Manually driven reciprocating pumps

The manually driven reciprocating pump assembly addresses the limitation of short-term vacuum generation in existing pumps by employing a cylinder, piston mechanism, and recoil drivers with pulleys and ratchets, achieving stable vacuum pressure for prolonged medical procedures.

JP2025114497APending Publication Date: 2025-08-05ASAHI INTECC CO LTD
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Patent Information

Application Number
JP2025005453
Authority / Receiving Office
JP · JP
Patent Type
Applications
Current Assignee / Owner
Priority Date
2024-01-24
Filing Date
2025-01-15
Publication Date
2025-08-05

AI Technical Summary

Technical Problem

Existing medical vacuum pumps, such as 30 mL or 60 mL syringe pumps, are inadequate for generating stable vacuum pressure for extended periods during procedures like thrombectomy, as they lack the capacity to maintain vacuum force over time.

Method used

A manually driven reciprocating pump assembly with a cylinder, piston mechanism, check valves, and recoil drivers, including pulleys and ratchet mechanisms, allows for the application of vacuum pressure through a distal end, enabling rapid and sustained vacuum generation without lengthy build-up times.

Benefits of technology

The assembly effectively applies and maintains vacuum pressure for medical procedures, such as thrombectomy, by using a combination of pulleys, ratchets, and recoil springs to translate the piston, ensuring stable vacuum force over extended durations.

✦ Generated by Eureka AI based on patent content.

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Patent Text Reader

Abstract

To provide various assemblies, devices, components, systems, and methods related to manually driven reciprocating pumps.SOLUTION: An example assembly may include a cylinder comprising a proximal end, a distal end, and a body portion defined between the proximal end and the distal end. The assembly may further comprise a piston disposed within the cylinder. The assembly may further comprise a first check valve and a second check valve fluidly coupled to the distal end of the cylinder. The assembly may further comprise a piston mechanism. The piston mechanism may comprise a rotating shaft and a crank having a connecting rod. The assembly may further comprise a reaction driver. The reaction driver may include a first pull handle, a first pull cord, a first pulley, and a first reaction spring.SELECTED DRAWING: None
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Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to a manually driven reciprocating pump assembly capable of applying vacuum pressure. For example, exemplary embodiments relate to a manually driven reciprocating pump assembly for use in medical applications such as thrombectomy. (CROSS-REFERENCE TO RELATED APPLICATIONS) This application was filed on January 24, 2024, and is a patent application for "MANUALLY DRIVEN RECIP This application claims benefit of and priority to U.S. Provisional Application No. 63 / 624,470, entitled "ROCAL PUMP," the disclosure of which is incorporated herein by reference in its entirety. [Background technology]

[0002] Various medical procedures apply vacuum pressure as part of the medical procedure. For example, during thrombectomy, negative vacuum pressure is used to remove a blood clot from a patient's vasculature. When vacuum pressure is applied for only a short amount of time, a 30 mL or 60 mL syringe pump may be used. However, when vacuum pressure is applied for more than a significantly shorter amount of time, the volume of the syringe pump is insufficient to generate a stable vacuum force for the required period of time. Therefore, there is a need for devices and assemblies that can easily and more effectively generate a stable pressure. Through diligence, ingenuity, and innovation, the applicant has solved problems associated with medical vacuum pumps, as well as related systems, assemblies, components, and methods, by developing the solutions embodied in this disclosure, as described in detail below. Summary of the Invention

[0003] Various embodiments of the present disclosure include cylinders, pistons, reaction drivers, assemblies, pump assemblies, and corresponding systems, mechanisms, devices, components, and methods related to manually driven reciprocating pump assemblies.

[0004] Various embodiments of the present disclosure may include an assembly. An exemplary manually driven reciprocating pump assembly includes a cylinder having a proximal end, a distal end, a body portion defined between the proximal end and the distal end, the proximal end and the distal end further defining a flow path, a piston disposed within the cylinder, a first check valve and a second check valve fluidly coupled to the distal end of the cylinder, a connector connected to the second check valve, and a piston mechanism including a crank having a rotatable shaft and a connecting rod, the connecting rod being configured to engage a plunger such that rotation of the rotatable shaft causes circular motion of the crank. the piston mechanism coupled to the cylinder for translating a piston within the cylinder; and a recoil driver, the recoil driver including a first pulling handle connected to a first pulling string wrapped around a first pulley and a first recoil spring coupled to the first pulley, the first pulley configured to rotate a rotatable shaft of the piston mechanism in response to actuation of the first pulling handle; and the manually driven reciprocating pump assembly configured to generate vacuum pressure through the second check valve when force is applied to the first pulling handle to translate the piston along the flow path.

[0005] The above summary is provided merely for the purpose of summarizing some exemplary embodiments to provide a basic understanding of some aspects of the present disclosure. Accordingly, it should be understood that the above embodiments are merely examples and should not be construed in any way as narrowing the scope or spirit of the present disclosure. It should be understood that the scope of the present disclosure encompasses many possible embodiments in addition to those summarized herein, some of which are further described below. Other features, aspects, and advantages of the subject matter will become apparent from the specification, drawings, and claims.

[0006] The following drawings are illustrations of certain embodiments of the present disclosure, which embodiments are not intended to limit the scope of the disclosure. The drawings, which are not necessarily drawn to scale, are intended to be used in conjunction with the following detailed description. [Brief explanation of the drawings]

