Surgical gas delivery system and method using proportional valves for gas seal insufflation and recirculation

Abstract

A surgical gas delivery system for gas seal insufflation and recirculation is disclosed, the surgical gas delivery system comprising: a gas seal manifold for communication with a gas seal access port; an insufflation manifold for communication with the gas seal access port and in communication with a valve seal access port; a compressor for recirculating gas through the gas seal access port by means of the gas seal manifold; a first outlet line valve associated with the insufflation manifold for controlling the flow of insufflation gas to the gas seal access port; a second outlet line valve associated with the insufflation manifold for controlling the flow of insufflation gas to the valve seal access port; and a proportional valve associated with the insufflation manifold and located upstream of the first and second outlet line valves for dynamically controlling the flow of insufflation gas to the first and second outlet line valves.

Description

[0001] Related Applications

[0002] This application claims priority to U.S. Patent Application No. 17 / 155,572, filed January 22, 2021, the disclosure of which is incorporated herein by reference in its entirety. TECHNICAL FIELD

[0003] The present invention relates to minimally invasive surgery, and more particularly, to a surgical gas delivery system and method for dynamically controlling gas flow with one or more proportional valves for gas seal insufflation and recirculation during endoscopic or laparoscopic surgery. BACKGROUND

[0004] Laparoscopic or “minimally invasive” surgical techniques have become increasingly prevalent in the performance of surgeries such as cholecystectomy, appendectomy, hernia repair, and nephrectomy. Benefits of such surgeries include reduced trauma to the patient, reduced opportunity for infection, and reduced recovery time. Such surgeries performed in the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.

[0005] Additionally, such surgeries often involve filling or “insufflating” the abdominal cavity with a pressurized fluid such as carbon dioxide to create a surgical space known as pneumoperitoneum. Insufflation can be performed through a surgical access device such as a trocar equipped to deliver insufflation fluid or through a separate insufflation device such as an insufflation (pneumoperitoneal) needle. It is desirable to introduce surgical instruments into the pneumoperitoneum without substantial loss of insufflation gas in order to maintain the pneumoperitoneum.

[0006] During a typical laparoscopic surgery, the surgeon makes three to four small incisions, each typically no larger than about twelve millimeters, often formed by the surgical access device itself through the use of a separate insert or obturator placed in the surgical access device. After insertion, the obturator is removed and the trocar allows instrument access for insertion into the abdominal cavity. A typical trocar provides a path for insufflation of the abdominal cavity so that the surgeon has an open interior space in which to work.

[0007] The trocar must also provide a way to maintain intra-cavity pressure while still allowing at least minimal freedom of movement of the surgical instruments by sealing between the trocar and the surgical instruments being used. Such instruments can include, for example, scissors, grasping and occluding instruments, cautery units, cameras, light sources, and other surgical instruments. Sealing elements or mechanisms are typically provided on the trocar to prevent escape of insufflation gas from the abdominal cavity. These sealing mechanisms often include duckbill valves made of a relatively pliable material to seal against the outer surface of the surgical instruments passing through the trocar.

[0008] ConMed Corporation's wholly-owned subsidiary, SurgiQuest, Inc., has developed unique gas-sealed surgical access devices that allow immediate access to insufflated surgical cavities without the use of conventional mechanical valve seals, as described, for example, in U.S. Patent No. 7,854,724 and U.S. Patent No. 8,795,223. These access devices are constructed from several nested components that include an inner tubular body portion and a coaxial outer tubular body portion. The inner tubular body portion defines a gas-sealed central lumen for introducing conventional laparoscopic or endoscopic surgical instruments into a patient's surgical cavity, and the outer tubular body portion defines an annular lumen that surrounds the inner tubular body portion for delivering insufflation gas to the patient's surgical cavity and facilitating periodic sensing of abdominal pressure.

