Gas-sealed access cap for robotic cannula

Abstract

To provide a gas-sealed access cap for a robotic cannula.SOLUTION: A gas-sealed access cap 30 for a robotic cannula includes a housing 82 defining an interior cavity 88 that supports an annular jet assembly 110 for receiving pressurized gas from an inlet port 90 of the housing 82, where the annular jet assembly 110 is adapted to generate a gaseous sealing zone within the robotic cannula to maintain a stable pressure within the surgical cavity of a patient during the performance of a robotically assisted laparoscopic surgical procedure.SELECTED DRAWING: Figure 7

Description

Technical Field

[0001] Cross - reference to related applications This application claims priority to U.S. Provisional Patent Application No. 63 / 227,449, filed Jul. 30, 2021, and U.S. Provisional Patent Application No. 63 / 231,390, filed Aug. 10, 2021, the disclosures of which are hereby incorporated by reference in their entirety (including all appendices thereto).

[0002] Field of disclosure The present disclosure is directed to endoscopic surgery, and more particularly, to a gas-sealing access cap for performing robot-assisted laparoscopic surgery using a robotic cannula, and a method of using the same.

Background Art

[0003] Description of related art Laparoscopic or “minimally invasive” surgical techniques are becoming increasingly popular in performing surgeries such as cholecystectomy, appendectomy, hernia repair, and nephrectomy. Advantages of such surgeries include reduced trauma to the patient, reduced likelihood of infection, and shorter recovery times. Such surgeries within the abdomen (peritoneal cavity) are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the patient's abdominal cavity.

[0004] In addition, such surgeries generally involve filling the abdomen or “insufflating” the abdomen with a pressurized fluid, such as carbon dioxide, to create a surgical space known as pneumoperitoneum. Insufflation can be performed by a surgical access device, such as a trocar equipped to deliver the insufflation fluid, or by a separate insufflation device, such as an insufflation (Veress) needle. To maintain pneumoperitoneum, it is desirable to introduce surgical instruments into the pneumoperitoneum without substantial loss of the insufflation gas.

[0005] During typical laparoscopic surgery, the surgeon makes three to four small incisions (usually each about 12 millimeters or less), which are often made using the surgical access device itself and often using separate inserters or obturators placed therein. After insertion, the obturator is removed and the trocar allows access to the instruments inserted into the abdominal cavity. A typical trocar provides a path for insufflating air into the abdominal cavity so as to have an open internal space in which the surgeon works.

[0006] The trocar must provide a way to maintain the pressure within the cavity by means of a seal between the trocar and the surgical instrument being used while still allowing at least a minimum amount of freedom of movement of the surgical instrument. Such instruments can include, for example, scissors, grasping instruments and obturators, cautery units, cameras, light sources, other surgical instruments. A sealing element or mechanism is typically provided in the trocar to prevent leakage of the insufflated gas from the abdominal cavity. These sealing mechanisms often comprise duckbill valves made of a relatively flexible material to seal around the outer surface of the surgical instrument passing through the trocar.

[0007] SurgiQuest, Inc., a wholly-owned subsidiary of ConMed Corporation, has developed a unique gas-sealed surgical access device that provides immediate access to the insufflated surgical cavity without the need for a conventional mechanical valve seal, as described, for example, in U.S. Patent No. 8,795,223. These devices are constructed from several nested components including an inner tubular portion and a coaxial outer tubular portion. The inner tubular portion defines a central lumen for introducing conventional laparoscopic surgical instruments into the patient's abdominal cavity, and the outer tubular portion defines an annular lumen surrounding the inner tubular portion for delivering insufflation gas to the patient's abdominal cavity and for facilitating periodic sensing of abdominal pressure.

[0008] Robot-assisted minimally invasive surgery is also becoming increasingly common. One well-known system for performing these surgeries is called the Da Vinci robotic surgical system, which is manufactured and sold by Intuitive Surgical, Inc. of Sunnyvale, California. The Da Vinci system utilizes custom-designed trocars or cannulas that are adapted and configured to receive robotic instruments and to be engaged by robotic arms. The custom-designed Da Vinci cannulas have a proximal housing that forms a bowl for receiving components such as a gas-tight seal assembly, as disclosed, for example, in U.S. Patent No. 10,463,395. The Da Vinci gas-tight seal assembly utilizes a mechanical seal to seal around the outer surface of a surgical instrument passing through the cannula and to prevent leakage of insufflation gas from the abdominal cavity.

