Venting surgical cannula for providing gases to patient

Abstract

To provide an improved cannula.SOLUTION: A surgical cannula for providing insufflation gases to a surgical cavity of a patient (such as the pneumoperitoneum), allowing insertion of medical instruments into the surgical cavity through the cannula, and venting gases from the surgical cavity to the outside environment can include venting features including filters to more safely reduce the amount of undesirable materials such as smoke from reaching the outside environment.SELECTED DRAWING: Figure 3A

Description

[Technical field]

[0001] The present disclosure relates in some aspects to humidifier systems and components of humidifier systems configured to deliver gases to a patient, particularly during a medical procedure. [Background technology]

[0002] Various medical procedures require the provision of a gas, typically carbon dioxide, to a patient during the medical procedure. For example, two common categories of medical procedures often require the provision of a gas to a patient. These include closed medical procedures and open medical procedures.

[0003] In closed medical procedures, the insufflator is deployed to deliver gas to a patient's body cavity during a medical procedure to inflate the cavity and / or resist collapse of the cavity. Examples of such medical procedures include laparoscopy and endoscopy, although the insufflator may be used in any other type of medical procedure as needed. In an endoscopic procedure, an endoscope or the like is inserted through one or more natural openings, small perforations, or incisions to generate an image of the cavity, allowing medical personnel to visualize the cavity. In a laparoscopic procedure, medical personnel typically insert surgical instruments through one or more natural openings, small perforations, or incisions to perform a surgical procedure in the cavity. In some cases, an endoscopic procedure may be performed first to evaluate the cavity, followed by a subsequent laparoscopy to perform surgery on the cavity. Such procedures are widely used, for example, for the peritoneal cavity or during thoracoscopy, colonoscopy, gastroscopy, or bronchoscopy.

[0004] In open medical procedures, e.g., open surgery, gas is used to fill the surgical cavity, with excess gas spilling out through the opening. Gas may also be used, for example, to provide a layer of gas over exposed body parts that do not have a discernible cavity. In these procedures, gas does not serve to inflate a cavity, but may be used to prevent or reduce desiccation and infection by covering exposed internal body parts with a layer of heated, humidified, sterile gas.

[0005] Apparatus for delivering gas during these medical procedures may include an insufflator arranged to be connected to a remote source of pressurized gas, for example a gas supply system within a hospital. The apparatus is operable to control the pressure and / or flow of gas from the gas source to a suitable level for delivery to a body cavity, typically via a cannula or needle connected to the apparatus and inserted into the body cavity, or via a diffuser arranged to cover a wound or surgical cavity and diffuse the gas therein.

[0006] The body temperature of a human patient is typically about 37°C. It may be desirable to match the temperature of the gas delivered from the device as closely as possible to the body temperature of a typical human. It may be desirable to deliver gas above or below the body temperature, such as above or below the body temperature by, for example, 1°C, 2°C, 3°C, 4°C, 5°C, 6°C, 7°C, 8°C, 9°C, 10°C, or 15°C, or a range including any two of the foregoing values. It may also be desirable to deliver gas at a desired constant or variable humidity and / or at a desired constant or variable temperature. The gas at the desired gas temperature and / or humidity (sometimes referred to herein as standard) may be, for example, a dry cold gas, a dry hot gas, a humidified cold gas, or a humidified hot gas. Additionally, the gas delivered to the patient's body may be relatively dry, which may cause damage to the body cavity, such as cell death or adhesions. Often, a humidifier is operatively coupled to the insufflator. The device controller can energize a heater in a humidifier located in the gas flow path to provide humidifying fluid (eg, water) vapor to the gas stream before it enters the patient's body cavity.

[0007] The humidified gas may be delivered to the patient via additional tubing, which may also be heated. The insufflator and humidifier may be located in separate housings connected together via appropriate tubing and / or electrical connections, or may be located in a common housing arranged to be connected to a remote gas supply via appropriate tubing. Summary of the Invention [Problem to be solved by the invention]

[0008] During laparoscopic surgery, there is generally some form of electrosurgery, electrocautery, laser ablation or cauterization, or other type of energy to produce ablation or coagulation in the surgical cavity, e.g., the pneumoperitoneum in certain abdominal procedures. This generates surgical smoke that may increase in concentration over time in the sealed and pressurized surgical cavity, e.g., the peritoneum, especially in the absence of significant gas leakage or suction / irrigation. The smoke plume may rise and block the view. Additional smoke plumes may contact the scope or deposit particles on the scope. Smoke plumes contacting the scope may also cause fogging or condensation on the scope. In other words, high concentrations of smoke in the pneumoperitoneum and in the field of view may significantly impede optical clarity when viewing the intraperitoneal space through a lens inserted through a trocar. The trocar may include a cannula and an obturator. Without the use of evacuation or suction, the surgeon generally has no choice but to release a certain amount of gas from the pneumoperitoneum by degassing and then re-inflate. This can be inconvenient and can unnecessarily increase operating room and anesthesia time. Therefore, it can be useful to evacuate the smoke plume and smoke concentration, which can prevent or at least reduce condensation and / or fogging. Condensation can occur on various surfaces of the medical device. When condensation forms on a visible surface of the medical device, it is observed as a fogging effect that manifests as an impairment of visibility through a lens or any other visible surface of the medical device (e.g., a mirror or a transparent or translucent window, etc.). When condensation forms on various surfaces of the medical device, it can coalesce into water droplets. This can occur directly on the visible surface, or it can occur on other surfaces and then migrate to or be deposited on the visible surface. Thus, as used herein, condensation and / or fogging refers to condensation in general, and in some cases, condensation (ie, fogging) on ​​visible surfaces specifically.

[0009] In some configurations, the systems and methods disclosed herein can advantageously vent gases (and smoke plumes generated during electrosurgery, electrocautery, laser ablation or cauterization, or by other types of energy) from within the pneumoperitoneum, which can provide at least two benefits: diluting the smoke concentration within the pneumoperitoneum to improve visibility, and also reducing the amount of CO2 from the insufflator. 2 A constant flow of "clean" CO over / over the observation area can be ensured. 2 A flow of gas is generated, which carries away or displaces smoke that obstructs vision in the area between the lens and the surgical area. The evacuation flow rate may be related to the delivery flow rate. In one example, the evacuation rate (i.e., evacuation flow rate) may be set to achieve a specified pressure in the surgical site. In another explanation, the evacuation rate is such that the surgical cavity is maintained at a predetermined pressure rate. In some embodiments, the evacuation flow rate may be a predetermined flow rate. For example, the flow rate may be set by the user. The evacuation element used may be made or adjusted to achieve a predetermined flow rate. However, there may be a tradeoff when evacuation in terms of adversely affecting pneumoperitoneum stability and pressure.

[0010] In some configurations, the systems and methods can advantageously filter out harmful chemicals and biological particles from gases exhausted into an operating room. A growing concern in the surgical environment is the danger to surgical staff (and patients) from smoke generated during electrosurgery, electrocautery, laser ablation or cauterization, or other types of energy. Studies have shown that surgical smoke contains many chemicals and biological particles that can be harmful if inhaled by humans, potentially resulting in cancer or other health issues. Thus, in some cases, it can be advantageous to include an integrated smoke filter, or the ability to have a filter as a removable attachment at the exhaust outlet. Standards governing the filtration of surgical smoke in operating rooms are still being developed and implemented around the world, with the most stringent of these standards specifying filtration of particles down to about 0.1-0.2 microns with 99.999% efficiency. In some embodiments, filters can be used that may include ULPA filters that filter 0.12 microns and smaller with 99.9995% efficiency or greater, possibly in addition to a carbon filter stage for odor removal. Both smoke filtration and removal can be combined in several different ways. [Means for solving the problem]

[0011] The present disclosure provides examples of cannulas having one, two, or more than two lumens configured to evacuate gases, including smoke, from a surgical cavity that can address the aforementioned and / or other challenges. The cannulas can be single-use (disposable) or reusable. Alternatively, parts of the cannulas can be single-use (disposable) or reusable. The cannulas may be made of biocompatible and / or sterilizable materials. In the present disclosure, features of different examples of evacuation cannulas can be incorporated or combined with each other.

[0012] In some aspects, disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, the surgical cannula including a cannula upper housing and an elongate shaft extending from the cannula upper housing. The cannula upper housing and the elongate shaft include a first lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet. The first lumen is configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft. The first lumen inlet is in fluid communication with a source of insufflation gas. The cannula upper housing and the elongate shaft include a second lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust gas out of the surgical cavity through the second lumen outlet. The second lumen is in fluid communication with an exhaust element operatively connected to the surgical cannula.

[0013] In some configurations, the first lumen and the second lumen are at least partially or completely nested within one another or are concentric with one another.

[0014] In some configurations, the first lumen is radially offset relative to the second lumen, or the second lumen is radially offset relative to the first lumen.

[0015] In some configurations, the second lumen includes a diameter that is greater than, less than, or equal to the diameter of the first lumen.

[0016] In some configurations, the evacuation element is configured to provide passive evacuation caused by a pressure differential relative to the surgical cavity.

[0017] In some configurations, the first lumen inlet is configured to connect with a gas source outlet. In some configurations, the first lumen inlet is configured to connect with a gas source outlet.

[0018] In some configurations, the first lumen or the second lumen includes one or more positioning ribs, e.g., at least two, three, or more positioning ribs, configured to position and / or retain the other of the first lumen or the second lumen.

[0019] In some configurations, the positioning rib is integrally formed with an inner wall of the first lumen or the second lumen.

[0020] In some configurations, the first lumen includes a cross-sectional area that is greater than, less than, or equal to the cross-sectional area of ​​the second lumen.

[0021] In some configurations, the second lumen includes one of a semicircular, a crescent, or an arcuate profile.

[0022] In some configurations, the first lumen includes a circular profile.

[0023] In some configurations, the second lumen includes a spiral shape that at least partially circumscribes the first lumen.

[0024] In some configurations, the first lumen is configured to accommodate a medical device within the first lumen.

[0025] In some configurations, the cannula further includes a third lumen, the third lumen configured to accommodate a medical device therein.

[0026] In some configurations, the cannula also includes one or more filters in fluid communication with the second lumen.

[0027] In some configurations, the filter is contained within a drainage element that is removably coupled to the cannula upper housing.

[0028] In some configurations, the evacuation element is removably coupled to the cannula upper housing by a clip.

[0029] In some configurations, the filter is integrally formed with the cannula upper housing and / or the second lumen.

[0030] In some configurations, the filter is located within the cannula upper housing.

[0031] In some configurations, the filter is operatively connected to a conduit that is connected to the proximal end of the cannula upper housing.

[0032] In some configurations, the outlet of the second lumen is angled relative to a longitudinal axis of the cannula top housing.In some configurations, the outlet of the second lumen is angled relative to a longitudinal axis of the cannula top housing.

[0033] In some configurations, the second lumen exit angle is about 45 degrees.In some configurations, the second lumen exit angle is about 45 degrees.

[0034] In some configurations, the cannula also includes a seal configured to seal against the medical instrument, the seal being located within the cannula upper housing and aligned with at least one of the first lumen and the second lumen.

[0035] In some configurations, the seal is a duckbill seal or a flap seal.

[0036] In some configurations, disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, the surgical cannula including a cannula top housing and an elongate shaft extending from the cannula top housing. The cannula top housing and the elongate shaft include a lumen configured to receive insufflation gas from an inlet in the cannula top housing and deliver the insufflation gas to the surgical cavity near a distal end of the elongate shaft. The lumen inlet is in fluid communication with a source of insufflation gas. The lumen is also configured to receive gas from the surgical cavity and evacuate gas from the surgical cavity out of the surgical cavity. The cannula also includes an evacuation element in fluid communication with the lumen. The evacuation element further includes a filter configured to filter gas from the surgical cavity before the gas from the surgical cavity is evacuated from the surgical cannula.

[0037] In some configurations, the evacuation element is integrated into the cannula upper housing and / or lumen.

[0038] In some configurations, the lumen includes a wall extending partially axially along the lumen, the wall configured to divide the lumen into a first passageway configured to deliver insufflation gas to the surgical cavity and a second passageway configured to evacuate gas from the surgical cavity.

[0039] In some configurations, the first passageway is concentric with, offset from, and / or fluidly isolated from the second passageway.

[0040] In some configurations, the evacuation element is removably attached to the cannula upper housing.

[0041] In some configurations, the evacuation element further includes a first locking mechanism configured to lock the evacuation element to a second complementary locking mechanism on the cannula upper housing.

[0042] In some configurations, the first locking mechanism creates a seal between the evacuation element and the cannula upper housing when the first locking mechanism is locked to the second locking mechanism.

[0043] In some configurations, the evacuation element also includes at least one evacuation aperture, and the filter is disposed adjacent to the evacuation aperture and configured such that gas from the surgical cavity passes through the filter and exits through the at least one evacuation aperture.

[0044] In some configurations, the cannula also includes multiple evacuation apertures, and evacuation of gas from the surgical cavity occurs passively due to the pressure differential between the surgical cavity and the surrounding air.

[0045] In some configurations, the exhaust element also includes an exhaust valve, for example a solenoid valve.

[0046] In some configurations, the evacuation element also includes one or more sensors configured to sense at least one of temperature, pressure, and humidity.

[0047] In some configurations, the drainage element also includes a built-in heating element configured to heat a portion of the filter to prevent condensation on the filter.

[0048] In some configurations, the evacuation element also includes fins that extend into the cannula upper housing and are positioned adjacent the gas inlet port to guide the flow of insufflation gas from the gas inlet port.

[0049] In some configurations, also disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, the surgical cannula including a cannula top housing, an elongate shaft extending from the cannula top housing, and a first filter and a second filter in fluid communication with a second lumen, the second filter being distally spaced from the first filter. The cannula top housing and the elongate shaft may include a first lumen including an inlet and an outlet. The cannula top housing and the elongate shaft may include a first lumen including a first lumen inlet and a first lumen outlet. The first lumen may be configured to receive insufflation gas from an inlet of the cannula top housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft. The first lumen inlet is in fluid communication with a source of insufflation gas. The cannula upper housing and the elongate shaft may include a second lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft may include a second lumen including a second lumen inlet and a second lumen outlet. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust gas out of the surgical cavity through the second lumen outlet. The second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula. The first filter is contained within the evacuation element removably coupled to the cannula upper housing.

[0050] In some configurations, the second filter is disposed distal to the first filter and includes a sidewall gas exhaust outlet port.

[0051] In some configurations, a second filter is also disposed within the cannula upper housing.

