Surgical fluid delivery system and components thereof

Abstract

A medical instrument accessory for providing fluid to a patient's body cavity during a surgical procedure. The medical instrument accessory includes a body mountable over at least a portion of a shaft of the medical instrument. The body includes an inner wall defining a lumen, a proximal end, a distal end defining an opening, a fluid interface configured to connect the lumen in fluid communication with a fluid source, and a sealing element configured to provide a substantially fluid-tight seal with the medical instrument. The sealing element is configured to permit rotation of the medical instrument accessory relative to the medical instrument shaft, thereby decoupling rotational movement of the fluid interface from rotational movement of the medical instrument shaft. Also disclosed are a swivel connector for the medical instrument accessory, a flow controller for controlling flow in a fluid drain line for a surgical system, a fluid line connector for connecting a first fluid drain line and a second fluid drain line to an aspiration canister, a fluid drainage system, and a system for providing fluid to and draining fluid from a patient's body cavity during a surgical procedure.

Description

[Technical Field]

[0001] In particular, the present disclosure relates to systems and system components configured to deliver fluids to and / or evacuate fluids from a body cavity of a patient during a medical procedure. [Background technology]

[0002] Various medical procedures may require the provision of a fluid, such as carbon dioxide gas, to a patient during the procedure. Medical procedures may additionally or alternatively require the evacuation of fluid from a body cavity.

[0003] Injectors may be deployed to deliver fluids to a patient's body cavity during a surgical procedure to inflate the cavity and / or prevent it from collapsing. Examples of such medical procedures include laparoscopy and endoscopy, although injectors may be used in conjunction with any other type of medical procedure as needed. Endoscopic procedures allow a physician to visualize a body cavity by inserting an endoscope or the like through one or more natural orifices, small punctures, or incisions to generate images of the cavity. In laparoscopic procedures, physicians generally insert medical instruments through natural orifices, small punctures, or incisions to perform a medical procedure within the body cavity. In some cases, an initial endoscopic procedure is performed to evaluate the body cavity, and then a subsequent laparoscopy may be performed to operate on the body cavity. Such procedures are widely used, for example, in the peritoneal cavity or during thoracoscopy, colonoscopy, gastroscopy, or bronchoscopy.

[0004] The field of view through the viewing portion (e.g., lens) of the instrument can be impaired by several factors. For example, the field of view can be impaired by condensation forming on the viewing portion and / or on the instrument, which can coalesce into droplets and drip onto the viewing portion. The field of view can also be impaired by smoke in the cavity (e.g., from cauterization or the like) and / or by smoke particles adhering to the viewing portion.

[0005] Any discussion of documents, acts, materials, devices, articles or the like which has been included in this specification should not be taken as an admission that any or all of such matter forms part of the prior art or was common general knowledge in the art to which this disclosure pertains by virtue of existing prior to the respective priority dates of the appended claims. Summary of the Invention [Means for solving the problem]

[0006] The present disclosure provides example systems configured to deliver fluid to and / or evacuate fluid from a patient's body cavity during a medical procedure, e.g., a surgical procedure. The present disclosure also provides example systems and system components configured to deliver fluid to and / or evacuate fluid from a patient's body cavity during a medical procedure. The system components may include one or more of a medical instrument accessory, a flow controller, and a fluid line connector.

[0007] Condensation can occur when the temperature of a gas drops below the dew point temperature for the level of humidity the gas contains. This can be caused by the gas coming into contact with a surface that has a temperature below the dew point temperature of the gas. The human body is a warm, moist environment and can have a temperature (e.g., core body temperature) of approximately 37°C. Prior to insertion into this environment, a medical instrument intended for insertion into a body cavity, such as a camera, scope, or other medical instrument, may have and / or be exposed to a temperature below typical room temperature and / or below typical human body temperature. Upon insertion into this environment, condensation or fogging can form on the viewing portion of the medical instrument (e.g., the scope) or elsewhere on the medical instrument. In some cases, this condensation can collect into small droplets. Condensation can also form elsewhere, for example, in a cannula through which the medical instrument is inserted, and the condensation can collect into small droplets and migrate toward and onto the viewing portion. Additionally, when the instrument is removed from the body cavity, this can cause the instrument to cool, which can lead to further fogging and / or condensation when reintroduced into the cavity. Condensation, fogging, and / or droplets on the viewing area can impair the view of the user of the medical instrument.

[0008] Additionally and / or alternatively, during a medical procedure, various other substances may come into contact with and / or within the field of view of the viewing portion of the medical instrument, which may impair the field of view. For example, the viewing portion of a scope may come into contact with or be positioned near particles created by the procedure, such as surgical smoke. When the viewing portion becomes contaminated with particles, fluid droplets, or the like, it may be necessary to remove the medical instrument and clean the visual obstruction. However, removal of the medical instrument from the body cavity may cause the medical instrument to cool, for example, below the patient's body temperature, which may cause additional condensation and / or droplets to form when the instrument is reinserted into the body, which may again obstruct the view through the viewing portion. This process may need to be repeated multiple times. Past approaches to solving this include pre-warming the medical instrument and / or using a light or heat source at the end of the camera to warm the viewing portion. Such interventions generally require additional steps and may adversely affect the workflow and efficiency of the procedure. Furthermore, repeated heating of the instrument, or parts thereof, such as with a heating element adjacent to the viewing portion, may affect the structure of the instrument and / or increase the complexity of sterilization of the instrument.

[0009] The present disclosure provides examples of medical instrument accessories configured to direct fluid toward the end of a cannula / medical instrument. In particular, the disclosed examples are suitable for directing fluid flow around and / or near the distal end of a medical instrument and / or toward a desired area of ​​a body cavity. This may prevent or at least reduce condensation and / or droplets from forming on the cannula or viewing portion of the medical instrument and / or prevent or at least reduce other materials from contacting or coming within the field of view of the viewing portion.

[0010] Medical instrument accessories may be connected to tubing for fluid supply and / or drainage. Such tubing may adversely affect the maneuverability of the medical instrument during use. The present disclosure provides examples of medical instrument accessories in which the rotational movement of the medical instrument is decoupled from the rotational movement of the connected tubing. In the disclosed examples of medical instruments, the medical instrument may be rotated while the connected tubing remains in its initial position. This may increase the maneuverability of the medical instrument and / or associated components, such as a cannula.

[0011] The present disclosure provides examples of medical instrument accessories that allow relative rotational movement between the medical instrument and at least a portion of the medical instrument accessory and / or fluid connection portion while maintaining retention of the medical instrument accessory on the medical instrument and / or maintaining a seal between the medical instrument accessory and the medical instrument.

[0012] Rotational separation of the fluid connection portions can allow the fluid tubing connected to the medical instrument accessory to remain in substantially the same position / orientation due to the weight of the tubing during operation of the medical instrument. Thus, the medical instrument may be operable, if desired, while minimizing interference due to the orientation of the fluid tubing.

[0013] The present disclosure provides examples of sealing elements for medical instrument accessories. The sealing elements can be configured to seal against a medical instrument inserted into the medical instrument accessory, prevent fluid (e.g., gas) from escaping from the proximal end of the accessory, and / or hold the medical instrument in place within the medical instrument accessory. The sealing elements can be configured to provide a first resistance upon insertion of the medical instrument into the medical instrument accessory and a second resistance upon removal of the medical instrument from the medical instrument accessory.

[0014] The seal element can be configured to allow the medical instrument to rotate within the medical instrument accessory and / or the medical instrument accessory to rotate around the medical instrument. For example, the seal element can be configured to allow the shaft of the medical instrument to rotate within the seal and / or the seal to rotate around the medical instrument.

[0015] Additionally or alternatively, the sealing element may be configured as a fixation element to maintain or otherwise hold a medical instrument accessory on the medical instrument shaft in at least one desired position.

[0016] According to one disclosed aspect, there is provided a medical instrument accessory for providing fluid to and / or from a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: A body attachable over at least a portion of the shaft of a medical instrument. The main body comprises: an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; Equipped with The body is configured so that rotational movement of the fluid connection portion is decoupled from rotational movement of the medical instrument.

[0017] According to one disclosed aspect, there is provided a medical instrument accessory for providing fluid to and / or from a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: A body attachable over at least a portion of the shaft of a medical instrument. The main body comprises: an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; and Equipped with The sealing element is configured to allow rotation of the medical instrument accessory relative to the medical instrument shaft, whereby rotational movement of the fluid connection portion is decoupled from rotational movement of the medical instrument shaft.

[0018] According to one disclosed aspect, there is provided a medical instrument accessory for providing fluid to and / or from a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: A body attachable over at least a portion of the shaft of a medical instrument. The main body comprises: an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; a fixation element configured to maintain the position of the medical instrument shaft relative to at least a portion of the medical instrument accessory; Equipped with The body is configured such that rotational movement of the fluid connection portion is decoupled from rotational movement of the sealing element and / or the fixing element.

[0019] The medical instrument accessory described in the above paragraph may further comprise one or more of the following features:

[0020] The seal element may be configured to attach to a medical instrument shaft. The seal element may be configured to allow rotation of the medical instrument shaft relative to the seal. Rotation of the medical instrument shaft relative to the seal may allow rotation of the fluid connection portion about a longitudinal axis of the medical instrument shaft. The fluid-tight seal may be substantially maintained during relative rotation between the medical instrument shaft and the medical instrument accessory. The seal may provide a fluid-tight seal with the shaft of the medical instrument.

[0021] The sealing element may be configured to hold the medical instrument in a predetermined position within the medical instrument accessory, for example, at a desired longitudinal and / or rotational position. Resistance to movement between the sealing element and the medical instrument shaft may be configured to allow relative rotational movement between the sealing element and the medical instrument shaft.

[0022] The sealing element may be provided at or adjacent the proximal end of the lumen.The sealing element may be configured to mount at or adjacent the proximal end of the medical instrument shaft.

[0023] The body may be configured to receive the medical instrument shaft by sliding insertion of the medical instrument shaft into the lumen. The body may include a guide portion at the proximal end for guiding the medical instrument shaft during insertion.

[0024] According to one disclosed aspect, there is provided a medical instrument accessory for providing fluid to a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: A body attachable over at least a portion of the shaft of a medical instrument. The main body comprises: an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; Equipped with The sealing element is further configured to provide resistance to movement of the medical instrument shaft relative to the sealing element.

[0025] In some examples, the resistance may include resistance to longitudinal movement of the shaft relative to the sealing element. The resistance may be configured to hold the medical instrument in at least one desired position within the medical instrument accessory. The desired position may be a desired longitudinal position and / or a desired rotational position relative to the medical instrument shaft.

[0026] The body may be configured to receive a medical instrument shaft by sliding insertion of the medical instrument shaft into the lumen. The sealing element may be configured to provide a first resistance upon insertion of the medical instrument into the lumen and a second resistance upon withdrawal of the medical instrument shaft from the lumen. The second resistance may be greater than the first resistance.

[0027] The sealing element may be configured to allow the medical instrument to rotate within the medical instrument accessory. For example, the sealing element may hold the medical instrument accessory in a desired longitudinal position while allowing rotation of the medical instrument within the seal. In other examples, the sealing element may be configured to prevent rotation of the medical instrument relative to the sealing element.

[0028] Configuring the seal element to provide resistance may include configuring a width of the seal element. Configuring the seal element to provide resistance may include configuring a surface area of ​​a contact surface that contacts an outer wall of the medical instrument shaft. Configuring the seal element to provide resistance may include selecting material properties of the seal.

[0029] The sealing element may be at least partially formed from one or more of a material that is flexible, a material that is deformable, a material that is resilient, and / or a material that is compressible.

[0030] Proximal movement of the medical instrument shaft may deform the seal element in the proximal direction. The body may include a seal retaining structure configured to limit deformation of the seal element in at least the proximal direction. The seal retaining structure may be configured as an abutment surface extending radially inward from the inner surface of the lumen, wherein proximal sliding movement of the medical instrument shaft compresses at least a portion of the seal element against the abutment surface.

[0031] Configuring the sealing element to provide resistance may include treating the surface of the sealing element to modify the frictional characteristics of the surface. In some examples, the surface may be treated to reduce friction. For example, the surface may be textured to reduce friction between the surface and the medical instrument. The surface may be textured to increase surface roughness to reduce friction. The surface may be treated, for example, by sandblasting and / or polishing. The surface may be treated by applying or coating a low-friction layer.

[0032] The friction-reducing treated surface may be a surface configured to contact a medical instrument during insertion of the medical instrument into the medical instrument accessory. The friction-reducing surface treatment may result in a relatively low force being required to insert the medical instrument through the seal compared to the force required to withdraw the medical instrument from the seal.

[0033] In some examples, the sealing element can include a proximal surface that can be tapered. The tapered proximal surface can be configured to reduce friction on the medical instrument shaft during insertion into the lumen.

[0034] In some examples, the inwardly facing portion of the sealing element may be substantially devoid of corners or abrupt transitions in curvature.

[0035] In some examples, the sealing element may include a distal surface, which may be tapered.

[0036] The medical instrument accessory may include one or more fixation elements configured to maintain or otherwise hold the medical instrument accessory on the medical instrument shaft in a desired position. In such an example, the medical instrument accessory may be configured such that the fluid connection portion is rotatably decoupled from the fixation elements.

[0037] In some instances, the sealing element may also function as the fixation element, i.e., the sealing element and the fixation element may be the same component. Additionally or alternatively, the medical instrument accessory may include one or more non-sealing fixation elements.

[0038] The fixation element may include a non-sealing structure. In some examples, the fixation element may include a locking mechanism operable to secure the attachment for the medical instrument to the medical instrument.

[0039] The fixation element may be disposed adjacent an opening defined in a proximal end of the medical instrument accessory.

[0040] The fixation element may include a clamp, collar, or other similar structure that may be positioned adjacent to the proximal end opening of the medical instrument accessory and may be tightened to retain the accessory on the medical instrument.

[0041] The locking mechanism may include a cam. The cam may be rotatable about an axis to move the cam between a first (open) position and a second (locked) position. Placing the cam in the locked position may allow the cam to interfere with the medical instrument to secure the medical instrument shaft within the medical instrument accessory. The locking mechanism may include a lever extending from the cam. The locking mechanism may be configured to be actuable by a user by actuating the lever.

[0042] In some examples, the body may include a guide portion at the proximal end for guiding the medical instrument shaft during insertion into the lumen.

[0043] According to one disclosed aspect, there is provided a medical instrument accessory for providing fluid to a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: A body attachable over at least a portion of the shaft of a medical instrument. The main body comprises: an interior wall defining a lumen; a proximal end; a distal end defining an opening; a first portion including a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; a second portion including a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; Equipped with The second portion is rotatably coupled to the first portion, and the rotatable coupling of the first and second portions may be configured such that rotational movement of the fluid connection portion is decoupled from rotational movement of the medical instrument shaft.

[0044] The medical instrument accessory may be configured such that the fluid connection portion is rotatable (about the longitudinal axis of the accessory) independently of the sealing element and / or one or more other portions of the medical instrument accessory.

[0045] The second portion may be rotatable relative to the first portion about a longitudinal axis of the body. The sealing element and / or the fixation element may be fixed relative to the first portion.

[0046] The first and second parts may be configured to be connected together. The first and second parts may be configured to be rotatable when connected to one another. The first and second parts may include respective coupling elements configured to interlock, whereby the first and second parts are axially fixed but allowed to rotate relative to one another. The interlocking connection may be configured to be a permanent engagement.

[0047] The connection between the first and second portions can allow for rotation of the fluid connection portion relative to one or more other portions of the medical instrument accessory. The connection between the first and second portions can be positioned distal to the sealing element.

[0048] The coupling elements may include respective mating surfaces. The mating surfaces may be configured to mate to prevent fluid leakage. In some examples, the mating surfaces may mate to provide a substantially fluid-tight seal.

[0049] In some examples, one of the coupling elements may include a male swivel connector portion, while the other of the coupling elements includes a female swivel connector portion, and the first portion may be configured to partially receive the second portion (or the second portion may be configured to partially receive the first portion).