[0009] It is considered beneficial to provide a seal assembly for use with a Da Vinci cannula that allows immediate access to an insufflated surgical cavity without the need for a mechanical seal assembly. In fact, a recent example of such a valveless seal assembly is disclosed in U.S. Patent No. 11,026,717 by the same applicant, which describes a gas-sealing access cap for use with a Da Vinci robotic cannula. The present disclosure improves upon this previous gas-sealing access cap and provides a useful method for installing and using the access cap with a robotic cannula for performing laparoscopic surgery. SUMMARY OF THE INVENTION

[0010] The present disclosure is directed to a new and useful gas-sealing access cap for use with a robotic cannula that provides a stable pneumoperitoneum for a defined exposure even during aspiration and leakage, allows a surgeon to operate confidently at a low intra-abdominal pressure, provides a defined smoke evacuation to maintain visibility throughout the surgery, and provides valveless access to the surgical site to enable extraction of an intact specimen.

[0011] The gas-sealed access cap of the present disclosure includes a housing having a lid that defines a central access port communicating with an internal cavity, which receives pressurized gas through an inlet port to create a gas-sealed zone within the robotic cannula and directs used gas from the gas-sealed zone to an outlet port. The inlet port and the outlet port of the housing communicate with a manifold associated with a bull's-eye connector fitting to communicate with the pressurized gas line and the return gas line of the filter-equipped tube set.

[0012] The central access tube is aligned with the central access port of the housing and extends distally from the internal cavity to communicate with the tubular portion of the robotic cannula. The distal end of the housing extends distally beyond the distal end of the central access tube for reception within the proximal bowl portion of the robotic cannula, and a pair of diametrically opposed flexible clips extends from a circumferential flange integrally formed with the outer surface of the housing to removably secure the access cap to the proximal bowl portion of the robotic cannula.

[0013] The annular jet assembly is supported within the internal cavity of the housing for creating a gas-sealed zone within the robotic cannula to maintain a stable pressure within the surgical cavity of the patient. The annular jet assembly includes a central opening aligned with the central access port of the lid. A plurality of circumferentially spaced radially inwardly extending vanes are integrally formed with the housing and are positioned within the internal cavity below the annular jet assembly to direct used gas from the gas-sealed zone to the outlet port of the housing.

[0014] The circumferential groove is formed on the outer surface of the distal housing of the diametrically opposed flexible clips for accommodating the O-ring seal. The circumferential groove is located proximal to the plurality of spaced-apart wings. Each of the diametrically opposed flexible clips includes a proximal portion, an intermediate portion, and a distal portion. The proximal portions of the diametrically opposed flexible clips are parallel to each other, the distal portions of the diametrically opposed flexible clips extend to the circumferential groove, and the circumferential flange is proximal to the circumferential groove.

[0015] The gas-sealing access cap further includes an obturator having a proximal handle portion for cooperatingly engaging with the lid of the housing, and an elongated obturator shaft extending distally from the handle and having a distal cutting tip. The annular seal is supported on the obturator shaft at a position along its length for sealing against the inner surface of the central access tube when the obturator shaft is extended through the central access port of the housing.

[0016] The present disclosure also relates to a novel and useful method of performing robot-assisted laparoscopic surgery within a patient's abdominal cavity. The method includes inserting a first robotic cannula into the patient's abdominal cavity with a valve-sealing cannula cap connected thereto, connecting a single-lumen tube portion of a tube set to the valve-sealing cannula cap, inserting a second robotic cannula into the patient's abdominal cavity with a valve-sealing cannula cap connected thereto, and connecting a double-lumen tube portion of a filtered tube set to the gas-sealing cannula cap.

[0017] More specifically, the method includes providing a surgical access system having a gas delivery device, a Veress needle, a valve seal cannula cap, a gas seal cannula cap having an obturator connected to the gas seal cannula cap, a first robotic cannula, a second robotic cannula, and a filter tube set including a filter cartridge, a single lumen tube portion, and a double lumen tube portion, wherein a removable plug is initially attached to a fitting at the distal end of the double lumen tube portion of the filter tube set.

[0018] The method further includes inserting the filter cartridge of the filter tube set into the receiving port of the gas delivery device, locking the filter cartridge within the receiving port by rotating a mechanical lever arm of the gas delivery device, and then verifying that the flow rate setting and pressure setting of the gas delivery device are appropriate for the patient.