[0052] In some configurations, disclosed herein is a cannula for supplying insufflation gas to and evacuating gas from a surgical cavity. The cannula may include a cannula upper housing and an elongate shaft extending from the cannula upper housing. The cannula upper housing and the elongate shaft include a first lumen including an inlet and an outlet, the first lumen configured to receive insufflation gas from the inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft. The first lumen inlet is in fluid communication with a source of insufflation gas. The cannula upper housing and the elongate shaft include a second lumen including an inlet and an outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and evacuate gas through the second lumen outlet. The second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula. The cannula further includes a blower unit in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit, the blower unit configured to aspirate gas from the surgical cavity into the second lumen. The cannula may further include or be connected to one or more suction units configured to aspirate gas from the surgical cavity into the second lumen. The cannula may further include or be connected to a humidifier or heater configured to humidify or heat gas delivered to the first lumen.

[0053] In some configurations, the blower drive unit includes a magnetic circular ring.

[0054] In some configurations, also disclosed herein is a multi-cannula surgical cannula system for supplying insufflation gas to a surgical cavity and for recirculating filtered insufflation gas to the surgical cavity. The cannula system includes a first cannula having a first lumen configured to accommodate a first medical device within the first lumen, a second lumen, a blower unit in fluid communication with the second lumen, and at least one filter in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit configured to draw gas from the surgical cavity into the second lumen, the second lumen receiving the drawn gas from the surgical cavity. and a second cannula including a first lumen configured to accommodate a second medical device within the first lumen and a second lumen configured to be in fluid communication with the second lumen of the first cannula via the conduit, the second lumen of the second cannula configured to recirculate filtered insufflation gas to the surgical cavity.

[0055] In some configurations, at least one of the first cannula and the second cannula further includes an insufflation gas inlet connectable to a source of insufflation gas.

[0056] In some configurations, also disclosed herein is a surgical cannula system for supplying insufflation gas to a surgical cavity and for recirculating filtered insufflation gas to the surgical cavity. The cannula system includes a cannula including a first lumen configured to accommodate a first medical device within the first lumen, a second lumen, a blower unit in fluid communication with the second lumen, and at least one filter in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit, the blower unit configured to aspirate gas from the surgical cavity into the second lumen, the second lumen configured to receive aspirated gas from the surgical cavity. The cannula further includes a third lumen in communication with the second lumen of the first cannula through the at least one filter, the third lumen configured to recirculate filtered insufflation gas to the surgical cavity. The cannula may further include an insufflation gas inlet connectable to a source of insufflation gas.

[0057] In some configurations, also disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity. The cannula includes a cannula upper housing and an elongate shaft extending from the cannula upper housing. The cannula upper housing and the elongate shaft include a first lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft may include a first lumen including a first lumen inlet and a first lumen outlet. The first lumen may be configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft. The first lumen inlet is in fluid communication with a source of insufflation gas. The cannula upper housing and the elongate shaft include a second lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft may include a second lumen including a second lumen inlet and a second lumen outlet. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and to vent gas through the second lumen outlet. The second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula. The cannula further includes a control operatively connected to a seal proximate the second lumen outlet. The control has an inactivated state and an activated state, the control in the activated state causing the seal to open and allowing venting of gas through the second lumen outlet.

[0058] In some configurations, the control may include a button.

[0059] In some configurations, also disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity. The cannula includes a cannula upper housing and an elongate shaft extending from the cannula upper housing. The cannula upper housing and the elongate shaft include a first lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft may include a first lumen including a first lumen inlet and a first lumen outlet. The first lumen may be configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft. The first lumen inlet is configured to be in fluid communication with a first source of insufflation gas via a first conduit and with a second source of insufflation gas via a second conduit. The cannula upper housing and the elongate shaft include a second lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and exhaust gas through the second lumen outlet. The second lumen is in fluid communication with an exhaust element operatively connected to the surgical cannula. The second source of insufflation gas is a high pressure insufflation gas source configured to create a pressure differential sufficient to draw smoke from the surgical cavity into the second lumen via a Venturi effect.

[0060] In some configurations, the cannula includes one or more heating elements disposed within the cannula.

[0061] In some configurations, the heating element is disposed within the gas delivery lumen and / or exhaust path and extends some distance along the gas delivery lumen and / or exhaust path.

[0062] In some configurations, a heating element may be disposed within the shaft and in thermal communication with the evacuation element The heating element is used to prevent condensation and / or fogging of the evacuation cannula.

[0063] In some configurations, further disclosed herein is a surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity. The cannula includes a cannula upper housing and an elongate shaft extending from the cannula upper housing. The cannula upper housing and the elongate shaft include a first lumen including an inlet and an outlet. The cannula upper housing and the elongate shaft may include a first lumen including a first lumen inlet and a first lumen outlet. The first lumen may be configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas. The cannula upper housing and the elongate shaft include a second lumen including an inlet and a plurality of outlets. The cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a plurality of second lumen outlets. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and exhaust gas through the second lumen outlet. The second lumen may be configured to receive gas from the surgical cavity through the second lumen inlet and exhaust gas through the plurality of second lumen outlets. The second lumen is in fluid communication with an exhaust element operatively connected to the surgical cannula. The cannula upper housing is configured to connect to a rotatable proximal cap including a screw thread and a plurality of circumferentially oriented slots, the slots configured to block or at least partially allow exhaust from the plurality of outlets of the second lumen upon rotation of the rotatable cap to control the exhaust rate of gas. The cannula upper housing is configured to connect to a rotatable proximal cap including threads and a plurality of circumferentially oriented slots configured to block or at least partially allow exhaust from the plurality of second lumen outlets upon rotation of the rotatable cap to control the exhaust rate of gas.

[0064] These and other features, aspects, and advantages of the present disclosure will be described with reference to drawings of certain embodiments that are intended to illustrate certain embodiments in a schematic manner and not to limit the disclosure. In some cases, "slices" are shown for purposes of clarity in some cross-sectional and transverse views of a three-dimensional cannula. Those skilled in the art will understand that these views show slices of a three-dimensional cannula. In some cases, protrusion surfaces are not shown for purposes of clarity. For example, protrusion hole surfaces are not shown in some views. [Brief description of the drawings]

[0065] [Figure 1] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Diagram 2] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Figure 3A] FIG. 1 shows a perspective view of a dual concentric lumen cannula including a removable filter and seal. [Figure 3B] 1 shows an exploded longitudinal cross-sectional view of a dual concentric lumen cannula including a removable filter and seal. [Figure 3C] A cross-sectional view of the seal housing is shown. [Figure 4] FIG. 4 illustrates an unexploded cross-sectional view of the evacuation cannula embodiment shown in FIGS. 3A and 3B including dual concentric lumens. [Figure 5A] FIG. 13 is an exploded view of another embodiment of a cannula including a drainage element including a removable filter and a seal. [Figure 5B] 5B shows a cross-sectional view of an exploded embodiment of the cannula 400 of FIG. 5A. [Figure 6] FIG. 5C shows a cross-sectional view of the cannula of FIGS. 5A-B. [Figure 6A] FIG. 13 is an isometric view of another embodiment of a cannula that may include multiple spaced apart filter elements. [Figure 7A] 1 shows the proximal end of a cannula including an evacuation element having an evacuation aperture. [Figure 7B] FIG. 7B is a cross-sectional view taken along line 7B-7B of FIG. 7A. [Figure 7C] 1 illustrates an embodiment of a drainage valve that may be utilized with the drainage cannula. [Figure 7D] 1 illustrates an embodiment of a drainage valve that may be utilized with the drainage cannula. [Figure 7E] 1 illustrates an embodiment of a drainage valve that may be utilized with the drainage cannula. [Figure 8A] 13 illustrates additional mechanical / passive drainage embodiments that may be included in the drainage cannula, which may or may not include a valve. [Figure 8B] 13 illustrates additional mechanical / passive drainage embodiments that may be included in the drainage cannula, which may or may not include a valve. [Figure 8C] 13 illustrates additional mechanical / passive drainage embodiments that may be included in the drainage cannula, which may or may not include a valve. [Figure 8D] 13 illustrates additional mechanical / passive drainage embodiments that may be included in the drainage cannula, which may or may not include a valve. [Figure 9A] 1A-1C show diagrams of an embodiment of a drainage cannula that may include an electrical drainage feature. [Figure 9B] 1A-1C show diagrams of an embodiment of a drainage cannula that may include an electrical drainage feature. [Figure 10A] 13 shows an additional example of a separate arrangement of power sources for the electrical components of the evacuation cannula; [Figure 10B] 13 illustrates additional example connection configurations of a power source to electrical elements of the evacuation cannula; [Figure 11A] A cross-sectional view of one embodiment of a dual lumen drainage cannula 1100 is shown. [Figure 11B] A cross-sectional view of one embodiment of a dual lumen drainage cannula 1100 is shown. [Figure 12A] 13 shows an exploded view of another embodiment of a cannula including a drainage element that includes a removable filter and a seal. [Figure 12B] 13 shows an exploded view of another embodiment of a cannula including a drainage element that includes a removable filter and a seal. [Figure 13]FIG. 14 illustrates an unexploded longitudinal cross-sectional view of the evacuation cannula embodiment shown in FIGS. 12A and 12B, including dual offset non-concentric lumens. [Figure 14] 13 shows an unexploded longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula. [Figure 14A] FIG. 13 shows a longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula that may include a first port and a second port. [Figure 14B] 1 shows a longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula, which may include a first port and a second port in a sidewall of the cannula elongate shaft. [Figure 15A] 1 shows the proximal end of a cannula including an evacuation element having an evacuation valve. [Figure 15B] FIG. 15B is an enlarged view of FIG. 15A showing the valve relative to the flow path of the second lumen across the valve. [Figure 15C] FIG. 15C is a cross-sectional view taken along line 15C-15C of FIG. 15A. [Figure 16] 13A-13C are schematic diagrams illustrating additional mechanical / passive drainage embodiments that may be included within the drainage cannula. [Figure 17A] 1 illustrates an embodiment of a drainage cannula that may include an electrical drainage feature. [Figure 17B] 1 illustrates an embodiment of a drainage cannula that may include an electrical drainage feature. [Figure 17C] 1 illustrates an embodiment of a drainage cannula that may include an electrical drainage feature. [Figure 18] FIG. 1 illustrates a longitudinal cross-sectional view of one embodiment of an offset dual lumen drainage cannula. [Figure 19A] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 19B] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 19C] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 20A]1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 20B] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 20C] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 20D] 1 illustrates various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. [Figure 21A] 13 shows an exploded view of another embodiment of a cannula including a drainage element that includes a removable filter and a seal. [Figure 21B] 13 shows an exploded view of another embodiment of a cannula including a drainage element that includes a removable filter and a seal. [Figure 22] FIG. 22 illustrates an unexploded longitudinal cross-sectional view of the evacuation cannula embodiment shown in FIGS. 21A and 21B. [Figure 23A] 1 shows the proximal end of a cannula including an evacuation element having an evacuation aperture as described above. [Figure 23B] FIG. 23B is an enlarged view of FIG. 23A. [Figure 24] 13A-13C are schematic diagrams illustrating additional mechanical / passive drainage embodiments that may be included within the drainage cannula. [Figure 25A] 1 illustrates an embodiment of a single lumen drainage cannula that may include an electrical drainage feature. [Figure 25B] 1 illustrates an embodiment of a single lumen drainage cannula that may include an electrical drainage feature. [Figure 25C] 25C is a cross-sectional view taken along line 25C-25C of FIG. 25A. [Figure 26A] 1 illustrates a cross-sectional view of one embodiment of a dual lumen drainage cannula. [Figure 26B] 1 illustrates a cross-sectional view of one embodiment of a dual lumen drainage cannula. [Figure 27A] FIG. 13 shows another embodiment of the evacuation cannula including a blower unit. [Figure 27B]FIG. 13 shows another embodiment of the evacuation cannula including a blower unit. [Figure 27C] FIG. 13 shows another embodiment of the evacuation cannula including a blower unit. [Figure 28] FIG. 1 is a longitudinal cross-sectional view of one embodiment of a multi-cannula system configured to recirculate clean insufflation gas, e.g., carbon dioxide, through a secondary cannula. [Figure 29] FIG. 1 is a longitudinal cross-sectional view of one embodiment of a cannula system configured to recirculate clean insufflation gas through a single cannula. [Figure 30A] 1 illustrates a cross-sectional view of an embodiment of a cannula including a plunger feature configured to remove smoke upon actuation of the plunger. [Figure 30B] 1 illustrates a cross-sectional view of an embodiment of a cannula including a plunger feature configured to remove smoke upon actuation of the plunger. [Figure 30C] 1 illustrates a cross-sectional view of an embodiment of a cannula including a plunger feature configured to remove smoke upon actuation of the plunger. [Figure 31A] FIG. 1 shows a partial cutaway perspective view of a cannula configured for high pressure venturi evacuation of gas, smoke, and other unwanted materials from a surgical pneumoperitoneum cavity. [Figure 31B] FIG. 31B is a longitudinal cross-sectional view of the cannula of FIG. 31A. [Figure 32A] FIG. 1 shows an isometric view of a drainage cannula having drainage control features. [Figure 32B] FIG. 1 shows a cross-sectional view of a drainage cannula having drainage control features. [Figure 33A] Illustrated is an embodiment of a filter element that is not necessarily incorporated into the cannula itself, but rather may reside in a conduit proximal to the proximal end of the cannula upper housing of the cannula. [Figure 33B] Illustrated is an embodiment of a filter element that is not necessarily incorporated into the cannula itself, but rather may reside in a conduit proximal to the proximal end of the cannula upper housing of the cannula. [Figure 33C]Illustrated is an embodiment of a filter element that is not necessarily incorporated into the cannula itself, but rather may reside in a conduit proximal to the proximal end of the cannula upper housing of the cannula. [Figure 33D] Illustrated is an embodiment of a filter element that is not necessarily incorporated into the cannula itself, but rather may reside in a conduit proximal to the proximal end of the cannula upper housing of the cannula. [Figure 34A] 13A-13C show cross-sectional, unexploded views of a drainage cannula embodiment and obturator. [Figure 34B] FIG. 34B illustrates an unexploded cross-sectional view of the evacuation cannula embodiment of FIG. 34A with the obturator removed. [Figure 35A] 1 illustrates a cross-sectional view of an evacuation cannula configured to receive a surgical instrument and form a portion of an inner lumen wall of a multiple lumen cannula. [Figure 35B] 1 illustrates a cross-sectional view of an evacuation cannula configured to receive a surgical instrument and form a portion of an inner lumen wall of a multiple lumen cannula. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0066] Although specific embodiments and examples are described below, those skilled in the art will recognize that the disclosure extends beyond the specifically disclosed embodiments and / or uses and obvious modifications and equivalents thereof, and therefore it is not intended that the scope of the disclosure disclosed herein should be limited by any specific embodiments described below.

