storage area or calculated as described above. The insufflator controller 443 then calculates an optimal or required flow rate based on this estimate and in combination with the surgeon sensitivity setting described above. The insufflator controller 443 then sends a signal to set the flow rates of the smoke evacuator suction device 437 and insufflation device 445 to this optimal or required flow rate value.

[0047] Figure 5 Another exemplary embodiment of an electrosurgical smoke evacuation system 500 having an active smoke evacuator unit 530 and a central control unit 550 in accordance with the disclosed subject matter is shown. Figure 5It is also shown to include an electrosurgical unit (ESU) 510 and an active blower unit 540. ESU 510 includes an ESU controller 511, an ESU communication device 513, a power generation device 515, and a power monitoring device 517. A separate active smoke extractor unit 530 includes a smoke extractor communication device 531, a smoke extractor controller 533, a smoke extractor filter 535, and a smoke extractor suction device 537. Active blower unit 540 includes a blower communication device 541, a blower controller 543, and a blower device 545. Gas is supplied by a CO2 supplier 507 for the blower device 545.

[0048] Figure 5 It is also shown to include a central control unit 550. The central control unit 550 includes a central communication device 551 and a central controller 553. (As shown) Figure 5 As shown, the central communication device 551 facilitates all communications shared between one or all of the ESU 510, the active smoke exhaust unit 530, and the active blower unit 540. Furthermore, all control of the electrosurgical smoke exhaust system 500 can be centralized within the central controller 553. In this embodiment, the central controller 553 can provide commands to the ESU controller 511, the smoke exhaust controller 533, and the blower controller 543. Commands are transmitted via the central communication device 551 and exchange or direct information with the ESU communication device 513, the smoke exhaust communication device 531, and the blower communication device 541, respectively. Figure 1 , Figure 2 and Figure 4 Similarly, although all communications within the electrosurgical smoke extraction system are in... Figure 5 While it appears to use hardwired signal paths, this is not intended to impose such restrictions. For example, the communication could use wireless signals, such as those employing... The protocol or other wireless communication protocols known in the art can be used for RF radio signals. Furthermore, communication can be conducted via wireless signals with hard-wired signal path backup to maintain a high level of security.

[0049] In some embodiments, the central control unit 550 may also include all the lookup tables, algorithms, and / or databases discussed above for providing information to the central controller 553 to operate the electrosurgical smoke extraction system 500. In other embodiments, the lookup tables, algorithms, and / or databases may be included in one or all of the controllers 511, 533, 543, and 553. Such lookup tables and / or databases may optionally be stored in various types of hardware, firmware, and / or software devices or media known in the art and described in more detail below.

[0050] In a manner similar to the procedure disclosed above with reference to Figure 1 A parameter related to at least one of the impedance, power and / or current delivered to tissue in the surgical site is measured by the ESU 510 based on electrical feedback measurements obtained from the electrosurgical tool 131 in a manner similar to the procedure disclosed above with reference to

[0051] Except that the central control unit 550 is a separate device, each of these components is the same as or similar to the components shown and described above with reference to Figure 4

[0052] Examples of embodiments of the disclosed subject matter

[0053] In a first embodiment, the disclosed subject matter includes a surgical insufflation and smoke evacuation system including an electrosurgical unit (ESU) having a power generation unit to provide electrical power to an electrosurgical tool; a power monitoring device coupled to the ESU to measure at least one parameter from the electrosurgical tool; a controller coupled to the ESU to estimate an amount of generated smoke based on one or more parameters related to a surgical procedure; an insufflation device coupled to and controlled by the controller to deliver an insufflation gas during the surgical procedure, a flow rate of the insufflation device based on the estimated amount of generated smoke; and a suction device coupled to the controller to remove one or more gases within a volume proximate to the surgical procedure.

[0054] In a second embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of the first embodiment, wherein the at least one parameter is selected from the following parameters: an electrical impedance of a target site (e.g., a human or other tissue) to which energy is applied during the surgical procedure, a power delivered to the electrosurgical tool substantially during a time period in which the surgical procedure is being performed, and a current delivered to the electrosurgical tool substantially during a time period in which the surgical procedure is being performed.

[0055] In a third embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of any of the preceding embodiments, and further includes a manually adjustable sensitivity control that is settable by a surgeon during a surgical procedure to increase or decrease a flow rate of the insufflation device.

[0056] ​In a fourth embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of any of the preceding embodiments, wherein the power monitoring device measures impedance of tissue proximate to the volume undergoing the surgical procedure through signals received from the electrosurgical tool.