[0009] SurgiQuest has also developed multi-modal surgical gas delivery systems for use with the unique gas-sealed access devices described above. These gas delivery systems, disclosed, for example, in U.S. Patent No. 9,199,047 and U.S. Patent No. 9,375,539, have a first mode of operation for providing gas-sealed access to a body cavity, a second mode of operation for performing smoke evacuation from the body cavity, and a third mode of operation for providing insufflation gas to the body cavity.

[0010] In SurgiQuest's prior art gas delivery systems, the delivery or flow of insufflation gas to the body cavity is controlled by solenoid valves that have certain limitations in their ability to dynamically control gas flow rates. For example, a solenoid valve with a 6 mm orifice has two flow states: zero; and 6 mm orifice flow that varies with differential pressure. However, a 6 mm orifice proportional valve has an infinite number of intermediate flow settings or equivalent orifice diameters.

[0011] Because flow varies with the square of orifice diameter, the additional intermediate valve positions of a proportional valve provide fine control beyond a simple linear relationship, and the ability to achieve stable flow rates at low pressures, reduce pressure oscillations, and eliminate pneumatic hammer. Furthermore, the first 10% of valve opening or 0.6 mm of effective orifice diameter regulates one percent (10%) of the full open flow; this can be advantageous in pediatric applications. 2 ) ; this can be advantageous in pediatric applications. SUMMARY

[0012] A new and useful surgical gas delivery system for gas-sealed insufflation and recirculation during endoscopic or laparoscopic surgical procedures is disclosed.

[0013] The gas delivery system includes a gas-sealed manifold for communication with a gas-sealed access port and an insufflation manifold for communication with the gas-sealed access port and in communication with a valve-sealed access port, and a compressor for recirculating gas through the gas-sealed access port by means of the gas-sealed manifold.

[0014] The system also includes a first proportional outlet line valve operatively associated with the insufflation manifold for dynamically controlling the flow of insufflation gas to the gas sealed access port and a second proportional outlet line valve operatively associated with the insufflation manifold for dynamically controlling the flow of insufflation gas to the valve sealed access port. Additionally, the insufflation manifold includes a first pressure sensor downstream of the first outlet line valve and a second pressure sensor downstream of the second outlet line valve, wherein the first and second pressure sensors are located within a venture tube to maintain a pressure differential used to infer the rate of gas flow proximate to the access port.

[0015] The system also includes a surgical gas source in communication with the gas sealed manifold and the insufflation manifold. Gas from the surgical gas source flows through a high pressure regulator and a gas heater before the gas is delivered to the gas sealed manifold and the insufflation manifold.

[0016] The gas sealed manifold includes a gas injection valve operatively associated with the outlet side of the compressor for controlling the delivery of gas from the surgical gas source into the gas sealed manifold, and preferably the gas injection valve is a proportional valve. The gas sealed manifold also includes an exhaust valve operatively associated with the outlet side of the compressor for controlling the flow of gas between the gas sealed manifold and the insufflation manifold under certain operating conditions, and the exhaust valve is preferably a proportional valve.

[0017] The gas sealed manifold also includes a bypass valve between the outlet side of the compressor and the inlet side of the compressor for controlling the flow of gas within the gas sealed manifold under certain operating conditions, and the bypass valve is preferably a proportional valve. Also, the gas sealed manifold includes an air vent valve operatively associated with the inlet side of the compressor for controlling the entrainment of atmospheric air into the system under certain operating conditions, and the air vent valve is preferably a proportional valve.

[0018] The gas sealed manifold also includes an overpressure relief valve operatively associated with the outlet side of the compressor for controlling the release of gas from the system to atmosphere under certain operating conditions, and the overpressure relief valve is preferably a solenoid valve. Additionally, the gas sealed manifold includes a first pressure sensor operatively associated with the inlet side of the compressor and a second pressure sensor operatively associated with the outlet side of the compressor.