[0050] The coupling element may include a protrusion and a circumferential groove for receiving the protrusion. The coupling element may be configured to interlock via a suitable connection, such as, for example, a snap-fit ​​connection, a press / friction fit, a weld, a threaded connection, and / or an adhesive.

[0051] The coupling element may be configured to minimize friction between mating surfaces to promote free rotation between the first and second portions of the body. For example, the coupling element may be formed from a plastic material having low friction characteristics.

[0052] The first portion may be a first conduit component, and the second portion may be a second conduit component.

[0053] According to one aspect of the present disclosure, there is provided a swivel connector for a medical instrument accessory for providing fluid to a body cavity of a patient during a surgical procedure, the medical instrument accessory comprising: a first conduit component; and a second conduit component; Equipped with the first conduit component comprises a sealing element and / or a fixing element; The first conduit component and the second conduit component are configured to be connected together, and when connected, the first conduit component and the second conduit component are configured to be rotatable relative to one another.

[0054] The second conduit component may be configured to receive at least a portion of the first conduit component. The first conduit component may be configured to receive at least a portion of the second conduit component.

[0055] In some examples, the body may further include a third portion rotatably coupled to the second portion, the second portion may be located between the first portion and the third portion, and the third portion may be rotatably fixed relative to the first portion.

[0056] In any of the above aspects, the medical instrument accessory may further include at least one guide element on or within an inner wall of the accessory, the at least one guide element being configured to position a shaft of the medical instrument within the lumen.

[0057] In some examples, the at least one guide element may maintain the medical instrument shaft generally concentrically within the lumen. The at least one guide element may include one or more protrusions (e.g., ribs, bumps, fins, and / or splines) extending inwardly from the wall.

[0058] In some examples, the at least one guide element may include one or more ribs extending inwardly from the inner wall, and the one or more ribs may be located at or adjacent to the distal end of the lumen.

[0059] Additionally and / or alternatively, the at least one guide element may comprise one or more channels, notches, dimples, and / or grooves in the inner wall. The at least one guide element may be located at the proximal end, the distal end, and / or intermediate along the length of the lumen. In some examples, the at least one guide element comprises a plurality of guide elements. The guide elements may be substantially uniformly spaced around the lumen. The guide elements may be non-uniformly spaced around the lumen.

[0060] According to one disclosed aspect, there is provided a system for providing fluid to a body cavity of a patient during a surgical procedure, the system comprising: a medical instrument accessory according to the present disclosure; one or more fluid delivery tubes for connecting to the fluid connection portion of the medical device accessory; Includes.

[0061] The system may further comprise one or more filters.The system may further comprise one or more cannulas.

[0062] According to one disclosed aspect, there is provided a system for providing fluid to a body cavity of a patient during a surgical procedure, the system comprising: a medical instrument accessory according to the present disclosure; one or more cannulas; Includes.

[0063] In some examples, the at least one cannula may be configured to supply fluid to the body cavity. In some examples, the at least one cannula may be configured to drain fluid from the body cavity. In some examples, the at least one cannula may be configured to simultaneously supply fluid to and drain fluid from the body cavity.

[0064] The system may further comprise one or more filters.The system may further comprise one or more fluid delivery tubes for connection to a fluid connection portion of the medical instrument accessory.

[0065] According to one disclosed aspect, there is provided a flow controller for controlling flow in a fluid drain line for a surgical system, the flow controller comprising: a first body portion configured for fluid communication with a first portion of the fluid exhaust line; a first opening in fluid communication with a first portion of the fluid exhaust line; a second body portion coupled to the first body portion, the second body portion configured for connection with a second portion of the fluid discharge line; a second opening in fluid communication with a second portion of the fluid discharge line; A main body equipped with Equipped with The first body portion and the second body portion are movable relative to one another to bring the first opening into or out of fluid communication with the second opening, thereby selectively opening, closing, and / or altering the fluid flow path between the first and second portions of the fluid exhaust line.

[0066] According to one disclosed aspect, there is provided a flow controller for controlling flow in a fluid drain line for a surgical system, the flow controller comprising: a first body portion including a first fluid connection portion configured for connection with a first portion of a fluid exhaust line, the first body portion defining a first opening in fluid communication with the first fluid connection portion; a second body portion coupled to the first body portion, the second body portion including a second fluid connection portion configured for connection with a second portion of the fluid discharge line and defining a second opening in fluid communication with the second fluid connection portion; A main body equipped with Equipped with The second body portion is movable relative to the first body portion to bring the first opening into or out of fluid communication with the second opening, thereby selectively opening, closing, and / or altering the fluid flow path between the first fluid connection portion and the second fluid connection portion.

[0067] The second body portion may be movable relative to the first body portion from a first position in which the first opening and the second opening are offset relative to each other and the fluid flow path is closed, to a second position in which the first opening and the second opening are at least partially aligned relative to each other and the fluid flow path is at least partially open.

[0068] The first fluid connection portion may comprise a fluid inlet and the second fluid connection portion may comprise a fluid outlet.

[0069] The first body portion and the second body portion may each include a wall, the wall of the first body portion may include a first opening, and the wall of the second body portion may include a second opening.

[0070] The walls of the first and second body portions may be slidably engaged with one another, for example, the walls of the first and second body portions may be slidably engaged with one another in an axial and / or rotational manner.

[0071] In the first position, the first opening may be blocked by the wall of the second body portion, preventing fluid flow therethrough. In the second position, the first opening may be substantially (or at least partially) unblocked, allowing fluid flow therethrough. In at least one intermediate position between the first and second positions, the first opening may be partially blocked by the wall of the second body portion, partially restricting fluid flow therethrough.

[0072] The wall of the second body portion may define an interior portion of the second body portion. The interior portion may be in fluid communication with the second fluid connection portion. At least a portion of the interior portion of the second body portion may be received (e.g., nested) within the first body portion.

[0073] The walls of the first body portion and the second body portion may include respective cylindrical side walls. At least a portion of one cylindrical side wall may be received within the other cylindrical side wall (e.g., in a nested arrangement). For example, the cylindrical side wall of the second body portion may be at least partially received within the cylindrical side wall of the first body portion, or vice versa.

[0074] The first opening may extend through a wall (e.g., a cylindrical sidewall) of the first body portion, and the second opening may extend through a wall (e.g., a cylindrical sidewall) of the second body portion.

[0075] Additionally or alternatively, the walls of the first body portion and / or the second body portion may include respective end walls. In some examples, the first opening may extend at least partially through the end wall of the first body portion. The second opening may extend at least partially through the end wall of the second body portion.

[0076] In some examples, when the second body portion is moved between the first and second positions, the area of ​​the first opening blocked by the wall of the second body portion may change, changing the flow rate through the fluid flow path. Reverse configurations of the first and second openings are also contemplated. That is, when the first body portion is moved between the first and second positions, the area of ​​the second opening blocked by the wall of the first body portion may change, changing the flow rate through the fluid flow path. Thus, any feature of either the first opening and / or the second opening described herein may be applicable to the other of the first opening and / or the second opening.

[0077] For example, the second opening may have a length and a height, and the height of the second opening may vary along its length. For example, the second opening may be tapered along its length. In some examples, the second opening may have a shape that is generally triangular.

[0078] In some examples, the second opening may be defined by a notch in one end of the wall of the second body portion.

[0079] The notch may include a sloped base portion. The notch may be adjacent an open end of the inner cavity of the second body portion.

[0080] In some examples, the dimension of the first opening is shorter than the length of the second opening. The flow rate may be variable depending on the area of ​​the second opening with which the first opening is aligned. The flow rate may be variable between a minimum flow rate of about 0 liters per minute and a maximum flow rate greater than 0, for example, about 7 liters per minute, about 10 liters per minute, about 12 liters per minute, about 15 liters per minute, about 20 liters per minute, or more.

[0081] The flow controller may include a movement limiting device configured to limit relative movement between the second body portion and the first body portion, the movement limiting device being configured to limit the relative movement between limits defined in the first position and the second position.

[0082] The movement limiting device may comprise a protrusion on one of the first body portion or the second body portion and at least one stop on the other of the first body portion or the second body portion, and the protrusion may be configured to abut the at least one stop at the first position and / or the second position to prevent movement beyond said position.

[0083] In some examples, the second body portion may be rotatable relative to the first body portion, such that the first position may be a first angular position, and the second position may be a second angular position.

[0084] The first and second body portions may be axially fixed relative to one another, the second body portion may be rotatable relative to the first body portion about the longitudinal axis of the body, and the length of the second opening may extend in the rotational direction.

[0085] The flow controller may include at least one indicator for indicating the relative alignment of the first and second body portions and / or the relative alignment of the first and second openings. The at least one indicator may include a visual, tactile, auditory, and / or tactile indication to a user.

[0086] The flow controller may include a first indicator on the first body portion and a second indicator on the second body portion, where the relative alignment of the first indicator and the second indicator provides a visual indication of the position of the first opening relative to the second opening. Additionally or alternatively, the flow controller may include a first indicator on the first body portion and a second indicator on the second body portion, where the relative alignment of the first indicator and the second indicator provides a visual indication of the flow rate through the fluid flow path.

[0087] The flow controller may include one or more gripping elements to facilitate movement of the second body portion relative to the first body portion by a user.

[0088] Movement or adjustment of the first body portion and the second body portion relative to one another may be manually actuable.

[0089] For example, the grip element may include a pair of radially extending fins. The fins may be positioned opposite each other about the longitudinal axis. In other examples, the fins may not be opposite each other. In some examples, the position of at least one of the fins relative to an indicator on the first body portion provides a visual indication of the position of the first opening relative to the second opening.

[0090] The flow controller may include at least one retaining element configured to maintain relative alignment of the first body portion and the second body portion at one or more predetermined positions.

[0091] The at least one retaining element may be configured to provide frictional resistance to relative movement between the first body portion and the second body portion, and the frictional resistance may be configured to be overcome by manual application of a force between the first body portion and the second body portion by a user.

[0092] The at least one retaining element may comprise a plurality of retaining elements configured to maintain relative alignment of the first body portion and the second body portion at a corresponding plurality of positions.

[0093] The at least one retaining element may be configured to maintain relative alignment of the first body portion and the second body portion in the first position and / or the second position. The at least one retaining element may be configured to maintain relative alignment of the first body portion and the second body portion in at least one intermediate position between the first position and the second position.

[0094] In some examples, the at least one retaining element may include at least one protrusion and at least one recess, the protrusion being receivable in the recess, and the protrusion may engage the recess via a snap-fit ​​engagement.

[0095] In some examples, the flow controller may comprise an intermediate portion. In some examples, the first body portion may comprise a housing and an intermediate portion. In some examples, the second body portion may comprise a housing and an intermediate portion.

[0096] The intermediate portion may be rotationally and axially fixed relative to the housing.

[0097] In some examples, the intermediate portion may be separate from either the first body portion or the second body portion.

[0098] The intermediate portion may include a fluid flow opening. In some examples, the first body portion includes the first fluid opening and the intermediate portion includes the second fluid opening. In other examples, the intermediate portion includes the first fluid opening and the second body portion includes the second fluid opening.

[0099] The intermediate portion may be configured to be received in one of the first body portion and the second body portion, and the intermediate portion may be configured to receive the other of the first body portion and the second body portion.

[0100] In some examples, the intermediate portion may comprise an insert in the first body portion or the second body portion. The first body portion or the second body portion may comprise a housing and an insert. The first opening may be provided through the insert. The first fluid connection portion may be provided on the housing.

[0101] The insert may be rotationally and axially fixed relative to the housing, for example, the insert may be configured for engagement with the housing to prevent relative axial movement of the insert and the housing.

[0102] The first body portion or the second body portion may include an anti-rotation element for preventing relative rotation between the housing and the intermediate portion. The anti-rotation element may include a slot on one of the housing or the intermediate portion and a protrusion on the other of the housing or the intermediate portion, the protrusion being receivable in the slot.

[0103] The intermediate portion may comprise a wall of a first body portion. The wall of the first body portion may be at least partially located within an interior portion of a housing. The housing may define an interior portion in fluid communication with the first opening and the first fluid connection portion.

[0104] In some examples, the narrowest passage of the fluid flow path is defined by the first opening and / or by the second opening. For example, the body of the flow controller may not include a filter.

[0105] The first body portion may be axially aligned with the second body portion. The first fluid connection portion may be axially aligned with the second fluid connection portion. The first fluid connection portion and the second fluid connection portion may be coincident with a longitudinal axis of the body.

[0106] According to one disclosed aspect, there is provided a fluid drainage system for draining gases and irrigation fluids from a body cavity of a patient, the system comprising: a first fluid exhaust line in fluid communication with the body cavity for exhausting gas from the body cavity; a second fluid drain line in fluid communication with the body cavity for draining irrigation fluid from the body cavity; Equipped with The first fluid discharge line and the second fluid discharge line are connected to a single connection port for connection to a suction canister.

[0107] The fluid exhaust may include a one-way valve connecting to the first fluid exhaust line upstream of the connection with the second fluid exhaust line.

[0108] According to one disclosed aspect, there is provided a fluid line connector for connecting a first fluid discharge line and a second fluid discharge line to a suction canister, the fluid line connector comprising: a first inlet port for fluid connection with a first exhaust line; a second inlet port for fluid connection with a second fluid exhaust line; an outlet port for fluid connection with a suction canister; a junction region fluidly connecting the first inlet port, the second inlet port, and the outlet port; A connector body comprising: Equipped with The one-way valve is positioned within the connector body and configured to prevent fluid flow from the interface region to the first inlet port.

[0109] The fluid discharge system may include a fluid line connector.

[0110] The first and second inlet ports may be substantially perpendicular to one another. The first and / or second inlet ports may be perpendicular to the outlet port. The second inlet port and the outlet may be axially aligned. In other examples, the first and second inlet ports and the outlet port may be positioned at other angles relative to one another.

[0111] The first inlet port may be positioned upstream of the outlet port. The one-way valve may be configured to be positioned upstream of the outlet port. The one-way valve may be configured to be positioned within or adjacent to the first inlet port.

[0112] The first inlet port may be configured to be positioned above the second inlet port and / or above the outlet port during use. The one-way valve may be configured to be positioned above the second inlet port and / or above the outlet port during use. In other examples, the inlet, outlet, and valve may be configured for use in other relative orientations.

[0113] In some examples, the one-way valve may be positioned within the connector body. For example, the one-way valve may be positioned within the first inlet port. The one-way valve may be configured to prevent fluid flow from the junction area to the first inlet port. In other examples, the one-way valve may be spaced apart from the connector body and configured to prevent fluid flow from the junction area through the first fluid exhaust line past the location of the one-way valve. For example, the one-way valve may be connected to the connector body by a length of tubing. Additionally or alternatively, the one-way valve may be provided within a length of tubing connected to the connector body.

[0114] The fluid exhaust system may include at least one filter in fluid communication with the first fluid exhaust line, the filter being configured to filter smoke and / or particulate matter contained in the fluid flowing through the first fluid exhaust line.

[0115] At least one filter may be positioned upstream of the one-way valve. In some examples, the fluid line connector may include a filter. For example, the at least one filter may be positioned within the connector body. Additionally or alternatively, the at least one filter may be removably connectable to the connector body. The filter may be positioned upstream of the second inlet port and / or upstream of the outlet port.

[0116] According to one disclosed aspect, there is provided a system for providing fluid to and draining fluid from a body cavity of a patient during a surgical procedure, the system comprising: 1. An accessory for a medical instrument for providing a fluid to a body cavity, the accessory being attachable over at least a portion of a shaft of the medical instrument; an inner wall defining a lumen; Proximal end, an open distal end, a fluid connection portion configured to fluidly connect the lumen with a fluid source; and At least one structure configured to position the medical instrument shaft within the lumen such that a fluid flow path is defined between the inner lumen wall and the medical instrument shaft. A main body equipped with a medical instrument accessory comprising: a first fluid discharge line configured for connection with an outlet port in fluid communication with the body cavity for draining fluid from the body cavity; Includes.

[0117] At least one structure may be configured to be able to direct fluid into or out of the open distal end and around the end of the medical instrument.