[0067] Exemplary Medical Gas Delivery System For example, gas can be introduced into a surgical cavity, such as the peritoneal cavity, via a cannula inserted through an incision made in the patient's body (e.g., abdominal wall, etc.). The cannula can be coupled to an insufflator. Gas flow from the insufflator can be increased to inflate the surgical cavity (e.g., to maintain pneumoperitoneum, a gas-filled cavity within the abdomen, etc.). The introduced gas can inflate the surgical cavity. A medical instrument can be inserted into the inflated surgical cavity through the cannula. The medical instrument can be a surgical instrument. For example, an endoscope can be inserted into the cavity, and visibility within the cavity can be aided by the insertion of a fluid, including a gas, such as air or carbon dioxide, or a liquid. After initial insufflation through the main cannula and insertion of an instrument (e.g., laparoscope, etc.), additional cannulas can be inserted into the surgical cavity under laparoscopic observation. At the end of the surgical procedure, all instruments and cannulas are removed from the surgical cavity, the gas or liquid is released, and each incision is closed. For thoracoscopy, colonoscopy, sigmoidoscopy, gastroscopy, bronchoscopy, and / or others, the same or substantially similar procedures can be followed to introduce gas into the surgical cavity. The amount and flow of gas or liquid can be controlled by the clinician performing the examination and / or automatically by the surgical system. The surgical system can be an insufflation system. The insufflator can deliver intermittent or continuous flow. The insufflator can control the flow to ensure that the pressure in the surgical cavity is maintained at or about a predetermined range. The pressure allows the pneumoperitoneum cavity to be inflated to a predetermined amount.

[0068] Figures 1 and 2 show diagrammatically the use of an exemplary surgical system 1 during a medical procedure. The features of Figures 1 and 2 may be incorporated into one another. In Figures 1 and 2, like features have like reference numbers. As shown in Figure 1, a patient 2 may have a cannula 15 inserted into a cavity of the patient 2 (e.g., the abdomen of the patient 2 in the case of laparoscopic surgery), as described above.

[0069] As shown in FIGS. 1 and 2, a cannula 15 may be connected to a gas delivery conduit 13 (e.g., via a Luer lock connector 4). The cannula 15 may be used to deliver gas to a surgical site, such as, for example, within a cavity of a patient 2. The cannula 15 may include one or more passages for introducing gas and / or one or more surgical instruments 20 into the surgical cavity. The surgical instruments may be a scope, an electrocautery instrument, or any other instrument. The surgical instruments 20 may be coupled to an imaging device 30, which may have a screen. The imaging device 30 may be part of a surgical system, which may include multiple surgical instruments and / or devices. The surgical system may be a surgical stack.

[0070] The system may also include a drainage cannula 22. The drainage cannula 22 may have substantially the same features as the cannula 15. The drainage cannula may include a valve to allow drainage. The valve may be controlled automatically by a controller associated with the gas source (i.e., insufflator) or by a controller of the humidifier. A controller may be associated with both the gas source (e.g., insufflator) and the humidifier. The controller associated with the gas source and / or humidifier may be external to the gas source and / or humidifier. The controller may also be located internally within the cannula. The valve may also be manually actuated (e.g., by turning a stopcock by hand or with a foot pedal or other technique). The drainage cannula 22 may be coupled to a filtration system for filtering smoke and the like. Alternatively, the drainage cannula 22 may also be coupled to a recirculation system configured to recirculate gas from the surgical cavity to the insufflator for redelivery to the surgical cavity. The gas may be filtered and / or dehumidified before being returned to the insufflator.

[0071] The gas delivery conduit 13 may be made of flexible plastic and may be connected to the humidifier chamber 5. Optionally or preferably, the humidifier chamber 5 may be connected in series to the gas supply 9 via a further conduit 10. The gas supply or gas source may be an insufflator, a bottled gas, or a wall gas source. The gas supply 9 may provide gas without humidification and / or heating. A filter 6 may be connected downstream of the outlet 11 of the humidifier. The filter 6 may also be located along the further conduit 10 or at the inlet of the cannula 15. The filter 6 may be configured to filter out pathogens and particulate matter to reduce infection or contamination of the surgical site by the humidifier or gas source. The gas supply may provide a continuous or intermittent flow of gas. The further conduit 10 may also preferably be made of flexible plastic tubing.

[0072] A gas supply 9 may provide one or more insufflation gases, such as carbon dioxide, to the humidifier chamber 5. The gases may be humidified as they pass through the humidifier chamber 5, which may contain a quantity of humidification fluid 8, such as water. The gases may also be humidified in the humidifier chamber 5, which may be heated or unheated.

[0073] A humidifier incorporating the humidifier chamber 5 may be any type of humidifier. The humidifier chamber 5 may include a chamber formed of plastic having a metal or other conductive bottom 14 sealed thereto. In use, the bottom may be in contact with a heater plate 16. A quantity of humidification fluid 8 (e.g. water) contained within the chamber 5 may be heated by the heater plate 16. The heater plate 16 may be under the control of a humidifier controller or control means 21. The quantity of humidification fluid 8 within the chamber 5 may be heated so as to evaporate and mix the humidification fluid vapor with gas flowing within the chamber 5, heating and humidifying the gas.

[0074] The controller or control means 21 may be housed in the humidifier base unit 3. The humidifier base unit 3 may also house the heater plate 16. The heater plate 16 may have an electric heating element in or in thermal contact with the heater plate 16. One or more insulating layers may be located between the heater plate 16 and the heater element. The heater element may be a base element (or core) on which a wire is wound. The wire may be a nichrome wire (or nickel chrome wire). The heater element may also include a multi-layer substrate on which heating tracks are electro-deposited or etched. The controller or control means 21 may include electronic circuitry that may include a microprocessor for controlling the supply of energy to the heating element. The humidifier base unit 3 and / or the heater plate 16 may be removably engageable with the humidifier chamber 5. Alternatively or additionally, the humidifier chamber 5 may also include a built-in heater.

[0075] The heater plate 16 may include a temperature sensor, such as a temperature transducer or otherwise, that may be in electrical communication with the controller 21. The heater plate temperature sensor may be located in the humidifier base unit 3. The controller 21 may monitor the temperature of the heater plate 16, which may estimate the temperature of the humidification fluid 8. The humidification fluid may be water.

[0076] A temperature sensor may also be located at or near the outlet 11 to monitor the temperature of the humidified gas exiting the humidifier chamber 5 from the outlet 11. The temperature sensor may also be connected (e.g., by cable or wirelessly) to the controller 21. Additional sensors may also be incorporated to detect properties of the gas (e.g., temperature, humidity, flow, or other such) at the patient end of the gas delivery conduit 13.

[0077] Gas may exit through the humidifier outlet 11 and enter the gas delivery conduit 13. Gas may pass through the gas delivery conduit 13 and enter the surgical cavity of the patient 2 via the cannula 15, thereby expanding the cavity and maintaining pressure within the cavity. Preferably, the gas exiting the outlet 11 of the humidifier chamber 5 may have a relative humidity of up to 100%, for example the relative humidity may be 100%. As the gas travels along the gas delivery conduit 13 further condensation and / or fogging may occur, so that humidification fluid vapor may condense on the walls of the gas delivery conduit 13. The humidification fluid may be water. Further condensation and / or fogging may have undesirable effects, such as, for example, adversely reducing the fluid content of the gas delivered to the patient. To reduce and / or minimize the occurrence of condensation and / or fogging in the gas delivery conduit 13, a heater wire 14 may be provided in, throughout, or around the gas delivery conduit 13. To power the heater wire 14, the heater wire 14 may be electronically connected to the humidifier base unit 3, for example, by an electrical cable 19. In some embodiments, other heating elements may additionally or alternatively be included, for example, conductive ink or a flexible PCB. The heating elements may include induction heating elements. The heating elements may include chemical heating elements, for example, including, but not limited to, silica beads. The cannula may be preheated prior to insertion.

[0078] The heater wire 14 may include insulated copper alloy resistance wire, other types of resistance wire, or other heater elements, and / or may be made of any other suitable material. The heater wire may be a straight or spirally wound element. The electrical circuit including the heater wire 14 may be located within the wall of the gas delivery tube 13. The gas delivery tube 13 may be a helically wound tube. Alternatively, the gas delivery tube 13 may include a non-helical or straight tube. The gas delivery tube 13 may be corrugated or non-corrugated. The heater wire 14 may be helically wound around an insulating core of the gas delivery conduit 13. The insulating coating around the heater wire 14 may include a thermoplastic material. The thermoplastic material may be in a state where it can change its shape when heated to a predetermined temperature, and upon cooling, the new shape may be substantially elastically retained. The heater wire 14 may be wound into a single or double helical winding. Measurements by the temperature sensor and / or additional sensors at the patient end of the conduit 13 may provide feedback to the controller 21 so that the controller 21 may energize the heater wire to raise and / or maintain the temperature of the gas in the gas delivery conduit 13 (e.g., to about 35° C.-45° C.). Thus, the gas is delivered to the patient at a desired temperature, which may be at or near 37° C., or above or below body temperature (e.g., about 5, 10, or 15 degrees above or below 37° C.). Alternatively or additionally, the system may include additional sensors configured to measure one or more parameters, such as an ambient temperature sensor and an ambient humidity sensor, and / or a flow sensor, and / or a pressure sensor configured to determine flow rate or flow pressure or to determine intraluminal or intratubal pressure. Additionally or alternatively, the system may also include additional sensors. The sensors may be located upstream of the humidifier, downstream of the humidifier, and / or within the humidifier. The sensor may be configured to determine one or more parameters of the insufflation gas or the patient / surgical cavity.Each sensor can provide feedback information to one or more controllers, which can further provide closed-loop feedback to maintain the humidity, temperature, flow, pressure, or other parameters at desired parameters, e.g., within preset ranges.

[0079] The controller or control means 21 may include, for example, a microprocessor or logic circuit with an associated memory or storage means capable of holding a software program. When executed by the control means 21, the software may control the operation of the surgical system 1 according to the set of instructions in the software and / or in response to external inputs. The surgical system may be an air delivery system. For example, an input may be provided to the controller or control means 21 from the heater plate 16 such that the controller or control means 21 may be provided with information regarding the temperature and / or power usage of the heater plate 16. An input of the temperature of the gas flow may be provided to the controller or control means 21. For example, a temperature sensor may provide an input indicative of the temperature of the humidified gas flow as the gas leaves the outlet 11 of the humidifier chamber 5. A flow sensor may also be provided at or near the same location as the temperature sensor or at another suitable location within the surgical system 1. The controller 21 may control a flow controller that regulates the flow rate of the gas within the system 1. The controller may be a flow regulator. The controller may include a flow inducer and / or an inhibitor, such as, for example, a powered fan. Additionally or alternatively, valves and / or vents may be used to control the flow rate of the gas.

[0080] A patient input 18 located on the humidifier base unit 3 may allow a user (e.g., a surgeon or nurse) to set the desired gas temperature and / or gas humidity level to be delivered. Other functions may also be controllable by the user input 18, such as control of the heating delivered by the heater wire 14. A controller 21 may control the system 1, and in particular, the flow rate, temperature, and / or humidity of the gas delivered to the patient, as appropriate for the type of medical procedure for which the system 1 is being used.

[0081] The humidifier base unit 3 may also include a display for displaying to a user the characteristics of the gas flow being delivered to the patient 2 .

[0082] Although not shown, the humidifier may also be a pass-over or bypass type humidifier that may include a chamber with a volume of water or any other type of humidifying fluid, but may not include a heater plate for heating the humidifying fluid. The chamber may be in fluid communication with a gas supply such that the insufflation gas is humidified by humidifying fluid vapor siphoned off from the volume of humidifying fluid as the insufflation gas passes over the volume of humidifying fluid.

[0083] In use, the humidifiers described above may be located outside the "operating sterile zone" and / or adjacent to the insufflator. As a result, medical personnel do not need to touch the humidifier when moving the cannula to manipulate medical instruments within the surgical cavity during surgery. The humidifier may not need to be as sterile as the medical instruments. Additionally, a humidifier located outside the "operating sterile zone" reduces obstacles to medical personnel that may limit the movement of medical personnel and / or medical instruments within an already crowded space during a surgical procedure.

[0084] Example of a drainage cannula During laparoscopic surgery, there is typically some form of electrosurgery, electrocautery, laser ablation or cauterization, or other type of energy to cause ablation or coagulation within the insufflated cavity. This creates surgical smoke that can build up in concentration over time within the sealed and pressurized peritoneal or other cavity, especially in the absence of significant gas leakage or suction / irrigation. Smoke plumes are also often created during these surgeries / procedures. The smoke plume may engulf the scope or cross the scope, limiting the surgeon's view. Smoke removal and smoke plume removal helps improve optical clarity during surgery, making surgery safer, faster, and more efficient. High concentrations of smoke within the insufflated cavity and field of view can significantly impede optical clarity when viewing the intraperitoneal space through a lens inserted through a trocar. The lens may be connected to a camera, for example, located outside the surgical cavity. Without the use of evacuation or suction, the surgeon generally has no choice but to evacuate all of the gas from the pneumoperitoneum by desufflation and then re-insufflation.

[0085] The present disclosure provides examples of cannulas that can be used as the cannulas 15 disclosed herein and include drainage and filtering features to increase the optical clarity of the surgical cavity without the need for additional components or instruments or time-intensive de-airing and re-insufflation procedures as described above. The exemplary drainage cannulas disclosed herein can be implemented into existing surgical systems without the need for custom and / or more expensive surgical systems. The surgical system may be an insufflation system. Thus, the exemplary drainage cannulas disclosed herein can improve the optical clarity of the lens and / or maintain clear vision, which can help minimize post-operative complications including, but not limited to, surgical time and pain, and / or make it easier for medical personnel, such as surgeons, to manipulate the scope during a medical procedure. The cannulas 22 as described above can be utilized as drainage cannulas or can be modified for use as drainage cannulas. In some embodiments, a cannula having a drainage passageway and a gas delivery passageway may be advantageous. This is because a cannula having an evacuation passageway and a gas delivery passageway provides a single device that can be used to deliver gas and to evacuate smoke and other gases from the pneumoperitoneum, thereby helping to maintain clear vision.

