Fluid management system

Abstract

The present invention relates to a fluid management system that can include an inflow pump configured to pump fluid from a fluid supply at a flow rate to a treatment site within a patient's body, and a controller configured to operate at a target flow rate in a flow control mode. In the flow control mode, the controller can be configured to maintain the target flow rate while monitoring a measured pressure communicated from a pressure sensor to the controller. When the measured pressure reaches a preset pressure threshold, the controller can be configured to automatically switch from the flow control mode to a pressure override mode in which the controller automatically reduces the flow rate below the target flow rate to restore the measured pressure to the preset pressure threshold or below the preset pressure threshold.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 62 / 967,806, filed January 30, 2020, the disclosure of which is incorporated herein by reference. Technical Field

[0003] This disclosure relates to a fluid management system. More specifically, this disclosure relates to a fluid management system and a method for controlling intracavitary pressure. Background Technology

[0004] For several reasons, flexible ureteroscopy (fURS), gynecological examinations, and other endoscopic procedures require fluid circulation. Currently, surgeons deliver fluids in various ways, such as by suspending fluid bags and using gravity, filling syringes and manually injecting fluid, or using peristaltic pumps to deliver fluid from a reservoir at a fixed pressure or flow rate via a fluid management system. The fluid management system can regulate the flow rate and / or pressure of the fluid delivered from the reservoir based on data collected from surgical devices such as, but not limited to, endoscopes and / or the fluid management system itself. Among the known medical devices, systems, and methods, each has its own advantages and disadvantages. There is a continuing need to provide alternative medical devices and fluid delivery systems. Summary of the Invention

[0005] In one example, the fluid management system may include: an inflow pump configured to pump fluid from a fluid supply source to a treatment site within the patient at a flow rate; and a controller configured to operate at a target flow rate in a flow control mode. In the flow control mode, the controller may be configured to maintain the target flow rate while monitoring the measured pressure transmitted from a pressure sensor to the controller. When the measured pressure reaches a preset pressure threshold, the controller may be configured to automatically switch from the flow control mode to a pressure overshoot mode, in which the controller automatically reduces the flow rate below the target flow rate to restore the measured pressure to or below the preset pressure threshold.

[0006] As a supplement to or alternative to any example disclosed herein, the controller is configured to switch back from pressure overload mode to flow control mode when the measured pressure drops below a preset pressure threshold.

[0007] As a supplement to or alternative to any of the examples disclosed herein, when the measured pressure drops below a preset pressure threshold, the controller is configured to display a prompt on the display asking the user whether they want to switch back to flow control mode.

[0008] As a supplement or alternative to any of the examples disclosed herein, the controller is configured to display a notification on the display and automatically switch from the pressure override mode to the adjusted flow control mode when the measured pressure drops below a preset pressure threshold.

[0009] As a supplement or alternative to any of the examples disclosed herein, the controller is configured to switch from the pressure override mode to the adjusted flow control mode when the measured pressure drops below a preset pressure threshold.

[0010] As a supplement or alternative to any of the examples disclosed herein, the controller is configured to operate in a reduced flow rate of the pressure override mode when in the adjusted flow control mode.

[0011] As a supplement or alternative to any of the examples disclosed herein, the controller is configured to display a prompt on the display asking whether the user wants to switch to the adjusted flow control mode when the measured pressure drops below a preset pressure threshold.

[0012] As a supplement or alternative to any of the examples disclosed herein, the controller is configured to display a notification on the display and automatically switch from the pressure override mode to the adjusted flow control mode when the measured pressure drops below a preset pressure threshold.

[0013] As a supplement or alternative to any of the examples disclosed herein, the measured pressure is an intraluminal pressure measured within the treatment site.

[0014] As a supplement or alternative to any of the examples disclosed herein, the preset pressure threshold is an intraluminal pressure limit.

[0015] As a supplement or alternative to any of the examples disclosed herein, the measured pressure is a system pressure measured within the fluid management system.

[0016] As a supplement or alternative to any of the examples disclosed herein, the preset pressure threshold is a system pressure limit.

[0017] Additionally or alternatively to any of the examples disclosed herein, the fluid management system can include an inflow pump configured to pump fluid from a fluid supply to a treatment site within a patient at a flow rate, and a controller configured to operate at a target flow rate in a flow control mode. In the flow control mode, the controller can be configured to maintain the target flow rate while monitoring a measured pressure communicated from a pressure sensor to the controller. When the measured pressure reaches a preset pressure threshold, the controller can be configured to automatically switch from the flow control mode to a pressure override mode in which the controller automatically reduces the flow rate below the target flow rate to cause the measured pressure to return to or below the preset pressure threshold. When the measured pressure falls below the preset pressure threshold, the controller can be configured to display a prompt on a display asking whether the user wants to switch out of the pressure override mode.

[0018] Additionally or alternatively to any of the examples disclosed herein, when the measured pressure falls below the preset pressure threshold, the controller is configured to switch back to the flow control mode from the pressure override mode.

[0019] Additionally or alternatively to any of the examples disclosed herein, when the measured pressure falls below the preset pressure threshold, the controller is configured to switch from the pressure override mode to an adjusted flow control mode.

[0020] Additionally or alternatively to any of the examples disclosed herein, in the adjusted flow control mode, the flow rate is subsequently maintained at the reduced flow rate associated with the pressure override mode.

[0021] Additionally or alternatively to any of the examples disclosed herein, the prompt asks the user whether to switch back to the flow control mode or to the adjusted flow control mode.

[0022] Additionally or alternatively to any of the examples disclosed herein, a method of controlling fluid flow in a fluid management system is presented, wherein the fluid management system includes an inflow pump configured to pump fluid from a fluid supply at a flow rate to a treatment site within a patient and a controller configured to operate in a flow control mode at a target flow rate, the method comprising: setting parameters within the controller, wherein the parameters include the target flow rate and a preset pressure threshold; operating the controller in the flow control mode, wherein the controller maintains the target flow rate while monitoring a measured pressure communicated from a pressure sensor to the controller; automatically switching the controller from the flow control mode to a pressure override mode when the measured pressure reaches the preset pressure threshold, in which the pressure override mode the controller automatically reduces the flow rate below the target flow rate to restore the measured pressure to the preset pressure threshold or below; and displaying a prompt on a display when the measured pressure falls below the preset pressure threshold, thereby inquiring a user whether they want to switch out of the pressure override mode.

[0023] Additionally or alternatively to any of the examples disclosed herein, the preset pressure threshold is an intracavity pressure limit.

[0024] Additionally or alternatively to any of the examples disclosed herein, the preset pressure threshold is a system pressure limit.

[0025] The above summary of some embodiments, aspects and / or examples is not intended to describe each embodiment or every implementation of the present disclosure. The figures and detailed description that follow more particularly exemplify these embodiments. BRIEF DESCRIPTION OF DRAWINGS

[0026] The application can be more completely understood in consideration of the following detailed description in connection with the accompanying drawings, in which:

[0027] Figure 1 is a schematic diagram of selected aspects of a fluid management system;

[0028] Figure 2 shows Figure 1 selected aspects of a medical device and a workstation of the system of

[0029] Figure 3 shows Figure 2 selected aspects of a medical device of

[0030] Figure 4 is a schematic diagram of a medical device of Figure 2 in situ;

[0031] Figure 5 is a partial perspective view showing selected aspects of a heater assembly and a cassette of the system of Figure 1

[0032] ​Figures 6A-6C is a flow diagram illustrating the interaction between different operating modes of a fluid management system;

[0033] Figures 7-10 is a graph illustrating the interaction between different operating modes of a fluid management system;

[0034] Figure 11 is a flow diagram illustrating aspects of a chamber pressure override mode of a fluid management system;

[0035] Figure 12 is a flow diagram illustrating aspects of a system pressure override mode of a fluid management system.

[0036] While the application is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit aspects of the application to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the application. DETAILED DESCRIPTION

[0037] The following description should be read with reference to the drawings, which are not necessarily to scale, in which like reference numerals in different drawings identify like elements. The detailed description and drawings are intended to illustrate but not limit the claimed application. Those skilled in the art will recognize that the various elements and / or components described and / or shown in the figures can be arranged and configured in a wide variety of different configurations and / or configurations without departing from the scope of the disclosure. The detailed description and drawings illustrate example embodiments of the claimed application. However, for clarity and ease of understanding, even though every feature and / or element can not be shown in each figure, it should be understood that features and / or elements from one figure can be incorporated into other figures unless context dictates otherwise.

[0038] For the following defined terms, these meanings are applied hereto unless otherwise indicated in the claims or elsewhere in the specification.

[0039] All numerical values assumed herein are by the term "about" modified, whether expressly stated or not. In the context of a numerical value, the term "about" generally means a range of numbers that a person of skill in the art would consider equivalent to the stated value (e.g., having the same function or result). In many cases, the term "about" can include numbers rounded to the nearest significant figure. Other uses of the term "about" (e.g., in contexts other than numerical values) can be assumed to have its ordinary and customary definition as understood by a person of skill in the art and as consistent with the context of the specification, unless otherwise indicated.

[0040] Numerical ranges recited herein include all values from and including the lower and upper values, in increments of one unit. For example, if a range is stated as 1 to 5, it includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5.

[0041] While certain dimensions, ranges, and / or values relating to various components, features, and / or specifications are disclosed, one of skill in the art, guided by the present disclosure, will appreciate that desired dimensions, ranges, and / or values can deviate from the explicitly disclosed dimensions, ranges, and / or values.

[0042] As used in this specification and the appended claims, the singular forms“a,”“an,” and“the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term“or” is generally employed in its sense of permitting either of the referenced items to be present. It should be noted that certain features of the disclosure can be described using singular terminology where pluralities can be implicit to facilitate understanding. Each instance of such features can be included and / or encompassed in separate disclosure(s) unless there is an explicit statement to the contrary. For the sake of brevity and clarity, not every element of the disclosure can be shown or discussed in every diagram or discussion. However, it should be understood that the following discussion can apply equally to any and / or all elements of the disclosure having more than one component, unless explicitly stated otherwise. Additionally, for the sake of clarity, not every instance of some elements or features can be shown in every diagram.

[0043] With respect to the positioning, orientation, and / or operation of various elements relative to a user / operator / handler of the device, relevant terms such as“proximal,”“distal,”“advance,”“retract,” and variations thereof can generally be considered, where“proximal” and“retract” mean or refer to being closer to or toward the user, and“distal” and“advance” mean or refer to being further from or away from the user. In some cases, the terms“proximal” and“distal” can be arbitrarily assigned to facilitate understanding of the disclosure, and such cases will be clear to one of skill in the art. Other relevant terms, such as“upstream,”“downstream,”“inflow,” and“outflow,” refer to the direction of fluid flow in lumens such as body lumens, intravascularly, or within the device.