[0019] The gas-sealed manifold also includes a gas quality sensor operatively associated with the outlet side of the compressor. Additionally, a first barrier valve is operatively associated with the inlet of the gas-sealed manifold, and a second barrier valve is operatively associated with the outlet of the gas-sealed manifold; preferably, the first and second barrier valves are pneumatically actuated. Furthermore, the first and second barrier valves communicate with a barrier valve pilot valve contained within the blow-in manifold, and the barrier valve pilot valve is a solenoid valve.

[0020] The blow-in manifold also includes a low-pressure safety valve located upstream of the outlet line valve for controlling the release of gas from the system to the atmosphere under certain operating conditions. The blow-in manifold also includes a vent valve located upstream of the outlet line valve for controlling the release of gas from the system to the atmosphere under certain operating conditions, and the vent valve is preferably a proportional valve. The blow-in manifold includes proportional valves located upstream of the low-pressure safety valve and the vent valve to maintain a constant intermediate pressure within the system.

[0021] The present invention also relates to a surgical gas delivery system for gas-tight blow-in and recirculation, the surgical gas delivery system comprising: a gas-tight manifold for communication with a gas-tight inlet; a compressor for recirculating gas through the gas-tight inlet via the gas-tight manifold; and a blow-in manifold for communication with both the gas-tight inlet and a valve-tight inlet, wherein the blow-in manifold includes a first outlet line valve for controlling the flow of blow-in gas to the gas-tight inlet and a second outlet line valve for controlling the flow of blow-in gas to the valve-tight inlet, and wherein at least one of the first and second outlet line valves is a proportional valve configured to dynamically control the flow of blow-in gas. According to a preferred embodiment of the invention, both the first and second outlet line valves are proportional valves.

[0022] The present invention also relates to a method for delivering surgical gas during surgical procedures, the method comprising the steps of: recirculating the surgical gas through a gas-sealed inlet to provide gas-sealed access to a body cavity and maintain a stable cavity pressure during the surgical procedure; and dynamically controlling the outflow of the blown gas through the gas-sealed inlet to the body cavity.

[0023] These and other features of the gas delivery system of the present invention will become more apparent to those skilled in the art from the following detailed description of preferred embodiments, taken in conjunction with the accompanying drawings. Attached Figure Description

[0024] To enable those skilled in the art to readily understand how to manufacture and use the gas delivery system and method of the present invention without improper experimentation, preferred embodiments thereof will now be described in detail with reference to the accompanying drawings, wherein:

[0025] Figure 1 This is a schematic diagram of the multimodal gas delivery system of the present invention, which includes a gas-sealed manifold for communication with a gas-sealed inlet port and a blow-in manifold for communication with both the gas-sealed inlet port and a valve-sealed inlet port. The gas delivery system includes a plurality of proportional valves, each of which includes a proportional outlet line valve for dynamically controlling the blow-in flow from the blow-in manifold through the gas-sealed inlet port or the valve-sealed inlet port to the patient's body cavity, depending on a selected operating mode. Detailed Implementation

[0026] Referring now to the accompanying drawings, wherein like reference numerals identify similar structural elements and features of the invention, Figure 1 A novel and useful multimodal surgical gas delivery system 10 is shown, which is adapted and configured for gas-tight blow-in, recirculation, and fume extraction during endoscopic or laparoscopic surgery. The multimodal surgical gas delivery system 10 of the present invention includes a gas-tight manifold 110 for communication with a gas-tight inlet 20 and a blow-in manifold 210 for communication with both the gas-tight inlet 20 and a valve-tight inlet 30.

[0027] Gas-tight inlet 20 is of the type disclosed in commonly assigned U.S. Patent No. 8,795,223, which is incorporated herein by reference. Gas-tight inlet 20 is adapted and configured to provide gas-tight instrument access to a body cavity while maintaining stable pressure within the cavity (e.g., stable pneumoperitoneum in the peritoneum or abdominal cavity). In contrast, valve-tight inlet 30 is a conventional or standard cannula used to provide access to a body cavity via a mechanical valve seal, such as a duckbill seal or diaphragm seal. Depending on the requirements of a particular surgical procedure, the multimodal gas delivery system 10 may be used with gas-tight inlet 20, valve-tight inlet 30, or both inlet ports 20 and 30 simultaneously.