[0007] [Figure 1A] 1 is a perspective view of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure; FIG. [Figure 1B] FIG. 1 is a perspective view of a manually driven reciprocating pump assembly having a water trap according to various embodiments of the present disclosure. [Figure 2A] 1 is a perspective view of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure; FIG. [Figure 2B] 1 is a perspective view of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure; FIG. [Figure 3A] 1A-1C are perspective views of piston mechanisms according to various embodiments of the present disclosure. [Figure 3B] 12A-12C are bottom perspective views of piston mechanisms according to various embodiments of the present disclosure. [Figure 3C] 1A and 1B are side perspective views of piston mechanisms according to various embodiments of the present disclosure; [Figure 4A] FIG. 1 is a perspective view of a reaction driver of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure. [Figure 4B] FIG. 1 is a perspective view of a manually driven reciprocating pump assembly having a single pulley according to various embodiments of the present disclosure. [Figure 4C] FIG. 1 is a perspective view of a portion of a reaction driver of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure. [Figure 4D] FIG. 10 is a perspective view of a pulley of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure. [Figure 5] 1A and 1B are perspective views of a ratchet mechanism according to various embodiments of the present disclosure. [Figure 6A] 1 is a perspective view of a cylinder according to various embodiments of the present disclosure. FIG. [Figure 6B] 1 is a perspective view of a cylinder according to various embodiments of the present disclosure. FIG. [Figure 7] 1 is a perspective view of a check valve mechanism attached to a cylinder according to various embodiments of the present disclosure. [Figure 8A] 1 is a perspective view of a portion of a check valve according to various embodiments of the present disclosure. FIG. [Figure 8B] 1 is a perspective view of a portion of a check valve according to various embodiments of the present disclosure. FIG. [Figure 8C] 1 is a perspective view of a portion of a check valve according to various embodiments of the present disclosure. FIG. [Figure 9] 1 is a flowchart of an exemplary method of operation according to various embodiments of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0008] Certain embodiments of the present disclosure will now be described in more detail with reference to the accompanying drawings, in which certain embodiments of the present invention are shown. Reference numerals refer to elements throughout the drawings. Embodiments of the present invention may be embodied in many different forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements.

[0009] As used herein, terms such as "front," "rear," and "on" are used to describe the relative position of some components or portions of components with respect to other components or portions of components for purposes of illustration in the examples provided below. As used herein, the term "or" is used in both the alternative and connective sense, unless otherwise indicated. The term "along" and similarly used terms mean near or on an edge or other referenced location, but do not necessarily necessarily be directly on the edge or other referenced location. The terms "about," "generally," and "substantially" refer to within manufacturing and / or engineering design tolerances for the corresponding materials and / or elements, unless otherwise indicated. The use of such terms is intended to be inclusive and to render the specific recited value independently claimable. Therefore, any such aforementioned terms or similarly interchangeable terms should not be construed as limiting the spirit and scope of the embodiments of the present invention.

[0010] As used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless expressly stated otherwise. The terms "includes" and / or "including," as used herein, define the presence of stated features, elements, and / or components and / or groups thereof.

[0011] As used herein, the phrases "in one embodiment," "according to one embodiment," "in some embodiments," and the like generally refer to a particular feature, structure, or characteristic that follows the phrase being included in at least one embodiment of the present disclosure. Thus, a particular feature, structure, or characteristic may be included in more than one embodiment of the present disclosure, such that these phrases do not necessarily refer to the same embodiment. As used herein, the terms "example," "exemplary," and the like are used to "serve as an example, instance, or illustration." Any implementation, aspect, or design described herein as "example" or "exemplary" should not necessarily be construed as preferred or advantageous over other implementations, aspects, or designs. Rather, use of the terms "example," "exemplary," and the like is intended to present concepts in a concrete manner.

[0012] The drawings are provided to illustrate some examples of the described invention. The drawings do not limit the scope of the present embodiments of the invention or the appended claims. Aspects of the exemplary embodiments are described below for illustrative purposes with reference to exemplary applications. It should be understood that specific details, relationships, and methods are shown to provide a thorough understanding of the exemplary embodiments. Those skilled in the art will appreciate that the exemplary embodiments may be practiced without one or more specific details, or with other methods.

[0013] Various embodiments provide a manually driven reciprocating pump assembly. In various embodiments, the manually driven reciprocating pump assembly is configured to apply vacuum pressure for the performance of a medical procedure. For example, during thrombectomy, the manually driven reciprocating pump assembly may be used to apply negative vacuum pressure to a catheter to remove a blood clot from a patient's vasculature. Various embodiments of the manually driven reciprocating pump assembly allow a user to apply vacuum pressure for any length of time and to apply maximum vacuum pressure rapidly (e.g., without requiring a long vacuum pressure build-up time). Thus, various embodiments provide improvements to the field of pump assemblies, and medical pump assemblies in particular.

[0014] Embodiments of the present disclosure may enable a desired vacuum pressure to be achieved and maintained using a manually driven reciprocating pump assembly. Alternatively, in some embodiments, the manually driven reciprocating pump assembly may include a piston mechanism capable of applying vacuum pressure through a distal end of a cylinder and at least one recoil driver. In some embodiments, the piston mechanism may include a crank having a rotatable shaft, a flywheel, and a connecting rod, the connecting rod coupled to a plunger of the cylinder such that rotation of the flywheel causes corresponding rotation of the rotatable shaft. In some embodiments, the at least one recoil driver may include a first pulling handle connected to a first tension string that may be wrapped around a first pulley, and a first recoil spring coupled to the first pulley. In some examples, the at least one recoil driver may further include a first ratchet mechanism configured to couple the pulley to the rotatable shaft in a first rotational direction of the first pulley. In some examples, the manually driven reciprocating pump may include a second recoil driver, the second recoil driver comprising the same components as the first recoil driver.

[0015] In some embodiments, the first ratchet mechanism and / or the second ratchet mechanism can couple the first pulley and / or the second pulley to the rotating shaft of the piston mechanism. For example, in some embodiments, when a pulling force is applied to the second pulling handle, the second ratchet mechanism can couple the second pulley to the rotating shaft, and torque can be transferred from the ratchet mechanism to the rotating shaft, applying an initial vacuum pressure through the distal end of the cylinder. In some embodiments, the second ratchet mechanism can be configured to separate the second pulley from the rotating shaft when the pulley is rotating in a direction opposite to the rotation caused by the pulling force. In some examples, when one or more additional pulling forces are applied to the second pulling handle and / or the first pulling handle, the applied vacuum pressure can increase. In various embodiments, the first pulley can have a diameter smaller than that of the second pulley. In some examples, the torque applied to the rotating shaft by the second recoil driver and / or the vacuum pressure applied through the distal end of the cylinder may be configured to be greater than that by the first recoil driver.