[0044] Note that reference in the specification to "an embodiment," "some embodiments," "other embodiments," etc. means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment, but not necessarily all embodiments. The various appearances of "an embodiment," "some embodiments," "other embodiments," etc. do not necessarily all refer to the same embodiments, though it can. In describing and / or illustrating various embodiments, it will be understood that the features, structures, and / or characteristics described in connection with one embodiment can be used in connection with other embodiments. Furthermore, it will be understood that the features, structures, and / or characteristics described in connection with one embodiment can be used in combination with one or more other features, structures, and / or characteristics described in connection with other embodiments, even if the combination is not explicitly described or shown.

[0045] For clarity, certain specified numerical terms (e.g., first, second, third, fourth, etc.) can be used throughout the description and / or claims, to refer to various described and / or claimed features. It will be understood that the numerical terms are not limiting, but are merely illustrative. In some embodiments, changes and deviations in the specified numerical terms can be made for the sake of brevity and clarity. That is, a feature identified as a "first" element can later be referred to as a "second" element, a "third" element, etc., or can be omitted entirely, and / or a different feature can be referred to as the "first" element. The meaning and / or name in each instance will be clear to the skilled artisan.

[0046] Some fluid management systems used in flexible ureteroscopy (fURS) procedures (e.g., flexible ureteroscopy, percutaneous nephrolithotomy (PCNL), benign prostatic hyperplasia (BPH), transurethral resection of the prostate (TURP), etc.), gynecological procedures, and other endoscopic procedures are used in conjunction with endoscopic devices such as, but not limited to, the LithoVue® TMThe scope of the present disclosure encompasses the use of the scope device in conjunction with an endoscope or other endoscopic device to regulate body cavity pressure using pressure and / or temperature data from the endoscope or other endoscopic device. During fURS procedures, the body cavity can be distended to make it easier to locate the target. In some procedures, there can be blood and / or debris in the body cavity that can negatively impact the image quality of the endoscopic device. Fluid flow (e.g., irrigation fluid) through the endoscopic device can be used to flush the body cavity to improve image quality. In some procedures, the body cavity can be relatively small and the irrigation fluid can flow continuously, which can increase the intracavity fluid pressure and / or system pressure (e.g., fluid pressure within the fluid management system itself). In some cases, the increased intracavity fluid pressure and / or system pressure can pose a risk to the patient. Accordingly, there is a need to maintain fluid flow (e.g., irrigation fluid) into the body cavity to maintain good visibility while limiting and / or reducing the intracavity fluid pressure and / or system pressure.

[0047] Figure 1 is a schematic view of a fluid management system 10 that can be used in endoscopic procedures such as fURS procedures. The fluid management system 10 can be coupled with a medical device 20 that allows fluid flow therethrough. In some embodiments, the fluid management system 10 and / or the medical device 20 can include a pressure sensor. In some embodiments, the medical device 20 can be a LithoVue® scope device or other endoscope. In illustrative embodiments, the medical device 20 can include a temperature sensor to provide intracavity temperature feedback to the fluid management system 10, a pressure sensor to provide intracavity pressure feedback to the fluid management system 10, and / or a camera to provide visual feedback to the fluid management system 10. TM The scope of the present disclosure encompasses the use of the scope device in conjunction with an endoscope or other endoscopic device to regulate body cavity pressure using pressure and / or temperature data from the endoscope or other endoscopic device. During fURS procedures, the body cavity can be distended to make it easier to locate the target. In some procedures, there can be blood and / or debris in the body cavity that can negatively impact the image quality of the endoscopic device. Fluid flow (e.g., irrigation fluid) through the endoscopic device can be used to flush the body cavity to improve image quality. In some procedures, the body cavity can be relatively small and the irrigation fluid can flow continuously, which can increase the intracavity fluid pressure and / or system pressure (e.g., fluid pressure within the fluid management system itself). In some cases, the increased intracavity fluid pressure and / or system pressure can pose a risk to the patient. Accordingly, there is a need to maintain fluid flow (e.g., irrigation fluid) into the body cavity to maintain good visibility while limiting and / or reducing the intracavity fluid pressure and / or system pressure. Figure 1 Some specific and / or additional features of the fluid management system 10 and / or the medical device 20 shown in Figure 1 are not specifically referenced but will be discussed below and / or in conjunction with other figures. Figure 1 These features are shown in

[0048] Briefly, the fluid management system 10 can include an inflow pump 50 configured to pump and / or deliver fluid from a fluid supply 34 (e.g., a fluid bag, etc.) to the medical device 20 and / or a treatment site within a patient at a fluid flow rate. In some cases, the fluid can pass through a fluid warming system 60 prior to entering the medical device 20. The flow rate of the fluid, the pressure of the fluid, the temperature of the fluid, and / or other operating parameters can be controlled by, or at least partially controlled by, the controller 48. The controller 48 can be in electronic communication (e.g., wired or wireless) with the medical device 20, the inflow pump 50, and / or the fluid warming system 60 to provide control commands and / or transmit or receive data therebetween. For example, the controller 48 can receive data from the medical device 20 such as, but not limited to, pressure and temperature data. The controller 48 can then use the data received from the medical device 20 to control operating parameters of the inflow pump 50 and / or the fluid warming system 60.

[0049] In some embodiments, the controller 48 can be configured to operate in a flow control mode at a target fluid flow rate. In some embodiments, in the flow control mode, the controller 48 can be configured to control the inflow pump 50 to maintain the target fluid flow rate based on a set of system operating parameters while monitoring a measured pressure communicated to the controller 48 from a pressure sensor. In some embodiments, when the measured pressure reaches a preset pressure threshold, the controller 48 can be configured to automatically switch from the flow control mode to a pressure override mode in which the controller 48 automatically reduces the fluid flow rate below the target fluid flow rate to restore the measured pressure to the preset pressure threshold or below. In some embodiments, the controller 48 can be configured to control the inflow pump 50 to maintain a desired intracavity fluid pressure at the treatment site and / or the target flow rate based on a set of system operating parameters.

[0050] The fluid management system 10 also includes a fluid management unit. An illustrative fluid management unit can include one or more fluid container supports such as fluid supply hanger(s) 32 that each support one or more fluid supplies 34 (e.g., fluid bags). In some embodiments, placement and / or weight of the fluid supplies 34 (e.g., fluid bags) can be detected using remote sensors and / or supply load sensors 94 associated with and / or operably coupled to each fluid supply hanger 32 and / or fluid container support. The controller 48 can be in electronic communication with the supply load sensors 94. The fluid supply hanger(s) 32 can receive fluid supplies 34 of various sizes, such as 1 liter (L) to 5 L fluid supplies (e.g., fluid bags). It should be appreciated that any number of fluid supplies 34 can be used. Further, any size of fluid supply 34 can be used depending on the surgical procedure. In some embodiments, the fluid management unit can be mounted to a rolling stand that can include a pole 36 and / or a base 38. The base 38 can include a plurality of wheels to facilitate easy movement of the fluid management unit when in use. However, it should be appreciated that the fluid supplies 34 can also be hung from the ceiling or other location depending on clinical preference. The fluid supply hanger(s) 32 can extend from the pole 36 and / or the controller 48 and can include one or more hooks on which one or more fluid supplies 34 can be hung. In some embodiments, the fluid used in the fluid management unit can be 0.9% saline. However, it should be appreciated that other fluids of various viscosities can be used depending on the surgical procedure.

[0051] In some embodiments, the fluid management unit can include a vacuum pump 24 and a collection container 26 in fluid communication with a collection drape 28. In some embodiments, the vacuum pump 24 can include a plurality of vacuum pumps. In some embodiments, the collection container 26 can include a plurality of containers, tanks, and / or other receptacles that can be fluidly connected to one another and / or to the vacuum pump 24. In some embodiments, the collection drape 28 can include a plurality of collection drapes. The vacuum pump 24 can be operably and / or electronically connected to the controller 48. In some embodiments, the vacuum pump 24 can be disposed adjacent to and / or proximate to the collection container 26, as shown. In some embodiments, the vacuum pump 24 can be disposed within the fluid management system 10. Other configurations are also contemplated. In some embodiments, the collection container 26 can be operably coupled to a collection load sensor 25 to detect placement and / or weight of the collection container 26. In embodiments having a plurality of containers, tanks, and / or other receptacles, each container, tank, and / or receptacle can be operably coupled to a respective collection load sensor 25. The controller 48 can be in electronic communication with the collection load sensor(s) 25. Figure 1 In some embodiments, the fluid management unit can include a vacuum pump 24 and a collection container 26 in fluid communication with a collection drape 28. In some embodiments, the vacuum pump 24 can include a plurality of vacuum pumps. In some embodiments, the collection container 26 can include a plurality of containers, tanks, and / or other receptacles that can be fluidly connected to one another and / or to the vacuum pump 24. In some embodiments, the collection drape 28 can include a plurality of collection drapes. The vacuum pump 24 can be operably and / or electronically connected to the controller 48. In some embodiments, the vacuum pump 24 can be disposed adjacent to and / or proximate to the collection container 26, as shown. In some embodiments, the vacuum pump 24 can be disposed within the fluid management system 10. Other configurations are also contemplated. In some embodiments, the collection container 26 can be operably coupled to a collection load sensor 25 to detect placement and / or weight of the collection container 26. In embodiments having a plurality of containers, tanks, and / or other receptacles, each container, tank, and / or receptacle can be operably coupled to a respective collection load sensor 25. The controller 48 can be in electronic communication with the collection load sensor(s) 25.

[0052] The fluid management system 10 can also include one or more user interface components such as a touchscreen interface 42. The touchscreen interface 42 includes a display 44 and can include switches or knobs in addition to touch capabilities. In some embodiments, the controller 48 can include the touchscreen interface 42 and / or the display 44. The touchscreen interface 42 allows a user to input / adjust various functions of the fluid management system 10, such as flow rate, pressure, or temperature. The user can also configure parameters and alarms (such as, but not limited to, intracavity pressure limits, system pressure limits, etc.), information to be displayed, and program modes. The touchscreen interface 42 allows the user to add, change, and / or stop using various modular systems within the fluid management system 10. The touchscreen interface 42 can also be used to change the fluid management system 10 between automatic and manual modes of various procedures. It is contemplated that other systems configured to receive user input can be used in place of or in addition to the touchscreen interface 42.