[0118] The system may further include a flow controller for controlling fluid flow in the first fluid outlet line. The flow controller may be as described in any of the examples herein. The system may include one or more fluid tubes for connecting to the first and second fluid connections of the flow controller to form at least a portion of the first fluid outlet line.

[0119] The at least one fluid tube may be configured for connection to a suction source. The at least one fluid tube may be configured for connection to at least one patient interface. The at least one patient interface may include at least one cannula. The at least one cannula may be configured to facilitate drainage of fluid from the body cavity.

[0120] The system may further comprise one or more filters, wherein at least one filter may be configured to filter smoke and / or particulate matter from the ejected fluid.

[0121] The system may include a fluid discharge system for connecting the first fluid discharge line and the second fluid discharge line to a common suction canister. The fluid discharge system may be a fluid discharge system as described in the examples herein.

[0122] The medical instrument accessory may include a sealing element configured to provide a substantially fluid-tight seal with the medical instrument. The sealing element may be configured to provide a substantially fluid-tight seal with the medical instrument shaft.

[0123] The medical instrument accessory may be configured such that the fluid connection portion is rotatable (about the longitudinal axis of the accessory) independently of the sealing element and / or independently of one or more other portions of the medical instrument accessory.

[0124] The sealing element may be configured to allow rotation of the medical instrument accessory relative to the medical instrument shaft, whereby rotational movement of the fluid connection portion is decoupled from rotational movement of the medical instrument shaft. The sealing element may be configured to provide resistance to movement of the medical instrument shaft relative to the sealing element.

[0125] In other examples, the sealing element may be configured to prevent the medical instrument from rotating relative to the sealing element.

[0126] The body of the medical instrument accessory may include a first portion including the sealing element and / or the fixation element and a second portion including the fluid connection portion, the first portion being rotatably decoupled from the second portion, and the second portion may be rotatable relative to the first portion about the longitudinal axis of the body.

[0127] The sealing element and / or the fixing element may be fixed relative to the first part.

[0128] Medical equipment accessories include: a first portion including a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; a second portion including a fluid connection portion configured to connect a lumen in fluid communication with a fluid source; and The second portion is rotatably coupled to the first portion.

[0129] The medical instrument accessory may include at least one guide element on or within an inner wall of the accessory configured to position the shaft of the medical instrument within the lumen. The at least one guide element may include one or more protrusions, e.g., ribs, bumps, fins, pins, dimples, in and / or on the inner wall. The at least one guide element may extend from the inner wall into the lumen.

[0130] The system may further comprise one or more fluid delivery tubes for connecting to fluid connections on the medical instrument accessory.

[0131] The system may optionally include a humidifier in fluid connection with the at least one fluid delivery tube. In some examples, the system may not include a humidifier.

[0132] The system may comprise at least one filter downstream of the outlet and in fluid connection with the outlet of the humidifier chamber.

[0133] The system may include a suction canister, which may have a single inlet port.

[0134] It should be recognized that references herein to "proximal" and "distal" follow the conventional meaning of these terms in the art, as they relate to the operator or user of the device. For example, the distal end of a medical instrument is generally the end located away from the operator, which is typically within or in contact with the patient during use.

[0135] Throughout this specification, the word "comprise" or variations such as "comprises" or "comprising" will be understood to imply the inclusion of a stated element, integer, or step, or group of elements, integers, or steps, but not the exclusion of any other element, integer, or step, or group of elements, integers, or steps.

[0136] These and other features, aspects, and advantages of the present disclosure will be described with reference to several example drawings, which are intended to illustrate several examples diagrammatically and not to limit the scope of the present disclosure. In some cases, "slices" are shown for clarity in several cross-sectional and transverse views of three-dimensional cannulas, sheaths, or accessories. Those skilled in the art will recognize that these drawings show slices of three-dimensional cannulas, sheaths, or accessories. In some cases, protruding surfaces are not shown for clarity. For example, protruding hole surfaces are hidden in some drawings. [Brief explanation of the drawings]

[0137] [Figure 1] 1 illustrates a schematic diagram of a medical gas delivery system according to one example of the present disclosure. [Figure 2] 1 illustrates a schematic diagram of a medical gas delivery system in use during surgery, according to one example of the disclosure. [Figure 3] 3 shows a cross section of a heated gas delivery tube of a medical gas delivery system according to one example of the present disclosure suitable for use in the system of FIG. 1 or the system of FIG. 2. [Figure 4] 3 shows an example of a humidifier chamber suitable for use in the system of FIG. 1 or the system of FIG. 2. [Figure 5] 1 illustrates a body cavity without a medical instrument accessory according to the present disclosure. [Figure 6] 1 illustrates an accessory for a medical instrument according to one example of the present disclosure that provides directional fluid flow. [Figure 7] 1 illustrates a medical instrument accessory according to one example of the present disclosure used as a drainage / venting means. [Figure 8] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 9] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 10] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 11] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 12] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 13] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 14] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 15] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 16] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, according to one example of the present disclosure. [Figure 17] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 18] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 19] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 20] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 21] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 22] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 23] 1A-1C illustrate various examples of medical instrument accessories having a body including a rotatably coupled first portion and a second portion. [Figure 24]1 illustrates directional fluid flow around a medical instrument according to one example of the present disclosure. [Figure 25] 1 illustrates directional fluid flow around a medical instrument according to one example of the present disclosure. [Figure 26] 1 illustrates a protrusion located on an inner surface of a medical instrument accessory according to one example of the present disclosure. [Figure 27] 1 illustrates a protrusion located on an inner surface of a medical instrument accessory according to one example of the present disclosure. [Figure 28] 1 illustrates a protrusion located at a distal end of a medical instrument accessory according to one example of the present disclosure. [Figure 29] 1 illustrates a protrusion located at a distal end of a medical instrument accessory according to one example of the present disclosure. [Figure 30] 1 illustrates a protrusion located at a distal end of a medical instrument accessory according to one example of the present disclosure. [Figure 31] 1 illustrates a protrusion located at a distal end of a medical instrument accessory according to one example of the present disclosure. [Figure 32] 1 illustrates a protrusion located at a first location on a distal end of a medical instrument accessory and at a second spaced apart location on a proximal end of the medical instrument accessory, according to one example of the present disclosure. [Figure 33] 1 illustrates a protrusion located at a first location on a distal end of a medical instrument accessory and at a second spaced apart location on a proximal end of the medical instrument accessory, according to one example of the present disclosure. [Figure 34] 1 illustrates a protrusion located at a first location on a distal end of a medical instrument accessory and at a second spaced apart location on a proximal end of the medical instrument accessory, according to one example of the present disclosure. [Figure 35] 1 illustrates unevenly spaced protrusions according to one example of the present disclosure. [Figure 36] 1 illustrates unevenly spaced protrusions according to one example of the present disclosure. [Figure 37] 10 illustrates protrusions of different widths according to one example of the present disclosure. [Figure 38] 10 illustrates protrusions of different widths according to one example of the present disclosure. [Figure 39]1 illustrates a notch positioned at least partially along the body of a medical instrument accessory according to one example of the present disclosure. [Figure 40] 1 illustrates a notch positioned at least partially along the body of a medical instrument accessory according to one example of the present disclosure. [Figure 41] 1 illustrates an accessory for a medical instrument according to one example of the present disclosure having a cross-sectional shape that is non-circular, thereby allowing fluid flow around the medical instrument. [Figure 42] 1 illustrates an accessory for a medical instrument according to one example of the present disclosure having a cross-sectional shape that is non-circular, thereby allowing fluid flow around the medical instrument. [Figure 43] 1 illustrates schematically a surgical system for providing fluid to and evacuating fluid from a body cavity of a patient during a surgical procedure, according to one example of the present disclosure. [Figure 44] FIG. 1 is a perspective view of a flow controller according to one example of the present disclosure. [Figure 45] FIG. 45 is an exploded perspective view of the flow controller of FIG. 44. [Figure 46] FIG. 45 is a partially transparent view of the second body portion and insert of the flow controller of FIG. 44. [Figure 47] 1A-C schematically illustrate the relative alignment of a first opening and a second opening of a flow controller in a first position (FIG. A), a second position (FIG. B), and a third position (FIG. C). [Figure 48] 45 shows a second body portion of the flow controller of FIG. 44. [Figure 49] 45 shows a front view of the second body portion and insert of the flow controller of FIG. 44 in a first position relative to each other. [Figure 50] 49 shows the second body portion of the flow controller of FIG. 44 in a rotated position relative to the position shown in FIG. 48. [Figure 51] 45 shows a front view of the second body portion and insert of the flow controller of FIG. 44 in a second position relative to each other. [Figure 52]45 shows a perspective view of the insert of the flow controller of FIG. 44. [Figure 53] 45 shows a perspective view of the insert of the flow controller of FIG. 44. [Figure 54] 45 shows a second body portion of the flow controller of FIG. 44. [Figure 55] 45 shows a partial, partially transparent, perspective view of the second body portion and insert of the flow controller of FIG. 44. [Figure 56] 1 illustrates a cross-sectional front view of a flow controller according to another example of the present disclosure having a first body portion and a second body portion. [Figure 57] FIG. 57 shows a cross-sectional side view of the flow controller of FIG. 56. [Figure 58] FIG. 57 shows a front view of the flow controller of FIG. 56. [Figure 59] FIG. 57 shows a side view of the flow controller of FIG. 56. [Figure 60] 10 illustrates a top view of a second body portion of a flow controller according to another example of the present disclosure. [Figure 61] 10 illustrates a partial top view of an insert for a flow controller according to another example of the present disclosure. [Figure 62] 61 shows a partial perspective view of the second body portion of FIG. 60. [Figure 63] 62 shows a perspective view of the insert of FIG. 61. [Figure 64] 1 shows a schematic representation of a prior art configuration of a system for fluid evacuation, including a first fluid evacuation line and a second fluid evacuation line connecting to respective suction canisters. [Figure 65] 1 illustrates a schematic diagram of a fluid ejection system according to one example of the present disclosure. [Figure 66] FIG. 66 is a front view of an exemplary fluid line connector used in the fluid discharge system of FIG. 65. [Figure 67] FIG. 67 is a perspective view of the fluid line connector of FIG. 66. [Figure 68] FIG. 67 is another perspective view of the fluid line connector of FIG. 66. [Figure 69]67 shows a cross section of the fluid line connector of FIG. 66. [Figure 70] 66 shows a perspective cross-section of the fluid line connector of FIG. 65. [Figure 71] 1 illustrates a perspective view of a second body portion of a flow controller according to one example of the present disclosure. [Figure 72] 72 shows a perspective view of the second body portion of FIG. 71. [Figure 73] 1 illustrates a cross section of a housing of a first body portion of a flow controller according to one example of the present disclosure. [Figure 74] 74 illustrates a cross section of the housing and first body portion insert of FIG. 73 according to one example of the present disclosure. [Figure 75] 75 shows a perspective view of the insert of FIG. 74. [Figure 76] FIG. 74 shows a perspective view of the housing of FIG. 73. [Figure 77] 1 illustrates a cross-sectional detail view of a rotatable connection for a medical instrument accessory according to one example of the present disclosure. [Figure 78] 78 shows a cross section of a proximal region of a medical instrument accessory including the rotatable connection of FIG. 77. [Figure 79] 10 illustrates a cross section of a proximal region of a medical instrument accessory according to another example of the present disclosure, including a rotatable connection having an inverted male-female configuration. [Figure 80] 1 illustrates a cross section of a gas inlet of a medical instrument accessory according to one example of the present disclosure. [Figure 81] 10 illustrates a cross section of a gas inlet of a medical instrument accessory according to another example of the present disclosure. [Figure 82] 1 illustrates a cross section of a portion of a medical instrument accessory, including a locking mechanism in an open position, according to one example of the present disclosure. [Figure 83] 83 shows a cross section of a portion of the medical instrument accessory of FIG. 82 with the locking mechanism in a closed position. [Figure 84] 1 illustrates a proximal end of a medical instrument accessory that can be attached to a medical instrument, including a flexible seal, according to one example of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0138] While several examples are described below, it should be recognized that the present disclosure encompasses obvious modifications and equivalents beyond the disclosed examples and / or uses. The scope of the present disclosure is not intended to be limited to any particular examples described below. While some features may be disclosed in connection with one or more examples and other features may be disclosed in connection with one or more other examples, it should be recognized that combining these features together into one or more additional examples is within the scope of the present disclosure. Thus, it is understood that any combination of the disclosed features of either the examples of medical instrument accessories or the instruments themselves is within the scope of the present disclosure.

[0139] Examples of Surgical Systems and Medical Gas Delivery and / or Exhaust Systems A system for delivering a fluid during a medical procedure can include an infuser, which may operate to control the pressure and / or flow of the fluid from a fluid source to a suitable level for delivery to a body cavity. The fluid may be delivered through a cannula or needle connected to the system and inserted into the body cavity.

[0140] Such a system may be used, for example, in the context of minimally invasive surgery, which is performed by entering the body via small incisions through the skin or via natural body orifices. The body cavity (or surgical cavity) may include a viewing and / or working space for the surgery, sometimes referred to as the laparoscopic field of view.

[0141] It should be appreciated that fluid as referred to herein may refer to any gas or liquid or combination thereof. Specifically, where the term "gas" is used, it should be understood that the system and / or component / apparatus described may also be suitable for use with other fluids.

[0142] It may be desirable for the temperature of the gas delivered from the system to match typical human body temperature as closely as possible. It may also be desirable to deliver gas above or below body temperature, e.g., anywhere between 1°C and 10°C, 15°C, or, for example, more or less above or below body temperature, i.e., a range including any two of the above values. It may also be desirable to deliver gas at a desired fixed or variable humidity and / or a desired fixed or variable temperature. Gas at a desired gas temperature and / or humidity may be, for example, a dry cooled gas, a dry warm gas, a humidified cooled gas, or a humidified warm gas.

[0143] The gas delivered into the patient's body may be relatively dry and may cause damage to the body cavity, such as cell desiccation, cell death, or adhesions. In some examples, a humidifier may optionally be operably coupled to the infuser. A system controller may activate a heater in the humidifier located in the gas flow path to deliver humidified fluid to the gas stream before it enters the patient's body cavity. The humidified fluid may be water. The humidified gas may be delivered to the patient via additional tubing, which may also be heated. The infuser and humidifier may be located in separate housings connected together by suitable tubing and / or electrical connections, or may be located in a common housing arranged to be connected to a remote fluid supply via suitable tubing.

[0144] An exemplary medical gas delivery system is shown in Figure 1. An exemplary surgical system 100, including the medical gas delivery system 1, during a medical procedure is shown in Figure 2. A further exemplary configuration for the surgical system 100, including additional system components, is shown in Figure 43.

[0145] In some examples, the surgical system 100 can include a fluid source, such as a flow regulator 9 (e.g., a syringe), and a medical instrument 20 configured to be inserted into a body cavity 2, e.g., a surgical cavity within a patient, e.g., via a cannula 15. The flow regulator 9 can include or be associated with a flow generator, such as a blower. The flow regulator 9 can be associated with a suitable supply of fluid, such as a gas container 57 or a wall source 56 as shown in FIG. 43 , and it should be appreciated that, for example, fluid as referred to herein can refer to any gas or liquid or combination thereof.

[0146] The humidifier 5 may be located between the fluid source (and flow regulator 9) and the body cavity 2. Various styles or types of humidifiers may be used in combination with other elements of the surgical system 100. In some examples, the humidifier may include a chamber (e.g., a "pass-over" humidifier). However, other humidifier types are contemplated, such as humidifiers that include wicking or other suitable absorbent material to retain the humidifying fluid. The wicking or other suitable absorbent material may be located within other devices, such as, for example, tubing or a cannula.

[0147] The humidifier may be configured for use outside the sterile field of an operating room, for example, as shown in Figure 2. The humidifier may be configured for use within the sterile field of an operating room, for example, the humidifier may be a patient-proximal humidifier, for example, a humidifier integrated into a cannula.

[0148] In some examples, a suitable humidifier may include a humidifier chamber 5a or medium for holding a humidifying fluid and a heater configured to heat at least one of the gas and the humidifying fluid. In some examples, the humidifier 5 may include a heater base 5b and the chamber 5a. Examples of humidifiers are described in further detail in PCT / NZ2015 / 050045, filed April 16, 2015, and U.S. Patent Application No. 14 / 023,391, filed September 10, 2013, the disclosures of which are incorporated herein by reference in their entireties.