[0028] The gas delivery system 10 also includes a compressor or positive pressure pump 40 for recirculating surgical gas through a gas seal into the inlet 20 via a gas-sealed manifold 110. The compressor 40 is preferably driven by a brushless DC motor, which can advantageously be controlled to regulate gas pressure and flow rate within the gas delivery system 10, as disclosed, for example, in commonly assigned U.S. Patent No. 10,702,306, which is incorporated herein by reference. Alternatively, the compressor 40 may be driven by an AC motor, but a DC motor would be relatively smaller and lighter, and therefore more advantageous from a manufacturing perspective.

[0029] Intercooler and / or condenser 50 is operatively associated with compressor 40 for cooling or otherwise regulating gas recirculated through gas-sealed manifold 110. UVC radiator 52 is operatively associated with intercooler or condenser 50 for sterilizing gas recirculated through internal flow channels 54 formed therein by means of compressor 40. Additionally, UVC radiator 52 is intended to sterilize the inner surface of gas ducts or flow channels 54 through which the gas flows within intercooler / condenser 50.

[0030] The UVC radiator preferably includes at least one LED light source or fluorescent light source, which is adapted and configured to generate UVC radiation with wavelengths of about 240-350 nm and preferably about 265 nm. Such ultraviolet light at these wavelengths can kill viruses, bacteria and microorganisms in the gas ducts of the system and can reduce coronaviruses including SARS-CoV-2.

[0031] Preferably, the compressor 40, intercooler / condenser 50, gas-sealed manifold 110, and blow-in manifold 210 are all enclosed within a common housing that includes a graphical user interface and control electronics, as disclosed, for example, in commonly assigned U.S. Patent No. 9,199,047, which is incorporated herein by reference.

[0032] The gas delivery system 10 also includes a surgical gas source 60 in communication with the gas-sealed manifold 110 and the blow-in manifold 210. The gas source 60 may be a local pressure vessel or a remote supply tank associated with a hospital or healthcare facility. Preferably, gas flow from the surgical gas source 60 passes through a high-pressure regulator 65 and a gas heater 70 before being delivered to the gas-sealed manifold 110 and the blow-in manifold 210. Preferably, the high-pressure regulator 65 and the gas heater 70 are also enclosed in a common housing along with the compressor 40, the intercooler 50, the gas-sealed manifold 110, and the blow-in manifold 210.

[0033] The gas delivery system 10 also includes a first outlet line valve (OLV1) 212 operatively associated with an inlet manifold 210 for controlling the flow of blow-in gas to the valve seal inlet 30 and a second outlet line valve (OLV2) 214 operatively associated with an inlet manifold 210 for controlling the flow of blow-in gas to the gas seal inlet 20.

[0034] According to a preferred embodiment of the invention, the first outlet line valve 212 and the second outlet line valve 214 of the blow-in manifold 210 are proportional valves configured to dynamically change or otherwise control the outflow of blow-in gas to the inlet ports 20, 30 to match possible volume fluctuations in the patient's body cavity when such fluctuations occur. The first proportional outlet line valve 212 and the second proportional outlet line valve 214 provide fine control of the blow-in gas flow rate to the gas delivery system 10 to achieve a stable flow rate at low pressures, reduce pressure oscillations, and eliminate pneumatic hammering.

[0035] Because the first proportional outlet line valve 212 and the second proportional outlet line valve 214 are located proximally to the patient where flow friction loss is relatively low, the gas delivery system 10 is able to accurately measure peritoneal pressure. Furthermore, the only possible use of proportional outlet line valves here is for this purpose, as there is a constant gas recirculation throughout the gas delivery system 10 via closed-loop venting or via a gas-tight inlet 20.

[0036] The proportional valve allows for infinitely variable airflow adjustment between minimum and maximum flow conditions. Considering that some volume changes in the patient's body cavity, such as respiration, are expected and consistent, by employing a proportional outlet line valve, the blow-in manifold 210 can dynamically change the airflow into the body cavity to reverse the expected volume changes, thereby having a neutral effect on the pressure within the body cavity.