[0086] In some embodiments, the surgical cannula includes a housing, an elongate shaft extending from the housing, and at least one lumen within the elongate shaft. The cannula may include a gripping feature for gripping the surgical cavity. The housing may include one or more seals / valves disposed adjacent the instrument opening. The seals / valves are configured to seal against an instrument inserted through the instrument opening. A gas inlet is disposed on the housing or shaft. The gas inlet may be in fluid communication with the lumen and receive gas from either a humidifier or an insufflator. The surgical cannula may include other features, such as an external seal, and may include either a flat (e.g., square) tip or an angled (e.g., beveled) tip. As described, any number of drainage features disclosed elsewhere herein may be incorporated into the cannula.

[0087] In some embodiments, the exemplary evacuation cannula may have any of the features of the cannula 15. For example, the evacuation cannula may have a cannula top housing 102 connected to an elongate shaft 104. The elongate shaft 104 may have a tapered end so that the cannula may function as a trocar to more easily insert the cannula 100 into the surgical cavity. To more easily insert a medical instrument, the cannula top housing 102 may have a cross-sectional dimension that is larger than the elongate shaft 104. As shown in FIG. 2, the cannula top housing 102 may have a generally funnel shape that decreases in cross-sectional dimension (e.g., diameter) from a position distal to the elongate shaft 104 to a position proximal to the elongate shaft 104. The gas inlet 106 may be located in the cannula top housing 102. The cannula top housing 102 may include a cavity. The elongate shaft 104 may include a hollow passage. The cavity and the hollow passage may be in fluid communication. The evacuation cannula may include a heating element removably coupled to or embedded in the evacuation cannula (e.g., via a sleeve) (e.g., at least a portion of the cannula upper housing 102 and / or a portion of the elongate shaft 104). The evacuation cannula may include an evacuation element that includes a filter removably coupled to or embedded in the cannula. The heating element may be positioned to contact the filter or extend into the filter.

[0088] A surgical system for supplying insufflation gas to a surgical cavity, such as any of the surgical systems (e.g., insufflation systems) disclosed above, can incorporate any of the exemplary evacuation cannulas disclosed herein. As described above, the system can include a gas supply configured to provide insufflation gas, a humidifier in fluid communication with the gas supply and configured to humidify the insufflation gas received from the gas supply, and a gas delivery tube extending between the humidifier and the cannula and in fluid communication with the humidifier and the cannula, respectively. The gas delivery tube can also be in electrical communication with the humidifier and the cannula, respectively. When the system is in use, the gas delivery tube can direct the insufflation gas to the surgical cannula and can direct an electrical current from the humidifier to a heating element in the cannula. The heating element can be configured to transfer heat to the insufflation gas passing through the cannula and / or a portion of a medical device inserted into and / or removed from the cannula, increasing the temperature of the gas and / or the device and reducing condensation and / or fogging. The temperature of the insufflation gas and / or equipment can be raised above the dew point to prevent condensation of gas on the medical equipment and / or reduce condensation (and / or remove condensation already formed by evaporation). Condensation can also occur in the absence of external heating or humidification. For example, condensation can result from the inherent temperature (body heat) and humidity (body moisture) of the surgical cavity and / or from the temperature and humidity of the insufflation fluid. The temperature of the insufflation gas and / or equipment can be raised above the dew point to prevent condensation on the medical equipment due to the insufflation gas and / or surgical cavity.

[0089] As described herein, the proximal direction with respect to a cannula may generally refer to the upper end of the cannula upper housing, while the distal direction with respect to a cannula may generally refer to the lower end of the cannula shaft, which is configured to be the initial section of the cannula that is inserted into the surgical cavity.

[0090] More detailed examples of evacuation cannulas are described below. As described herein, a proximal direction relative to a medical instrument may generally refer to the upper end of the medical instrument body, while a distal direction relative to a medical instrument may generally refer to the lower end of the medical instrument body that is configured to be the first section of the medical instrument to be inserted into a cannula and / or surgical cavity. Reference numbers for the same or substantially the same features may share the same last two digits.

[0091] Example of a drainage cannula 3A is an exploded perspective view of a cannula including removable or built-in filters and seals, according to some embodiments. The cannula 300 can include a cannula top housing 302 and, for example, an elongate shaft 304 extending distally from the cannula top housing 302. Both the cannula top housing 302 and the elongate shaft 304 can include a first lumen 306 (e.g., continuous between the cannula top housing 302 and the elongate shaft 304) including an inlet 308 and an outlet 310. The first lumen 306 can be configured to receive insufflation gas delivered from a gas entry port 352 of the cannula top housing 302 and deliver the insufflation gas to the surgical cavity through an outlet 310 proximate the distal end 314 of the elongate shaft 302. The first lumen inlet 306 can be in fluid communication with a source of insufflation gas via the gas entry port 352. Cannula upper housing 302 and elongate shaft 304 may also include a second lumen 316 including an inlet 320 and an outlet 322, which may be configured to receive gases from the surgical cavity through second lumen inlet 320 and exhaust and filter gases outside the surgical cavity through second lumen outlet 322. In other words, for example, one lumen (e.g., first lumen 306) may deliver fresh insufflation gases in a first direction, such as into the surgical cavity, while another lumen (e.g., second lumen 316) may deliver gases, smoke and other "waste" gases in a second, opposite direction, such as out of the surgical cavity.

[0092] 3A, in some embodiments as shown, the cannula 300 may include a dual concentric lumen geometry where one of the lumens is nested within the other. In some embodiments, the first lumen 306 may be partially or completely nested within the second lumen 316 as shown. In some embodiments, the second lumen 316 may have a diameter and / or cross-sectional area larger than that of the first lumen 306, as shown, or in other embodiments may have a smaller or the same diameter and / or cross-sectional area. In some embodiments, the diameter of the second lumen may be about 5% to about 90% of the diameter of the first lumen. In some embodiments, the first and second lumens may have a larger diameter zone proximal to the cannula upper housing 302 and a smaller diameter zone distal to the elongate shaft 304, as shown, or in other embodiments may have a substantially constant diameter throughout.

[0093] The second lumen 316 can be in fluid communication with an instrument opening 333 and a seal housing 330, which can include a filter operatively connected to the cannula 300, for example, integrally formed or removably attachable (e.g., by a clip or other mechanism) to the proximal end of the cannula top housing 302. In some embodiments, the seal housing 330 forms or is operatively attached to the proximal-most portion of the cannula 300. A first seal 331 can also be present and can be integrally formed or removably attachable to the seal housing 330. The first seal 331 can be a duckbill-type seal flap made of silicone or other suitable material, or other type of seal. The filter can be bonded to additional materials, such as, for example, a desiccant material (e.g., silica), which can function to reduce vapor content and increase the life and effectiveness of the filter. A retaining ring 334 can also be present, for example, between the cannula top housing 302 and the seal housing 330.

[0094] FIG. 3B shows a cross-sectional view of an exploded view embodiment of the cannula 300 of FIG. 3A. FIG. 3C shows a cross-sectional view of the seal housing 330 with additional material as described below. The first lumen 306 and second lumen 316 described above are shown. The outer lumen (e.g., second lumen 316) may include positioning or guide ribs 358. The positioning or guide ribs 358 are disposed about the first lumen 306 and are configured to be disposed about the first lumen 306 to fix the position of the first lumen 306. In some embodiments, there may be about or at least about 1, 2, 3, 4, 5, 6, 7, 8, or more guide ribs 358. If multiple guide ribs 358 are present, they may be spaced apart and may be thin enough to prevent disturbance of the gas exhaust flow. In some embodiments, the ribs 358 may have a thickness that is less than about 25%, 20%, 15%, 10%, 5%, or less than 5% of the inner diameter of each lumen that contains the ribs 358, or a range including any two of the foregoing values. In some embodiments, the guide ribs 358 are integrally formed with or otherwise attached to the inner wall of the second lumen 316.

[0095] The cannula upper housing 302 can include a gas entry port 352 fluidly connected to the first lumen 306 via a gas entry channel 354, and there can be a solid wall isolating the second lumen 316 from the first lumen 306 to prevent or substantially prevent leakage or mixing between the fresh insufflation gas and the waste gas withdrawn from the surgical cavity.

[0096] Gas entry port 352 may include a valve or other mechanism to control gas intake. Gas entry channel 354 may be proximally sealed by section 350, which may be ultrasonically welded, bonded, or otherwise attached to cannula top housing 302. Second lumen 316 may include one, two, or more seals that lead to seal housing 330, which may include one or more filters. Gas from the surgical cavity may pass through channel 356, which may be in the proximal portion of second lumen 316. In some embodiments, seal housing 330 may form the proximal-most end of cannula 300. Seal housing 330 may have an arcuate, e.g., ring-like, shape, or other geometric shape as shown, and may include exhaust slot 340 configured to allow gas from the surgical cavity to reach the filter and be exhausted. Also shown is a pocket 362 configured to accommodate one, two, or more gas filters. The filter can be, for example, a carbon filter, a high-efficiency particulate air (HEPA) filter, and / or an ultra-low particulate air (ULPA) filter, between the exhaust slot 340 and an exhaust aperture 339 configured to allow filtered gas from the surgical cavity to escape to the outside environment. The filter can include multiple filter elements that can be arranged in series. For example, a ULPA filter and a carbon filter can be arranged in series, for example. FIG. 3C shows a pocket 362 configured to accommodate additional material 364, such as a desiccant material (e.g., silica), along with one or more gas filters 366. A first seal 332 for placing medical instruments (e.g., endoscopes and other instruments) therein is also shown, and in some embodiments, the first seal 332 can be centrally located and disposed in a proximal section of a lumen, such as the first lumen 306. The seal 331 may be overmolded or otherwise attached to a peripheral portion of the seal housing 330 with a component 333 made of hard plastic, silicone, rubber, or another desired material.The locking mechanism 336 can connect the seal housing 330, including the filter, to a complementary locking mechanism 346 on the retaining ring 334. The retaining ring 334 includes a second seal 344 configured to fit a medical device therein. The locking mechanisms 336, 346 can include complementary flanges, clips, retainers, press-fit surfaces, threads, and the like. The retaining ring 334 can also include a vent slot 342 configured to allow gas from the surgical cavity to reach the filter and then vent to the environment. In some embodiments, the seal housing 330 and the retaining ring 334 can be permanently coupled to one another rather than removably or in some cases can be integrally formed.

[0097] Figure 4 shows an unexploded cross-sectional view of an evacuation cannula embodiment 300 including dual concentric lumens as shown in Figures 3A and 3B. As shown, insufflation gas can enter the cannula 300 through gas entry port 352, enter the first (e.g., central) lumen 306 in the direction of the arrows, and enter the surgical cavity through an exit port 310 at the distal end 314 of the elongate shaft of the cannula 300. Gas from the surgical cavity can flow in the opposite direction, entering the second (e.g., outer) lumen 316 of the cannula 300, flowing proximally within the cannula 300, through a filter in the seal housing 330, and exiting to the environment through an evacuation aperture 339.

[0098] Figure 5A is an exploded view of another embodiment of cannula 400 including seal housing 430 including a removable or built-in filter and seal 431. Multiple filters, such as multi-stage filters, can be disposed in series, for example, within seal housing 430. Figure 5B shows a cross-sectional view of the exploded view embodiment of cannula 400 of Figure 5A. Cannula 400 can incorporate any of the features of cannula 300, except that in some embodiments the functions of the first and second lumens can be reversed. In some embodiments as shown, the first (e.g., central) lumen 406 is configured to receive gas from the surgical cavity through a first lumen inlet 420 (as opposed to directing gas to the surgical cavity as in FIGS. 3A-4 ) and exhaust gas out of the surgical cavity through an exhaust aperture 439 in the seal housing 430, and the second lumen 416 may be configured to receive insufflation gas delivered from a gas entry port 452 in the cannula top housing 402 and deliver insufflation gas to the surgical cavity through an exit port 410 proximate the distal end 414 of the elongate shaft 404. The second lumen 416 may be in fluid communication with a source of insufflation gas, such as, for example, the gas entry port 452, which may include a valve as described above. The first lumen 406 may be removably or permanently attached, such as, for example, ultrasonically welded at 483, to the retaining ring 434. Also shown are exhaust slot 440, pocket 462 configured to receive a gas filter, seal 438 for a medical device, component 433 overmolded onto the seal, and locking mechanism 436 for connecting seal housing 430 to a complementary locking mechanism 446 on secondary seal 444 having exhaust slot 442, all of which may be as described above.

[0099] 6 shows an unexploded cross-sectional view of the exhaust cannula embodiment shown in FIGS. 5A and 5B including dual concentric lumens. As shown, insufflation gas can enter the cannula 400 through gas entry port 452, enter the second (e.g., outer) lumen 416 in the direction of the arrows, and enter the surgical cavity through outlet 410 at the distal end 414 of the elongate shaft of the cannula 400. Gas from the surgical cavity can enter the first (e.g., central) lumen 406 of the cannula 400, flow proximally within the cannula 400, pass through a filter in the seal housing 430, and exit to the environment through exhaust aperture 439. As discussed above, the first lumen 406 can be removably or permanently attached, such as ultrasonically welded at 483, to the retaining ring 434. The seal housing 430 can be permanently or removably connected (e.g., by snapping together) to the retaining ring 434. Seal housing 430 may also be permanently or removably connected to another portion of cannula 400.

[0100] FIG. 6A is an isometric view of another embodiment of a cannula 500, similar to that of FIGS. 5A-6 above, except that the cannula 500 includes multiple spaced apart filter elements, and may include any number of features as shown in FIGS. 5A-6 above. As described above, a first filter may be disposed within the seal housing 530, and gas may be vented past the first filter, through a first set of vent apertures 539 in the seal housing 530, and out of the surgical cavity. A second filter may be disposed more proximally, such as, for example, in the upper cannula housing 502, and may include a second set of vent apertures 569 to allow venting at a more proximal location. The first filter may be a different type of filter than the second filter. For example, one filter may be a carbon filter and the other filter may be a ULPA filter. Also shown are gas entry port 552, instrument opening 533, cannula elongate shaft 504, exit port 510 proximate distal end 514 of elongate shaft 504 of cannula 500, and first lumen inlet 520, as described above. Figure 6B is a longitudinal cross-sectional view of the embodiment of Figure 6A, also showing first filter 579 and spaced apart second filter 589, as well as outer lumen 516 and inner lumen 506, as may be described above.