[0149] FIG. 4 shows one example of a humidifier chamber 5a, but other styles of humidifier chambers may be used. Generally, a suitable humidifier chamber includes at least an inlet 5ab and an outlet 5aa and is configured to maintain a volume of humidified fluid. The humidifier chamber may also include a heater plate and / or a thermally conductive casing disposed to at least partially surround the humidifier chamber. In the example shown, the humidifier chamber 5a and gas inlet 5ab are configured to introduce a gas flow into the humidifier chamber in a direction generally tangential to or adjacent to the sidewall of the humidifier chamber, such that the gas flow entering the humidifier chamber rotates within the humidifier chamber or swirls within the humidifier chamber before exiting through the outlet 5aa. Such an effect can increase the residence time of the gas within the humidifier chamber. In the example shown in FIG. 4, the gas inlet 5ab is oriented toward the sidewall of the humidifier chamber to introduce a gas flow into the humidifier chamber in a direction generally tangential to the sidewall of the humidifier chamber. The gas outlet 5aa is disposed at the top of the humidifier chamber at or near the center thereof. The gas outlet 5aa may have an inner diameter larger than the inner diameter of the gas inlet 5ab. Humidifier chambers configured to rotate or swirl the gas flow entering the humidifier chamber before exiting through the outlet are described in further detail in PCT / NZ2019 / 050032, filed March 26, 2019, the disclosure of which is incorporated herein by reference in its entirety.

[0150] The humidifier 5 may include a controller 5c configured to control one or more functions of the humidifier, including, for example, heating of a heating element such as a heater plate of the heater base 5b. The controller 5c may be configured to include a heating function. The humidifier 5 may be configured such that connection of the tubing 13 to the humidifier chamber outlet 5aa triggers heating of the heater plate. For example, the humidifier 5 may include one or more sensors communicatively coupled to the controller 5c and configured to detect connection of the tubing 13 to the humidifier chamber 5a.

[0151] The humidifier controller 5c may be configured to activate a heating mode of the humidifier 5 upon connection of the tubing 13, warming the heating element for a predetermined period of time. After the predetermined period of time has elapsed, the humidifier controller 5c may be configured to activate an operating mode of the humidifier 5. In the operating mode, the heating element of the humidifier 5 may be heated to a predetermined operating temperature.

[0152] The controller 5c may be configured to place the humidifier 5 in standby mode when the tube 13 is disconnected from the humidifier chamber 5a. The controller 5c may be configured to maintain the operating temperature of the heater plate of the humidifier 5 until the tube 13 is unplugged or the humidifier 5 is manually placed in standby mode or switched off. Other mechanisms for heating and operating the humidifier 5 are possible.

[0153] The gas may be delivered through one or more delivery tubes 10, 13 that are fluidly connected to the humidifier. One or both tubes may heat or cool the gas as it travels between the flow regulator 9 and the body cavity 2. Tube 10 may deliver gas between the flow regulator 9 and the humidifier 5. Tube 13 may deliver humidified gas between the humidifier 5 and the body cavity 2.

[0154] In some examples, the tube 13 comprises a heated tube configured for connection to the outlet of the chamber 5a of the humidifier 5. The tube 13 may include a heating element disposed within, throughout, or around the tube. For example, the tube 13 may include a heating element or heater wire having a predetermined resistance and / or a dedicated resistor. The tube resistance may be used to determine the current or power passing through the tube. The resistor within the tube may, for example, allow for tube identification. The humidifier 5 may be configured to detect connection of the heated tube 13 to the chamber outlet 5a.

[0155] Any of the fluid delivery tubes discussed herein may include a heating element, and the system may be configured so that the heating of each tube can be controlled independently and / or in conjunction with one or more other system components, such as other tubes, humidifiers, and infusers.

[0156] The heating element tube may be included in any tube where it is desired to maintain the temperature and / or humidity of the gas and / or to avoid condensation.

[0157] The tube can additionally or alternatively include at least a portion comprising a breathable material that is permeable to water molecules and relatively impermeable to liquid water, respiratory gases, and / or pathogens. Water molecules within the lumen of such a tube can diffuse through the breathable material. Water molecules can desorb into the ambient air via a gradient moving from a higher humidity side to a lower humidity side. This is known as a solution-diffusion mechanism (which can be distinguished from the pore flow mechanism of a porous membrane). Breathable tubes may incorporate a heating element or may be unheated. Examples of breathable tubes are disclosed, for example, in U.S. Patent No. 6,769,431, U.S. Patent No. 10,532,177, and PCT / NZ2023 / 050040.

[0158] 3 shows one example configuration for delivery tube 13, although other tube configurations are contemplated. Tube 10 may have any of the features described herein with respect to tube 13. Delivery tube 13 may be a flexible tube made from flexible plastic or other suitable material. Tube 13 may have a heating element, e.g., a hot wire, as described above. FIG. 3 shows one configuration of a tube having a heating element in the form of a hot wire.

[0159] The tube 13 may be provided in any suitable configuration. In the example shown in FIG. 3, the tube 13 comprises an inner tube 13a and an outer tube 13b. The tube 13 may also comprise a wall having an inner wall 13a and an outer wall 13b. The delivery tube 13 is configured to deliver gas through the lumen of the inner tube 13a. The tube 13 includes a heater wire 11 positioned within the lumen of the inner tube 13a. The heater wire heats the gas as it travels between the gas source and the body cavity. The gap between the inner tube 13a and the outer tube 13b provides insulation for the inner tube 13a and the gas traveling therethrough. In some cases, the outer tube 13b may be corrugated. In some cases, the inner tube 13a may comprise a smooth lumen.

[0160] The gas may pass through one or more filters or filter units in fluid communication with tubes 10 and / or 13. For example, a filter may be provided downstream of the gas source / flow regulator. Alternatively or additionally, filter 7 may be provided downstream of the outlet of humidifier 5. Filter 7 may be in fluid communication with the outlet of humidifier chamber 5a and tube 13, for example, as shown in FIG. 1, to filter the humidified gas. In some examples, filter 7 may be associated with a heating element operable to heat the gas passing through filter 7.

[0161] System 1 may include one or more patient interfaces for introducing fluids into body cavity 2, such as cannula 15 and / or medical instrument accessories 600. In some examples, cannula 15 may be used to deliver gas to body cavity 2.

[0162] Cannula 15 may include one or more passageways for introducing gases and / or one or more medical instruments 20 into body cavity 2. The medical instruments may be any suitable instrument for use within body cavity 2, such as a scope, an electrosurgical tool (e.g., an electrocautery tool), an energy, laser cutting and / or cauterizing tool, a grasping tool, etc.

[0163] The system may have functionality for suction and / or evacuation of surgical smoke and the like. This functionality may be provided via an evacuation pathway. The surgical system 100 may include one or more patient interfaces for evacuating fluids from the body cavity 2, such as one or more evacuation cannulas 22. Evacuation may be provided via an evacuation line 23 in fluid communication with the evacuation cannulas 22. The evacuation line 23 may be configured for connection to a suction source, such as, for example, an operating room wall suction port 24, or other suction source, such as a mobile suction unit / vacuum generator.

[0164] One or more suction canisters 26 may be provided in fluid connection with the exhaust line 23. In some instances, a single suction canister 26 may be provided for exhaust of gases and / or surgical smoke and for exhaust of irrigation fluid. The suction canister 26 may include a single inlet port. Using a single canister for all exhausted gases and irrigation fluid may reduce costs and / or waste associated with performing a surgical procedure. In other instances, for example, where exhaust of irrigation fluid is not necessary, the system may employ passive exhaust.

[0165] The exhaust line may be connected to one or more filters, such as smoke filter 25. In some cases, exhaust may be provided through the same cannula that provides insufflation gas to body cavity 2.

[0166] The surgical system 100 may include a monitoring device for use with the system. For example, a surgical scope (hereinafter "scope"), such as a laparoscope, may be used with or may be part of the medical instrument 20 to enable display of images recorded by the scope on an external monitor 31. The scope may be connected to a camera via a camera supply line 32 and to a light source via a light source line 33.

[0167] The surgical system 100 may include a medical instrument accessory 600. The medical instrument accessory may be configured to receive the medical instrument 20. The medical instrument accessory 600 may be used with a medical gas delivery or laparoscopic system, such as the cannula 15 of the surgical system 1 of FIG. 1. The medical instrument 20 and medical instrument accessory may be introduced into a body cavity via the cannula 15. The medical instrument accessory may be configurable to direct gas flow relative to the medical instrument 20, such as a scope, to reduce or prevent visibility problems resulting from condensation and / or surgical smoke. More detailed examples of medical instrument accessories are described below.

[0168] The surgical system 1 may include a flow controller (e.g., flow controller 300 or 3300), as described in further detail herein, connected to the exhaust line 23 to control flow within the exhaust line 23. The flow controller 300 may be positioned anywhere in the exhaust path downstream of the body cavity 2. In the example of FIG. 43 , the flow controller 300 is positioned proximal to the body cavity 2 with respect to the length of the exhaust line 23. For example, the proximal portion of the exhaust line 23 between the flow controller 300 and the patient interface, e.g., the exhaust cannula 22, may be shorter than the portion of the exhaust line 23 between the flow controller 300 and the suction source 24.

[0169] The flow controller 300 may be manually operable by surgical staff, e.g., a surgeon. The flow controller 300 may be positioned proximal to the body cavity 2 and within the sterile zone of the operating room, allowing easy access for a medical professional (e.g., a surgeon or surgical assistant) to access the flow controller 300 to increase or decrease fluid flow in the exhaust line 23. More detailed examples of flow controllers 300, 3300 are discussed below.

[0170] In some cases, reference numerals for the same or substantially the same features may have the same last two digits.

[0171] Examples of medical equipment accessories 2 and 43 show one example of a medical instrument accessory 600 in use with the cannula 15 of the surgical system 100. The medical instrument accessory 600 may be configurable to direct gas flow toward the medical instrument 20, e.g., a scope, to reduce or prevent visibility problems resulting from condensation and / or surgical smoke. The present disclosure provides additional examples of medical instrument accessories 610a, 610b, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1700, 1800, 1900, 2000, 2100, 2200 that may be suitable for use with the surgical system 100.

[0172] For example, a surgical system including, for example, an insufflation system for supplying insufflation gas to a body cavity, such as those described above with reference to Figures 1, 2, and 43, can incorporate any of the exemplary medical instrument accessories 600, 610a, 610b, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1700, 1800, 1900, 2000 disclosed herein.

[0173] The exemplary medical instrument accessories disclosed herein may be retrofitted to existing surgical systems, such as injection systems, without the need for customization (e.g., custom connectors). Accordingly, the exemplary medical instrument accessories disclosed herein can enhance the optical clarity of the scope viewing area and / or maintain a clear field of view during use. This can help minimize the duration of a procedure and reduce the number / frequency of interventions (e.g., withdrawing medical instruments to clean the viewing area). Furthermore, the exemplary medical instrument accessories disclosed herein can make it easier for medical personnel, e.g., surgeons, to operate the medical instruments during a medical procedure.

[0174] Delivery of a gas flow near, around, or adjacent to the distal end of a medical instrument, e.g., a scope, can heat the end of the instrument. This can inhibit the formation of condensation by affecting the environment of the scope viewing portion and the environment immediately surrounding the scope viewing portion. The directional fluid flow can create a "microenvironment" around the viewing portion of the medical instrument that is at least partially isolated from the environment of the body cavity. Additionally and / or alternatively, this can direct smoke particles away from the field of view of the medical instrument. This can be achieved by manipulating the fluid flow, temperature, and / or humidity within the microenvironment. This can advantageously maintain the temperature of the scope viewing portion (or other instrument components, e.g., sensors) above the dew point of the gas in a zone adjacent to the scope viewing portion.

[0175] A medical instrument accessory can be single-use (disposable) or reusable. Alternatively, multiple parts of a medical instrument accessory can be single-use (disposable) or reusable. A medical instrument accessory may be made from a material that is biocompatible and / or sterilizable.

[0176] During laparoscopic surgery, there may be some form of electrosurgery / electrocautery / ultrasound or laser surgery to cause cutting or coagulation within the insufflated body cavity. This can produce surgical smoke within the cavity, which can become highly concentrated, especially in the absence of significant or sufficient gas leakage or suction / irrigation. High concentrations of smoke within the insufflated cavity, or plumes of smoke moving toward the scope's viewing area within the cavity, can significantly obstruct the optical clarity and field of view of the scope operator, e.g., the surgeon or other members of the surgical team. In the absence of evacuation or suction, surgeons typically release all or a portion of the gas from within the cavity and then re-infuse. The surgeon may evacuate or use suction to draw out the smoke and / or reduce its concentration by injecting clean gas into the cavity.

[0177] Directing the gas flow toward the viewing portion of the scope may advantageously reduce the impact of smoke concentrated within the insufflated cavity on the visibility of the user operating the scope, for example, by affecting the environment immediately adjacent to the viewing portion. The directed gas can direct smoke away from the viewing portion of the scope, improving visibility and expanding the surgeon's field of view. This can also prevent plumes of smoke from contacting medical instruments.

[0178] In some cases, directional gas flow can facilitate directing gas closer to the target area. For example, directional gas flow can reduce or eliminate stagnant zones of gas flow around the scope viewing area. This can force clean gas into the field of view and / or dilute smoke with clean insufflated gas, both of which can improve optical clarity. Gas can be directed to a specific target area to help clear the area of ​​smoke, which can then allow for easier evacuation of the smoke cavity.

[0179] In some cases, exhaust adjacent to the viewing portion of the scope may effectively remove smoke by venting gas from near the source. This may allow for the removal of gas within or around the field of view. Similarly, exhaust adjacent to the distal portion of an instrument, such as an electrocautery device, may also assist in the removal of smoke by venting gas from near the source. Figures 5-7 illustrate the delivery of gas to and from a location adjacent to the distal end of a medical instrument, e.g., the scope. This may advantageously allow for the environment immediately surrounding the viewing portion to be affected, regardless of the depth of insertion of the medical instrument into the cavity and beyond the distal end of the cannula or accessory.

[0180] In some examples, the medical instrument accessory may include a guide element configured to position the medical instrument generally concentrically relative to the accessory, which is described in further detail below. Furthermore, some examples are configured to direct gas toward the observation portion. Other examples may be configured to direct gas in front of and / or away from the observation portion.

[0181] FIG. 5 illustrates a body cavity without the use of a medical instrument accessory described herein, so gas / smoke is not effectively removed. FIG. 6 illustrates the use of a first medical instrument accessory 610a to provide directional gas flow to the distal end of a medical instrument 611a, which may include a scope or camera. FIG. 7 illustrates the use of a second medical instrument accessory 610b to provide exhaust to the distal end of the second medical instrument 611b. In some examples, two medical instrument accessories (e.g., 610a and 610b) may be used simultaneously to provide directional gas flow and exhaust to the distal ends of the two medical instruments (e.g., 611a and 611b). In other examples, a single medical instrument accessory may provide directional gas flow and exhaust functionality.

[0182] 6 and 7, the medical instrument is inserted into a cannula, which may be an infusion cannula or an evacuation cannula. In other examples, the medical instrument may be inserted into a separate cannula from the infusion and evacuation cannula (which may not be directed toward the smoke pocket(s)). Gases exiting the infusion cannula may be directed toward the body cavity and relatively far from the smoke pocket(s) where they may stagnate. In contrast, medical instrument accessories according to examples of the present disclosure may direct gas flow toward the smoke pocket(s), evacuate gases from the smoke pocket(s), and / or be positioned within the smoke pocket(s).

[0183] Examples of seals and rotatable connections 8-14 show a medical instrument accessory 700 for directing fluid flow to, around, or adjacent to the distal end of a medical instrument. The accessory 700 can be positioned around and securable to the medical instrument.