[0037] An additional benefit of using a proportional valve to control the outflow of blown gas from manifold 210 is the reduced response time compared to a solenoid valve. A solenoid valve is operated by applying energy to a coil, which generates an electromagnetic force that moves a piston. However, energizing the coil requires a certain amount of time, introducing a delay between the command action and the physical movement of the piston. In contrast, the proportional valve used in the gas delivery system 10 of the present invention typically does not have this energizing delay, thus providing an improved response time compared to a solenoid valve.

[0038] The inflation manifold 210 also includes a first patient pressure sensor (PWS1) 222 downstream of the first outlet line valve 212 and a second patient pressure sensor (PWS1) 224 downstream of the second outlet line valve 214. These two patient pressure sensors are used to measure abdominal pressure to control the outlet line valves 212 and 214, respectively. Two additional pressure sensors, labeled DPS1 and DPS2, are located upstream of the outlet line valves 212 and 214. These two pressure sensors are located within a venturi tube to measure a pressure differential used to infer the total gas flow rate from the inflation manifold 210 to the patient's body cavity.

[0039] The main proportional valve (PRV) 216 is also operatively associated with the blow-in manifold 210 and is located upstream of the first outlet line valve 212 and the second outlet line valve 214 to control the flow of blow-in gas to the first outlet line valve 212 and the second outlet line valve 214. The proportional valve 216 is used to maintain the intermediate pressure within the blow-in manifold 210 (as the central node in the LPU) at a constant pressure between 1 and 80 mmHg, depending on the system operating mode. Opening of the PRV 216 can be indirectly initiated by any of the following actions: patient breathing, gas leakage downstream of the PRV 216, or opening of the safety valve LSV 227 or the ventilation valve VEV 228—that is, any event that causes a drop in intermediate pressure. LSV 227 and VEV 228 are described in more detail below within the system.

[0040] The gas-sealed manifold 110 also includes a high-pressure gas injection valve (GFV) 112 operatively associated with the outlet side of the compressor 40. The GFV 112 is adapted and configured to control the gas delivered from the surgical gas source 60 into the gas-sealed manifold 110. Preferably, the gas injection valve 112 is a proportional valve capable of dynamically controlling the surgical gas delivered into the gas-sealed manifold 110.

[0041] The gas-sealed manifold 110 also includes a smoke exhaust valve (SEV) 114, which is operatively associated with the outlet side of the compressor 40 for dynamically controlling the airflow between the gas-sealed manifold 110 and the blow-in manifold 210 under certain operating conditions, such as when the gas delivery device 10 operates in smoke exhaust mode. Preferably, the smoke exhaust valve 114 is a proportional valve.

[0042] A bypass valve (SPV) 116 is located between the outlet side and the inlet side of the compressor 40 and is used to control the airflow within the gas seal manifold 110 under certain operating conditions. Preferably, the bypass valve 116 is a proportional valve that can be variably opened to establish and control the gas seal generated within the gas seal inlet 20. Furthermore, the bypass valve 116 uses feedback from pressure sensors 122, 124 to control the gas flow rate to the gas seal, which is described in further detail below.

[0043] The gas-tight manifold 110 also includes an air vent valve (AVV) 118 operatively associated with the inlet side of the compressor 40 for controlling atmospheric air entrainment into the system 10 under certain operating conditions. For example, AVV 118 will allow atmospheric air to be introduced into the gas-tight line to increase the air mass (i.e., standard volume) within the line. Thermodynamics under clinical use conditions can cause a loss of standard volume within the gas line. Vent valve 118 allows the gas delivery system 10 to compensate for this lost volume to ensure that pump pressure and flow rate are sufficient to maintain the gas seal within the gas-tight inlet 20. Vent valve 118 can also be opened to reduce the vacuum-side pressure in the gas-tight line.