[0101] In some embodiments, the evacuation cannula may include one, two, or more valves to control evacuation to the environment (e.g., the operating room suite). FIG. 7A shows the proximal end of the cannula including a seal housing 730 having an evacuation aperture 739 and operatively connected to a retaining ring 734, as described above. A valve 770 may be present in the flow path of a lumen, such as the second or outer lumen 716, before reaching the seal housing 730 having the evacuation aperture 739, and is configured to evacuate gases from the surgical cavity. FIG. 7B is a cross-sectional view taken at line 7B-7B of FIG. 7A showing a plurality of spaced apart valves 770. The valves may be configured to control the evacuation rate, for example, the rate at which gases are evacuated from the cannula. The evacuation rate may be controlled to a predetermined rate such that smoke is cleared from the surgical cavity and smoke plumes are cleared. The solenoid valve may be controlled by a controller, for example, a controller in a humidifier or a controller in an insufflator. The valves 770 can be, for example, solenoid valves, or other types of valves, some of which are described elsewhere herein. Each valve 770 can be disposed within a flow path of a lumen configured to vent gas, such as the second, e.g., outer lumen 716, each of which includes a small vent aperture 771 controlled by the valve 770 to allow the gas to subsequently pass through a filter. A rigid plate 772 can hold the valves 770 in place by enclosing each valve 770 within its own housing 774. The plate 772 can be gas impermeable and can be configured to act as a seal so that gas can only pass through the valve 770 for venting.

[0102] Figure 7C illustrates another embodiment of a valve, which may be a diaphragm pressure relief valve 792 disposed across a flow passage 794 of a lumen. The valve 792 may have an initial closed state maintained by the pressure bias of a spring 793, as shown on the left side of Figure 7C. A flexible seal 790, which may be made of plastic or a similar composition, may open (e.g., move back toward the valve 792 as shown) when a pressure greater than the spring bias pressure is applied by gas flowing through the flow passage 794, thereby moving the valve 792 to an open configuration, as shown on the right side of Figure 7C.

[0103] Figure 7D illustrates another embodiment showing solenoid valve 740. As in Figure 7C, the biasing force of spring 793 may keep valve 740 closed, as shown on the left side of Figure 7D. When the circuit is turned off, switch 742 opens and the valve is closed. Switch 742 may be actuated (e.g., electrically) to open valve 740 and allow gas to flow across valve 410 and flow path 794, as shown on the right side of Figure 7D.

[0104] In some embodiments, the valves may be passive or active. Passive valves, e.g., spring valves or umbrella valves, are configured to vent at a predetermined pressure. The vent pressure is used to maintain a constant pressure in the surgical cavity and corresponds to a pressure that can provide a desired vent rate. Active valves are preferably actively controlled to obtain a constant pressure in the surgical cavity and to vent smoke and smoke plumes and gases at a predetermined rate to achieve optical clarity. Passive openings, e.g., multiple openings or flow-restricting openings, can be configured, e.g., shaped and constructed, to provide a desired vent rate.

[0105] Figure 7E illustrates another embodiment showing a pressure relief valve 730. As shown on the left hand side of Figure 7E, the biasing force of spring 793 can exert sufficient force to maintain valve 730 in a closed position. When a pressure greater than the spring pressure is applied by gas flowing through flow passage 794, as shown on the right hand side of Figure 7E, valve 730 can move to an open configuration.

[0106] 8A-8D show additional mechanical / passive drainage embodiments that may be included in the drainage cannula, which may or may not include a valve. As shown in FIG. 8A, the drainage element 810 may be located at or near the proximal end 802 of the cannula 800. FIG. 8B shows a drainage element that includes only a single restricted orifice 810. FIG. 8C shows a drainage element that includes multiple small spaced apart orifices 820, such as 2, 3, 4, 5, 6, 7, 8, 9, 10, or more orifices 820. FIG. 8D shows a drainage element that includes an umbrella pressure relief valve 830. As shown on the left hand side of FIG. 8D, when no pressure is applied, the valve 830 can "snap" back to a closed state. As shown on the right hand side of FIG. 8D, a flexible seal 832 made of rubber or another material can open when pressure greater than a predetermined value is applied by gas flow in the flow passage.

[0107] 9A-9B show an embodiment of a drainage cannula 900 that may include an electronic drainage feature. As shown in the longitudinal cross-section of FIG. 9A, one or more sensors 990 may be present in a lumen (e.g., outer lumen 916) configured to convey gases from the surgical cavity for filtering and drainage. The sensors 990 may be configured to sense, for example, smoke and other harmful substances, particulates, carbon monoxide, etc., and / or other gas parameters, such as, for example, pressure, temperature, humidity, and / or flow. The sensors 990 may perform continuous or intermittent sampling measurements as the gases are being drained. The sensors 990 may be molded or otherwise attached in place within the cannula 900 and may be in wired or wireless communication with a controller. FIG. 9B is a cross-sectional view taken at line 9B-9B of FIG. 9A. A valve 970 is shown. The valve 970 may be an electromagnetic gate valve operable via a controller built into the cannula or located elsewhere in the surgical gas delivery and / or humidification system. A line 972 may extend from the sensor 990 and a controller for the solenoid valve 970 to control the exhaust gas flow. In some cases, the line 972 may be overmolded into a cannula sidewall at 976 to seal the gas exit path. When the sensor 990 detects that a gas parameter meets or exceeds a predetermined or calculated threshold, the controller receiving data from the sensor 990 can signal the solenoid gate valve 970 (e.g., via line 972) to open or close to control the exhaust of gas.

[0108] Exemplary cannulas disclosed herein may also include a socket connection for providing power to the heating element via one or more electrical wires (e.g., provided by a tubing set). As shown in FIGS. 10A-10B, the gas inlet 1006 of the cannula may include an electrical connector 1036. The electrical connector 1036 may be in electrical communication with one or more electrical wires 1016. The one or more electrical wires 1016 may be embedded (e.g., overmolded) within the wall of a portion of the length of the cannula upper housing 1002 and may also be embedded (e.g., overmolded) within the wall of a portion of the length of the elongate shaft that extends between the heating element in the cannula and the electrical connector 1036.

[0109] The electrical connector 1036 may be configured to mate with a corresponding connector 1038 (e.g., a socket connector) on a gas delivery tube 13 of a surgical system (such as, for example, an insufflation system or any of the surgical systems disclosed herein) to provide power to the heating element. The gas delivery tube 13 may include a coiled tube molded into the corresponding connector 1038, which may include a hard plastic material. The socket connection may secure the gas delivery tube 13 to the cannula. As shown in FIGS. 10A and 10B , the electrical connector 1036 may include pins 1040. The pins 1040 are configured to be coupled to a PCB edge connector 1042 of the corresponding connector 1038 and establish electrical communication between the heating element and the heater wire circuit 14 of the gas delivery tube 13.

[0110] 11A-11B show a cross-sectional view of an embodiment of a dual lumen exhaust cannula 1100 that may include features as described above, including a cannula upper housing 1102, a cannula elongate shaft 1104 configured to house a first lumen 1106 and a second lumen 1116 therein, and a distal end 1108 of the elongate shaft 1104 of the cannula 1100. Also shown is the seal housing 1130, which may include a heating element 1145 distal to the exhaust aperture 1139 within the gas flow path of the seal housing 1130. The heating element 1145 may include a printed circuit board (PCB) heater, insulated copper alloy resistance wire, other types of resistance wire, or other heater elements, and / or may include a heater wire that may be made of any other suitable material. In some cases, the PCB may be flexible or rigid and may be preformed into an arcuate shape, for example. The heater wire can be a straight or spiral wound element. The heating element 1145 can advantageously heat the exhausted gas sufficiently to prevent the gas from condensing and clogging the filter. In some embodiments, the heating element 1145 is configured to heat the exhausted gas to at least about 70, 80, 90, 100, 110 degrees Celsius or higher, or a range including any two of the aforementioned values, and / or above the dew point of the gas. Electrical connection to the PCB heater can be made through electrical pins located within the filter compartment of the seal housing 1130 and between different layers of the cannula. FIG. 11B is a cross-sectional view taken at line 11B-11B in FIG. 11A. As shown, power to the PCB heater is provided by a wire connection 1172 to a power source, for example, in a connected surgical humidification system. In other embodiments, the power source can be directly connected to the cannula or can be wireless. The PCB heater 1145 may be disposed within the cannula and may be configured such that the PCB 1149 is not in direct contact with the gas flow path to avoid any contamination of the PCB itself.

[0111] In some cases, the heating element may be embedded in the wall of the cannula upper housing. The heating elements of the present disclosure and / or other heating elements may be attached and / or disposed on the inner wall of the cannula (e.g., the inner wall of the upper housing and / or the inner wall of the shaft). Alternatively, example heating elements may be wrapped around the outer surface of the cannula shaft. The heating element may be molded into the wall of the cannula upper housing.

[0112] 12A-12B show an exploded view of another embodiment of a cannula 1200 including a seal housing 1230 that includes a removable or built-in filter and seal 1231. As described elsewhere herein, the filter may include multiple filter elements that may be arranged in series. FIG. 12B shows a cross-sectional view of the exploded view embodiment of the cannula 1200 of FIG. 12A. The cannula 1200 may incorporate any of the features of the cannula as described elsewhere herein, except that the cannula 1200 includes multiple offset lumens (e.g., two or more lumens that are adjacent, not nested, or concentric with one another). In some embodiments as shown, the first lumen 1206 is configured to receive gas through a gas entry port 1252 in the cannula top housing 1202 and deliver insufflation gas to the surgical cavity from an outlet 1210 proximate the distal end 1214 of the elongate shaft 1204. The second lumen 1216 can transport gases from the surgical cavity through the inlet 1220 and can exhaust gases out of the surgical cavity through an exhaust aperture 1239 in the seal housing 1230. In some embodiments, the first lumen 1206 can have a diameter larger than the diameter of the second lumen 1216, for example, at least about, about, or only about 10%, 25%, 50%, 75%, 100%, or more than 100% larger than the diameter of the second lumen 1216. In some embodiments, the first lumen 1206 can have a diameter the same as or smaller than the diameter of the second lumen 1216. As mentioned above, the seal 1231 of the seal housing 1230 can be overmolded to a hard plastic 1233 or other material. Also shown distal to the seal housing 1230 can be a retaining ring 1234, which can be removably or permanently attached. The retaining ring 1234 may include exhaust slots 1242 to allow gas to reach the filter and be exhausted, and a duckbill seal 1245 for the medical instrument.Also shown are exhaust slot 1240, pocket 1262 configured to accommodate a gas filter as described above, seal 1231 for a medical device, component 1233 overmolded to the seal, locking mechanism 1236 (for reversibly attachable embodiments) for connecting seal housing 1230 to a complementary locking mechanism 1246 on retaining ring 1234 having exhaust slot 1242, first seal 1231, and second seal 1244, all of which may be as described above.

[0113] Figure 13 shows an unexploded longitudinal cross-sectional view of an embodiment of an evacuation cannula 1200 including dual offset non-concentric lumens as shown in Figures 12A and 12B. As shown, insufflation gas can enter the cannula 1200 through a gas entry port 1252, enter a first lumen (e.g., lumen 1206) in the direction of the arrows, and enter the surgical cavity through an outlet 1210 at the distal end 1214 of the elongate shaft of the cannula 1200. Gas from the surgical cavity can enter a second lumen 1216 of the cannula 1200, flow proximally within the cannula 1200, pass through a filter in a seal housing 1230 with a seal 1231, and exit to the environment through an evacuation aperture 1239. Seals 1231, 124 as may be described above are also shown.

[0114] 14 shows an unexploded longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula 1400 including a seal housing 1430 that includes a removable or built-in filter and seal 1431. Cannula 1400 can incorporate any of the features of cannula 1300 (or other cannula embodiments), except that the functions of the first and second lumens may be reversed. In some embodiments as shown, the first (e.g., larger diameter) lumen 1406 is configured to receive gas from the surgical cavity through the first lumen inlet 1410 (as opposed to directing gas to the surgical cavity as in FIGS. 12A-13 ) and vent gas out of the surgical cavity through the vent aperture 1439 of the vent element 1430, and the second (e.g., smaller diameter) lumen 1416 may be configured to receive insufflation gas delivered from a gas entry port 1452 in the cannula upper housing 1402 and deliver insufflation gas to the surgical cavity from an outlet 1420 proximate the distal end 1414 of the elongate shaft 1404. The second lumen 1416 may be in fluid communication with a source of insufflation gas, such as, for example, the gas entry port 1452, which may include a valve as described above. Seals 1431, 1444 as may be described above are also shown.

[0115] 14A shows a longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula 1450 that may include any number of the features described in FIGS. 13 and 14, except that the cannula 1450 may include a first port 1452 and a second port 1462. The first port 1452 may be a gas entry port in fluid communication with the first lumen 1406, as described above. The second port 1462 may be a gas exit port configured to evacuate gas from the surgical cavity through the second lumen 1416 and may include one or more filters 1469, 1479, such as, for example, carbon and ULPA filters or other filters as described elsewhere herein. The second port 1462 may be at substantially the same axial height as the first port 1452, as shown, or may be axially offset in other embodiments. Such an embodiment may advantageously control valve evacuation and insufflation by flow control through the ports 1452, 1462.

[0116] 14B shows a longitudinal cross-sectional view of another embodiment of a dual offset non-concentric lumen cannula 1460 that may include any number of the features described in FIGS. 13 and 14, except that the cannula 1460 may include a first port 1452 and a second port 1464, for example, in a sidewall of the cannula elongate shaft 1404. The first port 1452 may be a gas entry port in fluid communication with the first lumen 1406, as described above. The second sidewall port 1464 may be a gas exit port configured to evacuate gases from the surgical cavity through the second lumen 1416 and including one or more filters 1469, 1479, such as, for example, carbon and ULPA filters or other filters as described elsewhere herein. As shown, the second sidewall port 1464 may be distal to the first port 1452 on the cannula 1460.

[0117] FIG. 15A shows the proximal end of a cannula 1500 including a seal housing 1530 with an exhaust aperture 1539 as described above. A valve 1570 can be present in the flow path of a lumen, such as the second lumen 1516, configured to exhaust gases from the surgical cavity before reaching the seal housing 1530 with an exhaust aperture 1539 as described above. FIG. 15B is an enlarged view of FIG. 15A showing the valve 1570 relative to the flow path of the second lumen 1516 across the valve. FIG. 15C is a cross-sectional view taken at line 15C-15C of FIG. 15A showing a valve configuration including one, two, or more solenoid valves 1570, or other types of valves, some of which are described elsewhere herein. A single valve 1570 is shown molded into the wall 1572 of the cannula 1500. A wall 1572 of the cannula 1500 contains an offset second lumen 1516 and can hold a valve 1570 in place. A small vent hole in the second lumen 1516 can be controlled by the valve 1570 to selectively allow gas to pass through the filter. The offset first lumen 1506 is also shown. In some embodiments, the valve can include a diaphragm pressure relief valve, an electromagnetically actuated relief valve, and / or a pressure relief valve, as described elsewhere herein.