[0019] The method further includes inserting the Veress needle into the patient's abdominal cavity, connecting the single lumen tube portion of the filter tube set to the connector of the Veress needle, and then insufflating the abdominal cavity through the Veress needle until a set intra-abdominal pressure is reached.

[0020] The method further includes connecting the gas seal cannula cap, together with the obturator, to the second robotic cannula, inserting the first robotic cannula into the patient's abdominal cavity with the valve seal cannula cap connected thereto, and then inserting the second robotic cannula into the patient's abdominal cavity with the gas seal cannula cap connected thereto.

[0021] The method further includes removing a plug from a fitting at the distal end of the double lumen tube portion of the filtered tube set, and then connecting the fitting of the double lumen tube portion of the filtered tube set to the connector of the gas seal cannula cap. The method includes detaching the single lumen tube portion of the tube set from the Veress needle, and then connecting the single lumen tube portion of the tube set to the connector of the valve seal cannula cap, after which the gas delivery device will initiate circulation of pressurized gas through the gas seal cannula by way of the double lumen portion of the tube set, and the gas delivery device will perform a calibration process, and further includes the connecting step. Thereafter, the obturator is removed from the gas seal cannula cap.

[0022] After completion of the robot-assisted laparoscopic surgery, the method involves replacing the obturator within the gas seal cannula cap. At this point, the circulation of pressurized gas by the gas delivery device is stopped, and the method includes detaching the double lumen portion of the tube set from the connector of the gas seal cannula cap.

[0023] These and other features of the disclosed apparatus, system, and method will become more readily apparent from the following detailed description of the disclosed embodiments taken in conjunction with the drawings.

Brief Description of the Drawings

[0024] The embodiments will be described in detail below with reference to the drawings so that those skilled in the art can readily understand how to manufacture and use the gas seal access cap of the present disclosure without undue experimentation.

[0025]

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DETAILED DESCRIPTION OF THE INVENTION

[0026] Referring now to the drawings, an operating room including a robotic surgical system 10 and a multimodal gas delivery device 20 is illustrated in FIG. 1, along with the novel gas-sealed access cap 30 of the present disclosure being used to perform laparoscopic surgery on a patient.

[0027] The robotic surgical system 10 illustrated in FIG. 1 is depicted as a Da Vinci robotic surgical system, which is manufactured and sold by Intuitive Surgical, Inc. of Sunnyvale, California. The system basically includes a console 12 on which a surgeon sits to remotely perform a surgical operation on a patient, and a patient-side cart 14 having four interactive robotic arms 16a-16d controlled by the surgeon from the console 12.

[0028] The multimodal gas delivery device 20 shown in FIG. 1 is illustrated as an iFS intelligent flow system, which is manufactured and sold by Conmed Corporation of Largo, Florida. An example of such a device is disclosed in U.S. Patent No. 9,526,849, the disclosure of which is incorporated herein by reference in its entirety. The gas delivery device 20 is supported on a mobile tower cart 22 having a monitor screen 24 that enables the operating room staff to see what the surgeon is viewing inside the abdominal cavity with an endoscope at the console 12 during a surgical operation. The gas delivery device 20 is adapted and configured to operate in multiple modes to insufflate the patient's abdominal cavity during a surgical operation to measure the intra-abdominal pressure, maintain a stable pneumoperitoneum to facilitate access of instruments without a valve to the abdominal cavity, and facilitate smoke evacuation from the abdominal cavity.

[0029] Referring now to FIGS. 2 and 3, the gas-sealed access cap 30 of the present disclosure is shown in conjunction with a filtered tube set 40 and a valve-sealed access cap 60. The gas-sealed access cap 30 and the valve-sealed access cap 60 are each operably connected to their respective robotic cannulas 35c and 35a. These are Da Vinci Xi / X type robotic cannulas. An example is disclosed in U.S. Patent No. 10,463,395, which is assigned to Intuitive Surgical Operation Inc. and is hereby incorporated by reference in its entirety. The valve-sealed access cap 60 is also manufactured by Intuitive Surgical, Inc. A similar example of a valve-sealed access cap is disclosed in U.S. Patent No. 10,463,395.