[0044] An overpressure relief valve (ORV) 120 is operatively associated with the outlet side of the compressor 40 for controlling the release of gas from system 10 to the atmosphere under certain operating conditions. Preferably, the overpressure relief valve 120 is a proportional valve that opens to reduce the positive pressure side of the gas-sealed line, particularly in emergency situations such as a power outage of the gas delivery system 10. The normally open configuration of the relief valve 120 reduces the risk of over-pressurization of the patient cavity after the valve is de-energized.

[0045] A first pressure sensor (RLS) 122 is operatively associated with the inlet side of the compressor 40, and a second pressure sensor (PLS) 124 is operatively associated with the outlet side of the compressor 40. These pressure sensors 122 and 124 are positioned with unobstructed and minimally restricted reversal to the patient's abdominal cavity to continuously and accurately measure the cavity pressure. Signals from these two pressure sensors 122 and 124 are used by the controller of the gas delivery system 10 to adjust the opening of the two outlet line valves 212 and 214 to control the patient cavity pressure.

[0046] Additionally, the gas-sealed manifold 110 includes a gas quality sensor 126 operatively associated with the outlet side of the compressor 40. The gas quality sensor monitors the oxygen level in the recirculation line, which corresponds to the CO2 concentration in the patient's body cavity, as disclosed in U.S. Patent No. 9,199,047.

[0047] A first barrier valve (BV1) 132 is operatively associated with the outlet flow path of the gas-sealed manifold 110, and a second barrier valve (BV2) 134 is operatively associated with the inlet flow path of the gas-sealed manifold 110. Barrier valves 132 and 134 are employed during self-testing prior to surgical procedures, as disclosed in U.S. Patent No. 9,199,047. It is contemplated that the first barrier valve 132 and the second barrier valve 134 may be mechanically or pneumatically actuated.

[0048] The first filter element 142 is located downstream of the first barrier valve 132 and is used to filter pressurized gas flowing from the compressor 40 to the gas seal inlet 20, and the second filter element 144 is located upstream of the second first barrier valve 134 and is used to filter gas returning from the gas seal inlet 20 to the compressor 40. Preferably, the filter elements 142 and 144 are housed in a common filter cartridge, as disclosed, for example, in U.S. Patent No. 9,199,047.

[0049] The first and second blocking valves 132 and 134 are in communication with a blocking valve pilot valve (BVP) 226 contained within the blow-in manifold 210. Preferably, the blocking valve pilot valve 226 is a solenoid valve. It is envisioned that the BVP 226 can be fed from a compressor outlet or from a gas source such as surgical gas or air, as shown. The blow-in manifold 110 also includes a pressure sensor (PMS) 225 located downstream of the main proportional valve 216 and upstream of the outlet line valves 212, 214. The two outlet line valves are opened to introduce blow-in gas into the patient's body cavity through inlet ports 23, 30. This introduction of gas has the effect of increasing the pressure within the body cavity. Additionally, the outlet line valves 212, 214 can be combined with an air vent valve 228 to open and release gas from the body cavity, thereby having the effect of blowing out and reducing cavity pressure.

[0050] The blow-in manifold 210 also includes a low-pressure safety valve (LSV) 227 downstream of the main proportional valve 216 and upstream of the first outlet line valve 212 and the second outlet line valve 214 for controlling the release of gas from system 10 to the atmosphere under certain operating conditions. The LSV 227 is a purely mechanical valve used to limit the maximum intermediate pressure within manifold 210 or the LPU (low-pressure unit) in the event of a power outage, pressure controller malfunction, or a valve upstream of the LSV stuck in the open position.

[0051] In addition, a ventilation exhaust valve (VEV) 228 is located downstream of the main proportional valve 216 and upstream of the outlet line valves 212, 214, for controlling the release of gas from system 10 to the atmosphere under certain operating conditions. The ventilation exhaust valve 228 is preferably a proportional valve that opens to blow out or otherwise reduce the pressure in the patient cavity. Additionally, VEV 228 can open to reduce intermediate pressure within the LPU.