[0016] 1A-9 show diagrams of an exemplary manually-driven reciprocating pump, cylinder, piston mechanism, recoil driver, and portions thereof, according to various embodiments of the present disclosure. FIG. 1A shows an exemplary perspective view of a manually-driven reciprocating pump assembly 1000, which, in the illustrated embodiment, includes a housing 50 and a cylinder 100. In some embodiments, the housing 50 comprises a top and a bottom. In some examples, the top may be disposed above the bottom, and the top may be configured to connect to and decouple from the bottom of the housing 50. In some embodiments, the top may be configured to rotate via one or more hinges, and the top may be configured to rotate from a first position (e.g., a closed portion) to a second position (e.g., an open position). The top may be configured to engage and / or securely attach to the bottom to create the housing 50 that houses various internal components. In one or more exemplary embodiments, the housing 50 may include a square shape. In other embodiments, housing 50 may include any shape (e.g., rectangular, circular, oval, triangular, etc.) necessary to accommodate the internal components. In various embodiments, housing 50 is configured to receive cylinder 100. In various embodiments, cylinder 100 may be a syringe, a tube, a storage cylinder, a vial, etc. In various embodiments, cylinder 100 may include a diameter necessary to achieve a desired vacuum pressure.

[0017] 1B , in various embodiments, the manually driven reciprocating pump assembly 10 may further include a water trap 60 and / or a check valve mechanism 400. In various embodiments, the water trap 60 may be configured to receive at least a portion of the cylinder 100. The water trap may define an opening 62 configured to receive at least a portion of the cylinder 100. In various embodiments, the opening 62 may include a diameter slightly larger than the diameter of the cylinder so that the cylinder fits easily within the water trap. In other embodiments, the diameter of the opening 62 may be such that the inner surface of the opening creates a watertight seal with the outer surface of the cylinder 100. In various embodiments, the diameter of the opening 62 may be such that the water trap 60 stabilizes the cylinder 100 during reciprocating and / or violent piston movements. In various embodiments, as the piston (at the proximal end of the cylinder 100) moves backward, the pressure inside the cylinder 100 decreases. In this case, vacuum pressure may propagate through the distal end of the cylinder 100. This vacuum pressure may force air from the water trap 60 into the cylinder 100. As the piston moves forward, the pressure inside the cylinder may increase. This positive pressure may push the air inside the cylinder 100 out the distal end of the cylinder 100 and into the atmosphere. These two actions may constitute one cycle of the piston-cylinder mechanism.

[0018] In various embodiments, water trap 60 may further include a check valve connector 66 and an intake connector 64. Check valve connector 66 is configured to at least partially connect / secure to a check valve (shown in FIG. 8 ) such that check valve connector 66 and the check valve are at least in fluid communication with each other. In various embodiments, check valve connector 66 may be further configured to be at least in partial fluid communication with water trap intake connector 64. In various embodiments, water trap intake connector 64 is configured to be a portion of opening 62. In other embodiments, water trap intake connector 64 is configured to be inserted into opening 62.

[0019] With further reference to FIG. 1B , in various embodiments, the water trap 60 is configured to be positioned relative to the housing 50. In the illustrated embodiment, the water trap is configured to be positioned on the side of the housing. In other embodiments, the water trap 60 may be configured to be positioned above, below, diagonally across, etc. from the housing 50. In various embodiments, the water trap 60 may have the same shape as the housing 50. In other embodiments, the water trap 60 may have any shape necessary to achieve a desired function. In various embodiments, the water trap 60 may be configured to be selectively attached and / or detached to allow the cylinder 100 and / or the housing 50 to be reused. In various embodiments, the water trap may have a standard size (e.g., 1000 ml, 500 ml, 350 ml, etc.). In various embodiments, a larger size water trap may accumulate a larger volume of vacuum pressure. Thus, after a high level of vacuum pressure is achieved in the water trap, the vacuum pressure may become stronger when a certain amount of liquid enters the water trap through the catheter. In other embodiments, a smaller sized water trap may achieve the desired strength of vacuum pressure for the procedure. In other embodiments, the water trap 60 may have a larger or smaller volumetric size depending on the desired function. In an exemplary embodiment, the water trap 60 confines the liquid, preventing it from entering the cylinder 100 through the check valve and causing mechanical failure. In various embodiments, the water trap 60 is configured to assist in the buildup of vacuum pressure and / or to assist in maintaining higher vacuum pressures. In an exemplary embodiment, the water trap 60 may be configured to at least partially accommodate solid material (e.g., blood clots, etc.) to reduce the invasiveness of the procedure. The water trap 60 may have a volume configured to maintain the desired vacuum pressure, such that a larger volume of the water trap 60 may maintain a greater amount of vacuum pressure.

[0020] 2A-2B illustrate perspective views of a manually driven reciprocating pump assembly according to various embodiments of the present disclosure. Referring to FIG. 2A, in various embodiments, the manually driven reciprocating pump assembly 10 may include a cylinder 100, a piston 106 disposed within the cylinder, a check valve mechanism 400, a piston mechanism 200, and at least one recoil driver mechanism 302A-308A or 302B-308B. In various embodiments, the cylinder 100 is configured to define at least a distal end 102A and a proximal end 102B. In various embodiments, the cylinder 100 is configured to apply a vacuum pressure through the distal end 102A and / or to receive a plunger 104 coupled to the piston 106 at the proximal end 102B of the cylinder. The plunger 104 coupled to the piston is configured to translate within the cylinder 100, and the plunger 104 is configured to increase and / or decrease a volume within the cylinder 100. The plunger 104 may be configured to contact the innermost surface of the cylinder wall. In various embodiments, the plunger 104 may comprise a silicone or rubber material that provides pressure between the innermost surface of the cylinder and the plunger, while a lubricant, such as a PTFE inner layer, reduces friction and prevents the plunger from moving freely in only one direction. In various embodiments, the plunger 104 is configured to create a watertight and / or airtight seal while contacting the inner wall of the cylinder. In various embodiments, the cylinder 100 may further be configured to couple with a check valve mechanism 400 (shown fully in FIGS. 8A-8C ) at the distal end 102A. In various embodiments, the check valve mechanism 400 may be configured to assist in applying vacuum pressure at the distal end 102A of the cylinder.