[0053] The touchscreen interface 42 can be configured to include selectable areas that resemble buttons and / or can provide functionality similar to physical buttons, as understood by one of skill in the art. The display 44 can be configured to show icons related to the modular systems and devices included in the fluid management system 10. The display 44 can also include a flow rate display. The flow rate display can be determined based on a desired threshold of flow rate set by the user prior to a procedure or based on known common values, etc. In some embodiments, operating parameters can be adjusted by touching the corresponding portion of the touchscreen interface 42. The touchscreen interface 42 can also display visual warnings and / or audio alarms if a parameter (e.g., flow rate, pressure, temperature, etc.) is above or below a predetermined threshold and / or range. The touchscreen interface 42 can also be configured to display the amount of fluid remaining in the fluid supply 34 and / or any other information that the user can find useful during a procedure. In some embodiments, the fluid management system 10 can also include additional user interface components such as an optional foot pedal 46, a heater user interface, a fluid control interface, or other devices for manually controlling various modular systems. For example, the optional foot pedal 46 can be used to manually control flow rate. Some illustrative displays and other user interface components are described in commonly assigned U.S. Patent Application Publication No. 2018 / 0361055, entitled AUTOMATED FLUID MANAGEMENT SYSTEM, the entire disclosure of which is incorporated herein by reference.

[0054] The touchscreen interface 42 can be operably connected to or can be part of a controller 48. The controller 48 can be a computer, tablet, or other processing device. The controller 48 can be operably connected to one or more system components, such as the inflow pump 50, the fluid warming system 60, the fluid deficit management system, etc. In some embodiments, these features can be integrated into a single unit. The controller 48 is capable of and configured to perform various functions such as calculations, controls, operations, displays, etc. The controller 48 is also capable of tracking and storing data related to the operation of the fluid management system 10 and each of its components. In illustrative embodiments, the controller 48 includes wired and / or wireless network communication capabilities such as Ethernet or Wi-Fi through which the controller 48 can connect to, for example, a local area network. The controller 48 can also receive signals from one or more sensors of the fluid management system 10. In some embodiments, the controller 48 can communicate with a database to obtain best practice recommendations and to maintain patient records that can be displayed to a user on the display 44.

[0055] The fluid management system 10 can be selected by a user between different modes based on the procedure, patient characteristics, etc. For example, different modes can include, but are not limited to, a limit mode, a notification mode, etc. Once the user selects a mode, selected system parameters such as target fluid flow rate, intracavity fluid pressure limit, system fluid pressure limit, fluid deficit, and / or temperature can be provided to and / or input by the user via the touchscreen interface 42 and / or the display 44. Exemplary parameters for a particular mode can be predetermined and loaded onto the controller 48 using, for example, software. Thus, when the user selects a procedure from an initial display on the display 44 of the touchscreen interface 42, these known parameters can be loaded from the controller 48 to various components of the fluid management system 10 such as, but not limited to, the inflow pump 50, the fluid warming system 60, the fluid deficit management system, etc. The fluid management system 10 can also be selected by the user between automatic control and manual control. For example, for certain procedures, the user can wish to manually adjust fluid flow rate, fluid pressure, and / or other parameters. Once the user selects manual control on, for example, the touchscreen interface 42, the user can adjust fluid flow rate or fluid pressure via other manual interfaces such as, for example, an optional foot pedal 46. If the user selects automatic control, the user can be prompted to select or input via the touchscreen interface 42 being used by the medical device 20 so that the controller 48 can determine which data and / or parameters to use to facilitate control of the fluid management system 10. In some embodiments, the fluid management system 10 can be configured to verify that the selected medical device 20 is actually being used.

[0056] In some embodiments, the fluid management system 10 can include vision software or image recognition and analysis software. For example, the medical device 20 can include a camera 70 (e.g.,Figure 2 And Figure 4 ). In some embodiments, the controller 48 can be configured to include vision software / image recognition software that can detect visual noise based on changes in brightness (e.g., light monitoring), contrast, or color pixels. If it is determined that the image provided to the controller 48 is not clear or sharp enough, the fluid management system 10 can temporarily increase the fluid flow rate or fluid pressure to flush debris away from the treatment site, thereby making the image clear / sharp. The fluid flow rate or fluid pressure can be increased manually or automatically for a temporary period of time (e.g., a predetermined time period) or until the field of view is deemed clear enough. This temporary increase ensures that the time of fluid flow rate or fluid pressure increase is limited to ensure that the intracavity pressure does not exceed a safety limit.

[0057] For example, the fluid management system 10 can recognize a red tint in the irrigant (a sign of blood) and send a signal to the inflow pump 50 to increase the fluid flow rate above the target fluid flow rate until the blood is cleared from the field of view. Alternatively, the controller 48 can provide a visual warning on the display 44 or an audible warning to the physician or nurse indicating that a cloudy view was detected, and the user can then manually adjust the fluid flow rate. In another example, in the presence of a large amount of debris, the light reflected from the debris can make the image significantly brighter. In this case, the controller 48 detects this abnormal brightness and sends a signal to the inflow pump 50 to increase the fluid flow rate to flush away and / or remove the debris. Once the reflected light decreases as the debris is flushed out of the field of view of the vision system, the inflow pump 50 is controlled by the controller 48 to decrease the fluid flow rate. In some cases, the physician can create a baseline level of visibility at which he or she prefers to initiate a live cleaning flow of fluid and input these parameters into the fluid management system 10 via the touchscreen interface 42 prior to the procedure. Once the baseline is created, the fluid management system 10 can monitor the visual feed in the pictures for changes and automatically adjust the fluid flow rate as needed.

[0058] To regulate the fluid flow rate or fluid pressure through the fluid management system 10, the fluid management unit can include one or more pressurization or flow generation devices, such as an inflow pump 50. In some embodiments, the inflow pump 50 can be a peristaltic pump. In some embodiments, the inflow pump 50 can include multiple pumps or more than one pump. The inflow pump 50 can be electrically driven and can receive power from a line source such as a wall outlet, an external or internal electrical storage device such as a disposable battery or rechargeable battery, and / or an internal power source. The inflow pump 50 can operate at any desired speed sufficient to deliver fluid at a target pressure, for example, 5 mmHg to 50 mmHg, and / or at a target fluid flow rate. As described herein, the inflow pump 50 can be automatically regulated based on, for example, intracavity pressure and / or temperature readings within the treatment site and / or visual feedback from the medical device 20. The inflow pump 50 can also be manually regulated via, for example, the optional foot pedal 46, the touchscreen interface 42, or a separate fluid controller. Although not explicitly shown, the fluid controller can be a separate user interface that includes buttons that allow the user to increase or decrease the speed and / or output of the inflow pump 50. Alternatively, the fluid controller can be incorporated into the main processing device and receive inputs via the touchscreen interface 42. In some embodiments, the fluid management system 10 can include multiple pumps with different flow capabilities. In some embodiments, a flow rate sensor 77 (e.g., Figure 5 ) can be located before and / or after the inflow pump 50 to measure the actual fluid flow rate. The flow rate sensor 77 can be operably connected to the controller 48, and the controller 48 can use data from the flow rate sensor 77 to change selected system parameters.

[0059] The fluid flow rate and / or fluid pressure at any given time can be displayed on the display 44 to allow the operating room (OR) to see any changes. If the OR personnel notice that the fluid flow rate and / or fluid pressure is too high or too low, the user can manually adjust the fluid flow rate and / or fluid pressure back to a preferred level. This can occur, for example, when a physician inserts or removes a tool into the working channel of the medical device 20. The fluid management system 10 can also monitor and automatically adjust the fluid flow rate and / or fluid pressure based on previously set parameters, as described herein. This feature can also be beneficial when manually providing fluid flow, such as by a syringe-assisted injection of irrigation fluid.

[0060] In some embodiments, the fluid management system 10 can automatically adjust the fluid flow rate and / or fluid pressure based on a measured intracavity temperature and / or a measured pressure, for example, when the measured pressure reaches a pre-set pressure threshold. In some embodiments, the measured pressure can be an intracavity pressure measured within the treatment site, and the pre-set pressure threshold can be an intracavity pressure limit. The medical device 20 used in conjunction with the fluid management system 10 (e.g.,Figure 2 Temperature sensor 72 and / or pressure sensor 74 on the fluid management system 10 can be used to measure the intracavity temperature and / or intracavity pressure in situ. In some embodiments, the measured pressure may be the system pressure measured within the fluid management system 10, and the preset pressure threshold may be the system pressure limit. Pressure sensor 67 (e.g., located within the fluid management system 10) can be used. Figure 5 The system pressure is measured within the fluid management system 10. In some embodiments, the fluid management system 10 may include pressure monitoring software that allows a user to configure the inflow pump 50 to be automatically started, stopped, and / or its speed adjusted by the fluid management system 10 to maintain the fluid pressure delivered to the treatment site within a target pressure and / or predetermined pressure range. For example, a pressure sensor 74 may detect the intracavitary pressure within the treatment site (e.g., the kidney or uterus) and automatically change the fluid flow rate and / or fluid pressure within the fluid management system 10 based on the measured intracavitary pressure (e.g., within the kidney or uterus). If the intracavitary pressure is too high, the fluid management system 10 may reduce the fluid flow rate and / or fluid pressure; if the intracavitary pressure is too low, the fluid management system 10 may increase the fluid flow rate and / or fluid pressure.

[0061] Figures 2-4 Various aspects of a medical device 20 that can be used in conjunction with a fluid management system 10 are shown. In the illustrated embodiment, the medical device 20 may be a ureteroscope, such as a LithoVue. TM A ureteroscope. However, other medical devices, such as another endoscope, can be used as a supplement or alternative to a ureteroscope. Medical device 20 can be configured to deliver fluid from fluid management system 10 to a treatment site via an elongated shaft 76, which is configured to be close to the treatment site within the patient's body. In some embodiments, an inflow pump 50 may be in fluid communication with the elongated shaft 76. The elongated shaft 76 may include one or more working lumens for receiving fluid flow or other medical devices passing through it. Medical device 20 is connected to fluid management system 10 via one or more supply lines 78 (e.g., tubes), such as... Figure 1 and Figure 4 As shown.