[0118] 16 illustrates, in schematic form, additional mechanical / passive drainage embodiments that may be included in a drainage cannula, which may or may not include a valve, including, for example, those associated with FIGS. 12A-13. The drainage aperture 1639 of the seal housing 1630 may be located at or adjacent the proximal end 1601 of the cannula 1600, and may include a single restricted orifice, multiple small spaced apart orifices, an umbrella pressure relief valve, or other natural drainage options, as previously described herein.

[0119] 17A-17C show an embodiment of a drainage cannula 1700 that may include an electronic drainage feature. As shown in the longitudinal cross-section of FIG. 17A, one or more sensors 1790 may be present in a lumen (e.g., second lumen 1716) configured to convey gases from the surgical cavity for filtering and drainage. The sensors 1790 may be configured to sense, for example, smoke and other harmful substances, particulates, carbon monoxide, etc., and / or other gas parameters, such as pressure or flow, as described above. The sensors 1790 may be molded or otherwise attached in place in the cannula 1700, also as described above. In some embodiments, one, two, or more than two sensors may provide feedback to a controller operatively connected to a humidifier or gas supply (e.g., an insufflator). The drainage lumen may be fluidly coupled to a gas exhaust system, such as a vacuum. The sensor output may control the gas exhaust system. Additionally, in some embodiments, the sensor output may control an output valve to control the drainage rate. FIG. 17B is an expanded view of FIG. 17A showing the valve 1770 relative to the flow path of the second lumen 1716 across the valve.

[0120] FIG. 17C is a cross-sectional view taken at line 17C-17C of FIG. 17A. Valve 1770 is shown. Valve 1770 may be a solenoid gate valve operable via a controller built into the cannula or located elsewhere in the surgical air supply and / or humidification system, as described above. Wires 1772 may extend from a sensor 1790 and a controller of solenoid valve 1770 to control exhaust gas flow. In some cases, as described above, wires 1772 may be overmolded into the cannula sidewall at 1776 to seal the gas exit path. As described and illustrated above in connection with FIGS. 10A-10B, in some embodiments, cannula 1700 may also include a socket connection for providing power to the heating element via one or more electrical wires (e.g., provided by a tubing set).

[0121] FIG. 18 shows a longitudinal cross-sectional view of an embodiment of an offset dual lumen evacuation cannula 1800 that may include features as described above in connection with FIGS. 12A-13, etc., including a cannula upper housing 1802 and a cannula elongate shaft 1804 configured to house a first lumen 1806 and a second lumen 1816 therein. Also shown is an evacuation element 1830 that may include a heating element 1845 in the gas flow path of the evacuation element 1130 and distal to the evacuation aperture 1139. The heating element 1145 may include a printed circuit board (PCB) heater and may advantageously heat the evacuation gas sufficiently to prevent the gas from condensing and clogging the filter. Other aspects of the heating element 1145 may be as described above in connection with FIGS. 11A-11B, for example.

[0122] 19A-20D show various non-limiting embodiments of offset lumen shapes and / or cannula taper configurations. FIG. 19A shows a cross-sectional view of a cannula having an arcuate, larger diameter, first (main) lumen (e.g., circular main lumen 1901) and a smaller diameter, second (offset) lumen 1900 comprising a semi-moon / semicircular cross-sectional shape. FIG. 19B shows an embodiment similar to FIG. 19A, except that the second lumen 1900 comprises a circular cross-sectional shape. FIG. 19C shows another embodiment having a second lumen 1904 comprising a crescent shape. FIG. 20A shows the distal end of an elongate shaft of a cannula having a first main lumen 2006 and a second offset lumen 2016 with a distal taper toward the first main lumen 2006 (e.g., the first main lumen 2006 has a longer length than the second offset lumen 2016). Figure 20B, in contrast to Figure 20A, shows an embodiment having a taper towards the offset second lumen 2016. Figure 20C shows an embodiment having a helically offset second lumen 2086 that forms a turn around and at least partially circumscribes the larger diameter first main lumen 2006. Figure 20D shows an embodiment having a flat-bottom distal end (no taper) between the first lumen 2006 and the second lumen 2016.

[0123] 21A-21B show exploded views of another embodiment of a cannula 2100 including a seal housing 2130 that includes a removable or built-in filter and seal 2131. FIG. 21B shows a cross-sectional view of the exploded view embodiment of the cannula 2100 of FIG. 21A. The cannula 2100 can incorporate any of the features of the cannula as described elsewhere herein, except that the cannula 2100 includes only a single lumen configured to function as both an insufflation gas supply lumen and an exhaust gas lumen. In some embodiments as shown, the only gas lumen 2106 is configured to receive gas via a gas entry port 2152 in the cannula top housing 2102 and deliver insufflation gas to the surgical cavity from a common inlet / outlet 2110 proximate the distal end 2114 of the elongate shaft 2104. For example, one or more fins 2197 may be operatively attached proximally to the cannula 2100, such as in the retaining ring 2134, at reference number 2148, and may have an elongate body and a distal free end. The fixed or movable walls or fins 2197 may be advantageously configured to direct insufflation gas entering the cannula 2100 at the gas entry port 2152 distally in the sole gas lumen 2106, effectively dividing only a portion along the length of the sole gas lumen 2106 into a first passage for providing insufflation gas to the surgical cavity and a second passage for filtering and exhausting the surgical cavity gas outside the patient. In some embodiments, the first and second passages may be concentric or offset from one another. The sole lumen 2106 may also be configured to transport gas from the surgical cavity to a common inlet / outlet 2110 and exhaust gas outside the surgical cavity through an exhaust aperture 2139 in the seal housing 2130. The seal 2131 of the evacuation element 2130 may be overmolded with a hard plastic 2133 or other material, as described above. Also shown distal to the seal 2131 may be a retaining ring 2134. The retaining ring 2134 may include evacuation slots 2142 to allow gas to reach the filter and be evacuated, and a second seal 2144 for the medical device.Also shown are exhaust slots 2140, a pocket 2162 configured to receive a gas filter, a component 2133 overmolded to the seal, and a locking mechanism 2136 (for the removable embodiment, not required for the integral seal housing-retaining ring integrated embodiment) for connecting the seal housing 2130 to a complementary locking mechanism 2146 on a retaining ring 2134 having an exhaust slot 2142, all of which may be as described above.

[0124] 22 shows an unexploded longitudinal cross-sectional view of an evacuation cannula 2100 embodiment including a cannula upper housing 2102, an elongate shaft 2103, and a single gas lumen 2106 as shown in FIGS. 21A and 21B. As shown, insufflation gas can enter the cannula 2100 through gas entry port 2152 and into the single lumen 2106, be guided distally by fins 2197, and enter the surgical cavity through a common inlet / outlet 1210 at the distal end 2114 of the elongate shaft 2103 of the cannula 2100. Gas from the surgical cavity can enter the single gas lumen 2106 of the cannula 2100, flow proximally within the cannula 2100, pass through a filter in the seal housing 2130, and exit to the environment through an evacuation aperture 2139. Also shown are seals 2131, 2144, which may be as described above.

[0125] FIG. 23A shows the proximal end of the cannula 2300 including the seal housing 2330 with the exhaust aperture 2339 as described above. The valve 2370 can be in a lumen, e.g., a flow path in the only lumen 2306, configured to exhaust gases from the surgical cavity before reaching the seal housing 2330 with the exhaust aperture 2339, gas inlet port 2352, fins 2397, and other features that can be, e.g., as described above. FIG. 23B is an enlarged view of FIG. 23A showing the valve 2370 relative to the flow path of the only lumen 2306 across the valve. FIG. 23C is a cross-sectional view taken at line 23C-23C of FIG. 23A. Valve configurations including one, two, or more than two solenoid valves 2370, or other types of valves, some of which are described elsewhere herein, are shown. A single valve 2370 is shown molded into the wall 2372 of the cannula 2300. A wall 2372 of the cannula 2300 can hold the valve 1570 in place. A small vent hole 2388, offset from the longitudinal axis of the cannula and in fluid communication with only the lumen 2306 when the valve 2370 is open, can be controlled by the valve 2370 to selectively allow gas to pass through the filter, as described elsewhere herein. In some embodiments, the valve can include a diaphragm pressure relief valve, an electromagnetically actuated relief valve, and / or a pressure relief valve, as described elsewhere herein.

[0126] 24 illustrates, for example, schematic diagrams of additional mechanical / passive drainage embodiments that may be included in a drainage cannula, including those associated with FIGS. 21A-22, which may or may not include a valve. A drainage aperture 2439 in a drainage element 2430 may be located proximal to the filter and at or near the proximal end 2401 of the cannula 2400 to receive gases from the surgical cavity through lumen 2406, and may include a single restricted orifice, multiple small spaced apart orifices, an umbrella pressure relief valve, or other natural drainage options, as previously described herein.

[0127] 25A-25C show an embodiment of a single lumen drainage cannula 2500 that may include features, for example, as described in connection with FIGS. 20A-21, and also includes an electrical drainage feature. As shown in the longitudinal cross section of FIG. 25A, one or more sensors 2590 may be present in a single lumen 2506 configured to convey gases from the surgical cavity for filtering and drainage. The sensors 2590 may be configured to sense, for example, smoke and other harmful substances, particulates, carbon monoxide, etc., and / or other gas parameters, such as pressure or flow, as described above. The sensors 2590 may be molded or otherwise attached in place within the cannula 2500, also as described above. FIG. 25B is an expanded view of FIG. 25A showing the valve 2570 relative to the flow path of the lumen 2506 across the valve.

[0128] FIG. 25C is a cross-sectional view taken at line 25C-25C of FIG. 25A. Valve 2570 is shown. Valve 2570 may be a solenoid gate valve operable via a controller built into the cannula or located elsewhere in the surgical air supply and / or humidification system, as described above. Wires 2572 may extend from sensor 2590 and a controller of solenoid valve 2570 to control exhaust gas flow. In some cases, wires 2572 may be overmolded into the cannula sidewall at 2576 to seal the gas exit path, as described above. In some embodiments, as described and illustrated above in connection with FIGS. 10A-10B, cannula 2500 may also include a socket connection for providing power to the heating element via one or more electrical wires (e.g., provided by a tubing set).

[0129] Exemplary cannulas disclosed herein may also include a socket connection for supplying power to the heating element via one or more electrical wires (e.g., provided by a tubing set), such as, for example, as described above in connection with Figures 10A-10B.

[0130] 26A-26B show a cross-sectional view of an embodiment of a single lumen exhaust cannula 2600 having a fin 2697 creating a partition between a gas inflow path and a gas outflow path, which may include any number of features such as those described above in connection with FIGS. 20A-21, including a cannula upper housing 2602, a cannula elongate shaft 2604 configured to house a single lumen 2606 therein. Also shown is a seal housing 2630 that may include a heating element 2645 within the gas flow path of the exhaust element 2630 and distal to the exhaust aperture 2639. The heating element 2645 may include a printed circuit board (PCB) heater and may advantageously heat the exhausted gas sufficiently to prevent the gas from condensing and clogging the filter. Other aspects of the heating element 2645 may be as described above in connection with FIGS. 11A-11B, for example. FIG. 26B is a cross-sectional view taken at line 26B-26B of FIG. 26A. As shown, power to the PCB heater is provided by a wire connection 2672 to a power source, for example, in a connected surgical humidification system. The PCB heater 2645 can be located within the cannula as described above, and can be configured such that the PCB 2649 is not in direct contact with the gas flow path to avoid any contamination of the PCB itself.

[0131] 27A-27B are exploded views of another embodiment of a cannula 2700 including a seal housing 2730 including a removable or built-in filter and seal 2731. Multiple filters, such as, for example, multi-stage filters, as described above, may be disposed in series within the seal housing 2730, for example. Also shown is a blower unit 2788 including one or more blower fans 2787 in fluid communication with the outer lumen 2716 and an outer lumen inlet 2720 proximate the distal end 2714 of the elongate shaft 2704 between the retaining ring 2734 and the cannula upper housing 2702. The outer lumen 2716 is configured to allow for the inflow of gases, smoke, and other unwanted materials from the surgical cavity. The blower unit may include an opening, such as a central opening 2786, in fluid communication with the inner lumen 2706 as shown, to allow for normal use of the cannula, for example, for receiving a medical instrument within the cannula. The blower unit 2788 may be removably or permanently attached to other features of the cannula 2700 (e.g., the retaining ring 2734 and the cannula upper housing 2702 as described above). FIG. 27B shows a cross-sectional view of an exploded view embodiment of the cannula 2700 of FIG. 27A, also showing the exhaust aperture 2739, the pocket 2762 configured to receive a filter, the first seal 2731, the second seal 2744 on the retaining ring 2734, and the gas inlet port 2752. Also shown is a blower drive unit, which may be a magnetic circular ring 2785 configured to drive (e.g., rotate) the blower fan 2787 sufficiently to draw smoke out of the surgical cavity pneumoperitoneum. The magnetic circular ring 2785 may be connected to a wired connection (or wirelessly in other embodiments) operatively connected to the air delivery line of the gas inlet port 2752.

[0132] Figure 27C is an unexploded longitudinal cross-sectional view of a cannula 2700 including a blower unit 2788 as shown in Figures 27A-B, showing a blower drive unit including a magnetic circular ring 2785 configured to drive a blower fan blade, blower fan 2787, for suction of smoke within the exhaust lumen. Also shown is an exhaust aperture 2739, which may be as described elsewhere herein, and one more removable or built-in filter 2769 for exhausting smoke.

[0133] 28 is a longitudinal cross-sectional view of one embodiment of a multi-cannula system 2800 configured to recirculate clean insufflation gas, e.g., carbon dioxide, through a secondary cannula. A first cannula 2840 and a second cannula 2850 are shown fluidly connectable via a conduit 2880. The cannulas 2840, 2850 are shown positioned under the skin S and within the pneumoperitoneum of the surgical cavity SC. Gas, smoke, and other unwanted materials from the surgical cavity SC may be drawn into the exhaust lumen 2816 of the first cannula 2840 by activation of the blower unit 2888 as described above. Gas may be circulated in the direction of the arrows and may be filtered and removed by one or more filters 2869. The filtered insufflation gas may not be exhausted to the outside environment as in certain other embodiments described herein, but instead may remain within the closed system and travel via conduit 2880 into lumen 2817 of second cannula 2850 configured to allow the recirculated insufflation gas to re-enter surgical cavity SC. As described elsewhere herein, additional insufflation gas may be added over time through gas inlet ports 2852, 2852', if needed, and in some embodiments automatically by a controller receiving sensor data. First cannula 2840 and second cannula 2850 may each have a lumen, e.g., inner lumen 2806, 2806', as described above, configured to facilitate passage of medical equipment (not shown), and seals 2831, 2844, as described above, which when closed, may advantageously maintain the closed nature of the multi-cannula insufflation gas recirculation system.