[0021] 2A , in various embodiments, piston mechanism 200 may include a rotatable shaft 206 and a crank 204 having a connecting rod 202. Crank 204 may be configured to be heavy so that crank 204 can function as a flywheel. Additionally or alternatively, piston mechanism 200 may include a separate flywheel. Connecting rod 202 is configured to couple with piston 106 disposed within cylinder 100. In various embodiments, piston 106 may further include plunger 104, which is configured to reduce and / or increase the volume within cylinder 100. In various embodiments, crank 204 is configured to rotate in response to a torque force applied to rotatable shaft 206, and the flywheel is configured to assist in the rotation of rotatable shaft 206 and / or crank 204. The flywheel imparts a circular motion to the crank 204, which in turn causes the connecting rod 202 to translate the piston 106 disposed within the cylinder 100, causing the flywheel to cause a corresponding rotation of the rotating shaft 206. The circular motion of the crank 204 may further cause the plunger 104 to increase and / or decrease the volume disposed within the cylinder. In various embodiments, the circular motion of the crank 204 may further cause the cylinder 100 to apply a vacuum pressure at the distal end 102A of the cylinder. In various embodiments, the vacuum pressure applied at the distal end 102A of the cylinder 100 increases during the increase in the volume of the cylinder 100. In various embodiments, the increase in volume within the cylinder 100 comprises a linear relationship with the increase in applied vacuum pressure (e.g., as the volume within the cylinder increases, the applied vacuum pressure increases).

[0022] 2A , in various embodiments, the recoil driver 300 of the manually driven reciprocating pump may include at least a first pulling handle 310, a first pulling string 308A, and a first recoil spring 304A (shown in FIG. 4C ). In various embodiments, the first pulling handle 310 is configured to connect to the first pulling string 308A, which is configured to be wrapped around the first pulley 302A. The first pulling string 308A may be wrapped around the first pulley 302A and configured to keep the first pulling string 308A attached to the first pulley 302A. In various embodiments, when an operator applies force to the first pulling handle 310, the first pulling string 308A is configured to unwind and rotate the first pulley 302A. In various embodiments, the first pulley 302A can be configured to transmit rotation in a first direction to the rotating shaft 206 of the piston mechanism. Thus, rotation of the first pulley 302A in the first direction causes the connecting rod 202 to translate the piston 106 within the cylinder, generating vacuum pressure at the distal end 102A of the cylinder. When the piston 106 translates in the first direction, the cylinder 100 is configured to pull air from the water trap. When the piston 106 translates in a second direction (e.g., opposite the first direction), at least one check valve can be connected to and / or attached to the distal end 102A of the cylinder 100, the at least one check valve configured to allow air to flow out of the water trap 60 and / or prevent air from flowing into the water trap 60. In various embodiments, the first recoil spring 304A is configured to be coupled to the first pulley 302A (e.g., as shown in FIG. 2B). The first recoil spring 304A is configured to have a length such that the expansion and contraction of the first recoil spring 304A matches the stroke length of the first pull string 308A. In various embodiments, the first recoil spring 304A can be configured to assist in returning the first pull string 308A and first pull handle 310 to their initial positions (e.g., positions before a force was applied to the first pull handle 310).

[0023] 2A , in various embodiments, the recoil driver may further include a first ratchet mechanism 306A (shown in FIG. 5 ), where the first ratchet mechanism 306A is configured to couple to the first pulley 302A. In various embodiments, the first ratchet mechanism 306A is coupled to the first pulley 302A opposite the first recoil spring 304A. In various embodiments, the first ratchet mechanism 306A is configured to selectively couple and decouple the first pulley 302A from the rotatable shaft 206 of the piston mechanism 200. The first ratchet mechanism 306A is configured to couple the first pulley 302A to the rotatable shaft 206 when a force (e.g., an initial force) is applied to the first pulling handle 310. A force applied to the first pulling handle 310 rotates the first pulley in a first direction, causing the first ratchet mechanism 306A to couple the first pulley 302A to the rotatable shaft 206 of the piston mechanism. While coupled to the rotatable shaft 206, the first ratchet mechanism 306A is configured to transfer force (e.g., torque) from the first pulley 302A to the rotatable shaft 206. The torque transfer rotates the crank 204, thus causing the plunger 104 and piston 106, which are coupled to the connecting rod 202, to translate within the cylinder 100. The translation of the plunger 104, which is coupled to the piston 106, generates vacuum pressure that is applied to the distal end 102A of the cylinder. In some embodiments, the first ratchet mechanism 306A is further configured to decouple the first pulley 302A from the rotatable shaft 206 during rotation of the first pulley 302A in the second direction, such that no force (e.g., torque) is applied to the rotatable shaft 206. In various embodiments, the first recoil spring 304A can be configured to decouple the first pulley 302A and / or the first ratchet mechanism 306A from the rotatable shaft 206, such that the first pull string 308A and the first pull handle 310 return to their initial positions and apply no torque to the rotatable shaft 206 in a second position (e.g., opposite the first rotational direction).

[0024] 2A-2B, in various embodiments, the recoil driver of the manually operated reciprocating pump may further include a second pulling handle 310, a second pulling string 308B, a second pulley 302B, and a second recoil spring 304B (shown in FIG. 4C). In various embodiments, the second pulling handle 310 is configured to be connected to the second pulling string 308B, and the second pulling string 308B is configured to be wrapped around the second pulley 302B. The second pulling string 308B is configured to be wrapped around the second pulley 302B, and the second pulling string 308B is configured to remain attached to the second pulley 302B. In various embodiments, an operator is configured to apply force to the second pulling handle 310, thereby unwinding the second pulling string 308B and rotating the second pulley 302B. In various embodiments, the recoil driver is further configured with a second ratchet mechanism 306B, which is configured to couple to the second pulley 302B opposite the second recoil spring 304B. In various embodiments, the second pulling handle 310, the second pulling string 308B, the second pulley 302B, the second ratchet mechanism 306B, and the second recoil spring 304B are configured to function similarly to that described above for the first pulling handle 310, the first pulling string 308A, the first pulley 302A, the first ratchet mechanism 306A, and the first recoil spring 304A.