[0184] The accessory 700 may be securable to the medical instrument by a fixation element. In some examples, the seal of the accessory 700 may function as the fixation element. Additionally or alternatively, the accessory 700 may include a non-sealing fixation element separate from the seal element. For example, the accessory may include a locking mechanism, such as a cam lock, as discussed in more detail below with respect to FIGS. 82 and 83 . The fixation element may include a clamp, collar, or other similar structure that may be positioned adjacent the proximal end opening of the medical instrument accessory and tightened to retain the accessory on the medical instrument.

[0185] The medical instrument accessory 700 includes a body 704 that is mountable over at least a portion of a medical instrument 710, for example, over the shaft of a scope. At least a portion of the medical instrument accessory 700 may be movable (e.g., rotatable) relative to the medical instrument 710 during a surgical procedure. The body 704 includes an elongate shaft 702 extending from a proximal end to a distal end. The shaft 702 may define one or more lumens. In the example shown in FIGS. 12 and 13 , the shaft 702 defines an inner lumen 706 that is sized to at least partially receive a shaft 714 of the medical instrument 710. The one or more lumens may extend from and be in fluid communication with an opening or outlet defined in the distal end of the body 704. The lumen 706 is defined at least in part by an inner wall 712 of the body 704. When the medical instrument accessory 700 is placed over the medical instrument shaft 714 , a fluid flow path is defined between the outer wall 715 of the medical instrument shaft 714 and the inner wall 712 of the body 704 .

[0186] In other examples, the fluid flow path may be defined by an additional lumen. For example, lumen 706 may be configured to receive a medical instrument without providing fluid flow, while the additional lumen may provide a fluid flow path. In such examples, the additional lumen may be concentric with or offset from lumen 706.

[0187] Figures 8, 9, and 12 show the proximal portion of body 704. Body 704 may be sized to extend further distally or may be connected to a further distally extending portion of the body. Figure 14 shows a profile view of body 704. Fitting 700 may be secured to release gas at or adjacent the distal end of medical instrument 710.

[0188] The accessory 700 may enable the directional gas flow to be delivered closer to the target area. For example, the accessory 700 may emit gas closer to the field of view of the medical instrument 710. In some cases, the body 704 may have a length that extends toward but stops short of the distal end of the medical instrument accessory 700, such that the distal end of the medical instrument 710 can extend distally past the distal end of the medical instrument accessory 700. The distal end of the medical instrument 710 may protrude at least partway from the open distal end of the accessory 700. In some examples, the distal end of the medical instrument 710 may protrude a desired distance beyond the distal end of the accessory 700. Positioning the distal end of the medical instrument 710 adjacent to and beyond the distal end of the accessory 700 can facilitate smoke evacuation, particularly when the medical instrument 710 includes a cutting tool (e.g., an electrocautery tool) that produces smoke during use. In some examples, the body 704 can have a length that extends to or beyond the distal end of the medical instrument 710. In such examples, the distal end of the body 704 can be positioned adjacent to the distal end of the medical instrument 710 or can extend beyond the distal end of the medical instrument 710. For example, the distal end of the medical instrument 710 can be positioned within the attachment 700 adjacent the distal end. In some cases, the body 704 can be adjusted relative to the medical instrument 710 such that the distal end of the body 704 extends beyond the distal end of the medical instrument 710.

[0189] The body 704 may include a fluid connection, such as a gas port 716, configured to connect a lumen in fluid communication with a fluid source and / or a vent, allowing gas to enter and / or exit the body 704. The port 716 may be connectable to a gas delivery tube, which is then fluidly connectable to a gas source. For example, the port 716 may be connectable to a medical gas delivery system, such as an infusion system (e.g., any of the systems disclosed herein). In the illustrated example, gas is delivered to the lumen 706 of the accessory 700 through a port, configured in this illustrated example as a gas inlet port 716. The accessory 700 may include one or more apertures 792 in the wall 712 of the body 704, allowing gas to pass from the inlet port 716 to the lumen 706. In other examples, the proximal end of the body 704 may be in fluid communication with a gas source.

[0190] The gas inlet port 716 may be opened and closed by movement of an actuator. In the example shown, the actuator comprises a spigot. The actuator can rotate to open and close the port, providing gas flow to the lumen 706 of the accessory 700 as needed.

[0191] 12 shows medical instrument accessory 700 attached to a medical instrument shaft 714. In some examples, body 704 may be configured to accept medical instrument shaft 714 by slidingly inserting medical instrument shaft 714 into lumen 706 through the proximal end of body 704. In some examples, body 704 may include a guide portion 718 at its proximal end for accepting and guiding medical instrument shaft 714 during insertion into lumen 706. In the example shown, guide portion 718 comprises a flared proximal portion of the body, which defines a funnel-shaped opening to lumen 706.

[0192] The body 704 further comprises a sealing element 720. Figure 8 shows an exemplary sealing element 720 on the inner surface of the shaft 702 of the body 704. In the example shown, the sealing element 720 is overmolded onto the shaft 702. In some examples, the sealing element 720 is not overmolded onto the shaft 702. In some examples, the sealing element 720 is positioned only inward from the inner wall 712. That is, the sealing element 720 does not extend from the outside of the body 704.

[0193] The sealing element may serve multiple functions. The sealing element 720 is configured to provide a substantially fluid-tight seal between the medical instrument 710 and the medical instrument accessory 700. In addition to sealing the fluid flow path, the sealing element 720 may be configured to provide resistance to movement of the medical instrument 710 relative to the accessory 700, for example, to retain the medical instrument 710 within the medical instrument accessory 700. As described in further detail below, the sealing element 720 may also allow relative rotation between the sealing element 720 and the medical instrument 710 while maintaining a substantially fluid-tight seal. In some examples, the sealing element 720 may be configured to function as a fixation element, retaining the accessory 700 in a desired position on the shaft of the medical instrument.

[0194] Additionally and / or alternatively, sealing element 720 may provide greater resistance during withdrawal of a medical instrument from attachment 700 than during insertion of the medical instrument from attachment 700. These various functions of the sealing element are discussed in further detail below.

[0195] As shown in FIG. 12 , the sealing element provides a substantially fluid-tight seal between the inner wall 712 of the body 704 and the outer wall 715 of the medical instrument shaft 714. FIG. 13 shows an enlarged view of the area of ​​FIG. 12 indicated by the dashed circle. The sealing element 720 is configured to prevent gas from escaping from the proximal end of the lumen 706 such that the gas is released at the distal end of the accessory 700. The sealing element 720 may be positioned on the body 704 such that at least a portion of the sealing element 720 extends inward from the inner wall 712 of the body 704. The sealing element 720 may be positioned at or adjacent to the proximal end of the lumen 706 of the accessory 600. The sealing element 720 may be configured to be attached to or adjacent to the proximal end of the medical instrument 710.

[0196] An exemplary seal element 720 is shown in further detail in Figures 10 and 11. The seal element 720 comprises at least one contact surface configured to sealingly abut the outer wall 715 of the medical instrument shaft 714. In the example shown, the contact surface comprises an intermediate surface 722 located between a proximal surface 724 and a distal surface 726. In some examples, the contact surface may further include part or all of the proximal surface 724 and / or the distal surface 726. That is, part or all of the proximal surface 724 and / or the distal surface 726 may be configured to sealingly abut the outer wall 715 of the medical instrument shaft 714.

[0197] Seal element 720 may be configured to maintain relative axial (longitudinal) positioning between medical instrument 710 and accessory 700. In such an example, resistance to longitudinal movement of seal element 720 relative to medical instrument shaft 714 may be high enough to withstand forces exerted during routine use of medical instrument accessory 700 with medical instrument 710, thereby maintaining relative axial positioning between medical instrument 710 and accessory 700 and retaining medical instrument 710 within accessory 700.

[0198] As described above, seal element 720 may be configured to allow relative rotation between seal element 720 and medical instrument shaft 714. This may allow relative rotation between inlet port 716 and medical instrument 710. For example, inlet port 716 may be rotatable about longitudinal axis X of body 704. In other examples, inlet port 716 may be rotatable about an axis offset from longitudinal axis X of the shaft.

[0199] The medical instrument accessory 700 may be configured to position the medical instrument 710 generally concentrically within the lumen 706 of the medical instrument accessory 700, such that the inlet port 716 is rotatable about the longitudinal axis of the medical instrument shaft 714. In other examples, the medical instrument 710 may be offset from the longitudinal axis X of the body 704 (e.g., linearly offset or angularly offset).

[0200] In some examples, the resistance to rotational movement between the sealing element 720 and the medical instrument shaft 714 may be small enough to be overcome by forces (e.g., torque caused by the weight of tubing attached to the inlet port 716) exerted during everyday use of the medical instrument accessory 700 with the medical instrument 710. This may allow the inlet port 716 to rotate substantially freely relative to the medical instrument 710. Thus, movement of the inlet port 716 (and any attached tubing) may be substantially decoupled from movement of the medical instrument 710. This may increase the maneuverability of the medical instrument and attached medical instrument accessory, for example, by reducing movement and resistance of attached tubing when a user manipulates the medical instrument 710.

[0201] Seal element 720 may be configured to allow slidable insertion of medical instrument shaft 714 into lumen 706 through a central aperture in seal element 720. Medical instrument shaft 714 may similarly be removable by a longitudinal sliding movement to withdraw medical instrument 710 from attachment 700. Seal element 720 may be configured to provide resistance to longitudinal movement of medical instrument shaft 714 relative to seal element 720. The resistance to longitudinal movement of seal element 720 relative to medical instrument shaft 714 may be small enough to be overcome by a user applying manual force to medical instrument 710, thereby allowing the user to insert and / or withdraw medical instrument 710 by hand.

[0202] Various configurations of seal element 720 may provide a first resistance to longitudinal movement during insertion of medical instrument shaft 714 and a second resistance to longitudinal movement during withdrawal of medical instrument shaft 714. The second resistance may be greater than the first resistance, such that it is easier to insert medical instrument 710 than to withdraw medical instrument 710. Both the first and second resistances to longitudinal movement may be configured to be greater than the resistance to rotational movement of seal 720 relative to medical instrument shaft 714. In some cases, the first resistance may be greater than the second resistance and / or the resistance to rotational movement of seal 720 relative to medical instrument shaft 714.

[0203] Seal element 720 may be configured to provide a desired degree of resistance between seal element 720 and outer wall 715 of medical instrument shaft 714. The desired degree of resistance may be small enough and / or large enough, for example, a resistance described in more detail below for various examples, to achieve the above-described functions of seal element 720. As discussed in more detail below, one or more features or characteristics of seal element 720 may be configured to vary the resistance provided between seal element 720 and medical instrument shaft 714.

[0204] The width A of at least a portion of the seal element 720 (e.g., the portion of the seal element 720 positioned inward from the inner wall 712 of the body 704) may be adjusted to vary the degree of compressive force between the seal element contact surface and the outer wall of the medical instrument shaft when the seal element 720 is engaged with the instrument shaft 714. For example, the resistance provided by the seal element may be based at least in part on the width of the seal element. The width of the seal element is configured to be greater than the distance between the outer wall of the medical instrument shaft and the inner lumen wall, such that at least a portion of the seal element is radially compressed between the outer wall of the medical instrument shaft and the inner lumen wall. Generally, a greater degree of compression provides greater resistance during insertion and / or withdrawal.

[0205] Additionally, the surface area B, as shown in FIG. 13, of the contact surface (e.g., intermediate surface 722) that contacts the outer wall 715 of the medical instrument shaft 714 may be adjusted to increase or decrease frictional resistance by adjusting the size and / or geometry of the sealing element 720 to change the cross-sectional profile shape of the sealing element 720.

[0206] Additionally, the material properties of seal element 720 may be configured to vary the resistance between seal element 710 and medical instrument shaft 714. In some cases, a surface treatment such as sandblasting or polishing may be applied to one or more contact surfaces (e.g., at least interface surface 722) to vary (e.g., reduce) the frictional resistance. In other cases, one or more contact surfaces (e.g., interface surface 722) may be roughened or otherwise treated to increase the frictional resistance.

[0207] In the example shown in FIG. 84 , seal element 720′ includes a flexible portion 721′ configured to bend radially when a medical instrument shaft is inserted. Seal element 720′ includes a proximal surface 724′ configured to contact the outer surface of the medical instrument shaft. In this example, a friction-reducing treatment 725′ (e.g., a coating, low-friction layer, or other treatment configured to reduce frictional resistance) has been applied to proximal surface 724′ to reduce friction between seal element 710′ and the medical instrument shaft during insertion of the medical instrument. During withdrawal of the medical instrument shaft, friction between the medical instrument shaft and the seal element causes seal element 720′ to compress and / or fold back on itself, increasing resistance to withdrawal. Additionally or alternatively, the seal element may move during withdrawal such that the seal surface contacting the shaft has increased frictional resistance compared to proximal surface 724′.

[0208] In some cases, seal element 720 is configured such that proximal movement of the medical instrument shaft deforms the seal element proximally. For example, seal element 720 may be at least partially formed from one or more of a flexible material, a compressible material, a resilient material, and / or a deformable material. In some examples, the material may include a thermoplastic elastomer, although other suitable materials may also be used. Deformation of seal element 720 may increase the compressive force and / or the surface area in contact with surface 715 of medical instrument 710, thereby increasing the resistance between seal element 720 and medical instrument shaft 714.

[0209] In the example shown, body 706 includes a radially inwardly extending abutment surface 707 that abuts the proximal edge of seal element 720, which prevents or limits proximal movement of seal element 720. Upon withdrawal of medical instrument shaft 714 from lumen 706, instrument shaft 714 compresses seal element 720 against abutment surface 707.

[0210] 13 , in some examples, proximal surface 724 may be tapered, angled, curved, or otherwise shaped to extend away from surface 715 of medical instrument shaft 714 when accessory 700 is worn over medical instrument 710. Proximal surface 724 may be configured to at least partially define proximal gap C between proximal surface 724 and outer surface 715 of medical instrument 710. Compression of sealing element 720 against abutment surface 707 may force sealing element 720 partially into gap C. This may cause an increase in the compression force and / or contact force of sealing element 720 against shaft 714 due to more sealing element 720 material being forced against shaft 714, and / or may increase the surface contact area of ​​sealing element 720 against shaft 714, increasing the resistance between sealing element 720 and shaft 714.

[0211] Proximal face 724 may define a funnel-shaped opening (in addition to the funnel-shaped opening defined by the flared guide portion of the body) configured to further guide medical instrument shaft 714 into lumen 706 during insertion. Thus, more force is required to withdraw medical instrument shaft 714 from lumen 706 than to insert medical instrument shaft 714 into lumen 706.

[0212] In some examples, distal surface 726 of seal element 720 may be configured to define a distal gap between medical instrument shaft surface 715 and seal element 720. Distal surface 726 may be configured to allow insertion and / or removal of medical instrument shaft 714 with reduced friction and / or shear on seal element 720. In some examples, distal surface 726 may be tapered, angled, curved, or otherwise shaped to extend away from surface 715 of medical instrument shaft 714 when accessory 700 is worn over medical instrument 710.

[0213] In the example shown, distal surface 726 includes a convex fillet between mid-surface 722 and the distal end of seal element 720. Surfaces 722, 724, and / or 726 of seal element 720 may be substantially free of sharp corners or abrupt transitions in curvature that could catch on instrument 710 and tear the material of seal element 720 during insertion and / or removal. This can reduce or prevent damage to seal element 720 during insertion and / or removal of medical instrument 710.

[0214] 15 and 16 show alternative seal profiles. In this example, medical instrument accessory 800 includes a body 804 that includes a seal element 820. Seal element 820 is configured to seal against shaft 814 of medical instrument 810. Seal element 820 may include one or more of the features or characteristics as discussed above with respect to seal element 820. For example, as described with respect to seal element 820, seal element 820 may be configured to allow relative rotation between seal element 820 and medical instrument shaft 814, thereby decoupling movement of medical instrument 810 from movement of a gas inlet (not shown) attached to body 804. Additionally, seal element 820 may be configured to provide resistance to longitudinal movement. Seal element 820 may be configured to provide a first resistance to longitudinal movement during insertion of medical instrument shaft 814 and a second resistance to longitudinal movement during withdrawal of medical instrument shaft 814. In some examples, the first resistance may be less than the second resistance. In some examples, the first resistance may be greater than the second resistance.