[0030] The filtered tube set 40 shown in FIG. 2 includes a disposable filter cartridge 42 sized and configured for insertion into the receiving port 27 of the gas delivery device 20. A rotatable lever arm 25 is used to lock the filter cartridge 42 within the receiving port 27. The filter cartridge 42 includes a generally cylindrical housing 45 defining a plurality of internally filtered flow paths (not shown) extending between a rear end cap 44 and a front end cap 46. This type of filter cartridge is disclosed in U.S. Patent No. 9,067,030 to the same applicant, and the entire disclosure thereof is hereby incorporated by reference. The internally filtered flow paths of the filter cartridge are shown and described therein.

[0031] The air supply and sensing lumen or tube 48, the gas supply lumen or tube 50, and the gas return lumen or tube 52 extend from a manifold 54 on a front end cap 46 of the filter cartridge 42. In one embodiment of the present disclosure, the air supply lumen 48 consists of a transparent tube, while the gas supply tube 50 and the gas return tube 52 consist of colored tubes. This helps to visually distinguish these tubes from each other within the operating room. The air supply and sensing lumen 48 has a standard luer fitting 56 at its distal end for mating with a luer connector 58 of a valve seal access cap 60. The gas supply lumen 50 and the gas return lumen 52 distally extend to a common multi-lumen bull's eye fitting 62 for mating with a multi-lumen bull's eye connector 96 on a gas seal access cap 30 (see FIG. 8).

[0032] The bull's eye fitting 62 is of the triple-lumen type disclosed in U.S. Patent No. 9,526,886 by the same applicant, the entire disclosure of which is incorporated herein by reference. The bull's eye fitting 62 is somewhat different from the triple-lumen fitting disclosed in U.S. Patent No. 9,526,886 in that only two of the three gas flow paths of the fitting are utilized for gas flow. More specifically, the gas delivery and gas return passages of the fitting 62 are utilized. The remaining unused flow path is intentionally blocked during manufacturing, as best seen in FIG. 3. The gas delivery device 20 is programmed to recognize this difference.

[0033] However, it is envisioned that the fitting 62 can be constructed as a double-lumen bull's eye fitting having only two gas flow paths, as disclosed, for example, in U.S. Patent No. 10,736,657 by the same applicant, the entire disclosure of which is incorporated herein by reference, and is within the scope of the present disclosure. Other types of double-lumen fittings and connectors can also be used, such as those disclosed in U.S. Patent No. 11,065,430 by the same applicant, which is also incorporated herein by reference in its entirety.

[0034] As shown in FIG. 3, the robotic arms 16a - 16c of the patient - side cart 14 are used to grip and manipulate their respective robotic cannulas 35a - 35c during robotic - assisted laparoscopic surgery. More specifically, the first robotic arm 16a is shown gripping a first robotic cannula 35a associated with a valve - sealed access cap 60a connected to the insufflation and sensing lumen 48 of the tube set 40 by a Luer fitting 56. The second robotic arm 16b is shown gripping a second robotic cannula 35b associated with a second valve - sealed access cap 60b, and the third robotic arm 16c is shown gripping a third robotic cannula 35c associated with the gas - sealed access cap 30 of the present disclosure. The gas - sealed access port 30 is connected to the gas supply lumen 50 and the gas return lumen 52 by a bull - eye fitting 62.

[0035] In this exemplary view of FIG. 3, the first valve - sealed access cap 60a connected to the lumen 48 is used for insufflating the patient's abdomen and for allowing the gas delivery device 20 to periodically sense the intra - abdominal pressure. This first sealed access cap of the valve can also be used for access to instruments. The second valve - sealed access port 60b is used to provide abdominal access to the laparoscope A, and the gas - sealed access port 30 connected to the lumens 50 and 52 is used during surgery to maintain a stable pneumoperitoneum, to provide valve - less access to surgical instrument B, and to allow for smoke evacuation from the abdomen. One of ordinary skill in the art will readily understand that the size, orientation, and / or arrangement of the robotic cannulas and surgical instruments shown in FIG. 3 can vary depending on the patient's anatomical structure and the surgery being performed.

[0036] Referring now to FIGS. 4-6, the gas-sealing access cap 30 of the present disclosure is shown in conjunction with the robotic cannula 35 and the obturator 70. The obturator 70 is adapted and configured to facilitate percutaneous introduction of the robotic cannula 35 into the patient's abdominal cavity during surgery. This is typically done under visualization by the surgeon through a small incision in the abdominal wall.