[0062] In some embodiments, the medical device 20 may communicate electronically with the workstation 81 via a wired connection 79. The workstation 81 may include a touch panel computer 83, an interface box 85 for receiving the wired connection 79, a cart 87, a power supply 89, and other features. In some embodiments, the interface box 85 may be configured with a wired or wireless communication connection 91 to the controller 48 of the fluid management system 10. The touch panel computer 83 may include at least a display screen and an image processor. In some embodiments, the workstation 81 may be a multi-purpose component (e.g., for more than one program), while the medical device 20 may be a single-purpose device, although this is not necessary. In some embodiments, the workstation 81 may be omitted, and the medical device 20 may be directly electrically connected to the controller 48 of the fluid management system 10.

[0063] In some embodiments, one or more supply lines 78 from the fluid management system 10 to the medical device 20 may be formed of a material that helps suppress peristaltic movement generated by the inflow into the pump 50. In some embodiments, the supply lines 78 may be formed of small-diameter tubing with a diameter less than or equal to 1 / 16 inch (1.5875 mm). However, it should be understood that the size of the tubing may vary depending on the application. The supply lines 78 and / or tubing may be disposable and configured to be sterile and spare. Different types of tubing may be used for various functions within the fluid management system 10. For example, one type of tubing may be used for fluid heating and fluid flow control within the medical device 20, while another type of tubing may be used for flushing within the body and / or treatment site.

[0064] like Figure 2 As shown, the medical device 20 may include one or more sensors near the distal end 80 of the elongated shaft 76. For example, the medical device 20 may include a pressure sensor 74 located at the distal end of the elongated shaft 76 to measure intracavitary pressure within the treatment site. The medical device 20 may also include other sensors, such as a temperature sensor 72, a fiber Bragg grating fiber 75 for detecting stress, and / or an antenna or electromagnetic sensor 93 (e.g., a position sensor). In an illustrative embodiment, the distal end 80 of the medical device 20 may also include at least one camera 70 to provide visual feedback to the user on the display screen of the touch panel computer 83. In another embodiment, the medical device 20 may include two cameras 70 with different communication requirements or protocols, such that each camera 70 can convey different information to the user. When configured in this way, the user can freely switch between the cameras 70 via the touchscreen interface 42 and / or the touch panel computer 83. Although not explicitly shown, the elongated shaft 76 may include one or more working lumens for receiving fluids or other medical devices.

[0065] In some embodiments, the position of the distal end 80 of the elongated shaft 76 can be tracked during use. For example, a mapping and navigation system can include an operating table (or other procedure or examination table or chair, etc.) that is configured to act as or function as an electromagnetic generator to generate a magnetic field of known geometry. Alternatively or additionally, an electromagnetic generator can be provided separate from the operating table. The operating table and / or electromagnetic generator can be coupled to a control unit, which can include a processor, memory, a display, and input devices, among other features. A position sensor (e.g., electromagnetic sensor 93, etc.) or other antenna can be incorporated into the distal end 80 of the elongated shaft 76 of the medical device 20. The position sensor can be configured to sense the position of the position sensor in the magnetic field of the mapping and navigation system. In some embodiments, the position sensor can be electrically coupled to the workstation 81. When the position sensor is in the magnetic field, the position of the position sensor can be determined mathematically relative to the electromagnetic field source (e.g., the operating table and / or electromagnetic generator). The workstation 81 and the control unit can communicate to determine the position of the position sensor relative to the patient.

[0066] The medical device 20 includes a handle 82 coupled to the proximal end of the elongated shaft 76. The handle 82 can have a fluid flow on / off switch 84 that allows a user to control when fluid flows through the medical device 20 and into the treatment site. The handle 82 can further include other buttons 86 that perform other various functions. For example, in some embodiments, the handle 82 can include a button to control the temperature of the fluid. It will be appreciated that while the example embodiments describe a ureteroscope, the features described in detail above can also be directly integrated into a bladder scope, an endoscope, a hysteroscope, or virtually any device that has imaging capabilities. In some embodiments, the medical device 20 can also include a continuous drainage port 88 that can be connected to a drainage system. Some illustrative drainage systems are described in commonly assigned U.S. Patent Application Publication No. 2018 / 0361055, entitled AUTOMATED FLUID MANAGEMENT SYSTEM, the disclosure of which is incorporated by reference herein.

[0067] In some embodiments, the controller 48 can be configured to calculate fluid deficit when the distal end 80 of the elongated shaft 76 is disposed within the patient, the fluid deficit representing fluid lost, absorbed by the patient, and / or otherwise not accounted for during the procedure. In some embodiments, the controller 48 can be configured to notify a user when the total fluid deficit reaches a preset fluid deficit limit. In some embodiments, the controller 48 can be configured to stop the inflow pump 50 and / or the vacuum pump 24 when the total fluid deficit reaches the preset fluid deficit limit. In some embodiments, the controller 48 can be configured to notify a user when the total amount of fluid infused reaches a preset fluid infusion limit. In some embodiments, the controller 48 can be configured to stop the inflow pump 50 and / or the vacuum pump 24 when the total amount of fluid infused reaches the preset fluid infusion limit.

[0068] In some embodiments, the controller 48 can be configured to monitor the amount of fluid in the fluid supply 34 by weight using, for example, a supply load sensor 94, a scale, or other suitable device. The controller 48 can use the supply load sensor 94 to determine the weight of the fluid supply 34 attached to the fluid supply hanger 32 to compare the initial amount of fluid in the fluid supply 34 to the current amount of fluid remaining in the fluid supply 34. The reading of the supply load sensor 94 can be shown to the user on the display 44. As the procedure progresses, the reading of the supply load sensor 94 can be updated in real-time to alert the physician of how much fluid remains in the fluid supply 34, which can then be used to determine how much fluid has been infused into the patient. In some embodiments, the amount of fluid remaining in the fluid supply 34 can be shown. For example, when 10% of the fluid remains in the fluid supply 34, a warning with an audible signal can be shown on the display 44. In some embodiments, the supply load sensor 94 can be connected to the display 44 via a wireless (e.g., Wi-Fi) signal. In some embodiments, the supply load sensor 94 can be connected to the display 44 via a hardwire connection. If the fluid supply 34 runs empty during the procedure, a full or unused fluid supply 34 can be utilized for replacement.

[0069] Similarly, controller 48 can be configured to monitor the amount of fluid in collection container 26 by weight using, for example, collection load sensor 25, a balance, or other suitable device. Controller 48 can use collection load sensor 25 to determine the weight of collection container 26 to compare the initial amount of fluid in collection container 26 with the current amount of fluid in collection container 26. The reading of collection load sensor 25 can be displayed to the user on display 44. As the procedure progresses, the reading of collection load sensor 25 can be updated in real time to alert the physician how much fluid is in collection container 26, which can then be used to determine how much fluid has been collected from the patient and / or collection drape 28. In some embodiments, the amount of fluid in collection container 26 can be displayed. For example, a warning with an audible signal can be displayed on display 44 when 10% of the initial empty volume remains in collection container 26. In some embodiments, collection load sensor 25 can be connected to display 44 wirelessly (e.g., via Wi-Fi). In some embodiments, collection load sensor 25 can be connected to display 44 via a hardwired connection. If the collection container 26 becomes full during the procedure, it can be emptied and reused, or it can be replaced with an empty collection container.

[0070] In some embodiments, the fluid management system 10 may include a fluid heating system 60, such as Figure 5 As shown, this is for heating fluid to be delivered to a patient. The fluid heating system 60 may include a heater 62 and a heater housing 64. The heater housing 64 may be configured for single use, while the heater 62 may be reused in multiple procedures. For example, the heater housing 64 may isolate fluid flow, allowing the heater 62 to be reused with minimal maintenance. The heater housing 64 may be formed of, for example, polycarbonate or any high-thermal-rating biocompatible plastic, and may be formed as a single integral and / or integral piece or multiple pieces permanently bonded together. In some embodiments, the heater housing 64 may include a fluid inlet port 61 and a fluid outlet port 63 located on the side of the heater housing 64. The fluid inlet port 61 and the fluid outlet port 63 may each be configured to be coupled to a plurality of supply lines 78 of the fluid management system 10. For example, the fluid inlet port 61 may be coupled to the fluid supply source 34 and the fluid heating system 60 (via the inflow pump 50), while the fluid outlet port 63 may be coupled to the fluid heating system 60 and the medical device 20, respectively, via the plurality of supply lines 78.

[0071] In some embodiments, the heater cartridge 64 can include an internal flow path along the channel through which fluid can flow from the fluid inlet port 61 to the fluid outlet port 63. The heater cartridge 64 can include one fluid path or multiple fluid paths. In some embodiments, the channel can pass through a susceptor 66, which can allow the fluid to be heated via inductive heating. The susceptor 66 can be configured to be located within the induction coil 68 when the heater cartridge 64 is coupled with the heater 62. Other fluid warming system configurations and methods can also be used as desired. For example, the heater 62 can include one or more heat sources such as a plate system using electrical energy or an inline coil in the supply line(s) 78. The heating can be specifically designed and customized according to the flow rate desired in the particular application of the fluid management system 10. Some illustrative fluid warming systems are described in commonly assigned U.S. Patent Application Publication No. 2018 / 0361055, entitled AUTOMATED FLUID MANAGEMENT SYSTEM, the disclosure of which is incorporated by reference herein.

[0072] While not explicitly shown, the fluid warming system 60 can include a heater user interface separate from the touchscreen interface 42. The heater user interface can simply be a display screen that provides a digital display of the internal temperature of the heater 62. In another embodiment, the user interface can also include temperature adjustment buttons to increase or decrease the temperature of the heater 62. In this embodiment, the heater user interface and / or display screen can indicate the current temperature of the heater 62 as well as the target temperature to be reached. Note that all information output from the fluid warming system 60 can be transmitted directly to the display 44, thereby eliminating the need for a heater user interface.

[0073] The fluid warming system 60 can include one or more sensors configured to monitor the fluid flowing therethrough. For example, temperature sensors 65 can be installed in the fluid warming system 60 such that they detect the temperature of the fluid flowing through the heater cartridge 64. The temperature sensors 65 can be located at or near the fluid inlet port 61 and / or the fluid outlet port 63. In some embodiments, the temperature sensors 65 can be installed such that they detect the temperature of the fluid flowing through the heater cartridge 64 before the fluid enters the receiving portion 66 and after the fluid exits the receiving portion 66. In some embodiments, additional sensors can be located at an intermediate portion of the receiving portion 66 such that they detect the progression of the temperature increase of the fluid in the heater cartridge 64. The temperature sensors 65 can transmit any information remotely to the display 44, or they can transmit information to the heater user interface and / or its display screen, if so provided. In another embodiment, the temperature sensors 65 can be hardwired to the heater user interface, if so provided, which can then remotely transmit the desired information to the display 44. Alternatively or additionally, the temperature sensors 65 can be hardwired to and / or with the controller 48.