[0052] Filter element 242 is located downstream of the first outlet line valve 212 and is used to filter the blow-in gas flowing from the blow-in manifold 210 to the valve seal inlet 30. Another filter element 244 is located downstream of the second outlet line valve 224 and is used to filter the insulating gas flowing from the blow-in manifold 210 to the gas seal inlet 20. Preferably, filter element 244 houses filter elements 142 and 144 within a common filter cartridge, while filter element 242 is positioned separately.

[0053] Although the gas delivery system of this disclosure has been shown and described with reference to preferred embodiments, those skilled in the art will readily understand that changes and / or modifications can be made thereto without departing from the scope of this disclosure.

Claims

1. A surgical gas delivery system for gas-tight blow-in and recirculation, comprising: a) Gas-tight manifold, which is used to connect to the gas-tight inlet port; b) A blow-in manifold, which is connected to the gas seal inlet and to the valve seal inlet; c) A compressor for recirculating the blow-in gas through the gas seal into the inlet via the gas seal manifold; d) A first proportional outlet line valve, which is operatively associated with the blow-in manifold for dynamically controlling the flow of the blow-in gas to the gas seal inlet. e) A second proportional outlet line valve, operatively associated with the blow-in manifold for dynamically controlling the flow of the blow-in gas to the valve-sealed inlet, wherein the first proportional outlet line valve and the second proportional outlet line valve are respectively configured to dynamically control the flow of the blow-in gas to the gas-sealed inlet and the flow of the blow-in gas to the valve-sealed inlet to match volume fluctuations in the patient's body cavity when such fluctuations occur; and f) A main proportional valve, operatively associated with the blow-in manifold and located upstream of the first proportional outlet line valve and the second proportional outlet line valve, controls the flow of the blow-in gas to the first proportional outlet line valve and the second proportional outlet line valve, and is used to maintain intermediate pressure within the blow-in manifold, wherein the surgical gas delivery system is configured such that when a release valve located downstream of the main proportional valve and upstream of the first proportional outlet line valve and the second proportional outlet line valve opens to release the blow-in gas from the surgical gas delivery system to the atmosphere, thereby causing a drop in intermediate pressure within the blow-in manifold, the main proportional valve will open to maintain the intermediate pressure within the blow-in manifold.

2. The surgical gas delivery system of claim 1, wherein the blow-in manifold includes a first pressure sensor downstream of the first proportional outlet line valve and a second pressure sensor downstream of the second proportional outlet line valve.

3. The surgical gas delivery system of claim 2, wherein a pair of pressure sensors are located upstream of the first proportional outlet line valve and the second proportional outlet line valve to measure a pressure difference, the pressure difference being used to infer the gas flow rate from the blow-in manifold.

4. The surgical gas delivery system according to claim 1, wherein the surgical gas source is in communication with the gas sealing manifold and the blow-in manifold.

5. The surgical gas delivery system of claim 4, wherein the blow-in gas from the surgical gas source flows through a high-pressure regulator and a gas heater, and then the blow-in gas is delivered to the gas sealing manifold and the blow-in manifold.

6. The surgical gas delivery system of claim 4, wherein the gas-sealed manifold includes a gas injection valve operatively associated with the outlet side of the compressor for controlling the blow-in gas delivered from the surgical gas source into the gas-sealed manifold, and wherein the gas injection valve is a proportional valve.

7. The surgical gas delivery system of claim 1, wherein the gas-sealed manifold includes a smoke exhaust valve operatively associated with the outlet side of the compressor for controlling airflow between the gas-sealed manifold and the blow-in manifold under certain operating conditions, and wherein the smoke exhaust valve is a proportional valve.

8. The surgical gas delivery system of claim 1, wherein the gas-sealed manifold includes a bypass valve located between the outlet side and the inlet side of the compressor for controlling the airflow within the gas-sealed manifold under certain operating conditions, and wherein the bypass valve is a proportional valve.