[0057] In a fifth embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of any of the preceding embodiments, and further includes a filter coupled downstream of the suction device to remove particulates from effluent received by the suction device.

[0058] In a sixth embodiment, the disclosed subject matter includes a surgical insufflation and smoke evacuation system, the system including a controller coupled to an electrosurgical unit (ESU) to estimate an amount of smoke generated based on one or more parameters related to a surgical procedure, the one or more parameters including at least one parameter including an electrical impedance of a target site (e.g., a human or other tissue) to which energy is applied during the surgical procedure, an electrical power delivered to the electrosurgical tool substantially during a time period in which the surgical procedure is being performed, and an electrical current delivered to the electrosurgical tool substantially during the time period in which the surgical procedure is being performed; an insufflation device coupled to the controller to deliver an insufflation gas during the surgical procedure, a flow rate of the insufflation device based on the one or more parameters; and a suction device coupled to the controller to control a flow rate of one or more gases within a suction tube during the surgical procedure.

[0059] In a seventh embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of the sixth embodiment, wherein a sensitivity of the insufflation device is manually adjustable by a surgeon based on an extent to which smoke generated within a surgical volume obscures a field of view.

[0060] In an eighth embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of either of the sixth or seventh embodiments, wherein the suction control device is automatically adjusted based on signals received by the suction control device from the ESU.

[0061] In a ninth embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of any of the sixth through eighth embodiments, and further includes a power monitoring device coupled to the ESU to measure the one or more parameters.

[0062] In a tenth embodiment, the disclosed subject matter further includes the surgical insufflation and smoke evacuation system of the ninth embodiment, wherein the power monitoring device measures impedance of tissue proximate to the volume undergoing the surgical procedure through signals received from the electrosurgical tool.

[0063] In an eleventh embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of any of the sixth through tenth embodiments, and further includes a filter coupled downstream of the suction device to at least partially remove particulates and effluent received from the suction device.

[0064] In a twelfth embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of any of the sixth through eleventh embodiments, and further includes a water reservoir component coupled downstream of the suction device to at least partially remove carcinogens generated.

[0065] In a thirteenth embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of any of the sixth through twelfth embodiments, and further includes a manually adjustable sensitivity control settable by the surgeon during the surgical procedure to increase or decrease the flow rate of the insufflator device.

[0066] In a fourteenth embodiment, the disclosed subject matter also includes the surgical insufflation and smoke evacuation system of any of the sixth through thirteenth embodiments, wherein the smoke includes vapor.

[0067] In a fifteenth embodiment, the disclosed subject matter includes a method of performing insufflation and smoke evacuation from a surgical site during a surgical procedure. The method includes determining an estimated amount of smoke present within a volume proximate the surgical site; and setting an insufflator device flow rate based on the estimated amount of smoke.

[0068] In a sixteenth embodiment, the disclosed subject matter also includes the method of the sixteenth embodiment, wherein the estimated amount of smoke is based on at least one parameter selected from the group consisting of: a measured electrical impedance of a target site (e.g., a human or other tissue) to which energy is applied during the surgical procedure, an electrical power delivered to an electrosurgical tool during a time period substantially during which the surgical procedure is being performed, and an electrical current delivered to an electrosurgical tool during a time period substantially during which the surgical procedure is being performed.

[0069] In a seventeenth embodiment, the disclosed subject matter also includes the method of any of the fifteenth and sixteenth embodiments, and further includes setting a flow rate of a suction device coupled to a suction tube within the surgical site to be, for example, about equal to or about 10% less than the flow rate of the insufflator device.

[0070] In an eighteenth embodiment, the disclosed subject matter also includes the method of any of the fifteenth through seventeenth embodiments, and further includes filtering particulates and effluent received from an output of the suction device.

[0071] In a nineteenth embodiment, the disclosed subject matter also includes the method of the eighteenth embodiment, and further includes transmitting the effluent received from the output of the suction device through a water reservoir component to at least partially remove carcinogens generated.

[0072] In a twentieth embodiment, the disclosed subject matter also includes the method of any one of the fifteenth through nineteenth embodiments, and further includes adjusting the flow rate of the insufflator device based on a manually adjustable sensitivity control.

[0073] Such systems and methods as described above can run on various types of devices, as described in more detail below. For example, these devices include computers or microprocessors, special purpose processors, such as field programmable gate arrays (FPGAs) or application specific integrated circuits (ASICs) programmed with software, firmware, or implemented as hardware embodiments, having one or more aspects of the disclosed subject matter described above.