[0074] The heater 62 can further include a pressure sensor 67 configured to monitor the pressure of the system and / or a bubble sensor 69 configured to monitor the fluid flowing through the system for air bubbles. The heater cartridge 64 can include a corresponding pressure sensor interface 71 and bubble sensor interface 73 that allow the pressure sensor 67 and bubble sensor 69, respectively, to monitor the fluid flowing through the heater cartridge 64 when the heater cartridge 64 is coupled with the fluid warming system 60. The pressure sensor 67 and / or bubble sensor 69 can transmit any information remotely to the controller 48, display 44, and / or they can transmit information to the heater user interface and / or its display screen, if so provided. In another embodiment, the temperature sensors 67 and / or bubble sensor 69 can be hardwired to the heater user interface, if so provided, which can then remotely transmit the desired information to the display 44. Alternatively or additionally, the temperature sensors 67 and / or bubble sensor 69 can be hardwired to and / or with the controller 48.

[0075] Figures 6A-6CA flowchart illustrating the interactions, decision-making, and / or methods associated with the fluid management system 10 is shown. In the current example, controller 48 is configured to operate at a target flow rate in flow control mode. In some cases, a physician may find it beneficial to maintain the target flow rate as much as possible to, for example, maintain clear vision. In flow control mode, controller 48 may attempt to maintain the target flow rate regardless of other factors or settings, until or unless certain predetermined conditions are met. For example, in flow control mode, controller 48 may be configured to “sacrifice” other measures and / or characteristics to maintain the target flow rate.

[0076] Initially, the fluid management system 10 can be initialized and / or enabled. This is in Figure 6A The figure is shown with reference numeral 100. Next, the controller 48 can check to determine what type of endoscope and / or medical device 20 is connected to the fluid management system 10. The fluid management system 10 can be used with the medical device 20, which is configured to use pressure sensor 74 to monitor intracavitary pressure. If the medical device 20 is configured this way, the controller 48 can operate in a mode where intracavitary pressure and system pressure can be monitored and / or used to influence the control of the fluid management system 10, such as... Figure 6A As shown. Therefore, controller 48 then allows the user to set selected operating and / or system parameters at reference numeral 104, such as target flow rate, pressure limits (e.g., intracavitary pressure limits and / or system pressure limits), and / or the control mode of operation. In some embodiments, one or more operating and / or system parameters may be preset, preloaded, and / or hard-coded into controller 48 and therefore cannot be manually selected or entered. Other operating and / or system parameters are also considered for user selection.

[0077] At reference numeral 110, the controller 48 can be configured to query the operating and / or system parameters entered at reference numeral 104 to determine whether to run in a limit mode 112 or a notification mode 114. In the limit mode 112, the controller 48 can be configured to remain in the flow control mode by default at the target flow rate and will attempt to maintain the target flow rate as much as possible while monitoring the measured pressure (e.g., the intra-cavity pressure and / or the system pressure) communicated to the controller 48 from the pressure sensor 74 and / or the pressure sensor 67. When the measured pressure reaches a preset pressure threshold, the controller 48 can be configured to automatically switch from the flow control mode to a pressure override mode in which the controller 48 automatically reduces the flow rate below the target flow rate to cause the measured pressure to return to or below the preset pressure threshold. In some embodiments, when the measured pressure reaches and / or rises above the preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode to the pressure override mode. In some embodiments, the measured pressure is the intra-cavity pressure measured within the treatment site. In at least some embodiments, the intra-cavity pressure can be measured using the pressure sensor 74. In some embodiments in which the measured pressure is the intra-cavity pressure, the preset pressure threshold can be the intra-cavity pressure limit set at reference numeral 104. In some embodiments, the measured pressure is the system pressure measured within the fluid management system 10. In at least some embodiments, the system pressure can be measured using the pressure sensor 67. In some embodiments in which the measured pressure is the system pressure, the preset pressure threshold can be the system pressure limit set at reference numeral 104.

[0078] In some embodiments, when the measured pressure reaches and / or rises above the preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode to the pressure override mode and giving the user the option to override and / or ignore the preset pressure threshold, thereby causing the controller 48 to return to the flow control mode and permitting the measured pressure to continue to rise above and / or remain above the preset pressure threshold. The controller 48 can be configured to automatically switch from the flow control mode to the pressure override mode unless the user has explicitly confirmed the option to override and / or ignore the preset pressure threshold and / or explicitly instructed the controller 48 to return to the flow control mode.

[0079] At reference numeral 118 within limit mode 112, controller 48 can compare the measured pressure (e.g., intra-cavity pressure) plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) to the intra-cavity pressure limit set at reference numeral 104. If the intra-cavity pressure plus the preset tolerance is less than the intra-cavity pressure limit set at reference numeral 104, controller 48 can proceed to reference numeral 122 and then compare the system pressure to the system pressure limit set at reference numeral 104. If the system pressure is less than the system pressure limit, controller 48 can continue to operate in flow control mode 140, or controller 48 can be configured to automatically switch back to flow control mode 140 from a pressure override mode (as described herein) when the measured pressure (e.g., intra-cavity pressure and / or system pressure) falls below a preset pressure threshold. In the pressure override mode, controller 48 can be configured to calculate a reduced flow rate that depends on the target flow rate, the actual flow rate, and / or the measured pressure relative to the preset pressure threshold, and then operate at the reduced flow rate to restore the measured pressure to the preset pressure threshold or below the preset pressure threshold while continuing to monitor the measured pressure.

[0080] If the measured pressure (e.g., intra-cavity pressure) plus the preset tolerance is greater than (e.g., exceeds) the intra-cavity pressure limit set at reference numeral 104, controller 48 can proceed to reference numeral 120 and then compare the system pressure to the system pressure limit set at reference numeral 104. If the system pressure is less than the system pressure limit, controller 48 can be configured to automatically switch to intra-cavity pressure override mode 160, in which the controller automatically reduces the flow rate below the target flow rate to restore the intra-cavity pressure to the intra-cavity pressure limit or below the intra-cavity pressure limit. In some embodiments, controller 48 can be configured to display a notification on display 44 informing the user that controller 48 has switched from flow control mode to intra-cavity pressure override mode when the intra-cavity pressure reaches and / or rises above the intra-cavity pressure limit. In some embodiments, controller 48 can be configured to display a prompt on display 44 informing the user that controller 48 has switched from flow control mode to intra-cavity pressure override mode when the intra-cavity pressure reaches and / or rises above the intra-cavity pressure limit and giving the user the option to override and / or ignore the intra-cavity pressure limit, thereby causing controller 48 to revert to flow control mode and permitting the intra-cavity pressure to continue to rise above and / or remain above the intra-cavity pressure limit. Controller 48 can be configured to automatically switch from flow control mode to intra-cavity pressure override mode unless the user has explicitly confirmed the option to override and / or ignore the intra-cavity pressure limit and / or explicitly instructed controller 48 to revert to flow control mode. Controller 48 can then return to reference numeral 118 and begin querying again.

[0081] If the system pressure is greater than (e.g., exceeds) the system pressure limit set at 104, the controller 48 can be configured to automatically switch to a system pressure override mode 150 in which the controller automatically reduces the flow rate below the target flow rate to restore the system pressure to the system pressure limit or below. In some embodiments, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode to the system pressure override mode when the system pressure reaches and / or rises above the system pressure limit. In some embodiments, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode to the system pressure override mode when the system pressure reaches and / or rises above the system pressure limit and giving the user the option to override and / or ignore the system pressure limit, thereby causing the controller 48 to return to the flow control mode and permitting the system pressure to continue to rise above and / or remain above the system pressure limit. The controller 48 can be configured to automatically switch from the flow control mode to the system pressure override mode unless the user has affirmatively confirmed the option to override and / or ignore the system pressure limit and / or affirmatively instructed the controller 48 to return to the flow control mode. The controller 48 can be configured to compare the reduced flow rate of the system pressure override mode 150 to the reduced flow rate of the chamber pressure override mode 160 and then operate at the lower of the reduced flow rates. The controller 48 can then return to 118 and begin querying again.

[0082] Returning to 110, the controller 48 can be configured to query the operating and / or system parameters entered at 104 to determine whether to operate in the limit mode 112 or the notification mode 114. In the notification mode 114, as shown, the controller 48 can be configured to remain in the flow control mode with the target flow rate by default and will attempt to maintain the target flow rate as much as possible while monitoring the measured pressures (e.g., the intra-chamber pressure and / or the system pressure) communicated to the controller 48 from the pressure sensor 74 and / or the pressure sensor 67. Figure 6B

[0083] ​At reference numeral 124 within notification mode 114, controller 48 can compare the measured pressure (e.g., intra-cavity pressure) plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) to the intra-cavity pressure limit set at reference numeral 104. However, in contrast to limit mode 112, when the measured pressure (e.g., intra-cavity pressure) plus the preset tolerance is greater than (e.g., exceeds) the intra-cavity pressure limit set at reference numeral 104, controller 48 can be configured to display a cavity limit notification / warning 126 on display 44. In some embodiments, cavity limit notification / warning 126 can be accompanied by an audible alarm. This would notify the user of the situation without changing the flow rate. For example, controller 48 would still continue to maintain the target flow rate.

[0084] Next, or if the intra-cavity pressure plus the preset tolerance is less than the intra-cavity pressure limit set at reference numeral 104, controller 48 can proceed to reference numeral 128 and then compare the system pressure to the system pressure limit set at reference numeral 104. If the system pressure is less than the system pressure limit, controller 48 can continue to operate in flow control mode 140. If the system pressure is greater than (e.g., exceeds) the system pressure limit set at reference numeral 104, controller 48 can be configured to automatically switch to system pressure override mode 150, in which the controller automatically reduces the flow rate below the target flow rate to restore the system pressure to the system pressure limit or below the system pressure limit. In some embodiments, controller 48 can be configured to display a notification on display 44 informing the user that controller 48 has switched from flow control mode 140 to system pressure override mode 150 when the system pressure reaches and / or rises above the system pressure limit. In some embodiments, controller 48 can be configured to display a prompt on display 44 informing the user that controller 48 has switched from flow control mode 140 to system pressure override mode 150 when the system pressure reaches and / or rises above the system pressure limit and giving the user the option to override and / or ignore the system pressure limit, thereby causing controller 48 to revert to flow control mode 140 and permitting the system pressure to continue to rise above and / or remain above the system pressure limit. Controller 48 can be configured to automatically switch from flow control mode 140 to system pressure override mode 150 unless the user has explicitly confirmed the option to override and / or ignore the system pressure limit and / or explicitly instructed controller 48 to revert to flow control mode 140. Controller 48 can then return to reference numeral 124 and begin the inquiry again.