[0025] In various embodiments, the second pulley 302B is configured to have a diameter greater than the diameter of the first pulley 302A. In some embodiments, the second pulley 302B is configured to apply a greater amount of torque to the rotatable shaft 206 of the piston mechanism with the assistance of the second ratchet mechanism 306B than the torque applied by the first pulley 302A when the same amount of torque is applied. In various embodiments, the torque applied to the rotatable shaft 206 by the second ratchet mechanism 306B is configured such that the plunger 104 coupled to the piston 106 within the cylinder transmits a greater force than the torque force applied by the first ratchet mechanism 306A. In various embodiments, the torque applied to the rotatable shaft 206 by the second ratchet mechanism 306B is further configured to more easily generate a vacuum pressure at the distal end 102A of the cylinder that is greater than the torque force applied by the first ratchet mechanism 306A. In various embodiments, an operator may apply an initial force to the first pulling handle 310. The initial force causes the first ratchet mechanism 306A to couple the first pulley 302A to the rotatable shaft 206 while the first pulley rotates in a first rotational direction. The second ratchet mechanism 306B remains disengaged from the rotatable shaft, ensuring that only one ratchet mechanism is coupled to the rotatable shaft at a time. After the initial force applied to the first pulling handle 310 applies an initial vacuum force to the water trap, a second force is applied to the second pulling handle 310, causing the second ratchet mechanism 306B to couple the second pulley 302B to the rotatable shaft 206 and apply a second vacuum force to the water trap. The first ratchet mechanism 306A remains disengaged from the rotatable shaft, and during this disengagement, the second ratchet mechanism 306B remains coupled to the rotatable shaft.In certain embodiments, using two pulleys and a ratchet mechanism to apply vacuum force to the water trap may have the advantage of efficiently applying vacuum force to the water trap, with the first pulley 302A being able to quickly apply vacuum force to the water trap and the second pulley 302B being able to further apply vacuum force to the water trap, thereby creating a large amount of vacuum and allowing for continuous suction of fluid.

[0026] 3A-3C show perspective views of piston mechanisms and portions of piston mechanisms according to various embodiments of the present disclosure. In various embodiments, the piston mechanism may include a rotating shaft 206, a crank 204, and a connecting rod 202, where the connecting rod 202 is connected to the crank 204 at a first connection point 222 and to the piston 106 at a second connection point 224. In various embodiments, the first connection point 222 and / or the second connection point 224 are hingedly connected, such that the connecting rod 202 can rotate at the first connection point 222 and / or the second connection point 224. In various embodiments, the crank 204 may be configured to rotate the first connection point 222, initially rotating the first connection point 222 away from the second connection point 224, which in turn translates the piston 106 connected to the connecting rod 202. In various embodiments, the crank 204 has a total moment of inertia (kg m 2 ) In various embodiments, this total moment of inertia is configured to assist in the translation of the piston 106. In various embodiments, the crank 204 may be configured to be an eccentric cam, a crank, or the like. In various embodiments, the piston mechanism may further include a flywheel. The flywheel is configured to rotate when a force is applied to the pull handle, which transfers the rotation to a rotating shaft, causing the piston 106 to translate within the cylinder.

[0027] 4A-4D show perspective views of a manually driven reciprocating pump assembly and portions thereof having a single pulley according to various embodiments of the present disclosure. In various embodiments, the piston mechanism can include a flywheel 212 below a ratchet mechanism 306. In various embodiments, the recoil driver 300 is configured to apply rotational motion to the rotating shaft of the piston mechanism via at least one recoil spring and / or at least one ratchet mechanism. In various embodiments, at least one recoil spring is coupled to the at least one pulley and configured to constantly apply a torque opposite to the force applied to the pull handle 310. When the force applied to the pull handle is stopped, the recoil spring is configured to return the pull string and pull handle to their initial positions (e.g., as shown in FIG. 4B). Referring to FIG. 4C, in various embodiments, the pull string 308 has a predetermined length and is configured to provide one stroke of the pull string to generate the desired vacuum pressure from the distal end of the syringe. In various embodiments, the pull string 308 further comprises a diameter such that the pull string is configured to withstand the tensile strength of the force applied to the pull handle 310 .

[0028] Referring to FIG. 4D , in various embodiments, the first pulley 302A and the second pulley 302B (collectively “302”) are configured to have a pulley diameter (Dp). In various embodiments, the pulley diameter is configured to determine the final drive ration (Fr) of the manually driven reciprocating pump assembly. In an exemplary embodiment, the first pulley 302A has a Dp=2.0 cm and the second pulley has a Dp=6.0 cm, resulting in a first Fr=0.5 and a second Fr=1.5. In various embodiments, the width of the pulley 302 is configured to match the diameter of the tension string 308. For example, the pulley 302 may have a width of 1.0 cm and the tension string may have a thickness of 1 mm, resulting in the pulley being able to accommodate 10 revolutions. In various embodiments, the pulley width and / or string diameter are set to a predetermined value to achieve a desired number of revolutions for a given applied force.

[0029] 5 shows a perspective view of a ratchet mechanism according to various embodiments of the present disclosure. In various embodiments, ratchet mechanism 306 may include a keyway 320 configured to engage with a corresponding key on a respective pulley and a keyway 330 configured to engage with a corresponding key on a rotating shaft. In various embodiments, the connection between the key and keyway 320 is configured to couple the pulley to the rotating shaft of the piston mechanism.

[0030] 6A-6B show perspective views of syringes according to various embodiments of the present disclosure. In various embodiments, the cylinder may have a predetermined stroke length 602 and a predetermined bore diameter 604. In various embodiments, the stroke length 602 and bore diameter 604 may be individually increased and / or decreased to achieve a desired vacuum pressure applied by the cylinder. The stroke length 602 and bore diameter 604 may further be individually increased and / or decreased to optimize the force applied by the system and / or the number of pulls a user may perform to achieve a desired vacuum pressure within the water trap. In various embodiments, a larger bore diameter 604 requires more force to move the piston mechanism, and a larger stroke length 602 requires a longer pull length. In various embodiments, the vacuum pressure applied by a manually driven reciprocating pump assembly can be calculated using the displacement volume (Vp (cc)), bore area (Ab (cm)), and stroke length (S (cm)): Vp = Ab x S. The pressure in the water trap (which closely approximates the pressure in the cylinder) applied by the assembly and the volume after one cycle can be calculated using Equations 1 and 2, and the pressure applied by the assembly after n cycles can be calculated using Equation 3.

number

[0031] In various embodiments, Equations 1-3 may be used with the aid of at least the volume of the water trap, the size of the cylinder, and / or the displacement of the piston relative to the number of cycles of piston movement. The vacuum may be determined as Px (=P0, P1, Pn). In some embodiments, the bore size affects the amount of force required to pull the piston (e.g., the larger the bore size, the more force is required). In other embodiments, a longer stroke and / or an increased number of cycles may require the user to pull a longer string or pull the string multiple times to achieve the same level of vacuum. In various embodiments, as the piston moves back and forth, air is configured to move from the water trap, enter the cylinder once, exit the cylinder, and then exit into the atmosphere. In another embodiment, the piston mechanism may be configured to apply vacuum pressure to the water trap, initially pushing and / or displacing air inside the water trap toward the piston.