[0037] The robotic cannula 35 (i.e., the Da Vinci X / Xi robotic cannula) generally includes a generally cylindrical proximal bowl portion 32 and an elongated tubular body portion 34 extending distally from the proximal bowl portion 32. The proximal bowl portion 32 includes an internal bowl region 37 dimensioned and configured to receive the gas-sealing access cap 30. The grasping handle 36 extends radially outward from the outer wall of the proximal bowl portion 32 to facilitate manipulation of the cannula 35 by the robotic arms 16a-16d, as shown in FIG. 3. The annular engagement flange 38 is formed at the upper end of the proximal bowl portion 32 of the cannula 35. The engagement flange 38 cooperates with a pair of diametrically opposed cantilever flexible engagement clips 102 and 104 that are integrally formed with the access cap 30, as shown in FIGS. 5 and 6. The engagement clips 102, 104, and the manner in which they cooperate with and releasably engage the flange 38 will be described in more detail below with reference to FIGS. 9 and 10.

[0038] When the access cap 30 is inserted into the internal bowl region 37 of the proximal bowl portion 32 of the robotic cannula 35, as depicted in FIG. 4, the annular O-ring seal 118 seated on the outer surface of the access cap 30 will sealingly engage the inner surface of the bowl region 37. This sealing interface will also be described in more detail below with reference to FIGS. 9 and 10.

[0039] Continuing to refer to FIGS. 5 and 6, obturator 70 is of the type disclosed in U.S. Patent No. 9,545,264 by the same applicant, the entire disclosure of which is incorporated herein by reference. Obturator 70 has a proximal handle portion 72 having a pair of diametrically opposed spring-biased latches 73a, 73b for cooperating engagement with a pair of diametrically opposed recesses 83 in the lid 84 of the housing (see FIG. 10).

[0040] The elongated tubular obturator shaft 74 extends distally from the handle portion 72 of obturator 70. Shaft 74 has a transparent optical cutting tip 76 at its distal end for visualization during insertion. An annular seal 78 is supported on obturator shaft 74 at a position along its length for interaction with the inner surface of access cap 30, which is described in more detail below with reference to FIG. 10. The proximal handle portion 72 of obturator 70 defines a central port 75 (see FIG. 25). The central port 75 of handle portion 72 communicates with a central bore 77 that extends through the elongated obturator shaft 74 to the distal optical cutting tip 76 (see FIG. 5). The central bore 77 of shaft 74 is dimensioned and configured to accommodate a rigid scope for visualization through cutting tip 76 during insertion through the patient's abdominal wall.

[0041] Referring now to FIGS. 7-10, gas-sealed access cap 30 includes a generally cylindrical housing 82 formed by an injection molding process from a lightweight medical-grade thermoplastic material. The material can be transparent, translucent, or opaque. The housing 82 of access cap 30 has an internal cavity 88 surrounded by a cover or lid 84 that defines a central access port 86. As previously shown in FIG. 6, diametrically opposed recesses 83 are formed in lid 84 and cooperate with diametrically opposed spring-biased latches 73a and 73b on obturator housing 72.

[0042] The internal cavity 88 of the housing 82 receives pressurized gas from the pump of the gas delivery device 20 through the inlet port 90. The pressurized gas is used to create a gas-sealed zone within the robotic cannula 35. The gas-sealed zone maintains a stable pneumoperitoneum and facilitates access of a valveless gas-sealing instrument to the abdominal cavity through the cannula 35. The spent gas used to create the gas-sealed zone within the robotic cannula 35 is directed from the internal cavity 88 of the housing 82 to the outlet port 92 and returns to the gas delivery device 20 by way of the filter cartridge 42 for recirculation.

[0043] Referring to FIGS. 7 and 8, the inlet port 90 and the outlet port 92 of the housing 82 communicate with a manifold 94 associated with a multi-lumen bull's-eye connector 96 designed to communicate with the bull's-eye fitting 62 of the tube set 40. The bull's-eye connector 96 and the manner in which it cooperates with the fitting 62 are described in greater detail in U.S. Patent No. 9,526,886 by the same applicant.