[0085] The fluid management system 10 can also be used with a medical device 20 that does not have a pressure sensor configured to detect the pressure within the lumen associated therewith. If the medical device 20 is so configured, the controller 48 can be limited to a mode in which only the system pressure can be monitored and / or used to affect control of the fluid management system 10, as shown at Figure 6C At reference numeral 106, the controller 48 can permit the user to set selected operating and / or system parameters, such as a target flow rate and a system pressure limit, at reference numeral 104. In some embodiments, one or more operating and / or system parameters can be preset, preloaded, and / or hard-coded into the controller 48 and, thus, not available for manual selection or input. Other operating and / or system parameters are also contemplated for user selection.

[0086] The controller 48 can be configured to remain in the flow control mode by default at a target flow rate and will attempt to maintain the target flow rate as much as possible while monitoring the measured pressure (e.g., system pressure) communicated from the pressure sensor 67 to the controller 48. At reference numeral 116, the controller 48 can compare the measured pressure (e.g., system pressure) plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) to the system pressure limit set at reference numeral 106. If the measured pressure is less than the system pressure limit, the controller 48 can continue to operate in the flow control mode 140. If the measured pressure is greater than (e.g., exceeds) the system pressure limit set at reference numeral 106, the controller 48 can be configured to automatically switch to the system pressure override mode 150 in which the controller automatically reduces the flow rate below the target flow rate to restore the system pressure to the system pressure limit or below the system pressure limit. In some embodiments, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150 when the system pressure reaches and / or rises above the system pressure limit. In some embodiments, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150 when the system pressure reaches and / or rises above the system pressure limit and giving the user the option to override and / or ignore the system pressure limit to cause the controller 48 to return to the flow control mode 140 and permit the system pressure to continue to rise above and / or remain above the system pressure limit. The controller 48 can be configured to automatically switch from the flow control mode 140 to the system pressure override mode 150 unless the user has affirmatively acknowledged the option to override and / or ignore the system pressure limit and / or affirmatively instructed the controller 48 to return to the flow control mode 140. The controller 48 can then return to reference numeral 116 and begin querying again.

[0087] Figure 7 and Figure 8 Aspects of the controller 48 switching into and out of the chamber pressure override mode 160 are shown. The graphs show pressure on the vertical axis and time on the horizontal axis. Initially, when the fluid management system 10 is turned on, the measured pressure (e.g., the intra-chamber pressure 162) can be zero or very close to zero. The target flow rate 142 and / or the intra-chamber pressure limit 168 can be input into the controller 48 by a user at reference numeral 104 (e.g., a user interface), which is typically coincident with the vertical axis and / or coincident with the zero point along the horizontal axis. As the fluid management system 10 and / or the controller runs at the target flow rate 142, the intra-chamber pressure 162 can increase. The increase can be linear, exponential, parabolic, and / or irregular, rising and falling over time, depending on the procedure being performed, actions taken during the procedure, changes in conditions, etc. Figure 6A

[0088] ​At some point in time, the measured intracavity pressure 162 can rise above the intracavity pressure limit 168, as shown by the plot at reference numeral 164. After the measured intracavity pressure 162 rises above the intracavity pressure limit 168 and / or above the intracavity pressure limit 168 plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) of the intracavity pressure limit set at reference numeral 104, the controller 48 can be configured to switch to a cavity pressure override mode 160 in which the controller 48 automatically reduces the flow rate below the target flow rate 142, as shown at reference numeral 144 (e.g., a reduced flow rate), to restore the measured pressure (e.g., the intracavity pressure 162) to the preset pressure threshold (e.g., the intracavity pressure limit 168) or below. In some embodiments, when the measured intracavity pressure 162 reaches and / or rises above the intracavity pressure limit 168, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the cavity pressure override mode 160. In some embodiments, when the measured intracavity pressure 162 reaches and / or rises above the intracavity pressure limit 168, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the cavity pressure override mode 160 and giving the user the option to override and / or ignore the intracavity pressure limit 168, thereby causing the controller 48 to revert to the flow control mode 140 and permitting the measured intracavity pressure 162 to continue rising above the intracavity pressure limit 168 and / or remain above the intracavity pressure limit. The controller 48 can be configured to automatically switch from the flow control mode 140 to the cavity pressure override mode 160 unless the user has explicitly acknowledged the option to override and / or ignore the intracavity pressure limit 168 and / or explicitly instructed the controller 48 to revert to the flow control mode 140.

[0089] In some embodiments, when the measured pressure (e.g., the intracavity pressure 162) is released and / or falls below the preset pressure threshold (e.g., the intracavity pressure limit 168), as shown by reference numeral 166, the controller 48 can be configured to switch back to the flow control mode 140 from the cavity pressure override mode 160. In some embodiments, when the measured pressure is released and / or falls below the preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44 asking the user whether the user wants to switch out of the cavity pressure override mode 160. In some embodiments, the prompt can ask the user whether the user wants to switch back to the flow control mode 140 from the cavity pressure override mode 160 or an adjusted flow control mode 141. In at least some embodiments, when switching back to the flow control mode 140, the flow rate can revert to the target flow rate 142 configured by and / or associated with the flow control mode 140, as shown by reference numeral 142.Figure 7 In some embodiments, when the measured pressure (e.g., lumen pressure 162) drops below a preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44 asking the user if they want to switch out of the flow control mode 140. In some embodiments, when the measured pressure (e.g., lumen pressure 162) drops below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch back to the flow control mode 140 from the lumen pressure override mode 160.

[0090] In some embodiments, when the measured pressure (e.g., lumen pressure 162) is released and / or drops below a preset pressure threshold (e.g., lumen pressure limit 168), as shown by reference number 166, the controller 48 can be configured to switch from the lumen pressure override mode 160 to an adjusted flow control mode 141. The controller 48 can be configured to operate at a reduced flow rate of the lumen pressure override mode 160 when in the adjusted flow control mode 141, as shown by reference number 148 in FIG. 1C. For example, in the adjusted flow control mode 141, the flow rate can then be held at the reduced flow rate associated with the lumen pressure override mode 160. In some embodiments, when the measured pressure (e.g., lumen pressure 162) drops below a preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44 asking the user if they want to switch to the adjusted flow control mode 141. In some embodiments, when the measured pressure (e.g., lumen pressure 162) drops below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch to the adjusted flow control mode 141 from the lumen pressure override mode 160. Figure 8

[0091] Figure 9 and Figure 10 Aspects of the controller 48 switching into and out of the system pressure override mode 150 are shown. The graphs show pressure on the vertical axis and time on the horizontal axis. Initially, when the fluid management system 10 is turned on, the measured pressure (e.g., system pressure 152) can be zero or very close to zero. The target flow rate 142 and / or the system pressure limit 158 can be set by the user at reference number 104 (e.g., the flow rate control 104) or reference number 106 (e.g., the system pressure control 106) in FIG. 1A. The controller 48 can be configured to switch into the system pressure override mode 150 when the measured pressure (e.g., system pressure 152) drops below a preset pressure threshold (e.g., system pressure limit 158), as shown by reference number 154 in FIG. 1D. In some embodiments, when the measured pressure (e.g., system pressure 152) drops below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch into the system pressure override mode 150. Figure 6A ) or reference number 106 (e.g., Figure 6C ​​) into the controller 48, which is generally coincident with zero on the vertical axis and / or along the horizontal axis. The system force 152 can increase when the fluid management system 10 and / or the controller is operating at the target flow rate 142. The increase can be linear, exponential, parabolic, and / or irregular, rising and falling over time, depending on the program being executed, actions taken during the program, changes in conditions, etc.

[0092] At some point in time, the measured system pressure 152 can rise above the system pressure limit 158, as shown on the graph at reference numeral 154. After the measured system pressure 152 rises above the system pressure limit 158 and / or rises above the system pressure limit 158 plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) of the system pressure limit set at reference numerals 104 / 106, the controller 48 can be configured to switch to a system pressure override mode 150 in which the controller 48 automatically reduces the flow rate below the target flow rate 142, as shown at reference numeral 144 (e.g., a reduced flow rate), to restore the measured pressure (e.g., the system pressure 152) to a preset pressure threshold (e.g., the system pressure limit 158) or below. In some embodiments, when the measured system pressure 152 reaches and / or rises above the system pressure limit 158, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150. In some embodiments, when the measured system pressure 152 reaches and / or rises above the system pressure limit 158, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150 and giving the user the option to override and / or ignore the system pressure limit 158, thereby causing the controller 48 to revert to the flow control mode 140 and permitting the measured system pressure 152 to continue rising above the system pressure limit 158 and / or remain above the system pressure limit. The controller 48 can be configured to automatically switch from the flow control mode 140 to the system pressure override mode 150 unless the user has affirmatively acknowledged the option to override and / or ignore the system pressure limit 158 and / or affirmatively instructed the controller 48 to revert to the flow control mode 140.

[0093] In some embodiments, when the measured pressure (e.g., system pressure 152) is released and / or falls below a preset pressure threshold (e.g., system pressure limit 158), the controller 48 can be configured to switch back to the flow control mode 140 from the system pressure override mode 150, as indicated by reference numeral 156. In some embodiments, when the measured pressure is released and / or falls below the preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44, asking the user whether they want to switch out of the system pressure override mode 150. In some embodiments, the prompt can ask the user whether they want to switch back to the flow control mode 140 or the adjusted flow control mode 141 from the system pressure override mode 150. In at least some embodiments, when switching back to the flow control mode 140, the flow rate can resume to the target flow rate 142 configured by and / or associated with the flow control mode 140, as indicated by reference numeral 146 in FIG. 1. Figure 9 In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44, asking the user whether they want to switch out of the flow control mode 140. In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch back to the flow control mode 140 from the system pressure override mode 150.