[0215] In contrast to seal element 720, seal element 820 may include a tapered and / or pointed inner rim 821. Inner rim 821 flexes when medical instrument shaft 814 is inserted into lumen 806, providing a sealing contact surface 822. Upon withdrawal of medical instrument shaft 814 from lumen 806, instrument shaft 814 deforms seal element 820. This may cause an increase in the compressive force of seal element 820 against shaft 814, thereby making withdrawal of instrument shaft 814 more difficult than insertion. This may be due to several factors, such as an increase in the surface contact area of ​​seal element 820 against instrument shaft 814 and / or a geometric constraint of seal element 820 in at least one direction. Deformation of seal element 820 may result in increased radial compression and / or increased axial friction as a result of the change in shape of seal element 820. In some examples, the surface of seal element 820 may be configured to provide increased friction during withdrawal compared to insertion of medical instrument shaft 814. In some examples, the surface of seal element 820 may be configured to provide relative ease of deformation and relative resistance to deformation in one direction (e.g., insertion) or to return to a neutral position in a second direction (e.g., withdrawal).

[0216] In some examples, the medical instrument accessory may include a body having a first portion and a second portion rotatably coupled to at least the first portion, allowing rotational movement between the fluid connection portion of the medical instrument accessory and the medical instrument. In some examples, the body may include additional rotatably coupled portions. For example, a sealing element may be configured on the first portion, and a fluid connection portion, such as an inlet port, may be configured on the second portion. This may allow rotational movement of the inlet port relative to the sealing element, thereby rotatably decoupling the inlet port from the sealing element. Examples of this are shown in the examples shown in Figures 15-22 and discussed in further detail below.

[0217] The first and second portions may include respective rotational coupling elements. The coupling elements may be configured to interlock such that the first and second portions are axially fixed relative to one another but rotationally decoupled. That is, the coupling elements may impede or substantially prevent relative axial movement between the first and second portions, but may allow relative rotation between the first and second portions. The interlocking coupling elements may also be configured to create a fluid-tight seal that prevents fluid (e.g., gas) from passing between the first and second portions, preventing fluid from leaking at the proximal end of the attachment. For example, the coupling elements may be configured to substantially sealingly interlock and / or may include a secondary sealing element therebetween. The coupling elements may be configured to allow rotational movement between the first and second portions while maintaining a fluid-tight seal between the first and second portions and between the sealing element and the medical instrument shaft.

[0218] In such examples, the degree of frictional resistance between the seal element and the medical instrument shaft may be configured to prevent rotational movement between the seal element and the medical instrument shaft, whereby one portion (e.g., the first portion) of the body is secured to the medical instrument shaft by the seal. Alternatively, the seal element may provide a degree of rotational freedom relative to the medical instrument shaft in addition to the rotational freedom provided by the rotational coupling. In some cases, the rotatability of the medical instrument shaft relative to the seal element may be determined by the frictional force between the instrument and the seal, which may be configured by incorporating one or more of the features / characteristics of seal element 620 or 720 discussed above.

[0219] As one example, FIGS. 17-19 show a medical instrument accessory 900 for directing fluid flow around the distal end of a medical instrument. The medical instrument accessory 900 includes a body 904 that can be worn over at least a portion of a medical instrument (not shown), such as a scope. The body 904 extends from a proximal end to a distal end. The body 904 may define one or more lumens. In the example shown, the body 904 defines an inner lumen 906 that is sized to at least partially receive the shaft of the medical instrument. The one or more lumens can extend from and be in fluid communication with an opening or outlet defined in the distal end of the body 904. The lumen 906 is at least partially defined by an inner wall 912 of the body 904. When the medical instrument accessory 900 is worn over the medical instrument shaft, a fluid flow path is defined between the outer wall of the medical instrument shaft and the inner wall 912.

[0220] 17-19 show a proximal portion of body 904. Body 904 includes a first portion 950 and a second portion 960, with second portion 960 rotatably coupled to first portion 950. First portion 950 and second portion 960 comprise first and second conduit components, respectively. Body 904 may be dimensioned to extend further distally, as shown in FIG. 18, for example, or may be connected to additional distally extending portions of body 904.

[0221] In the example shown in FIGS. 17-19, the first portion 950 and the second portion 960 are configured to be connected together to form a swivel connection. The swivel connection is shown in more detail in FIGS. 77 and 78. The first portion 950 and the second portion 960 are shown with at least a portion of the first portion 950 disposed externally of the proximal end of the second portion 960, the proximal end of which is partially received within the first portion. That is, there are internal and external connector components of the swivel connection. In the example shown, the first portion 950 includes a female (external) connector component 952, and the second portion 960 includes a male (internal) connector component 962. However, the reverse configuration is also contemplated. For example, in the body 904' shown in FIG. 79, the first portion 950' includes a male (internal) connector component 952', and the second portion 960' includes a female (external) connector component 962'.

[0222] The swivel connection allows for relative rotation between the first portion 950 and the second portion 960 , and therefore allows for relative rotation between the first portion 950 and the gas inlet port 916 .

[0223] The male connector component 952 and the female connector component 962 include respective mating surfaces configured to contact one another when the components are connected. One or more of the mating surfaces may be tapered.

[0224] The first portion 950, shown here as the outer component, comprises a wall having an inner surface. The second portion 960, shown here as the inner component, comprises a wall having an outer surface. The outer surface may be substantially aligned with the inner surface. The outer surface may be generally parallel to the inner surface. One or both surfaces may be angled relative to the other surface.

[0225] 77 , the first portion 950 includes an external shoulder or flange 951. The shoulder or flange 951 may be at or adjacent to the distal end of the first portion 950. The shoulder or flange 951 may extend around the periphery of the outer surface. The second portion 960 includes a shoulder or flange 961 on the outer surface of the wall. When the first and second portions 950 and 960 are assembled, the respective shoulders / flanges abut one another. The abutting shoulder / flange connection acts as an end stop, limiting the distance the second portion 960 can be inserted into the first portion 950.

[0226] The first portion 950 and the second portion 960 may be connected together by a permanent interference fit, for example by a snap fit connection.

[0227] The inner surface of the first portion 950 and the outer surface of the second portion 960 include engagement features that are engageable with one another to form a permanent connection. The connection mechanism is configured so that the first portion 950 and the second portion 960 can be assembled without requiring significant axial force (e.g., allowing for manual assembly), but cannot be easily separated thereafter. After assembly, the first portion 950 and the second portion 960 can rotate independently of and relative to one another while maintaining a secure connection. The connection may be configured to minimize or avoid gas leakage through the connection.

[0228] 77 , the outer surface of second portion 960 has an engagement formation in the form of a protrusion 966 extending circumferentially around its distal end. Second portion 960 tapers toward the distal end to define a radially inwardly extending undercut 963 adjacent protrusion 966. In other words, protrusion 966 extends over undercut 963. Protrusion 966 may be a radial protrusion.

[0229] The engagement formation with the protrusion may form a bending portion or a bending arm. One or more slots may be provided to allow easier bending of the bending arm, particularly when the second portion 960 is inserted into the first portion 950 for connecting engagement. This can facilitate easier assembly of the first portion 950 and the second portion 960. As shown in FIG. 77 , the second portion 960 may include a slot 965.

[0230] When viewed in cross section, the protrusion 966 of the second part 960 has a wedge shape with a sloped distal surface that acts as a lead-in to facilitate insertion of the second part 960 into the first part 950. The protrusion 966 has a proximal surface that engages the first part 950. The proximal surface of the protrusion 966 (adjacent the undercut 963) may be angled (with respect to the axial or longitudinal direction), which contributes to an interference fit between the second part 960 and the first part 950 and promotes a permanent connection.

[0231] A ledge 956 is disposed on the inner surface of the first portion 950. The ledge may engage a protrusion 966 on the distal end of the second portion 960. The protrusion 966 of the second portion 960 may have a larger outer diameter than the ledge 952 of the first portion 950, such that when connected, there is an interference fit between the two components, providing a permanent connection.

[0232] When the two components are assembled, a proximal face of the protrusion 966 of the second part 960 abuts the ledge 956 of the first part 950, thereby rotatably connecting the first part 950 and the second part 960. The ledge 956 can provide a support surface for the protrusion 966, and the proximal face of the protrusion 966 can contact the ledge 956 during use. The contact between the ledge 956 and the protrusion 966 can also help minimize gas leakage.

[0233] The accessory 900 can be sized to extend to or beyond the distal end of the medical instrument and can be secured to release gas at the end of the medical instrument. The accessory 900 can enable a directional gas flow to be delivered closer to the target area. For example, the accessory 900 can direct gas closer to the field of view of the medical instrument 910. In some cases, the body 904 can have a length that extends to or beyond the distal end of the medical instrument 910, such that the distal end of the body 904 is adjacent to or extends beyond the distal end of the medical instrument 910. The accessory 900 is configured to receive a medical instrument shaft, for example, by sliding insertion of the medical instrument shaft into the lumen 906 through the proximal end of the body 904.

[0234] The first portion 950 includes a seal element 920 configured to sealably secure the attachment 900 to the medical instrument. The seal element 920 may be configured to attach to an outer wall of a medical instrument shaft. For example, the seal element 920 may be configured to attach to or adjacent the proximal end of the medical instrument. The seal element 920 is configured to create a fluid-tight seal between the inner wall 912 of the body 904 and the outer wall of the medical instrument shaft. The seal element 920 is configured to extend between the outer wall 914 of the medical instrument shaft and the inner lumen wall 912 to seal the fluid flow path. The seal element 920 is configured to prevent gas from leaking out at the proximal end of the lumen 906 so that the gas can be released at the distal end of the attachment 900.

[0235] Seal element 920 may be further configured to reduce, limit, or prevent relative movement (rotational and / or axial) between the medical instrument and first portion 950. The seal element may be rotatable and / or axially fixed relative to first portion 950. It should be appreciated that in some cases, frictional resistance may be overcome to slidably insert and / or remove the medical instrument relative to attachment 900. However, the frictional resistance may be configured such that first portion 950 may be effectively fixed to the medical instrument shaft under forces applied during normal use of the medical instrument.

[0236] Additionally or alternatively, the medical instrument accessory may include a separate fixation element secured to the first portion of the medical instrument accessory body, which may be separate from the sealing element. Figures 82 and 83 show a portion of an exemplary medical instrument accessory 7600 including a fixation element in the form of a locking mechanism 7620 positioned adjacent to an opening defined in a proximal end of a first portion 7650 of the medical instrument accessory 7600.

[0237] In the example shown, the locking mechanism 7620 includes a cam 7622 that is rotatable about an axis to move between a first (open) position (shown in FIG. 82 ) and a second (locked) position (shown in FIG. 83 ). The locking mechanism 7620 can be activated, for example, by a user manipulating a lever 7626 extending from the cam 7622. As shown in FIG. 82 , the cam 7622 is shown in the open position so that the cam 7622 does not block the opening and therefore does not interact with a medical instrument placed within the attachment 7600. FIG. 83 shows the cam 7622 in a locked position extending into the opening. Placing the cam 7622 in the locked position allows the cam 7622 to interfere with the medical instrument, securing the instrument within the attachment 7600.

[0238] The first portion 7650 is rotatably connected to the second portion 7660 via a swivel connection, for example, as described with respect to FIG. 77 , whereby the gas inlet port 7616 of the medical instrument accessory 7600 is rotatably decoupled from the locking mechanism 7620.

[0239] The second portion 960 may include a fluid connection, such as a gas inlet port 916, configured to connect a lumen that is fluidly connected to a fluid source and / or a vent, allowing gas to enter and / or exit the body 904. The inlet port 916 may be connectable to a gas source, for example, a gas delivery tube of an infusion system (e.g., any of the systems disclosed herein). In the illustrated example, gas is delivered to the lumen 906 of the accessory 900 through a port configured as the gas inlet port 916 in this illustrated example. The accessory 900 may include one or more apertures (not shown) in the wall 912 of the body 904 that allow gas to pass from the inlet port to the lumen 906. In other examples, the proximal end of the body 904 may be in fluid communication with a gas source.

[0240] The gas inlet port 916 may be configured to be approximately perpendicular to the lumen 906 of the medical instrument accessory 900, as shown in FIG. 17 . In another example, shown in FIGS. 80 and 81 , for example, the gas inlet port 916′ and / or its internal lumen 917′ may be angled relative to the lumen 906′ of the medical instrument accessory 900′. Angling the gas inlet port 916′ (and / or its lumen 917′) can facilitate delivery of fluid to the medical instrument accessory 900′ at an angle closer to the intended direction of flow than would be achieved with a perpendicular inlet. This can help minimize fluid leakage through the sealing element 920 by directing flow away from the sealing element 910 and toward the distal opening of the medical instrument accessory 900′.

[0241] The gas inlet port 916 may be fluidly connected to the lumen 906' via a movable coupling, such as a ball joint coupling. Such a coupling may allow for further variation in the inlet angle and / or may provide some additional isolation of the gas inlet rotation relative to the medical instrument.

[0242] The rotatable coupling between the first portion 950 and the second portion 960 allows for relative rotational movement between the inlet port 916 and the medical instrument shaft 914. For example, the inlet port 916 can be rotatable about the medical instrument shaft 914 and can be substantially rotatably decoupled from the medical instrument shaft 914. As shown in FIG. 18 , the first portion 950 and the second portion 960 are aligned relative to one another along a longitudinal axis X. The first portion 950 is configured to secure the medical instrument shaft within the lumen 906. Because the second portion 960 comprises the inlet port 916, the inlet port 916 is configured to rotate freely relative to the medical instrument shaft 914 and the first portion 950. When fitted over the medical instrument, the lumen 906 can be concentric with the outer wall of the medical instrument shaft 914, such that the inlet port 916 is rotatable about the longitudinal axis of the medical instrument shaft 914, which coincides with the longitudinal axis X of the lumen 906. In other examples, the longitudinal axis of the medical device shaft may be offset from the longitudinal axis X of the lumen.

[0243] The first portion 950 and the second portion 960 may include mating surfaces to guide relative rotation and / or provide a fluid-tight seal. In the example shown in FIGS. 17-19 , the first portion 950 includes a female swivel connector portion 952, and the second portion 960 includes a male swivel connector portion 962 (although the reverse configuration of male and female connector portions is also contemplated). In this example, the female swivel connector portion 952 includes a protrusion 954 that is receivable in a groove 964 on the male connector portion 962. The groove 964 may be on the outer surface of the male connector portion 962. In some examples, the protrusion 954 and groove 964 may be circumferential. The male swivel connector portion 962 and the female swivel connector portion 952 may be configured to interlock via a snap-fit ​​connection. In other examples, the first portion 950 and the second portion 960 may include a retention mechanism (e.g., a clip) to connect the first portion 950 and the second portion 960.

[0244] Further examples of rotatable couplings between first and second portions of the body of a medical instrument accessory are shown in Figures 20-22.

[0245] FIG. 20 shows a cross-sectional view of a further arrangement for a swivel connection. The body 1004 of the medical instrument accessory 1000 may comprise a first portion 1050 and a second portion 1060. The first portion 1050 may be a first conduit component. The second portion 1060 may be a second conduit component. In the example shown in FIG. 20 , the swivel connection between the first swivel connector portion 1050 and the second swivel connector portion 1060 is approximately or substantially in the same plane as the seal element 1020. The first portion 1050 may comprise a female swivel connector portion 1052, and the second portion 1060 may comprise a male swivel connector portion 1062 (although the reverse configuration of male and female connector portions is also contemplated in this and other examples described herein).

[0246] The female swivel connector portion 1052 defines a groove 1054 configured to receive a correspondingly shaped protrusion 1064 on the proximal end of the male swivel connector portion 1062. The protrusion 1064 protrudes inward and outward relative to the lumen 1006. The protrusion 1064 defines a pair of outwardly extending shoulders or flanges and defines undercuts on either side of the protrusion 1064. The undercuts are configured to abut a distal ledge of the groove 1054 and, when connected, prevent separation of the protrusion 1064 from the groove 1054. The ledge may provide a support surface for the protrusion 1064. The protrusion 1064 includes a sloped proximal surface that facilitates insertion of the protrusion 1064 into the groove 1054.