9. The surgical gas delivery system of claim 1, wherein the gas-sealed manifold includes an air vent valve operatively associated with the inlet side of the compressor for controlling atmospheric air entrainment into the surgical gas delivery system under certain operating conditions, and wherein the air vent valve is a proportional valve.

10. The surgical gas delivery system of claim 1, wherein the gas sealing manifold includes an overpressure relief valve operatively associated with the outlet side of the compressor for controlling the release of the blow-in gas from the surgical gas delivery system to the atmosphere under certain operating conditions, and wherein the overpressure relief valve is a solenoid valve.

11. The surgical gas delivery system of claim 1, wherein the gas-sealed manifold includes a first pressure sensor operatively associated with the inlet side of the compressor and a second pressure sensor operatively associated with the outlet side of the compressor.

12. The surgical gas delivery system of claim 1, wherein the gas-sealed manifold includes a gas quality sensor operatively associated with the outlet side of the compressor.

13. The surgical gas delivery system of claim 1, further comprising a first blocking valve operatively associated with the inlet of the gas-sealed manifold and a second blocking valve operatively associated with the outlet of the gas-sealed manifold, wherein the first blocking valve and the second blocking valve are pneumatically actuated.

14. The surgical gas delivery system of claim 13, wherein the first blocking valve and the second blocking valve are in communication with a blocking valve pilot valve contained in the blow-in manifold, and wherein the blocking valve pilot valve is a solenoid valve.

15. The surgical gas delivery system of claim 1, wherein the blow-in manifold includes a low-pressure safety valve upstream of the first proportional outlet line valve and the second proportional outlet line valve for controlling the release of the blow-in gas from the surgical gas delivery system to the atmosphere under certain operating conditions.

16. The surgical gas delivery system of claim 15, wherein the blow-in manifold further includes a vent valve upstream of the first proportional outlet line valve and the second proportional outlet line valve for controlling the release of the blow-in gas from the surgical gas delivery system to the atmosphere under certain operating conditions, and the vent valve is a proportional valve.

17. The surgical gas delivery system of claim 16, wherein the main proportional valve is located upstream of the low-pressure safety valve and the ventilation exhaust valve.

18. The surgical gas delivery system of claim 1, wherein the intermediate pressure is between 1 and 80 mmHg, depending on the system operating mode.

19. A surgical gas delivery system for gas-tight blow-in and recirculation, comprising: a) Gas-tight manifold, which is used to connect to the gas-tight inlet port; b) A compressor for recirculating the blow-in gas through the gas seal into the inlet via the gas seal manifold; c) A blow-in manifold for communication with the gas-tight inlet or with a valve-tight inlet, wherein the blow-in manifold includes a first outlet line valve for controlling the flow of the blow-in gas to the gas-tight inlet and a second outlet line valve for controlling the flow of the blow-in gas to the valve-tight inlet, and wherein at least one of the first outlet line valve and the second outlet line valve is respectively configured to dynamically control the flow of the blow-in gas to the gas-tight inlet or dynamically control the flow of the blow-in gas to the valve-tight inlet to match the volume fluctuations in the patient's body cavity when volume fluctuations occur; as well as d) A main proportional valve, contained within the blow-in manifold and located upstream of the first and second outlet line valves, controls the flow of the blow-in gas to the first and second outlet line valves and maintains intermediate pressure within the blow-in manifold, wherein the surgical gas delivery system is configured such that when a release valve located downstream of the main proportional valve and upstream of the first and second outlet line valves opens to release the blow-in gas from the surgical gas delivery system to the atmosphere, causing a drop in intermediate pressure within the blow-in manifold, the main proportional valve will open to maintain the intermediate pressure within the blow-in manifold.

20. The surgical gas delivery system of claim 19, wherein the first outlet line valve and the second outlet line valve are both proportional valves.

21. The surgical gas delivery system of claim 19, wherein the intermediate pressure is between 1 and 80 mmHg, depending on the system operating mode.

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