[0134] FIG. 29 is a longitudinal cross-sectional view of one embodiment of a cannula system 2900 configured to recirculate clean insufflation gas, e.g., carbon dioxide, similar to that of FIG. 28, except that it uses only a single cannula 2900. The cannula 2900 is shown positioned under the skin S and within the pneumoperitoneum of the surgical cavity SC. Gas, smoke, and other unwanted materials from the surgical cavity SC can be drawn into the exhaust lumen 2916 of the cannula 2900 by activation of the blower unit 2988 by the blower drive unit, e.g., rotation of the magnetic ring 2985 as described above. Gas can be circulated in the direction of the arrows and can be filtered and removed by one or more filters 2969. The filtered insufflation gas is not exhausted to the outside environment as in certain other embodiments described herein, but instead can remain in a closed system and can travel to a lumen 2917 separate from the lumen 2916, which is configured to allow the recirculated insufflation gas to re-enter the surgical cavity SC. As described elsewhere herein, additional insufflation gas can be added, if needed, over time through gas inlet port 2952, and in some embodiments automatically by a controller receiving sensor data. The cannula can include a lumen 2906, e.g., an inner lumen, configured to facilitate passage of a medical instrument (not shown), and a seal as described above that, when closed, can advantageously maintain the closed nature of the single cannula insufflation gas recirculation system.

[0135] 30A-30C show various cross-sectional views of an embodiment of a cannula 3000 including a plunger feature configured to remove smoke upon actuation of the plunger. The cannula 3000 may include one or more filters 3069 as described above and a control 3093, such as a spring-loaded button, operatively connected to, for example, a seal 3095. The control 3093 may be on the upper cannula housing 3002 or in other locations, such as, for example, on the cannula shaft, a retaining ring, or a seal housing. Actuation of the control 3093 (e.g., pressing a button) may open the seal 3095, allowing smoke or other gases from the surgical cavity to be vented to the outside environment. FIG. 30B shows a close-up view of the seal 3095 in a resting closed position. FIG. 30C shows a close-up view of the seal 3095 of FIG. 30B after actuation of the control, with the seal 3095 in an open position allowing vented gases to exit the cannula 3000. The seal 3095 may be made of, for example, silicone, rubber, or other materials as described elsewhere herein. Figure 31A shows a partial cutaway perspective view of a cannula 3100 configured for high pressure venturi evacuation of gas, smoke, and other unwanted materials from the surgical cavity, according to some embodiments of the present invention. Although other cannula features described herein may be incorporated into the cannula 3100, for simplicity, some internal cannula components are not shown. Shown are an inlet 3133 configured to fit a medical device therein, an insufflation lumen 3152 for delivery of fresh insufflation gas, e.g., carbon dioxide, and an additional high pressure insufflation gas line 3153 configured to create a pressure differential and evacuate smoke through an outlet port of the evacuation lumen 3162. Gas G may flow around the walls of the cannula and then into the evacuation lumen, drawing smoke and other surgical cavity gases into the evacuation lumen, as shown. Figure 31B is a longitudinal cross-sectional view of the cannula 3100 of Figure 31A, further showing a sidewall inlet opening 3197 in communication with the drainage lumen 3162, and one or more filters 3169 along the drainage lumen 3162. These may be as described elsewhere herein.

[0136] 32A-B show isometric and cross-sectional views, respectively, of an exhaust cannula 3200 having exhaust control features, such as a series of small holes or apertures, that allow only gas to pass and retain particulate matter. The cannula 3200 may include a rotatable proximal cap 3230. The rotatable proximal cap 3230 may have a series of circumferentially aligned exhaust slots 3298 on the cap 3230 that partially or completely line up with or block an exhaust aperture that includes one or more filter materials 3269 that may be in the cannula upper housing 3202, and may be rotated / twisted (e.g., using a threaded interior surface in some cases) in the appropriate direction, such as in the direction of the arrow, to open or close the vent. FIG. 32A shows the vent in a semi-open position, with the filter material 3269 visible in the semi-open zone. Manipulating the degree to which the slots 3298 overlap the vent may control the rate of exhaust. Also shown in Figure 32B is the evacuation lumen 3216 in fluid communication with the aperture 3299, and the insufflation lumen 3206, which may be as described above. Although the evacuation cannula 3200 shows a dual concentric lumen configuration, it will be understood that the evacuation control features may be used or modified for use with other cannula lumen geometries, for example, as disclosed elsewhere herein.

[0137] In some embodiments, a filter such as those described and illustrated herein may include multiple filter elements. The multiple filter elements may be placed in fluid communication with the exhaust passage / exhaust lumen. The filter elements may be placed in the valve exhaust gas path. The filter elements may be placed in series such that the exhaust gas / smoke travels through two or more filter elements. In the multi-filter element, different types of filters may be used. For example, a carbon filter and a UPLA filter may be used to filter out particulate matter and any potentially harmful substances in the exhaust gas.

[0138] In some embodiments, the exhaust gas cannula, such as those described and illustrated herein, may include one or more heating elements. The heating elements may be located in one, two, or more than two lumens. The heating elements may extend a portion or the entire length of the lumens. The heating elements are configured to heat the gas delivered to the surgical cavity and maintain the temperature of the cavity at a target value. Further heating of the gas prevents condensation of the insufflation gas and the exhaust gas. Further heating of the gas may also reduce fogging on any equipment, such as a scope. Additionally, the one or more heating elements may communicate with or contact one or more filter elements to heat the filter elements. Heating the filter elements prevents clogging and condensation on the filters. Additionally, the heating elements may also be structured and configured to heat one or more valves to heat the vents or valves. Heating these portions reduces the formation of condensation in the vents and clogging of the vents.

[0139] Various filter embodiments have been described herein. In some embodiments, a filter element configured to filter gases, smoke, etc. from the surgical cavity need not necessarily be incorporated into the cannula itself, but rather may be in a conduit proximal to the proximal end of the cannula top housing 3302 of the cannula. As shown diagrammatically in the cross-sectional view of FIG. 33A, a conduit 3355 may be operatively attached, e.g., overmolded to the proximal portion 3356 of the cannula top housing 3302. FIG. 33B diagrammatically illustrates an embodiment of a tea bag filter 3360 fluidly connected via a conduit 3356 to the proximal end of the cannula top housing 3302 of the cannula. FIG. 33C diagrammatically illustrates an embodiment of a snake filter 3362 fluidly connected via a conduit 3356 to the proximal end of the cannula top housing 3302 of the cannula. 33D shows an embodiment of a box filter 3364, which may include an active filter, electronics, controls, and other features, fluidly connected to the proximal end of the cannula top housing 3302 via a conduit 3356. In this case, the filter 3364 may be in a device or housing connected to the distal end of the conduit 3356 furthest from the proximal end of the cannula top housing 3302.

[0140] 34A-B show a cross-sectional view of one embodiment of a dual lumen evacuation cannula 3400 that may include features as described above, including a cannula top housing 3432 and a cannula elongate shaft 3404 configured to house a first lumen 3406 and a second lumen 3416 therein. As shown, insufflation gas may enter the cannula 3400 through a gas entry port 3452, enter the first (e.g., central) lumen 3406 in the direction of arrow 3454, and enter the surgical cavity through an exit port 3410 at the distal end 3414 of the elongate shaft 3404 of the cannula 3400. With reference to FIG. 34A, an obturator 3460 may be positioned within the first lumen 3406 of the cannula 3400. The obturator 3460 may be configured to seal the evacuation area 3439 of the seal housing 3430. The obturator 3460 may be configured to seal the first (e.g., inner) lumen 3406. The obturator 3460 may include a proximal end or cap portion 3462 configured to seal an evacuation area 3439 of the seal housing 3430, such as, for example, an evacuation aperture 3439 disposed on the proximal end of the seal housing 3430. The elongate shaft 3464 of the obturator 3460 may be configured to be disposed within the first lumen 3406 of the cannula 3400 such that insufflation gas can pass between the exterior of the obturator shaft 3464 and the interior of the first lumen 3406 of the cannula 3400 and exit the distal end 3410 of the cannula 3400. This may be accomplished, for example, when the outer diameter of the obturator shaft 3464 is smaller than the inner diameter of the first lumen 3406. Further, the elongate shaft 3464 of the obturator 3460 can include a lumen disposed concentrically with, for example, the first lumen 3406 of the cannula 3400. The obturator lumen can also be configured to allow insufflation gas entering the gas entry port 3452 to enter the surgical cavity through the distal end 3466 of the obturator 3460.

[0141] 34B, when the obturator 3460 is removed (not shown in FIG. 34B), gas can flow from the surgical cavity in the direction of arrow 3474, into the second (e.g., outer) lumen 3416 of the cannula 3400, flow proximally within the cannula 3400, through a filter in the seal housing 3430, and out an exhaust aperture 3439 in the seal housing 3430 to the environment outside the surgical cavity. Similar to the gas flow described in FIG. 34A, when the obturator 3460 is removed (not shown in FIG. 34B), gas can flow in the direction of arrow 3454 such that the first lumen 3406 can be configured to receive insufflation gas delivered from a gas entry port 3452 in the cannula top housing 3432, and to deliver insufflation gas to the surgical cavity from an outlet 3410 proximate the distal end 3414 of the elongate shaft 3404.

[0142] 35A-35B show cross-sectional views of an embodiment of a multi-lumen drainage cannula 3500. A scope or other medical instrument 3560 is not shown in FIG. 35A, but is shown in FIG. 35B for clarity. The lumen 3516 shown in FIG. 35B is created such that when a scope or other medical instrument 3560 is placed within the central lumen 3506 of the elongate shaft 3504 of the cannula 3500, one or more walls of the medical instrument 3560 define at least a portion of one or more side walls of the lumen 3516. The ribs 3508 are configured to extend inwardly, e.g., radially inwardly, from an inner surface of the elongate shaft 3504 to an outer surface of a medical instrument, such as a scope 3560, placed within the lumen 3506 of the elongate shaft 3504 of the cannula 3500. The lumen 3516 may be formed by ribs 3508 disposed around the medical device 3560 and configured to secure the position of the medical device 3560. Depending on the number of ribs 3508 present, multiple lumens 3516 may be formed when the medical device 3560 is disposed within the cannula 3500. One or more of the lumens 3516 may be gas exhaust lumens. However, any combination of the lumens 3506, 3516 may be used to exhaust gas or provide insufflation gas. In other embodiments, all of the lumens 3506, 3516 are used for exhaust. In some embodiments, the cannula 3500 does not provide insufflation gas at all. In some embodiments, there may be about or at least about 1, 2, 3, 4, 5, 6, 7, or 8, or more than 8 ribs 3508. The multiple ribs 3508 may be configured to be spaced apart from one another and thin enough to prevent the gas exhaust flow from being disturbed. In some embodiments, the ribs 3508 can have a thickness less than about, e.g., 25%, 20%, 15%, 10%, 5%, or less than 5% of the inner diameter of each lumen that contains the ribs 3508, or a range including any two of the foregoing values. In some embodiments, the ribs 3508 are integral with or otherwise attached to the inner wall of the elongate shaft 3504. The ribs 3508 can create a partition between the gas inflow path (the lumen 3506 of the elongate shaft 3504) and the gas outflow path (the outer lumen 3516 toward the vent).

[0143] FIG 35B is a cross-sectional view of FIG 35A with a scope or other medical instrument 3560 disposed within the cannula 3500. As shown, the medical instrument, for example, the scope 3560, can be configured to form a portion of the inner lumen wall. Rather than forming a wall with a separate inner lumen to create a multi-lumen cannula (such as the cannula 300 shown in FIG 4), the illustrated outer lumen 3516 can be formed by the inner surface of the elongate shaft 3504, the ribs 3508, and a portion of the outer surface of the medical instrument 3560 (inserted within the elongate shaft 3504). The inner lumen 3506 can be formed by the scope 3560 inserted within the elongate shaft 3504 of the cannula 3500.

[0144] term Examples of medical gas delivery systems and related components and methods have been described with reference to the figures. The figures show various systems and modules and connections between them. The various modules and systems can be combined in various configurations, and the connections between the various modules and systems may represent physical or logical links. The representations in the figures are presented for clarity of the principles, and details regarding the division of modules or systems are provided for ease of explanation, rather than attempting to detail separate physical embodiments. The examples and figures are intended to be illustrative, and do not limit the scope of the inventions described herein. For example, the principles herein may be applied to other types of humidification systems, including respiratory humidifiers, as well as surgical humidifiers. However, the humidification systems and methods may also, optionally, not involve the patient's respiratory system, and may not be located within a portion of the airway (e.g., nose, mouth, trachea, and / or bronchi).

[0145] As used herein, the term "processor" broadly refers to any suitable device, logic block, module, circuit, or combination of elements for executing instructions. For example, the controller 8 may include any conventional general-purpose single or multi-chip microprocessor, such as, for example, a Pentium® processor, a MIPS® processor, a Power PC® processor, an AMD® processor, an ARM® processor, or an ALPHA® processor. Additionally, the controller 122 may include any conventional special-purpose microprocessor, such as, for example, a digital signal processor or a microcontroller. The various illustrative logic blocks, modules, and circuits described in connection with the embodiments disclosed herein may be implemented or executed with a general-purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein, or pure software within a main processor. For example, the logic modules may be software-implemented functional blocks that do not utilize any additional and / or specialized hardware elements. A controller may be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a combination of a microcontroller and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration.

[0146] Data storage can refer to electronic circuitry that allows data to be stored and retrieved by a processor. Data storage can refer to external devices or systems, such as disk drives or solid-state drives. Data storage can also refer to high-speed semiconductor storage (chips), such as random access memory (RAM) or various forms of read-only memory (ROM), that are directly connected to a communication bus or controller. Other types of data storage include bubble memory and core memory. Data storage can be physical hardware configured to store data in a non-transitory medium.