[0247] In use, first portion 1050 is secured relative to the shaft of a medical instrument (not shown) by seal element 1020 (e.g., as described above with respect to seal element 920 of FIGS. 17-19). Second portion 1060 includes a gas inlet port, which may be substantially as described with respect to gas inlet port 916 of FIGS. 17-19. The rotatable coupling of swivel connector portions 1052 and 1062 allows rotation of second portion 1060 relative to first portion 1050 and the medical instrument (not shown).

[0248] 21 shows another arrangement for a swivel connection. The body 1104 of the medical instrument accessory 1100 may include a first portion 1150 and a second portion 1160, where the second portion is rotatably coupled to the first portion 1150. The second portion 1160 includes a gas inlet port 1192. In this example, the body 1104 may include a third portion 1170 distal to the first portion 1150 and the second portion 1160.

[0249] The first portion 1150, the second portion 1160, and the third portion 1170 may rotate independently of one another. For example, the third portion 1170 may be rotatably connected to the second portion 1160 by a rotatable coupling such that the second portion 1160 can rotate independently of the first portion 1150 and the third portion 1170. As shown in FIG. 21 , the first portion 1150 may include a female swivel connector portion 1152, and the second portion 1160 may include a proximal male swivel connector portion 1162a. These swivel connector portions 1152, 1162a may interlock similarly to the swivel connector portions 1052 and 1062, as described with respect to FIG. 20 , to allow rotational movement between the first portion 1150 and the second portion 1160. The second portion 1160 further includes a distal male swivel connector portion 1162b that is configured to interlock with a female swivel connector portion 1172 of the third portion 1170. Thus, the gas inlet port 11192 may be rotatable relative to the first portion 1150 and / or the third portion 1170.

[0250] 22 , medical instrument accessory 1200 includes body 1204 including first portion 1250 including circumferential ring 1254. Second portion 1260 includes circumferential recess 1264 in wall 1212 configured to receive ring 1254. First portion 1250 includes sealing element 1220, which is configured to seal against the shaft of a medical instrument (not shown). Sealing element 1220 may be further configured to secure first portion 1250 to the medical instrument. In some examples, sealing element 1220 may be integrally formed with first portion 1250. For example, first portion 1250 may include a semi-rigid sealing surface (e.g., a rubber material, etc.) that has lubricity within recess 1264.

[0251] 22 , second portion 1260 includes gas inlet 1216. The rotatable coupling of ring 1254 and recess 1264 allows rotation of second portion 1260, and therefore gas inlet 1216, relative to first portion 1250 and the medical instrument. Second portion 1260 may extend from the proximal end toward the distal end of medical instrument accessory 1200 and defines both the proximal and distal portions of lumen 1206. Second portion 1260 defines an exterior portion of body 1204, while first portion 1250 is located within second portion 1260. Thus, the entire exterior length of body 1204 (as defined by second portion 1260) can rotate along with gas inlet 1216 relative to the medical instrument.

[0252] 23 , the body 1304 of the medical instrument accessory 1300 may include a first portion 1350 and a second portion 1360. The first portion 1350 includes a shaft 1312 defining a circumferential recess 1352 in its outer surface. The second portion 1350 includes a circumferential ring 1362 configured to be rotatably received in the recess 1352. During use, the first portion 1350 is fixed relative to the shaft of the medical instrument (not shown) by the sealing element 1320. The second portion 1360 includes a gas inlet 1316. The rotatable coupling of the ring 1362 and the recess 1354 allows rotation of the second portion 1360, and therefore the gas inlet 1316, about the shaft 1312 of the first portion 1350.

[0253] The shaft 1312 defines a plurality of apertures 1392 extending from the recess 1354 through a lumen 1306 defined by the inner wall 1312 of the body 1304. As shown in FIG. 23 , the apertures 1392 may be an annular array spaced circumferentially about the lumen 1306. The apertures 1392 are longitudinally aligned with the gas inlets 1316 to allow gas to pass from the gas inlets 1316 to the lumen 1306 as the gas inlets rotate about the shaft 1312. The body 1304 may include channels 1305 in fluid communication with the apertures 1392 and the gas inlets 1316 to allow gas to flow into the lumen 1306 regardless of the rotational position of the first portion 1350 relative to the second portion 1360.

[0254] Example of directional gas flow around a medical device with medical device accessories As previously mentioned, it may be desirable to create a microenvironment around, near, or adjacent to the distal end of a medical instrument to overcome some of the challenges of condensation, fogging, or other factors that can reduce visibility. Directed gas flow around the medical instrument may allow for controlled creation of a microenvironment around the observation portion or working end of the medical instrument. This microenvironment can isolate the observation portion from the warm, moist environment of a body cavity, e.g., a pneumoperitoneum. A medical instrument with an observation portion may be held either concentrically or off-axis and surrounded by a gas passageway. This allows the insufflation gas to conform to and substantially surround the medical instrument. The gas can thus coat the observation portion of the medical instrument and, to some extent, form a barrier between the observation portion and the surrounding environment. If the conditions of the delivered gas are controlled, this can affect the environment around the medical instrument. Furthermore, the gas flow can be advantageously directed to the area of ​​interest by adjusting the positioning of the medical instrument accessories and / or the medical instrument. For example, the gas flow can be directed to an area of ​​the body cavity where smoke is present or where smoke may otherwise collect or stagnate.

[0255] Figure 24 illustrates directional gas flow around a medical instrument 1410 within a medical instrument accessory 1400. As shown in Figure 25, gas flows through one or more fluid flow paths defined between an outer surface 1415 of the medical instrument 1410 and an inner wall 1412 of the medical instrument accessory 1400.

[0256] In some cases, the medical instrument accessory can include at least one guide element to position the medical instrument relative to the lumen, thereby defining a gas flow path between the inner lumen wall and the medical instrument shaft. The medical instrument can be positioned concentrically with the longitudinal axis defined by the lumen or offset from the axis (e.g., linearly offset or at an angle relative to the axis). The medical instrument accessory can include a guide element in combination with or in addition to any of the features described above, e.g., features related to the sealing element or rotatable component.

[0257] Detailed examples of guide elements that may be used in combination with or in addition to those described herein are described in International Application No. PCT / NZ2019 / 050100, filed August 16, 2019 ("DIRECTED GAS FLOW SURGICAL CANNULA FOR PROVIDING GASES TO A PATIENT"), or International Application No. PCT / IB2021 / 05115, filed December 2, 2021 ("DIRECTED GAS FLOW ACCESSORY FOR PROVIDING GASES TO AND VENTING GASES FROM A PATIENT"), the disclosures of which are incorporated by reference in their entirety into this application.

[0258] At least one guide element may be on or within the inner wall of the accessory and may be configured to position the shaft of the medical instrument within the lumen. In some cases, the guide element may be disposed on the inner wall of the accessory, e.g., defined by the inner wall or mountable to or adjacent to the inner wall. For example, the guide element may extend inward from the inner wall of the accessory shaft. For example, the guide element may be separate from the accessory shaft and may be securable to the accessory shaft and disposed on the inner wall. The guide element may extend inward relative to the inner wall, such that during use, the guide element is positioned between the inner wall and the medical instrument. In some cases, a medical instrument accessory may have multiple guide elements.

[0259] In some examples, the guide element may extend partway along the longitudinal length of the inner wall of the accessory. It should be appreciated that the guide element may be disposed adjacent one or both of the proximal and distal ends of the accessory, either continuously between the ends or discontinuously at intervals between the ends. In some examples, the guide element extends to the distal end of the accessory and terminates flush with the distal end of the inner wall. In other examples, one or more terminal ends of the guide element may be offset from the distal end of the accessory.

[0260] The guide element, together with the interior wall and the exterior surface of the medical instrument, may define one or more fluid flow paths, for example, as shown in Figure 24. The proximal end of the body of the medical instrument accessory may be in fluid communication with a gas source or vent. Gas may be directed around the end of the medical instrument, out the open distal end of the accessory.

[0261] In some examples, at least one guide element is formed by one or more ribs. As one example, FIG. 26 shows longitudinally (axially) extending ribs 1520 defined by the inner wall of a medical instrument accessory 1500. The ribs 1520 are arranged to position the accessory 1500 approximately concentrically around a medical instrument (not shown). FIG. 27 shows a cross section of the medical instrument accessory 1500 taken along line AA in FIG. 26. As shown in FIG. 27, the ribs 1520 can form a circumferentially spaced annular array around the inner wall to maintain the medical instrument approximately concentrically within the medical instrument accessory 1500. The ribs 1520 are arranged to allow gas to flow through the accessory 1500, between the sidewalls 1521 of the ribs 1520, and around the outer surface of the medical instrument (not shown). In some cases, the ribs 1520 can extend inward from the interior wall of the medical instrument accessory 1500, as shown in Fig. 27. Furthermore, configuring the guide elements as ribs 1520 is exemplary, and it should be appreciated that these guide elements may be configured in other forms, such as one or more bumps, dimples, fins, splines, pins, grooves, or channels.

[0262] As shown in FIG. 28 , ribs 1620 can be positioned at or adjacent the open distal end of the medical instrument accessory 1600. The ribs 1620 extend longitudinally, but to a shorter extent than the ribs 1520 of FIG. 26 . The ribs 1620 can define a gas passageway for gas to travel around the periphery or circumference of the medical instrument. The ribs 1620 can maintain the medical instrument generally concentric within the lumen of the medical instrument accessory. In some cases, one or more of the ribs may not contact the medical instrument during use but can function as a limit or stop, preventing the medical instrument from contacting the interior sidewall of the medical instrument accessory shaft. This may allow the gas passageway to remain open. FIG. 29 shows a cross-section of the medical instrument accessory 1600 along line AA in FIG. 28 . 29, the ribs can be radially splayed to facilitate centering of the medical instrument within the medical instrument accessory 1600, and gas flow can pass between the sidewalls 1621 of the ribs 1620 around the medical instrument and the outer surface of the medical instrument (not shown). In some cases, the ribs 1620 can be spaced axially and / or longitudinally at regular or irregular intervals along the inner circumference of the medical instrument accessory 1600.

[0263] In some cases, the at least one guide element may include a protrusion, such as a bump or indentation, on the medical instrument accessory to direct gas flow concentrically around the medical instrument. The protrusion may extend inward from an inner wall of the lumen of the medical instrument. The protrusion may be located anywhere along the body of the medical instrument accessory to position the medical instrument within the lumen. The protrusion may also be further configured to direct fluid flow around the medical instrument. The protrusion may be located at a proximal end, a distal end, and / or an intermediate portion along the length of the lumen of the accessory.

[0264] As shown in FIG. 30 , the protrusions 1720 can be positioned at the open distal end of the medical instrument accessory 1700, and gas can pass between the protrusions 1720 in a generally concentric manner around the medical instrument (not shown). The protrusions 1720 can be in the form of dimples in and / or on the outer wall, extending the wall into the lumen. FIG. 31 shows a cross-section of the medical instrument accessory 1700 along line AA in FIG. 30 . In the example shown, the protrusions 1720 are dimples formed in the wall of the medical instrument accessory 1700, having a convex portion that extends into the lumen and a corresponding concave portion on the outer surface of the medical instrument accessory 1700. As shown in FIG. 31 , the protrusions 1720 can expand radially to maintain the medical instrument generally concentrically within the medical instrument accessory 1700, and gas flow can pass between the protrusions 1720 around the medical instrument. In some cases, the protrusions may be evenly (or nearly evenly) spaced around the diameter of the accessory lumen, while in other cases the protrusions may be unevenly spaced around the diameter of the accessory lumen and / or unevenly spaced axially along the accessory lumen, creating gas flow paths of different sizes.

[0265] In some cases, at least one guide element can include more than one set of structures (e.g., ribs, protrusions, fins, dimples, bumps, etc.) on the medical instrument accessory. The more than one set of structures can be located at any location or multiple locations along the body of the medical instrument accessory. As shown in FIG. 32 , guide element, shown here as rib 1820, can be positioned at a first location at the distal end of medical instrument accessory 1800. Rib 1822 can be positioned at a second location on medical instrument accessory 1800 that is more proximal than the first location. Gas can pass generally concentrically between ribs 1820 and 1822 around the medical instrument (not shown).

[0266] FIG. 33 shows a cross section of medical instrument accessory 1800 taken along line AA in FIG. 32 through a guide element, shown here as rib 1822. FIG. 34 shows a cross section taken along line BB in FIG. 32. As shown in FIGS. 33 and 34, ribs 1820 and 1822 can diverge radially at two locations to maintain the medical instrument generally concentric within medical instrument accessory 1800. Gas flow can pass between ribs 1820 and 1822 around the medical instrument. In some cases, ribs 1820 and 1822 can be positioned any number of times and at any number of locations along the accessory. In some cases, the ribs can be located adjacent the proximal end of the medical instrument accessory.

[0267] In some cases, the guide elements may be uniformly sized and unevenly spaced around the attachment. The guide elements can create gas flow channels between adjacent guide elements. FIGS. 35-36 show one example in which the guide elements are provided in the form of ribs 1920. The ribs 1920 can be positioned at the distal end of the medical instrument attachment 1900. The ribs 1920 can be unevenly spaced around the attachment 1900 to help deflect contaminants or water droplets away from the viewing area or promote evaporation of condensation / clouding that forms on the viewing area, as shown by the arrows at the distal end of the attachment 1900 in FIG. 35 . The ribs 1920 can be located at any point along the attachment 1900 or along the entire length of the attachment 1900. The ribs 1920 can be unevenly spaced around the attachment 1900 to direct entrainment of gas over the top side of the medical instrument. The uneven spacing of the ribs 1920 can create different sized channels around the inner wall of the attachment 1900. The different sized channels can result in different gas velocities, which can create a pressure differential at the distal end of the attachment 1900. Figure 36 shows a cross section along line AA of Figure 35, illustrating the uneven spacing of the ribs 1920 around the inner wall of the attachment 1900. The ribs 1920 can maintain a medical instrument generally concentric within the attachment 1900.

[0268] In some cases, the guide elements may be of different sizes spaced around the attachment. One or more guide elements may define a gas flow channel between adjacent guide elements. As shown in the example of FIGS. 37-38 , the guide elements are shown in the form of ribs 2020, although other forms of guide elements described herein may also be used. The ribs 2020 may be positioned at the distal end of the medical instrument attachment 2000. The ribs 2020 may have different sizes that cover different portions of the circumference of the inner sidewall of the medical instrument attachment 2000. The ribs 2020 may be of different sizes and spaced around the attachment 2000 to entrain gas flow over the top side of the medical instrument, as indicated by the arrow at the distal end of the attachment 2000 in FIG. 37 . The ribs 2020 may be located at any point along the attachment or along the entire length of the attachment.

[0269] Channels of different sizes can be created by guide elements of different widths around the inner wall of the accessory. Channels of different sizes have different gas velocities and can create pressure differentials at the distal end of the instrument. As shown in FIG. 38, a cross section taken along line AA in FIG. 37, ribs 2020 can be ribs of different widths spaced around the inner wall of the accessory to maintain the scope concentrically within the accessory. While ribs 2020 are shown at the distal end, ribs 2020 can be of any length.

[0270] The at least one guide element can include one or more notches or channels in the interior wall of the body of the medical instrument accessory to direct the gas flow generally concentrically around the medical instrument. The notches or channels in the body of the medical instrument accessory can define a channel for the gas flow wherever the medical instrument is positioned within the accessory. Depending on the axial position of the medical instrument in the accessory, the gas flows generally concentrically around the medical instrument or is jetted over it.