[0074] Throughout this specification, plural instances can implement components, operations, or structures described as a single instance. Although individual operations of one or more methods are illustrated and described as separate operations, one or more of the individual operations can be performed concurrently, and nothing requires that the operations be performed in the order illustrated. Structures and functionality presented as separate components in example configurations can be implemented as a combined structure or component. Similarly, structures and functionality presented as a single component can be implemented as separate components. These and other variations, modifications, additions, and improvements fall within the scope of the subject matter herein.

[0075] Certain embodiments are described herein as including logic or a number of components, devices, or means. Any of these components, devices, or means can be implemented as software modules (e.g., code stored or transmitted on a machine-readable medium) or hardware modules. A "hardware module" is a tangible unit capable of performing certain operations (e.g., a processor or a portion of a processor) and can include or be associated with software (e.g., an application program or portion thereof) that can be executed by the hardware module. The hardware module can be configured by software (e.g., an application or application portion) as a hardware module that is capable of performing certain operations.

[0076] In some embodiments, a hardware module can be implemented mechanically, electronically, pneumatically, or in any suitable combination of these. For example, a hardware module can include dedicated circuitry or logic that is permanently configured to perform certain operations. For example, a hardware module can be a special-purpose processor, such as a FPGA or an ASIC.

[0077] Hardware modules may also include programmable logic or circuitry temporarily configured by software to perform certain operations. For example, a hardware module may include software contained within a general-purpose processor or other programmable processor. It should be understood that the decision to implement a hardware module mechanically, in dedicated and permanently configured circuitry, or in temporarily configured circuitry (e.g., configured by software) may be driven by cost and time considerations.

[0078] Therefore, the phrase "hardware module" should be understood to include tangible entities, whether physically constructed, permanently configured (e.g., hardwired), or temporarily configured (e.g., programmed), that operate or perform certain operations described herein. As used herein, "hardware-implemented module" refers to a hardware module. Considering embodiments where hardware modules are temporarily configured (e.g., programmed), each hardware module does not need to be configured or instantiated on any one time instance. For example, in cases where hardware modules include general-purpose processors configured by software as dedicated processors, the general-purpose processor can be configured as different dedicated processors (e.g., including different hardware modules) at different times. The software can configure the processor accordingly, for example, to constitute a specific hardware module in one time instance and different hardware modules in different time instances.

[0079] Hardware modules can provide information to and receive information from other hardware modules. Therefore, the described hardware modules can be considered communication-coupled. In the presence of multiple hardware modules, communication can be achieved through signal transmission between two or more hardware modules (e.g., via appropriate circuitry and buses). In embodiments where multiple hardware modules are configured or instantiated at different times, communication between these hardware modules can be achieved, for example, by storing and retrieving information in a memory structure accessible to the multiple hardware modules. For example, one hardware module can perform an operation and store the output of that operation in a memory device to which it is communication-coupled. Another hardware module can then access the memory device at a later time to retrieve and process the stored output. Hardware modules can also initiate communication with input or output devices and can operate on resources (e.g., information sets).

[0080] The various operations of the example methods described herein can be performed at least in part by one or more processors, which are temporarily configured (e.g., by software) or permanently configured to perform the relevant operations. Whether temporarily or permanently configured, such processors can constitute processor-implemented modules that operate to perform one or more of the operations or functions described herein. As used herein, "processor-implemented module" means a hardware module implemented using one or more processors.

[0081] Similarly, the methods described herein can be implemented at least in part by a processor, which is an example of hardware. For example, at least some operations of a method can be performed by one or more processors or modules implemented by processors.

[0082] The performance of certain operations can be distributed across one or more processors, residing not only within a single machine but also deployed across multiple machines. In some embodiments, one or more processors or processor-implemented modules may reside in a single geographic location (e.g., in a home environment, office environment, or server farm). In other embodiments, one or more processors or processor-implemented modules may be distributed across multiple geographic locations.

[0083] As used herein, the term "or" can be interpreted as inclusive or exclusive. Furthermore, other embodiments will be understood by those skilled in the art upon reading and understanding the provided disclosure. Moreover, upon reading and understanding the provided disclosure, those skilled in the art will readily understand that various combinations of the techniques and examples provided herein can be applied in various ways.

[0084] Although various embodiments have been discussed individually, these individual embodiments are not intended to be considered as independent technologies or designs. As stated above, each of the various parts may be interconnected, and each may be used individually or in combination with other embodiments of the electrosurgical smoke extraction system discussed herein. For example, while various embodiments of methods, operations, and processes have been described, these methods, operations, and processes may be used individually or in various combinations.