[0147] Although specific embodiments and examples are disclosed herein, the subject matter extends to other alternative embodiments and / or uses, as well as modifications and equivalents thereof, other than the specifically disclosed embodiments. Thus, the scope of the claims or embodiments appended hereto is not limited by any of the specific embodiments described herein. For example, in any method or process disclosed herein, the acts or operations of the method or process can be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described in sequence as multiple separate operations, in a manner that may be useful in understanding a particular embodiment. However, the order of description should not be construed as implying that these operations are order dependent. Furthermore, structures described herein may be embodied as integral components or as separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily achieved by any particular embodiment. Thus, for example, various embodiments may be practiced in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0148] As used herein, conditional language such as, among others, "can," "could," "might," "may," "eg," and the like, unless otherwise indicated or understood within the context in which it is used, is intended to generally convey that certain embodiments include certain features, elements, and / or conditions, while other embodiments do not include certain features, elements, and / or conditions. Thus, such conditional language does not generally imply that the features, elements, and / or conditions are in any way required for one or more embodiments. As used herein, the terms "comprises," "comprising," "includes," "including," "has," "having," or any other variation thereof, are intended to include a non-exclusive inclusion. For example, a process, method, article, or apparatus that includes a list of elements is not necessarily limited to only those elements and may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Also, the term "or" is used in its inclusive (rather than its exclusive) sense, for example, when used to connect a list of elements, so that the term "or" means one, some, or all of the elements in the list. A conjunction such as "at least one of X, Y, and Z" is understood to convey that an item, term, etc., can be either X, Y, or Z, unless otherwise indicated, in the context of common usage. Thus, such a conjunction does not generally imply that a particular embodiment requires that at least one X, at least one Y, and at least one Z, respectively, are present. As used herein, the term "about" or "approximately" can mean that a value is within ±10%, within ±5%, or within ±1% of the stated value.

[0149] The methods and processes described herein may be embodied in and partially or fully automated through software code modules executed by one or more general-purpose and / or special-purpose computers. The term "module" refers to logic embodied in hardware and / or firmware, or a collection of software instructions, possibly with entry and exit points, written in a programming language, such as, for example, C or C++. Software modules may be compiled and linked into executable programs, installed in dynamically linked libraries, or written in an interpreted programming language, such as, for example, BASIC, Perl, or Python. It will be understood that software modules may be callable from other modules or from themselves, and / or may be called in response to a detected event or interrupt. Software instructions may be embedded in firmware, such as an erasable programmable read-only memory (EPROM). It will be further understood that hardware modules may include connected logic units, such as gates and flip-flops, and / or may include programmable units, such as programmable gate arrays, application specific integrated circuits, and / or processors. The modules described herein may be implemented as software modules, but may also be represented in hardware and / or firmware. Further, in some embodiments, the modules may be separately compiled, while in other embodiments, the modules may represent a subset of instructions of a separately compiled program and may not have an interface available to other logical program units.

[0150] In particular embodiments, the code modules may be implemented and / or stored on any type of computer readable medium or other computer storage device. In some systems, data (and / or metadata) entered into the system, data generated by the system, and / or data used by the system may be stored in any type of computer data repository, such as a relational database and / or a flat file system. Any of the systems, methods, and processes described herein may include interfaces configured to enable interaction with users, operators, other systems, components, programs, and the like.

[0151] It should be emphasized that many variations and modifications may be made to the embodiments described herein, and these elements are to be understood as being among the permissible examples. All such modifications and variations are intended to be included herein within the scope of this disclosure and protected by the following claims. Moreover, nothing in the foregoing disclosure is intended to imply that any particular component, feature, or process step is required or essential.

Claims

1. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity through an outlet proximate a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas out of the surgical cavity through the second lumen outlet; the second lumen in fluid communication with an evacuation element operatively connected to the surgical cannula; Surgical cannula.

2. The surgical cannula of claim 1 , wherein the first lumen and the second lumen are at least partially nested within one another.

3. 3. The surgical cannula of claim 1, wherein the first lumen and the second lumen are fully nested within one another.

4. The surgical cannula according to any one of claims 1 to 3, wherein the first lumen and the second lumen are concentric with each other.

5. The surgical cannula of claim 1 , wherein the first lumen is radially offset relative to the second lumen.

6. The surgical cannula of claim 1 , wherein the second lumen is radially offset relative to the first lumen.

7. The surgical cannula of any one of claims 1 to 6, wherein the second lumen comprises a diameter greater than a diameter of the first lumen.

8. The surgical cannula of any one of claims 1 to 6, wherein the first lumen comprises a diameter greater than a diameter of the second lumen.

9. The surgical cannula of any one of claims 1 to 8, wherein the evacuation element is configured to provide passive evacuation caused by a pressure differential across the surgical cavity.

10. The surgical cannula of any one of claims 1 to 9, wherein the first lumen inlet is configured to connect with a gas supply outlet.

11. 11. A surgical cannula according to any one of claims 1 to 10, wherein the first lumen or the second lumen includes one or more positioning ribs configured to position and / or retain the other of the first lumen or the second lumen.

12. The surgical cannula of claim 11 including at least three positioning ribs.

13. 12. The surgical cannula of claim 11, wherein the positioning rib is integrally formed with an inner wall of the first lumen or the second lumen.

14. The surgical cannula of any one of claims 1 to 6 or 8 to 13, wherein the first lumen comprises a cross-sectional area that is greater than a cross-sectional area of ​​the second lumen.

15. The surgical cannula of any one of claims 1 to 6 or 8 to 13, wherein the second lumen comprises a cross-sectional area greater than a cross-sectional area of ​​the first lumen.

16. 15. The surgical cannula of any one of claims 1 to 14, wherein the second lumen comprises one of a semicircular, crescent, or arcuate profile and the first lumen comprises a circular profile.

17. The surgical cannula of claim 1 , wherein the second lumen includes a spiral shape that at least partially circumscribes the first lumen.

18. The surgical cannula of any one of claims 1 to 17, wherein the first lumen is configured to accommodate a medical instrument within the first lumen.

19. 19. The surgical cannula of any one of claims 1 to 18, further comprising a third lumen, the third lumen configured to accommodate a medical instrument within the third lumen.

20. The surgical cannula of any one of claims 1 to 19, further comprising a filter in fluid communication with the second lumen.

21. 21. The surgical cannula of claim 20, wherein the filter is contained within the evacuation element that is removably coupled to the cannula upper housing.

22. 22. The surgical cannula of claim 21, wherein the evacuation element is removably coupled to the cannula upper housing by a clip.

23. 21. The surgical cannula of claim 20, wherein the filter is integrally formed with the cannula upper housing.

24. 21. The surgical cannula of claim 20, wherein the filter is integrally formed with the second lumen.

25. 21. The surgical cannula of claim 20, wherein the filter is disposed within the cannula upper housing.

26. 22. The surgical cannula of claim 20 or 21, wherein the filter is operatively connected to a conduit connected to a proximal end of the cannula upper housing.

27. The surgical cannula of claim 1 , wherein the second lumen outlet is at an angle relative to a longitudinal axis of the cannula upper housing.

28. 26. The surgical cannula of claim 25, wherein the angle of the second lumen outlet is approximately 45 degrees.

29. 29. The surgical cannula of any one of claims 1 to 28, wherein the cannula further comprises a seal configured to seal against a medical instrument, the seal being located within the cannula upper housing and aligned with at least one of the first lumen and the second lumen.

30. 30. The surgical cannula of claim 29, wherein the seal comprises a duckbill seal or a flap seal.

31. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula upper housing and the elongate shaft include a lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity proximate a distal end of the elongate shaft, the lumen inlet being in fluid communication with a source of the insufflation gas; The lumen is also configured to receive gas from the surgical cavity and vent the gas from the surgical cavity out of the surgical cavity; the cannula further includes an evacuation element in fluid communication with the lumen, the evacuation element including a filter configured to filter the gas from the surgical cavity before the gas from the surgical cavity is evacuated from the surgical cannula. Surgical cannula.

32. 32. The surgical cannula of claim 31, wherein the evacuation element is integrated into the cannula upper housing.

33. A surgical cannula according to any one of claims 31 to 33, wherein the evacuation element is integrated into the lumen.

34. 34. The surgical cannula of any one of claims 31 to 33, wherein the lumen includes a wall extending axially partially along the lumen, the wall configured to divide the lumen into a first passageway configured to deliver insufflation gas to the surgical cavity and a second passageway configured to evacuate gas from the surgical cavity.

35. 35. The surgical cannula of claim 34, wherein the first passageway is concentric with the second passageway.

36. 35. The surgical cannula of claim 34, wherein the first passageway is offset from the second passageway.

37. A surgical cannula according to any one of claims 34 to 36, wherein the first passageway is fluidly isolated from the second passageway.

38. A surgical cannula according to any one of claims 31 or 34 to 37, wherein the evacuation element is removably attached to the cannula upper housing.

39. 39. The surgical cannula of any one of claims 31 to 38, wherein the evacuation element further comprises a first locking mechanism configured to lock the evacuation element to a second complementary locking mechanism on the cannula upper housing, the first locking mechanism creating a seal between the evacuation element and the cannula upper housing when the first locking mechanism is locked to the second locking mechanism.

40. 40. The surgical cannula of any one of claims 31 to 39, wherein the evacuation element includes at least one evacuation aperture, the filter being disposed adjacent to the evacuation aperture and configured such that gas from the surgical cavity passes through the filter and exits through the at least one evacuation aperture.

41. 41. The surgical cannula of claim 40 including a plurality of evacuation apertures, wherein the evacuation of gas from the surgical cavity occurs passively due to a pressure differential between the surgical cavity and the surrounding air.

42. A surgical cannula according to any one of claims 31 to 40, wherein the evacuation element comprises a evacuation valve.

43. 43. The surgical cannula of claim 42, wherein the exhaust valve comprises a solenoid valve.

44. 44. The surgical cannula of any one of claims 31 to 43, wherein the evacuation element includes one or more sensors, the one or more sensors configured to sense at least one of temperature, pressure, and humidity.

45. 44. The surgical cannula of any one of claims 31 to 43, wherein the evacuation element includes a built-in heating element configured to heat a portion of the filter and prevent condensation on the filter.

46. 46. ​​The surgical cannula of claim 31, wherein the evacuation element includes fins extending into the cannula upper housing and positioned adjacent a gas inlet port to guide the flow of insufflation gas from the gas inlet port.

47. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; a first filter and a second filter in fluid communication with the second lumen, the second filter being spaced distally from the first filter; Including, the cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity through an outlet proximate a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas out of the surgical cavity through the second lumen outlet; the second lumen in fluid communication with an evacuation element operatively connected to the surgical cannula; Surgical cannula.

48. 48. The surgical cannula of claim 47, wherein the first filter is contained within the evacuation element that is removably coupled to the cannula upper housing.

49. 48. The surgical cannula of claim 47, wherein the second filter is disposed distal to the first filter and includes a sidewall gas exhaust exit port.

50. 49. The surgical cannula of claim 48, wherein the second filter is disposed within the cannula upper housing.

51. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity through an outlet proximate a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas through the second lumen outlet; the second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula; the cannula further includes a blower unit in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit, the blower unit configured to draw the gas from the surgical cavity into the second lumen. Surgical cannula.

52. 52. The surgical cannula of claim 51, wherein the blower drive unit includes a magnetic circular ring.

53. 1. A multi-cannula surgical cannula system for supplying insufflation gas to a surgical cavity and for recirculating filtered insufflation gas to said surgical cavity, comprising: a first cannula including a first lumen configured to accommodate a first medical device within the first lumen, a second lumen, a blower unit in fluid communication with the second lumen, and at least one filter in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit, the blower unit configured to aspirate the gas from the surgical cavity into the second lumen, the second lumen configured to receive the aspirated gas from the surgical cavity; a second cannula including a first lumen configured to accommodate a second medical device within the first lumen and a second lumen configured to be in fluid communication with the second lumen of the first cannula via a conduit, the second lumen of the second cannula configured to recirculate the filtered insufflation gas to the surgical cavity; Including, At least one of the first cannula and the second cannula further includes an insufflation gas inlet connectable to a source of insufflation gas. Surgical cannula system.

54. 1. A surgical cannula system for supplying insufflation gas to a surgical cavity and for recirculating filtered insufflation gas to said surgical cavity, comprising: a cannula including a first lumen configured to accommodate a first medical device within the first lumen, a second lumen, a blower unit in fluid communication with the second lumen, and at least one filter in fluid communication with the second lumen, the blower unit including a fan and a blower drive unit, the blower unit configured to draw gas from the surgical cavity into the second lumen, and the second lumen configured to receive the drawn gas from the surgical cavity. Including, the cannula further includes a third lumen in communication with the second lumen of the first cannula through the at least one filter, the third lumen configured to recirculate the filtered insufflation gas to the surgical cavity; The cannula further includes an insufflation gas inlet connectable to a source of insufflation gas. Surgical cannula system.

55. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity through an outlet proximate a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas through the second lumen outlet; the second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula; The cannula further includes a control operatively connected to a seal adjacent the second lumen outlet, the control having an inactivated state and an activated state, the control in the activated state opening the seal and allowing the gas to escape through the second lumen outlet. Surgical cannula.

56. 56. The surgical cannula of claim 55, wherein the control comprises a button.

57. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula top housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet in the cannula top housing and deliver the insufflation gas to the surgical cavity from an outlet near a distal end of the elongate shaft, the first lumen inlet configured to be in fluid communication with a first source of insufflation gas via a first conduit and with a second source of insufflation gas via a second conduit; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a second lumen outlet, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas through the second lumen outlet; the second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula; the second source of insufflation gas is a high pressure insufflation gas source configured to create a pressure differential sufficient to draw smoke from the surgical cavity into the second cavity by a Venturi effect; Surgical cannula.

58. 1. A surgical cannula for supplying insufflation gas to and evacuating gas from a surgical cavity, comprising: A cannula upper housing; an elongate shaft extending from the cannula upper housing; Including, the cannula upper housing and the elongate shaft include a first lumen including a first lumen inlet and a first lumen outlet, the first lumen configured to receive insufflation gas from an inlet of the cannula upper housing and deliver the insufflation gas to the surgical cavity through an outlet proximate a distal end of the elongate shaft, the first lumen inlet being in fluid communication with a source of insufflation gas; the cannula upper housing and the elongate shaft include a second lumen including a second lumen inlet and a plurality of second lumen outlets, the second lumen configured to receive gas from the surgical cavity through the second lumen inlet and to exhaust the gas through the plurality of second lumen outlets; the second lumen is in fluid communication with an evacuation element operatively connected to the surgical cannula; the cannula upper housing is configured to be connected to a rotatable proximal cap including threads and a plurality of circumferentially oriented slots configured to block or at least partially allow exhaust from the plurality of second lumen outlets upon rotation of the rotatable cap to control the exhaust rate of the gas. Surgical cannula.

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