[0032] Using Equations 1-3, the vacuum pressure output from the cylinder after n cycles (Pn) can be calculated using the volume of the water trap (Vw), the displacement of the pump (Vp), and the number of strokes (n).

[0033] 7 and 8A-8C show perspective views of check valve mechanisms and portions thereof according to various embodiments of the present disclosure. In various embodiments, check valve mechanism 400 is configured to securely attach to the distal end 102A of the cylinder. In various embodiments, check valve mechanism 400 may be threaded, snapped, glued, etc., onto the distal end 102A of the cylinder. In various embodiments, check valve mechanism 400 may include a first check valve 402A and a second check valve 402B that allow unidirectional flow. First check valve 402A allows fluid to flow into the cylinder from one side. Second check valve 402B allows fluid to flow from the cylinder to the other side. 8A-8C , each check valve 402 (e.g., check valve 402A or check valve 402B) may include at least one air outlet 404, at least one gasket 408, and / or at least one air inlet 410. In various embodiments, air outlet 404 may be configured to be the bottom-most component, with gasket 408 disposed above air outlet 404 and air inlet 410 disposed above gasket 408. In various embodiments, air outlet 404 is configured to allow air to flow through one or more outlet holes. Gasket 408 is configured to be flexible so that gasket 408 can move away from inlet 410, allowing air to flow through one or more inlet holes 412 when positive pressure (air flows from the air inlet to the air outlet) is applied. Gasket 408 is configured to not obstruct air flow through outlet holes 406. In various embodiments, air inlet 410 is configured to prevent air from flowing through inlet holes 412 when negative pressure (e.g., as opposed to positive pressure) is applied. Gasket 408 is configured to block air from flowing through inlet holes 412 when negative pressure is applied.

[0034] FIG. 9 provides a flowchart illustrating an exemplary method 900 of operating a manually driven reciprocating pump assembly according to various embodiments of the present disclosure. In block 902, an operator may secure a water trap to the housing using one or more connectors. In block 904, an operator may secure a catheter to the intake side of the water trap using one or more connectors. In block 906, the operator applies an initial force to the first pull handle, and the first ratchet mechanism transmits torque to the rotating shaft, applying an initial vacuum pressure to the distal end of the cylinder and / or within the water trap. To achieve the desired vacuum pressure, the operator may apply one or more additional forces to the first pull handle to generate a larger additional vacuum force, 908A. Additionally and / or alternatively, the operator may apply one or more additional forces to the second pull handle to generate a larger additional vacuum force, 908B. In various embodiments, the operator can apply one or more additional forces to the first pull handle and / or the second pull handle to achieve a desired vacuum pressure applied to the distal end of the cylinder. In various embodiments, the operator can apply one or more additional forces to the first pull handle and / or the second pull handle to achieve a desired vacuum pressure applied to the distal end of the cylinder and / or within the water trap. In various embodiments, the desired vacuum pressure can be the amount of pressure required to cause fluid and / or at least partially solid material to flow through the cylinder and / or water trap.

[0035] In some embodiments, the manually driven reciprocating pump assembly further comprises a water trap with an intake valve. In some embodiments, the water trap is configured to connect to the connector, evacuate air from the water trap, apply negative pressure to the catheter, and allow the water trap to accept at least one of air or fluid. In some embodiments, the water trap is configured to be detachable so that the manually driven reciprocating pump assembly is reusable.

[0036] In some embodiments, the manually driven reciprocating pump assembly further comprises a first ratchet mechanism configured to couple the first pulley to the rotatable shaft of the piston mechanism in a first rotational direction of the first pulley and to decouple the first pulley from the rotatable shaft in a second rotational direction of the first pulley. In some embodiments, a force applied to the first pull handle is configured to cause the first pulley to rotate the rotatable shaft of the piston mechanism. In some embodiments, rotation of the piston mechanism is configured to translate the piston within the body portion of the cylinder. In some embodiments, translation of the piston within the body portion of the cylinder is configured to apply vacuum pressure through a distal end of the cylinder.

[0037] In some embodiments, the first recoil spring is configured to decouple the first ratchet mechanism from the rotatable shaft of the piston mechanism and return the first pulling handle to its initial position. In some embodiments, in response to at least one additional pulling force, the first pulling handle is configured to create a target vacuum pressure in the water trap and force at least one of air or fluid through a flow channel in the body portion of the cylinder. In some embodiments, the recoil driver further comprises a second pulling handle connected to the second pulling string, the second pulling string wrapped around a second pulley, the recoil driver further comprising a second recoil spring coupled to the second pulley, the second pulley configured to rotate the rotatable shaft of the piston mechanism in response to actuation of the second pulling handle.

[0038] In some embodiments, the diameter of the first pulley is smaller than the diameter of the second pulley, the first pulley is configured to apply a first vacuum pressure to the water trap, and the second pulley is configured to apply a second vacuum pressure to the water trap, the second vacuum pressure being greater than the first vacuum pressure. In some embodiments, the manually driven reciprocating pump assembly further comprises a first ratchet mechanism and a second ratchet mechanism. In some embodiments, the first ratchet mechanism is configured to couple the first pulley to a rotatable shaft of the piston mechanism in response to rotation of the first pulley in a first direction and to decouple the first pulley from the rotatable shaft of the piston mechanism in response to rotation of the first pulley in a second direction. In some embodiments, the second ratchet mechanism is configured to decouple the second pulley from the rotatable shaft of the piston mechanism in response to rotation of at least one of the first pulley or the second pulley in a first direction, and to couple the second pulley to the rotatable shaft of the piston mechanism in response to rotation of at least one of the first pulley or the second pulley in a second direction.