[0094] In some embodiments, when the measured pressure (e.g., system pressure 152) is released and / or falls below a preset pressure threshold (e.g., system pressure limit 158), the controller 48 can be configured to switch to the adjusted flow control mode 141 from the system pressure override mode 150, as indicated by reference numeral 156. The controller 48 can be configured to operate at a reduced flow rate of the system pressure override mode 150 when in the adjusted flow control mode 141, as indicated by reference numeral 148 in FIG. 1. For example, in the adjusted flow control mode 141, the flow rate can then be maintained at the reduced flow rate associated with the system pressure override mode 150. In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44, asking the user whether they want to switch to the adjusted flow control mode 141. In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch to the adjusted flow control mode 141 from the system pressure override mode 150. Figure 10 In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a prompt on the display 44, asking the user whether they want to switch out of the flow control mode 140. In some embodiments, when the measured pressure (e.g., system pressure 152) falls below a preset pressure threshold, the controller 48 can be configured to display a notification on the display 44 and automatically switch back to the flow control mode 140 from the system pressure override mode 150.

[0095] Figure 11is a flowchart illustrating aspects of the chamber pressure override mode 160. When the controller 48 switches to the chamber pressure override mode 160 as described herein, the controller 48 can be configured to calculate an adjusted flow rate or a reduced flow rate that depends on the target flow rate 142, the actual flow rate, and / or the measured chamber pressure 162 relative to a preset pressure threshold (e.g., the chamber pressure limit 168), as indicated at reference numeral 180. Next, the controller 48 can compare the measured pressure (e.g., the chamber pressure 162) plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) to the chamber pressure limit 168 set at reference numeral 104, as can be seen at reference numeral 182. In some embodiments, if the measured chamber pressure 162 plus the preset tolerance is greater than (e.g., exceeds) the chamber pressure limit 168 set at reference numeral 104, the controller 48 can continue to compare the system pressure to the set system pressure limit as described herein. In some embodiments, if the measured chamber pressure 162 plus the preset tolerance is greater than the chamber pressure limit 168 set at reference numeral 104, the controller 48 can continue to operate at the reduced flow rate to bring the measured chamber pressure 162 back to the chamber pressure limit 168 or below while continuing to monitor the measured chamber pressure 162 under the chamber pressure override mode 160. The controller 48 can then continue to again initiate the inquiry.

[0096] In some embodiments, if the measured chamber pressure 162 plus the preset tolerance is less than the chamber pressure limit 168 set at reference numeral 104, the controller 48 can be configured to display a prompt on the display 44 asking whether the user wants to switch out of (e.g., exit) the chamber pressure override mode 160, as can be seen at reference numeral 184. If the user responds “no” or in some embodiments does not respond at all, the controller 48 can continue to operate at the reduced flow rate while continuing to monitor the measured chamber pressure 162 under the chamber pressure override mode 160. The controller 48 can then continue to again initiate the inquiry. If the user responds “yes”, the controller 48 can then display a second prompt on the display 44 asking whether the user wants to return to the flow control mode 140 using the target flow rate 142 or whether the user wants to switch to the adjusted flow control mode 141 by continuing to use the reduced flow rate, as indicated at reference numeral 186. The controller 48 can then continue to operate in the flow control mode 140 or the adjusted flow control mode 141 depending on the user selection.

[0097] Figure 12is a flowchart showing aspects of the system pressure override mode 150. When the controller 48 switches to the system pressure override mode 150 as described herein, the controller 48 can be configured to calculate an adjusted flow rate or reduced flow rate that depends on the target flow rate 142, the actual flow rate, and / or the measured system pressure 152 relative to a preset pressure threshold (e.g., the system pressure limit 158), as indicated at reference numeral 190. Next, the controller 48 can compare the measured pressure (e.g., the system pressure 152) plus a preset tolerance (e.g., 5%, 10%, 15%, 25%, etc.) to the system pressure limit 158 set at reference numerals 104 / 106, as seen at reference numeral 192. In some embodiments, if the measured system pressure 152 plus the preset tolerance is greater than (e.g., exceeds) the system pressure limit 158 set at reference numerals 104 / 106, the controller 48 can continue to run at the reduced flow rate to bring the measured system pressure 152 back to the system pressure limit 158 or below while continuing to monitor the measured system pressure 152 in the system pressure override mode 150. The controller 48 can then continue to again initiate the query.

[0098] In some embodiments, if the measured system pressure 152 plus the preset tolerance is less than the system pressure limit 158 set at reference numerals 104 / 106, the controller 48 can be configured to display a prompt on the display 44 asking whether the user wants to switch out of (e.g., exit) the system pressure override mode 150, as seen at reference numeral 194. If the user responds “no” or in some embodiments does not respond at all, the controller 48 can continue to run at the reduced flow rate while continuing to monitor the measured system pressure 152 in the system pressure override mode 150. The controller 48 can then continue to again initiate the query. If the user responds “yes”, the controller 48 can then display a second prompt on the display 44 asking whether the user wants to return to the flow control mode 140 using the target flow rate 142 or whether the user wants to switch to the adjusted flow control mode 141 by continuing to use the reduced flow rate, as indicated at reference numeral 196. The controller 48 can then continue to run in the flow control mode 140 or the adjusted flow control mode 141 depending on the user selection.

[0099] In some embodiments, a method of controlling fluid flow in a fluid management system 10 is presented, where the fluid management system includes an inflow pump 50 configured to pump fluid from a fluid supply 34 to a treatment site within a patient at a flow rate, and a controller 48 configured to operate at a target flow rate 142 in a flow control mode 140, the method can include setting a parameter within the controller 48, where the parameter includes the target flow rate 142 and a preset pressure threshold. In some embodiments, the preset pressure threshold is an intracavity pressure limit 168. In some embodiments, the preset pressure threshold is a system pressure limit 158.

[0100] In some embodiments, the method can include operating the controller 48 in the flow control mode 140, where the controller 48 maintains the target flow rate 142 while monitoring a measured pressure communicated to the controller 48 from a pressure sensor. In some embodiments, the measured pressure can be the intracavity pressure 162. In some embodiments, the intracavity pressure 162 can be communicated to the controller 48 from the pressure sensor 74. Other configurations are also contemplated. In some embodiments, the measured pressure can be the system pressure 152. In some embodiments, the system pressure 152 can be communicated to the controller 48 from the pressure sensor 67. Other configurations are also contemplated.

[0101] In some embodiments, the method can include a step of automatically switching the controller 48 from the flow control mode 140 to a pressure override mode when the measured pressure reaches the preset pressure threshold, in which the controller 48 automatically reduces the flow rate below the target flow rate 142 to restore the measured pressure to the preset pressure threshold or below. In some embodiments, the method can include automatically switching the controller 48 from the flow control mode 140 to a chamber pressure override mode 160, in which the controller 48 automatically reduces the flow rate below the target flow rate 142 to restore the measured intra-chamber pressure 162 to the intra-chamber pressure limit 168 or below. In some embodiments, the controller 48 can be configured to display a notification on the display 44 when the measured intra-chamber pressure 162 reaches and / or rises above the intra-chamber pressure limit 168, informing the user that the controller 48 has switched from the flow control mode 140 to the chamber pressure override mode 160. In some embodiments, the controller 48 can be configured to display a prompt on the display 44 when the measured intra-chamber pressure 162 reaches and / or rises above the intra-chamber pressure limit 168, informing the user that the controller 48 has switched from the flow control mode 140 to the chamber pressure override mode 160 and giving the user the option to override and / or ignore the intra-chamber pressure limit 168, causing the controller 48 to revert to the flow control mode 140 and permitting the measured intra-chamber pressure 162 to continue rising above and / or remain above the intra-chamber pressure limit 168. The controller 48 can be configured to automatically switch from the flow control mode 140 to the chamber pressure override mode 160 unless the user has explicitly confirmed the option to override and / or ignore the intra-chamber pressure limit 168 and / or explicitly instructed the controller 48 to revert to the flow control mode 140.

[0102] In some embodiments, the method can include automatically switching the controller 48 from the flow control mode 140 to the system pressure override mode 150 in which the controller 48 automatically reduces the flow rate below the target flow rate 142 to restore the measured system pressure 152 to the system pressure limit 158 or below. In some embodiments, the controller 48 can be configured to display a notification on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150 when the measured system pressure 152 reaches and / or rises above the system pressure limit 158. In some embodiments, the controller 48 can be configured to display a prompt on the display 44 informing the user that the controller 48 has switched from the flow control mode 140 to the system pressure override mode 150 and giving the user the option to override and / or ignore the system pressure limit 158, thereby causing the controller 48 to return to the flow control mode 140 and permit the measured system pressure 152 to continue rising above and / or remain above the system pressure limit 158 when the measured system pressure 152 reaches and / or rises above the system pressure limit 158. The controller 48 can be configured to automatically switch from the flow control mode 140 to the system pressure override mode 150 unless the user has affirmatively acknowledged the option to override and / or ignore the system pressure limit 158 and / or has affirmatively instructed the controller 48 to return to the flow control mode 140.

[0103] In some embodiments, the method can include displaying a prompt on the display 44 to ask the user if they want to switch out of the pressure override mode (e.g., the chamber pressure override mode 160 and / or the system pressure override mode 150) when the measured pressure (e.g., the chamber pressure 162 and / or the system pressure 152, respectively) drops below the preset pressure threshold (e.g., the chamber pressure limit 168 and / or the system pressure limit 158, respectively). In some embodiments, the method can include displaying the prompt on the display 44 to ask the user if they want to switch out of the pressure override mode when the measured pressure drops below the preset pressure threshold. Thus, in at least some embodiments, the prompt is displayed in relation to the timing of the measured pressure dropping below the preset pressure threshold.

[0104] In some embodiments, the method can further include displaying a prompt on the display 44 to ask the user if they want to return to the flow control mode 140 and the target flow rate 142 or if they want to switch to the adjusted flow control mode 141 and continue using the reduced flow rate associated with the pressure override mode (e.g., the chamber pressure override mode 160 and / or the system pressure override mode 150) if the user affirms switching out of the pressure override mode.

[0105] In some embodiments, the range of the intracavity pressure limit 168 and / or the system pressure limit 158 can be from -600 mmHg to +600 mmHg, from -300 mmHg to +300 mmHg, from 0 mmHg to +300 mmHg, from +25 mmHg to +250 mmHg, from +50 mmHg to +150 mmHg, or can be other suitable ranges. In some embodiments, the intracavity pressure limit 168 and / or the system pressure limit 158 can be selected and / or determined based at least in part on the capabilities of the pressure sensor 67 and / or the pressure sensor 74. In some embodiments, the preset tolerance of the intracavity pressure limit 168 and / or the system pressure limit 158 can be + / - 5%, + / - 10%, + / - 15%, + / - 20%, + / - 25%, + / - 30% or other suitable ranges or values. In some embodiments, the preset tolerance of the intracavity pressure limit 168 and / or the system pressure limit 158 can be + / - 2 mmHg, + / - 5 mmHg, + / - 10 mmHg, + / - 15 mmHg or other ranges.