[0044] As best seen in FIG. 7, the two-piece annular jet assembly 110 is sealingly supported within the internal cavity 88 of the housing 82 of the access cap 30 for creating a gas-sealed zone within the robotic cannula 35 to maintain a stable pressure within the patient's surgical cavity. The annular jet assembly 110 is of the type disclosed in U.S. Patent No. 9,907,569 by the same applicant, the entire disclosure of which is incorporated herein by reference. The jet assembly 110 includes a central opening 112 that is aligned with the central access port 86 of the lid 84 (see FIG. 10). A sound attenuation disk 87 made of a foamed material is positioned within the housing 82 between the lid 84 and the annular jet assembly 110. The foamed disk 87 functions to filter, attenuate, or otherwise reduce noise that may emanate from the jet assembly 110 creating the gas-sealed zone.

[0045] Referring now to FIGS. 9 and 10, a plurality of vanes or fins 114 extending radially inwardly and spaced circumferentially are integrally formed with the housing 82 and are located within its internal cavity 88 below the annular jet assembly 110. These vanes 114 are adapted and configured to direct the spent gas from the gas-sealed zone of the cannula 35 towards the outlet port 92 of the housing 82. The arrangement of the vanes or fins 114 is similar to the arrangement of the vanes disclosed in U.S. Patent No. 8,795,223 by the same applicant, the disclosure of which is hereby incorporated by reference in its entirety. However, in that patent, the circumferentially spaced vanes are not integrally formed with the housing 82 of the access cap 30, but are formed within a separate nested insert.

[0046] The central access tube 98 extends distally from the arrangement of the circumferential vanes 114 within the lower portion of the internal cavity 88 and is aligned with the central access port 86 of the lid 84 of the housing 82 and the central opening 112 of the jet assembly 110. As best seen in FIG. 10, the central access tube 98 communicates with the internal bowl region 37 of the robotic cannula 35 and the central bore of the tubular body portion 34. As best seen in FIG. 9, the distal end of the housing 82 of the access cap 30 extends distally beyond the distal end of the central access tube 98.

[0047] The dimensional relationship between the distal end of the housing 82 and the distal end of the central access tube 98 ensures that when the two components are connected together, the gas-sealed access cap 30 will be properly seated within the proximal bowl portion 32 of the robotic cannula 35. As described above, the annular seal 78 is supported on the obturator shaft 74 of the obturator 70 at a position along its length. More specifically, the annular seal 78 is positioned to seal against the inner surface of the central access tube 98 adjacent to its distal end, as shown in FIG. 10. This prevents the outflow of insufflation gas through the gas-sealed access cap 30 at certain points during surgery, such as when the calibration or gas-sealing mode is not active.

[0048] As described above, the pair of diametrically opposed cantilever flexible engagement clips 102 and 104 are integrally formed with the housing 82 of the access cap 30 to removably engage the annular flange 38 at the upper portion of the proximal bowl portion 32 of the robotic cannula 35. More specifically, the engagement clips 102 and 104 are integrally formed with a circumferential flange 106 that extends radially outward from the outer surface of the housing 82 of the access cap 30 and is operably connected to the circumferential flange 106.

[0049] The two engagement clips 102, 104 each include a proximal portion 102a, 104a, an intermediate portion 102b, 104b, and a distal portion 102c, 104c. The proximal portions 102a, 104a of the flexible clips 102, 104 extend parallel to each other and have an outer gripping surface that can be pushed inward or bent by a user to release the clips 102, 104 from the flange 38 or otherwise disengage. The intermediate portions 102b, 104b are angled inwardly toward the housing 82 to provide a transition to the distal portions 102c, 104c. The distal portions 102c, 104c of the clips 102, 104 are integrally formed with opposing lateral bridges that extend radially outward from the respective circumferential flange 106. The distal ends of the distal portions 102c, 104c of the clips 102, 104 are bent radially inwardly to form diametrically opposed feet 102d, 104d that removably engage under the annular flange 38 in a mechanically retaining manner, which is best seen in FIG. 10.

[0050] As described above, when the access cap 30 is inserted into the inner bowl region 37 of the proximal bowl portion 32 of the robotic cannula 35, the annular O-ring seal 118 seated on the outer surface of the access cap 30 will sealingly engage the inner surface of the bowl region 37. The O-ring seal 118 is seated in a circumferential groove 116 formed in the outer surface of the housing 82, as best seen in FIG. 9. The O-ring seal 118 is located distally of the opposing legs 102d, 104d of the flexible clips 102, 104. This ensures that the O-ring seal 118 is properly seated against the inner wall of the inner bowl region 37 of the proximal bowl portion 32 of the robotic cannula 35, as best seen in FIG. 10.