[0039] In some embodiments, when a force is applied to the second pulling handle, the second ratchet mechanism is configured to couple to the rotating shaft of the piston mechanism while the first ratchet mechanism is disengaged from the rotating shaft and apply a corresponding torque to the rotating shaft, causing the rotating shaft to rotate. In some embodiments, when a force is applied to the first pulling handle, the first ratchet mechanism is configured to couple to the rotating shaft of the piston mechanism while the second ratchet mechanism is disengaged from the rotating shaft and apply a corresponding torque to the rotating shaft, causing the rotating shaft to rotate. In some embodiments, when a force is applied to the first pulling handle, an amount of at least one of air and fluid is drawn from the water trap for an increased number of piston cycles compared to when an equal force is applied to the second pulling handle, and when an equal force is applied to the second pulling handle, a greater vacuum pressure is applied to the water trap compared to when a force is applied to the first pulling handle.

[0040] In some embodiments, an initial vacuum pressure is configured to be applied through a distal end of the cylinder via a force applied to a first pulling handle, wherein application of the initial vacuum pressure through the distal end of the cylinder is configured to cause a first ratchet mechanism to rotate a rotatable shaft of the piston mechanism, wherein rotation of the rotatable shaft of the piston mechanism is further configured to translate the piston within the body portion of the cylinder. In some embodiments, an additional vacuum pressure is configured to be applied through the distal end of the cylinder via at least one application of an additional pulling force to the first pulling handle or the second pulling handle, wherein application of the at least one additional pulling force is configured to cause the first ratchet mechanism or the second ratchet mechanism to rotate the rotatable shaft of the piston mechanism, wherein rotation of the rotatable shaft of the piston mechanism is further configured to translate the piston within the body portion of the cylinder. In some embodiments, the manually driven reciprocating pump assembly further comprises a water trap having an intake valve configured to receive at least one of air or fluid and configured to be connected to the connector, the water trap configured to be detachable so that the cylinder and the manually driven reciprocating pump are reusable.

[0041] In some embodiments, the piston mechanism further comprises a flywheel, wherein rotation of the flywheel is configured to cause corresponding rotation of the rotatable shaft.

[0042] An exemplary method of applying vacuum pressure may be performed through operation of a device according to at least some embodiments of the present disclosure. The exemplary device may include a cylinder having a proximal end, a distal end, a body portion defined between the proximal end and the distal end, the proximal end and the distal end further defining a flow path, a piston disposed within the cylinder, first and second check valves fluidly coupled to the distal end of the cylinder, a first connector, a second connector, and a piston mechanism, the piston mechanism including a crank having a rotatable shaft, a flywheel, and a connecting rod, the connecting rod coupled to the plunger such that rotation of the flywheel causes corresponding rotation of the rotatable shaft, and rotation of the rotatable shaft causes circular motion of the crank. a crank configured to cause a circular movement of the crank to cause a translation of the piston within the cylinder; a recoil driver, the recoil driver being a pull handle connected to a first pull string, the first pull string wrapped around a first pulley; and a first recoil spring coupled to the first pulley, the first pulley configured to rotate a rotatable shaft of the piston mechanism in response to actuation of the pull handle, and the device configured to generate vacuum pressure through the second check valve to translate the piston along the flow path when force is applied to the pull handle.

[0043] In some embodiments, the method includes applying a pulling force to a pulling handle to apply a torque to the rotating shaft, the pulling force configured to rotate the rotating shaft. In some embodiments, the method further includes attaching a water trap to an intake valve disposed at a distal end of the cylinder, the water trap configured to be selectively attached and detached from the intake valve, the water trap configured to receive at least one of air or fluid. In some embodiments, the method further includes applying at least one additional force to the pulling handle to increase the vacuum pressure applied by the cylinder.

[0044] Although some embodiments described herein relate to manual reciprocating pumps that apply negative pressure, those skilled in the art will understand that the teachings herein may also be applied to a wide range of medical procedures and devices. The embodiments described herein may be expandable to accommodate at least the applications described above. Various components of the embodiments described herein may be added, removed, rearranged, modified, duplicated, etc., as those skilled in the art find advantageous and / or necessary to implement a particular application in conjunction with the teachings of the present disclosure. In some embodiments, specific features, characteristics, materials, components, and / or equipment may be applied as those skilled in the art find advantageous and / or necessary to implement a particular application in conjunction with the teachings of the present disclosure.

[0045] Moreover, numerous modifications and other embodiments of the present disclosure set forth herein will come to mind to those skilled in the art having the benefit of the teachings herein and presented in the foregoing description and the associated drawings. It is therefore to be understood that the present disclosure is not limited to the particular embodiments disclosed, and that modifications and other embodiments are intended to be included within the scope of any appended claims. Furthermore, while the foregoing description and associated drawings describe exemplary embodiments in the context of particular example combinations of elements and / or functions, it should be understood that alternative embodiments may provide various combinations of elements and / or functions without departing from the scope of any appended claims. In this regard, for example, different combinations of elements and / or functions than those expressly described above are also contemplated as being part of any appended claim. Although specific terms are employed herein, these terms are used in a generic and descriptive sense only and not for purposes of limitation.

Claims

1. 1. A manually operated reciprocating pump assembly for applying vacuum pressure, comprising: a cylinder having a proximal end, a distal end, and a body portion defined between the proximal end and the distal end, the proximal end and the distal end further defining a flow path; a piston disposed within the cylinder; a first check valve and a second check valve fluidly connected to the distal end of the cylinder; a connector connected to the second check valve; a piston mechanism comprising a crank having a rotatable shaft and a connecting rod, the connecting rod being coupled to a plunger such that rotation of the rotatable shaft causes circular motion of the crank and translation of the piston within the cylinder; a recoil driver comprising: a first pulling handle connected to a first pulling string, the first pulling string being wrapped around a first pulley; and a first recoil spring coupled to the first pulley, the first pulley configured to rotate the rotatable shaft of the piston mechanism in response to actuation of the first pulling handle; the manually operated reciprocating pump assembly is configured to generate vacuum pressure through the second check valve when a force is applied to the first pull handle, causing the piston to translate along the flow path.

2. a water trap with an intake valve; The water trap comprises: Connect to the connector, 2. The manually driven reciprocating pump assembly of claim 1, configured to evacuate air from within the water trap and apply negative pressure to the catheter, such that the water trap receives at least one of air or fluid.

3. 3. The manually driven reciprocating pump assembly of claim 2, wherein the water trap is configured to be removable so that the manually driven reciprocating pump assembly is reusable.

4. a first ratchet mechanism; The first ratchet mechanism comprises: connecting the first pulley to the rotatable shaft of the piston mechanism in a first rotational direction of the first pulley; The manually driven reciprocating pump assembly of claim 1 configured to decouple the first pulley from the rotatable shaft in a second rotational direction of the first pulley.