[0085] Therefore, many modifications and variations can be made, which will be apparent to those skilled in the art upon reading and understanding the disclosure provided herein. In addition to those listed herein, functionally equivalent methods and apparatus within the scope of this disclosure will be apparent to those skilled in the art from the foregoing description. Parts and features of some embodiments may be included in or replaced by those parts and features of other embodiments. Such modifications and variations are intended to fall within the scope of the appended claims. Therefore, this disclosure is limited only by the terms of the appended claims and the full scope of their equivalents. It should also be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting.

[0086] A summary of the disclosure is provided to allow the reader to quickly determine the nature of the technical disclosure. It is understood that the summary is not intended to interpret or limit the claims. Furthermore, as can be seen from the foregoing detailed description, various features may be combined in a single embodiment for the purpose of simplifying the disclosure. This method of disclosure should not be construed as limiting the claims. Therefore, the following claims are incorporated herein by reference, each claim existing independently as a separate embodiment or a set of embodiments.

Claims

1. A surgical smoke evacuation system, comprising: an electrosurgical unit (ESU) having a power generation unit to provide electrical power to an electrosurgical tool; a monitoring device coupled to the ESU to measure electrical impedance of a target site of application of RF energy during a surgical procedure; a controller coupled to the ESU; and an aspiration device coupled to and controlled by the controller to remove one or more gases within a volume proximate to the surgical procedure; wherein the controller estimates an amount of smoke generated based on the measured electrical impedance and controls the aspiration device to produce a flow rate of gases based on the estimated amount of smoke generated.

2. The surgical smoke evacuation system of claim 1, further comprising an insufflation device coupled to and controlled by the controller to deliver insufflation gases during the surgical procedure, wherein the controller controls the insufflation device to produce a flow rate of gases substantially equal to the flow rate of gases produced by the aspiration device.

3. The surgical smoke evacuation system of claim 2, further comprising a manually adjustable sensitivity control that can be set by a surgeon during the surgical procedure to increase or decrease the flow rate of the insufflation device.

4. The surgical smoke evacuation system of any one of claims 1, 2, or 3, wherein the monitoring device measures the electrical impedance of the target site of application of the RF energy proximate to the volume undergoing the surgical procedure through signals received from the electrosurgical tool.

5. The surgical smoke evacuation system of any one of claims 1, 2, or 3, further comprising a filter coupled downstream of the aspiration device to remove particulates from effluent received by the aspiration device.

6. The surgical smoke evacuation system of claim 1, wherein the monitoring device is contained within the ESU.

7. A surgical smoke evacuation system, comprising: a controller coupled to an electrosurgical unit (ESU); and an aspiration device coupled to and controlled by the controller to remove one or more gases within a volume proximate to a surgical procedure; wherein the controller estimates an amount of smoke generated based on electrical impedance of a site of energy application during the surgical procedure and controls the aspiration device to produce a flow rate of the one or more gases based on the estimated amount of smoke generated.

8. The surgical smoke evacuation system of claim 7, further comprising an insufflation device coupled to and controlled by the controller to deliver insufflation gases during the surgical procedure, wherein the controller controls the insufflation device to produce a flow rate of the insufflation gases substantially equal to the flow rate of the one or more gases produced by the aspiration device.

9. The surgical smoke evacuation system of claim 8, wherein a sensitivity of at least one of the suction device and the insufflation device is further manually adjustable by a surgeon based on a degree of obscuration of a field of view by generated smoke within the volume proximate the surgical procedure.

10. The surgical smoke evacuation system of any one of claims 7 to 9, further comprising a monitoring device coupled to the ESU to measure the electrical impedance of the energy application site during the surgical procedure.

11. The surgical smoke evacuation system of claim 10, wherein the monitoring device is contained within the ESU.

12. The surgical smoke evacuation system of claim 10, wherein the monitoring device measures the electrical impedance of the energy application site during the surgical procedure proximate the volume of the surgical procedure through signals received from an electrosurgical tool.

13. The surgical smoke evacuation system of claim 7, further comprising a filter coupled downstream of the suction device to at least partially remove particulates and effluent received from the suction device.

14. The surgical smoke evacuation system of claim 7, further comprising a water reservoir component coupled downstream of the suction device to at least partially remove generated carcinogens.

15. The surgical smoke evacuation system of any one of claims 7 or 8, wherein the smoke comprises vapor.

16. The surgical smoke evacuation system of claim 7, wherein the suction device is automatically adjustable based on signals received from the ESU.

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