[0051] Referring now to FIGS. 11 - 27, to perform robotic-assisted laparoscopic surgery according to the present disclosure, the method includes providing a surgical access system including a gas delivery device 20, a standard Veress needle 120, a gas-sealing access cap 30, a valve-sealing access cap 60 having an obturator 70 connected thereto, a first robotic cannula 35a, a second robotic cannula 35b, and a filter cartridge 42, a filter tube set 40 including a single lumen portion including a pneumoperitoneum / sensing lumen 48 and a double lumen portion including a gas supply lumen 50 and a gas return lumen 52. A removable plug 85 is attached to a fitting 62 at the distal end of the double lumen portions 50, 52, as best seen in FIG. 21.

[0052] As shown in FIG. 11, the method includes first inserting the filter cartridge 42 of the filtered tube set 40 into the receiving port 27 of the gas delivery device 20, and then locking the filter cartridge 42 within the receiving port 27 by rotating the mechanical lever arm 25 of the gas delivery device 20 as shown in FIG. 12. At this point, as depicted in FIG. 13, the user refers to the graphical user interface (GUI) screen 26 of the gas delivery device 20 to confirm that the flow rate setting (L / min) and pressure setting (mmHg) of the gas delivery device 20 are appropriate for the patient. The gas delivery device 20 can operate in a pediatric mode or an adult mode with different flow rate and pressure settings. If the settings are correct, as shown in FIG. 14, the user will press the confirmation button.

[0053] As shown in FIG. 15, the method further includes connecting the gas-sealed access cap 30 together with the obturator 70 to the robotic cannula 35. To ensure a stable connection between the cannula cap 30 and the cannula 35, an audible click sound is generated. This audible click sound will be generated by the mechanical interaction of the flexible engagement clips 102, 104, and the annular flange 38 of the cannula 35.

[0054] As shown in FIG. 16, the method further includes percutaneously inserting the Veress needle 120 into the patient's abdominal cavity, and then, as shown in FIG. 17, connecting the single-lumen tube portion 48 of the fitting portion 56 of the filtered tube set 40 to the luer connector 122 of the Veress needle 120. Thereafter, the GUI screen 26 of the gas delivery device 20 indicates that the device is ready, and the user presses the start button as shown in FIG. 18 to initiate the initial insufflation of the abdominal cavity through the Veress needle 120. When the set intra-abdominal pressure is reached (e.g., 8 mmHg), as illustrated in FIG. 19, a message indicating that the user can safely connect the double-lumen portions 50, 52 of the tube set 40 to the gas-sealed cannula cap 30 will be displayed on the GUI screen 26. At this point, the plug 85 on the bull's-eye fitting portion 62 at the distal ends of the double-lumen portions 50, 52 can be removed.

[0055] The method further includes the step of inserting the robotic cannula 35a into the patient's abdominal cavity with the valve-sealing cannula cap 60 connected thereto (see FIG. 22), and then, as shown in FIG. 20, inserting the robotic cannula 35 into the patient's abdominal cavity using the obturator 70 connected thereto and the gas-sealing cannula cap 30. Next, as shown in FIG. 21, the bull's-eye fitting 62 associated with the double lumen portions 50, 52 of the set of filter tubes 40 is inserted onto and rotatably engaged with the connector 96 of the gas-sealing cannula cap 30. One of ordinary skill in the art will readily understand that the gas-sealing cannula should be inserted last after all the valve-sealing cannulas associated with the surgery are positioned. This allows for the stiffest abdominal wall during the insertion of the cannula having the gas-sealing cannula cap 30.

[0056] Once the cannula 35a having the valve-sealing cannula cap 60 is positioned, the fitting 56 at the distal end of the single lumen tube portion 48 of the tube set 40 is disconnected from the Veress needle 120 and then rotatably connected to the luer connector of the valve-sealing cannula cap 60 as shown in FIG. 22. Thereafter, the gas delivery device 20 will automatically initiate the circulation of pressurized gas through the gas-sealing cannula 30 by way of the double lumen portions 50, 52 of the tube set 40, and the gas delivery device 20 will perform a calibration process.