5. the force applied to the first pull handle is configured to rotate the rotatable shaft of the piston mechanism via the first pulley; the rotation of the piston mechanism is configured to translate the piston within a body portion of the cylinder; 5. The manually driven reciprocating pump assembly of claim 4, wherein the translation of the piston within the body portion of the cylinder is configured to apply a vacuum pressure through the distal end of the cylinder.

6. 6. The manually driven reciprocating pump assembly of claim 5, wherein the first recoil spring is configured to disengage the first ratchet mechanism from the rotatable shaft of the piston mechanism and return the first pull handle to an initial position.

7. 7. The manually driven reciprocating pump assembly of claim 6, wherein the first pull handle is configured to, in response to application of at least one additional pulling force, create a target vacuum pressure within a water trap to force at least one of air or fluid through a flow passage in the body portion of the cylinder.

8. the recoil driver further comprises a second pull handle connected to a second pull cord; the second tensioning cord is wrapped around a second pulley; the recoil driver further comprises a second recoil spring coupled to the second pulley; The manually driven reciprocating pump assembly of claim 1 , wherein the second pulley is configured to rotate the rotatable shaft of the piston mechanism in response to actuation of the second pull handle.

9. The diameter of the first pulley is smaller than the diameter of the second pulley; the first pulley is configured to apply a first vacuum pressure to the water trap; the second pulley is configured to apply a second vacuum pressure to the water trap; 9. The manually driven reciprocating pump assembly of claim 8, wherein said second vacuum pressure is greater than said first vacuum pressure.

10. further comprising a first ratchet mechanism and a second ratchet mechanism; The first ratchet mechanism comprises: coupling the first pulley to the rotatable shaft of the piston mechanism in response to rotation of the first pulley in a first direction; configured to decouple the first pulley from the rotatable shaft of the piston mechanism in response to rotation of the first pulley in a second direction; The second ratchet mechanism includes: decoupling the second pulley from the rotatable shaft of the piston mechanism in response to rotation of at least one of the first pulley or the second pulley in the first direction; 10. The manually driven reciprocating pump assembly of claim 9, configured to couple the second pulley to the rotatable shaft of the piston mechanism in response to rotation of at least one of the first pulley or the second pulley in the second direction.

11. 11. The manually driven reciprocating pump assembly of claim 10, wherein, when the force is applied to the second pulling handle, while the first ratchet mechanism is disengaged from the rotatable shaft, the second ratchet mechanism is configured to couple to the rotatable shaft of the piston mechanism and apply a corresponding torque to the rotatable shaft to rotate the rotatable shaft.

12. 11. The manually driven reciprocating pump assembly of claim 10, wherein, when the force is applied to the first pulling handle, the first ratchet mechanism is configured to couple to the rotatable shaft of the piston mechanism and apply a corresponding torque to the rotatable shaft, causing the rotatable shaft to rotate, while the second ratchet mechanism is disengaged from the rotatable shaft.

13. wherein when the force is applied to the first pull handle, a quantity of at least one of air and fluid is drawn from the water trap for an increased number of cycles of the piston compared to when an equal force is applied to the second pull handle; 11. The manually driven reciprocating pump assembly of claim 10, wherein a greater vacuum pressure is applied to the water trap when the equal force is applied to the second pull handle compared to when the force is applied to the first pull handle.

14. an initial vacuum pressure is configured to be applied through the distal end of the cylinder via a force applied to the first pull handle; application of the initial vacuum pressure through the distal end of the cylinder is configured to cause the first ratchet mechanism to rotate the rotatable shaft of the piston mechanism; 14. The manually driven reciprocating pump assembly of claim 13, wherein rotation of the rotatable shaft of the piston mechanism is further configured to translate the piston within the body portion of the cylinder.

15. the additional vacuum pressure is configured to be applied through the distal end of the cylinder via application of at least one additional pulling force to the first pulling handle or the second pulling handle; the application of the at least one additional pulling force is configured to cause the first ratchet mechanism or the second ratchet mechanism to rotate the rotatable shaft of the piston mechanism; 15. The manually driven reciprocating pump assembly of claim 14, wherein rotation of the rotatable shaft of the piston mechanism is further configured to translate the piston within the body portion of the cylinder.

16. 16. The manually driven reciprocating pump assembly of claim 15, further comprising a water trap having an intake valve configured to receive at least one of air or fluid and configured to be connected to the connector, the water trap configured to be removable so that the cylinder and the manually driven reciprocating pump are reusable.

17. 2. The manually driven reciprocating pump assembly of claim 1, wherein the piston mechanism further comprises a flywheel, wherein rotation of the flywheel is configured to cause corresponding rotation of the rotatable shaft.

18. 1. A method of operating an apparatus for applying vacuum pressure, comprising: The device comprises: a cylinder comprising a proximal end, a distal end, and a body portion defined between the proximal end and the distal end, the proximal end and the distal end further defining a flow path; a first check valve and a second check valve fluidly connected to the distal end of the cylinder; a first connector; a second connector; a piston mechanism comprising a rotatable shaft, a flywheel, and a crank having a connecting rod, the connecting rod coupled to a plunger such that rotation of the flywheel causes corresponding rotation of the rotatable shaft, the rotation of the rotatable shaft being configured to cause circular motion of the crank, the circular motion of the crank being configured to cause translation of the piston within the cylinder; A reaction driver comprising: a pull handle connected to a first pull string, the first pull string wrapped around a first pulley; a recoil driver comprising: a first recoil spring coupled to the first pulley, the first pulley configured to rotate the rotatable shaft of the piston mechanism in response to actuation of the pulling handle; the device is configured to generate a vacuum pressure through the second check valve when a force is applied to the pull handle to translate a piston along a flow path; The method comprises: The method includes applying a pulling force to the pull handle to apply a torque to the rotating shaft, the pulling force configured to rotate the rotating shaft.

19. 20. The method of claim 18, further comprising attaching a water trap to an intake valve disposed at the distal end of the cylinder, the water trap configured to be selectively attached and detached from the intake valve, the water trap configured to receive at least one of air or fluid.

20. 20. The method of claim 18, further comprising applying at least one additional force to the pull handle to increase the vacuum pressure applied by the cylinder.