[0106] Those skilled in the art will realize that the application can be embodied in many forms and with many modifications not specifically described herein, without departing from the spirit or essential characteristics of the application. Accordingly, it is not intended that the application be limited, as described herein, but that the application be given the broadest interpretation of the terms in which the claims are expressed.

[0107] Materials that can be useful for the various components of the system(s) disclosed herein, and various elements thereof, can include materials commonly associated with medical devices. For the sake of simplicity, the discussion below refers to the system. This is not intended, however, to limit the devices and methods described herein, as the discussion can apply to other elements, members, components, or devices disclosed herein, such as, but not limited to, fluid management systems, medical devices, elongated shafts, inflow pumps, fluid warming systems, controllers, supply line(s), load sensors, handles, workstations, display screen(s), fluid supply source(s), collection container(s), and / or elements or components thereof.

[0108] In some embodiments, the system and / or components thereof can be made from a metal, a metal alloy, a polymer (some examples of which are disclosed below), a metal-polymer composite, a ceramic, combinations thereof, and the like, or other suitable material.

[0109] Some examples of suitable polymers can include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM), polyamide (PA), polyphenylsulfone (PPS), polyphthalamide (PPA), polyurethane (PU), polyether-ether ketone (PEEK), polyamide-imide (PAI), acrylonitrile butadiene styrene (ABS), ethylene vinyl acetate copolymer (EVA), polydimethylsiloxane (PDMS), polystryrene, polycarbonate (PCT), polyimide (PI), among other polymers. Some examples of suitable metals can include titanium (Ti), biocompatible steel, among other metals. Some examples of suitable metal alloys can include stainless steel, titanium alloys, cobalt-chrome alloys, among other metal alloys. ), polyether block ester, polyurethane (e.g., Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether ester (e.g., Rynite®, available from DSM Engineering Plastics ), ether or ester based copolymer (e.g., butylenes / poly(alkylene ether) phthalate and / or other polyester elastomers such as Hytrel® available from DuPont ), polyamide (e.g., Durethene® available from Bayer or Pebax® available from Elf Atochem ), elastomeric polyamide, block polyamide / ether, polyether block amide (PEBA, e.g., available under the trade designation PEBAX® ), ethylene vinyl acetate copolymer (EVA), silicone, polyethylene (PE), high density polyethylene, low density polyethylene, linear low density polyethylene (e.g., ), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyether ether ketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polyphthalamide (e.g., ), polysulfone, nylon, nylon-12 (e.g., Rompun® available from EMS American Grilon ), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefin, polystyrene, epoxy, polyvinylidene chloride (PVdC), poly(sytrene-b-isobutylene-b-styrene) (e.g., SIBS and / or SIBS 50A), polycarbonates, polyurethane silicone copolymer (e.g., Biomer® from Aortech Biomaterials or Grilene® from AdvanSource Biomaterials ), biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers of the same, polymer / metal composites, and the like. In some embodiments, the sheath can be blended with liquid crystal polymer (LCP). For example, the blend can contain up to about 6 percent LCP.

[0110] Some examples of suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear elastic and / or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as INCONEL® 625, UNS: N06022 such as HASTELLOY® C- 27636, and the like; other nickel-chromium alloys such as UNS: N08205 such as ALLOY® 2050; other nickel-copper alloys, nickel-cobalt alloys, nickel-tungsten or nickel-molybdenum alloys; other alloys of nickel, such as nickel-manganese alloys; other alloys, such as nickel-copper-silicon (NICSIL) alloys, other low-temperature metals, other high-temperature metals, and others under the trade designations BERYLLIUM CUPRONICKEL®, ELGILOY®, MUMETALL®, and the like. UNS: N06625 such as Other nickel-copper alloys (e.g., UNS: N04400 such as Monel® 400, 400, 400, 400, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nickel-molybdenum alloys (e.g., UNS: N 10665 such as HASTELLOY® ALLOY ALLOY ), other nickel-chromium alloys, other nickel-molybdenum alloys, other nickel-cobalt alloys, other nickel-iron alloys, other nickel-copper alloys, other nickel-tungsten or tungsten alloys, and the like; cobalt-chromium alloys; cobalt-chromium-molybdenum alloys (e.g., UNS: R30003, such as ELGILOY® and the like); platinum enriched stainless steels; titanium; platinum; palladium; gold; combinations thereof; or any other suitable material.

[0111] In at least some embodiments, portions or all of the system and / or components thereof can also be doped with, made of, or otherwise include a radiopaque material. Radiopaque materials are understood to be materials capable of producing an image suitable for diagnosis or therapy in medical imaging procedures such as x-ray, MRI, or other procedures. Such procedures can be used to image the system in a patient. In one embodiment, the radiopaque material is selected from the group consisting of gold, platinum, palladium, tantalum, tungsten alloys, polymer material loaded with radiopaque filler such as

[0112] In some embodiments, a degree of Magnetic Resonance Imaging (MRI) compatibility is imparted to the systems and / or other elements disclosed herein. For example, the system and / or components or portions thereof can be made of a material that does not substantially distort the image and create substantial artifacts (i.e., gaps in the image). Certain ferromagnetic materials, for example, can not be suitable because they can create artifacts in an MRI image. The system or portions thereof can also be made of a material that the MRI machine can image. Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as MP35-N® and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), Nitinol, and the like, and other materials.

[0113] ​​​In some embodiments, the systems and / or other elements disclosed herein can include and / or be treated with suitable therapeutic agents. Some examples of suitable therapeutic agents can include: antithrombotic agents (such as heparin, heparin derivatives, urokinase, and PPack (dextrophenylalanine proline arginine chloromethylketone)); antiproliferative agents (such as enoxaparin, hirudin, monoclonal antibodies capable of blocking smooth muscle cell proliferation, hirudin, and acetylsalicylic acid); anti-inflammatory agents (such as dexamethasone, prednisolone, corticosterone, budesonide, estrogen, sulfasalazine, and mesalamine); antitumor / antiproliferative / antineoplastic agents (such as paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine, epothilones, endostatin, angiostatin, and thymidine kinase inhibitors); anesthetics (such as lidocaine, bupivacaine, and ropivacaine); anticoagulants (such as D-Phe-Pro-Arg chloromethylketone, RGD peptide-containing compounds, heparin, antithrombin cofactors, platelet receptor antagonists, anti-thrombin antibodies, anti-platelet receptor antibodies, aspirin, prostaglandin inhibitors, platelet inhibitors, and tick antiplatelet peptides); vascular cell growth promoters (such as growth factor inhibitors, growth factor receptor antagonists, transcriptional repressors, transcriptional activators, and translational promoters); vascular cell growth inhibitors (such as growth factor inhibitors, growth factor receptor antagonists, transcriptional repressors, translational repressors, replication inhibitors, inhibitory antibodies, antibodies against growth factors, bifunctional molecules consisting of a growth factor and a cytotoxin, bifunctional molecules consisting of an antibody and a cytotoxin); cholesterol-lowering agents; vasodilating agents; and agents that interfere with endogenous vasoactive mechanisms.

[0114] It should be understood that the present disclosure is in many aspects only illustrative. Changes can be made in detail, especially in matters of shape, size, and arrangement of steps, without exceeding the scope of the application. This can include the use of any feature in one example embodiment with any other embodiment, as appropriate, to the full extent set forth by the language of the claims. Of course, the application is intended to be defined by the language of the claims that express the scope of the invention.

Claims

1. A fluid management system, comprising: An inflow pump configured to pump fluid from a fluid supply source to the treatment site within the patient at a flow rate; as well as A controller configured to operate at a target flow rate in flow control mode; In the flow control mode, the controller is configured to maintain the target flow rate while monitoring the measured pressure transmitted from the pressure sensor to the controller. Specifically, when the measured pressure reaches a preset pressure threshold, the controller is configured to automatically switch from the flow control mode to a pressure overload mode. In the pressure overload mode, the controller automatically reduces the flow rate to below the target flow rate, so that the measured pressure returns to or below the preset pressure threshold. When the measured pressure drops below the preset pressure threshold, the controller is configured to switch from the pressure over-control mode to the adjusted flow control mode.

2. The fluid management system according to claim 1, wherein, The controller is configured to operate at a reduced flow rate as in the pressure over-control mode when in the regulated flow control mode.

3. The fluid management system according to claim 1, wherein, When the measured pressure drops below the preset pressure threshold, the controller is configured to display a prompt on the display asking the user whether they want to switch to the adjusted flow control mode.

4. The fluid management system according to claim 1, wherein, When the measured pressure drops below the preset pressure threshold, the controller is configured to display a notification on the display and automatically switch from the pressure over-control mode to the adjusted flow control mode.

5. The fluid management system according to any one of claims 1-4, wherein, The measured pressure is the intracavitary pressure measured within the treatment site, and the preset pressure threshold is the intracavitary pressure limit.

6. The fluid management system according to any one of claims 1-4, wherein, The measured pressure is the system pressure measured within the fluid management system, and the preset pressure threshold is the system pressure limit.

7. A fluid management system, comprising: An inflow pump configured to pump fluid from a fluid supply source to the treatment site within the patient at a flow rate; as well as A controller configured to operate at a target flow rate in flow control mode; In the flow control mode, the controller is configured to maintain the target flow rate while monitoring the measured pressure transmitted from the pressure sensor to the controller. When the measured pressure reaches a preset pressure threshold, the controller is configured to automatically switch from the flow control mode to the pressure over-control mode. In the pressure over-control mode, the controller automatically reduces the flow rate to below the target flow rate so that the measured pressure returns to or below the preset pressure threshold. Specifically, when the measured pressure drops below the preset pressure threshold, the controller is configured to display a prompt on the screen, asking the user whether they want to switch out of the pressure over-control mode. When the measured pressure drops below the preset pressure threshold, the controller is configured to switch from the pressure over-control mode to the adjusted flow control mode.

8. The fluid management system according to claim 7, wherein, The prompt asks the user whether they want to switch back to the original flow control mode or the adjusted flow control mode.

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