[0057] FIG. 23 illustrates a graphical user interface screen 26 of a surgical gas delivery device 20 indicating to a user whether the gas delivery device 20 has automatically initiated or is initiating into a gas-sealed use mode, after which the system will calibrate with the obturator (e.g., obturator 70) in a predetermined position. At this point, the seal 78 on the obturator shaft 74 prevents the outflow of the supply gas through the access cap 30. The graphical user interface screen 26 of the surgical gas delivery device 20 will provide a message indicating that the gas-sealed use mode is active once calibration is complete, as depicted in FIG. 24. Next, the user can remove the obturator 70 from the gas-sealed cannula cap 30 and initiate a robot-assisted laparoscopic surgery, as shown in FIG. 25.

[0058] Upon completion of the robot-assisted laparoscopic surgery, the method involves replacing the obturator 70 within the gas-sealed cannula cap 30. At this point, the circulation of the pressurized gas by the gas delivery device 20 is stopped, and the fitting 62 at the distal ends of the double lumen portions 50, 52 of the tube set 40 is disconnected from the connector 96 of the gas-sealed cannula cap 30.

[0059] FIG. 26 illustrates a graphical user interface screen 26 of the surgical gas delivery device 20 providing the user with the ability to stop the gas-sealed use mode, after which the obturator 70 can be replaced within the access caps 30, 60 before disconnecting the cannula 35 from the filtered tube set 40 to prevent loss of intra-abdominal pressure. The GUI shown in FIG. 27 illustrates that the system will perform a final calibration, after which the power to the gas delivery device 20 can be turned off and the filtered tube set 40 can be unlatched and removed from the gas delivery device 20. Thereafter, the robot-assisted laparoscopic surgery will be terminated.

[0060] The present disclosure has been shown and described with reference to the preferred embodiments, but those skilled in the art will readily understand that changes and / or modifications can be made thereto without departing from the spirit or scope of the present disclosure.

Claims

1. A gas-sealing access cap for a robotic cannula, comprising: a) A housing having a lid defining a central access port extending to an internal cavity supporting an annular jet assembly for receiving pressurized gas from an inlet port, the annular jet assembly including a central opening aligned with the central access port of the lid and adapted to create a gas-sealed zone within the robotic cannula to maintain a stable pressure within the surgical cavity of a patient; b) A sound attenuation disk positioned within the housing between the lid and the annular jet assembly and coaxially disposed with the central access port of the lid to reduce noise generated from creating the gas-sealed zone; c) A plurality of vanes extending radially inwardly in a circumferentially spaced manner, integrally formed with the housing, and positioned within the internal cavity below the annular jet assembly to direct used gas from the gas-sealed zone to an outlet port of the housing; d) A central access tube extending distally from the internal cavity of the housing below the vanes and aligned with the central access port of the lid and the central opening of the annular jet assembly to communicate with a tubular portion of the robotic cannula, the distal end of the housing extending distally beyond the distal end of the central access tube for receipt within a proximal bowl portion of the robotic cannula; e) A pair of diametrically opposed flexible clips extending from a circumferential flange integrally formed with an outer surface of the housing for removably securing the access cap to the proximal bowl portion of the robotic cannula; f) An obturator having a proximal handle portion for cooperatively engaging the lid of the housing and an elongated obturator shaft extending distally from the handle and having a distal cutting tip, an annular seal being supported on the obturator shaft at a position along its length adjacent to its distal end to seal against an inner surface of the central access tube when the obturator shaft is extended through the central access port of the housing. A gas-sealing access cap as claimed in claim 1.

2. The gas-sealing access cap according to claim 1, wherein an O-ring seal is seated within a circumferential groove formed in the outer surface of the distal housing of the opposing flexible clip for sealing against the inner surface of the proximal bowl portion of the robotic cannula.

3. The gas-sealing access cap according to claim 1, wherein the proximal handle portion of the obturator includes a pair of diametrically opposed spring-biased clips for cooperating engagement with a lid of the housing.

4. The gas-sealing access cap according to claim 1, wherein the distal cutting tip of the obturator is a transparent distal optical cutting tip.

5. The gas-sealing access cap according to claim 4, wherein the proximal handle portion of the obturator defines a central port that communicates with a hole extending through the elongated obturator shaft to the distal optical cutting tip for receiving a scope.

6. The gas-sealing access cap according to claim 1, wherein the inlet port of the housing and the outlet port of the housing communicate with a manifold associated with a bull's eye connector fitting for communicating with a pressurized gas line and a return gas line of a filtered tube set.

7. The gas-sealing access cap according to claim 1, wherein the sound attenuation disk is made of a foamed material.

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