[0271] As shown in FIGS. 39-40 , the notches or channels 2120 can be positioned substantially along the length of the body of the accessory 2100. In other examples, the notches or channels may be positioned at the proximal end, distal end, and / or midway along the length of the body of the accessory. As shown in FIG. 40 , which is a cross-section along line AA of FIG. 39 , the notches or channels 2120 can allow gas to continue to flow around the medical instrument 2110 even when the medical instrument 2110 is pressed into the inner wall of the accessory 2100. The notches or channels 2120 may also allow gas to continue to flow even when the inner diameter of the accessory is similar or approximately the same as the outer diameter of the medical instrument. While the notches or channels 2120 are shown as being evenly spaced and extending the majority of the body of the accessory, the notches or channels can be any length and can be evenly or unevenly spaced. In some cases, the notch or channel may extend the entire length or nearly the entire length of the lumen of the accessory. In other instances, the notch or channel may extend only a partial length of the lumen of the accessory. In some instances, the ends of the notch or channel may be offset from the proximal and / or distal ends of the lumen.

[0272] At least one guide element may include a non-circular cross-section in the body of the medical instrument accessory. The medical instrument may have a circular or nearly circular shaft. Therefore, gas can flow through the accessory regardless of the position of the medical instrument within the medical instrument accessory. As shown in FIGS. 41-42, the medical instrument accessory 2200 may have a non-circular shape (e.g., oval or hexagonal), thereby allowing gas to flow around the medical instrument. Depending on the axial positioning of the scope, gas can be directed, for example, nearly concentrically around the medical instrument or can be jetted over the top side of the medical instrument. FIG. 42 shows a cross-section of the body of the medical instrument accessory 2200 of the medical instrument taken along line AA in FIG. 41. As shown in FIG. 42, the non-circular shape of the accessory 2200 may allow gas to flow around the medical instrument at any position. Although the non-circular cross-section of the accessory body is shown as elliptical, the non-circular cross-section of the accessory body can be any non-circular shape.

[0273] Flow Controller Example The present disclosure provides examples of flow controllers 300 for use with drain lines of surgical systems. A surgical system 100 that includes functionality for draining fluid from a patient's body cavity 2 (e.g., as described above with reference to Figures 2 and 43) may incorporate any of the exemplary flow controllers disclosed herein.

[0274] Suction may be required to evacuate fluid, smoke, and / or debris from a body cavity during a surgical procedure. As described above, the drainage may be provided through a drainage line. Such a drainage line may be connected to a suction source that provides constant suction. The suction source may include a separate suction unit and / or a wall port. A valve may be used in conjunction with the drainage line / suction source.

[0275] It may be desirable to control the amount / extent of drainage or to provide finer control over the amount / extent of drainage. Additionally, in some cases it may be desirable to turn drainage "off." It may be desirable to control drain flow from within the surgical sterile field, including proximate to the patient. The example flow controllers 300, 3300 described herein may be operable to control fluid flow within a fluid drain line, such as the fluid drain line 23 of the surgical system 100 of FIG. 43.

[0276] The exemplary flow controllers disclosed herein may be retrofitted to existing surgical systems that include exhaust lines. For example, the flow controllers disclosed herein may be coupled in fluid communication with existing exhaust lines to enable control of fluid flow in the exhaust lines.

[0277] The flow controller can be single use (disposable) or reusable. Alternatively, multiple portions of the flow controller can be single use (disposable) or reusable. The flow controller may be made from materials that are sterilizable.

[0278] The flow controller may include a body having a first body portion configured for fluid communication with a first portion of the fluid exhaust line 23 and a second body portion configured for fluid communication with a second portion of the fluid exhaust line 23. A fluid flow path is defined between the first portion of the fluid exhaust line 23 and the second portion of the fluid exhaust line 23.

[0279] An exemplary flow controller 300 is shown in FIG. 44. The flow controller 300 comprises a body 302 comprising a first body portion 320 coupled to a second body portion 340. The first body portion 320 comprises a first fluid connection portion 322 configured for connection to a first portion of the fluid exhaust line 23. The second body portion 340 comprises a second fluid connection portion 342 configured for connection to a second portion of the fluid exhaust line 23. A fluid flow path is defined between the first fluid connection portion 322 and the second fluid connection portion 342.

[0280] In the example shown, the second fluid connection portion 342 comprises a fluid inlet for connection with an upstream portion of the fluid discharge line 23 (i.e., closest to the body cavity 2). The first fluid connection portion 322 comprises a fluid outlet for connection with a downstream portion of the fluid discharge line 23 (i.e., away from the body cavity 2). However, it should be appreciated that the flow controller 300 may be connectable to the fluid discharge line 23 in the opposite direction.

[0281] The first fluid connection portion 322 and the second fluid connection portion 342 may be axially aligned with one another. As shown in FIG. 44 , the first fluid connection portion 322 and the second fluid connection portion 342 may be coincident with the longitudinal axis X of the main body 302. The first fluid connection portion 322 and the second fluid connection portion may be configured for fluid communication and in-line connection with upstream and downstream portions of the fluid exhaust line 23. The in-line alignment of the first fluid connection portion 322 and the second fluid connection portion 342 may facilitate fitting the flow controller 300 to an existing (or new) exhaust line 23. For example, the axial alignment of the first fluid connection portion 322 and the second fluid connection portion 342 may facilitate minimizing the size of the flow controller 300 and / or improving the ease of use of the flow controller 300. Additionally, providing the first and second fluid connection portions 322, 342 in axial alignment with one another can reduce the likelihood of liquid being trapped in the flow controller. For example, there may be a generally direct line through which a fluid (gas or other) passes, with minimal internal features of the flow controller that can trap liquid.

[0282] The second body portion 340 is movable relative to the first body portion 320 (or vice versa) to selectively open, close, and / or alter the fluid flow path between the first fluid connection portion 322 and the second fluid connection portion 342.

[0283] As described herein, a fluid flow path being closed may be understood to mean that fluid flow through the fluid flow path is obstructed and / or substantially prevented. For example, when a fluid flow path is closed, fluid flow through the fluid flow path may be obstructed or substantially blocked. A fluid flow path being open or at least partially open should be understood to mean that fluid flow can pass through the fluid flow path. For example, the fluid flow path may be altered by changing the degree of obstruction to fluid flow through the fluid flow path. Altering the fluid flow path may change one or more characteristics of the fluid flow, such as the rate (e.g., volumetric flow rate), velocity, and / or pressure of the fluid flow.

[0284] In some examples, the flow controller 300 may include an intermediate portion 331 positioned between the first body portion 320 and the second body portion 340. The intermediate portion 331 may be part of the first body portion 320 or the second body portion 340. The intermediate portion 331 may include a fluid flow opening. For example, if the intermediate portion 331 is part of the first body portion, the intermediate portion may include a first opening 325. If the intermediate portion 331 is part of the second body portion 340, the intermediate portion 331 may include a second opening 340. If the intermediate portion 331 is separate from either the first body portion 320 or the second body portion 340, the intermediate portion 331 may include the first opening 325 or the second opening 345. The intermediate portion 331 may be configured to be received in one of the first body portion 320 and the second body portion 340. Intermediate portion 331 may be configured to receive the other of first body portion 320 and second body portion 340 .

[0285] FIG. 45 shows the components of an exemplary flow controller 300 in a disassembled state. In the example shown, first body portion 320 includes a housing 330 and an intermediate portion in the form of an insert 331. The insert 331 and housing 330 can be assembled to form first body portion 320. For example, insert 331 may be at least partially receivable within housing 330. In other examples, first body portion 320 may be formed with a unitary structure. For example, housing 330 and insert 331 may be integrally formed. Fluid connection portion 322 may be provided on housing 330. In some examples, as described above, second body portion 340 may include a housing and insert 331. If second body portion 340 includes insert 331, the housing of second body portion 410 may be integrally formed with insert 331.

[0286] 45 , for example, housing 330 may define interior portion 336. Interior portion 336 is in fluid communication with fluid connection portion 322. Insert 331 may be configured to be at least partially received within interior portion 336 of housing 330. Insert 331 and housing 330 may be configured for assembly in predetermined alignment relative to one another.

[0287] When assembled, insert 331 is rotationally and axially fixed relative to housing 330. Insert 331 and / or housing 330 may include one or more features configured to prevent movement between insert 331 and housing 330. For example, one or both of housing 330 and insert 331 may include at least one protrusion configured to be received in at least one corresponding recess in the other of housing 330 and insert 331.

[0288] The housing 330 and the insert 331 may be configured for assembly with one another via a locking engagement. For example, the housing 330 and the insert 331 may be configured for a snap-locking engagement. The locking engagement may be configured such that the insert 331 is not easily separable from the housing 330 during use. In other examples, the insert 331 and the housing 330 may be configured for disassembly and reassembly (e.g., via a removable snap-fit ​​engagement as opposed to a locking engagement).

[0289] In the example flow controller of FIG. 45 , the insert 331 includes a protrusion in the form of a ridge 333. The ridge 333 is configured to be received in a corresponding recess in the form of a groove 332 in the housing 330, preventing axial movement of the insert 331 relative to the housing 330. In other examples, the insert 331 may include an annular flange configured to abut an edge of the housing 300. A clearance in the annular flange may correspond with a protrusion on the edge of the housing 300, limiting relative rotation between the insert 331 and the housing 300. In other examples, engagement between the insert 331 and the housing 300 may be provided by a friction fit, a tapered fit, or by a ridge on one of the insert 331 and the housing 300 and a taper on the other of the insert 331 and the housing 300. In other examples, the insert 331 and the housing may be secured by other means, such as welding, adhesive, or a retaining element such as a clip or fastener.

[0290] 73, the housing 330 has walls that define a tapered inner surface 3301. As shown in FIG. 74, the insert 331 may include a lip 337. The lip 337 may be configured to abut the inner surface of the housing 330, for example, at a ridge 324 on the inner surface of the housing. This may provide a friction and / or interference fit between the housing 330 and the insert 331, which may prevent separation of the housing 330 and the insert 331.

[0291] As shown in FIGS. 75 and 76 , insert 331 includes a cutout 337a in lip 337, and housing 330 includes a cutout 324a formed through ridge 324. Insert 331 may be configured to be received in housing 330 with cutout 327a in lip 337 aligned with cutout 324a in ridge 324, thereby providing a channel through lip 337 and ridge 324 to provide a fluid flow path therethrough. In particular, when coupled with the tapered inner surface of housing 330, the channel can facilitate directing fluid flow through flow controller 300. This can help minimize any fluid entrapment within the fluid controller.

[0292] The housing 330 and / or the insert 331 may include one or more anti-rotation elements to prevent relative rotation between the housing and the insert. For example, the insert 331 and / or the housing 330 may include one or more protrusions receivable into one or more corresponding recesses in the other of the insert 331 or the housing 330 to prevent relative rotation between these components. In the example shown in FIG. 45 , the anti-rotation elements include a slot 335 on the insert 331 and a protrusion 334 on the housing 330. The protrusion 334 is receivable in the slot 335 to prevent rotation of the insert 331 relative to the housing 330. In other examples, the slot 335 may be on the housing 330 and the protrusion 334 may be on the insert 331.

[0293] FIG. 46 shows a partially transparent view of the flow controller 300 of FIG. 44 (the housing 330 is not shown to enhance visibility of the interior features of the first body portion 320). As can be seen in FIG. 46, the first body portion 320 defines a first opening 325. The first opening 325 is in fluid communication with a first fluid connection portion 322 (not shown in FIG. 46). The second body portion 340 defines a second opening 345 that is in fluid communication with the second fluid connection portion 342. The first body portion 320 is movable relative to the second body portion 340 to place the first opening 325 in or out of fluid communication with the second opening 345, thereby selectively opening, closing, and / or altering the fluid flow path through the first opening 325 and the second opening 345.

[0294] The first body portion 320 and / or the second body portion 340 may be movable to at least partially overlap or remove the first opening 325 and the second opening 345 with respect to one another to change the fluid flow path. That is, the flow controller 300 may be configured such that the fluid flow path is closed when the first opening 325 and the second opening 345 are not aligned with one another and the fluid flow path is at least partially open when the first opening 325 and the second opening 345 are at least partially aligned with one another. The first body portion 320 and / or the second body portion 340 may be movable between a first position in which the first opening 325 and the second opening 345 do not overlap with one another and a second position in which the openings 325, 345 at least partially overlap with one another. The degree of overlap between the openings 325, 345 may be changed as the first body portion 320 and the second body portion 340 move between the first and second positions.

[0295] In some examples, the movement between the first body portion 320 and the second body portion 340 may be rotational movement. In such examples, the first body portion 320 and the second body portion 340 may be axially fixed relative to one another. In other examples, the movement between the first body portion 320 and the second body portion 340 may be axial movement. In other examples, the movement may be in more than one direction and / or include rotational and / or axial movement between the first body portion 320 and the second body portion 340.

[0296] In the illustrated example, movement between the first body portion 320 and the second body portion 340 is rotational movement about the longitudinal axis X of the body. Thus, in the illustrated example, the first position is a first angular position relative to the longitudinal axis X, and the second position is a second angular position relative to the longitudinal axis X. Movement between the first body position and the second body position can be movement within a predetermined angular range. The angular range of movement can be, for example, between about 90 degrees and about 120 degrees, or any value therebetween.

[0297] First opening 325 and second opening 345 may be provided in respective wall portions of first body portion 320 and second body portion 340. For example, openings 325, 345 may extend through respective sidewall and / or end wall portions of first body portion 320 and second body portion 340. For example, first body portion 320 of flow controller 300 includes a cylindrical sidewall 323. Similarly, second body portion 340 includes a cylindrical sidewall 343.

[0298] 45 and 46 , wall 323 of first body portion 320 is part of insert 331. Wall 323 may include side wall portions and end wall portions. When flow controller 300 is assembled, wall 323 is located within interior portion 336 of housing 330. Wall 323 of insert 331 may substantially close interior portion 336. Wall 323 of insert 331 of first body portion 320 may include first opening 325. First opening 325 may extend through wall 323, such that a fluid flow path extends through insert 331 and through interior portion 336 of housing 330 to fluid connection portion 322.

[0299] The wall 343 of the second body portion 340 defines an interior portion (or cavity) in fluid communication with the second fluid connection portion 342. The interior portion of the second body portion 340 may have a perimeter that is smaller than the perimeter of the interior portion 336 of the housing 330. The wall 343 of the second body portion 340 may include a second opening 345. In the example shown, the second opening 345 extends through the thickness of the wall 343.

[0300] In some examples, walls 323 and 343 may comprise generally cylindrical side walls. However, walls of other shapes are contemplated. At least a portion of one of the cylindrical side walls may be received within the other cylindrical side wall. At least a portion of an inner portion of second body portion 340 may be received within first body portion 320. In other examples, the reverse configuration is contemplated. That is, a portion of first body portion 320 may be received within second body portion 340.

[0301] In the illustrated example, the cylindrical sidewall 343 of the second body portion 340 is partially received within the cylindrical sidewall 323 of the first body portion 320, such that the first body portion 320 and the second body portion 340 are partially nested relative to one another. For example, as best shown in FIG. 46 , the cylindrical sidewall 343 of the second body portion 340 is partially received within the cylindrical sidewall 323 of the insert 331. Thus, the interior portion defined by the wall 343 of the second body portion is partially received within the interior portion defined by the wall 323 of the insert 331.

[0302] The walls 323, 343 of the first body portion 320 and the second body portion 340 may be slidably engaged with one another. Movement between the first body portion 320 and the second body portion 340 may include sliding movement of the wall 323 of the first body portion relative to the wall 343 of the second body portion. In the first position, the first opening 325 may be obstructed by the wall 343 of the second body portion 340, obstructing fluid flow therethrough. In some examples, in the second position, the first opening 325 may be substantially unobstructed, allowing fluid to flow therethrough. In some examples, the first opening 325 may be partially obstructed in the second position. In the illustrated example, the walls 323, 343 are configured to slide relative to one another as the second body portion 340 rotates relative to the first body portion 320.

[0303] In the exemplary flow controller 300, the first opening 325 extends through a sidewall portion of the wall 323 of the first body portion 320, and the second opening 345 extends through a sidewall portion of the wall 343 of the second body portion 340. In some examples, the first opening 325 and the second opening 345 may additionally and / or alternatively extend through end wall portions of the first body portion 320 and the second body portion 340, respectively. For example, as shown in the exemplary configuration of FIGS. 60-63 , the first opening 325′ extends through an end wall portion of the wall 323′ of the insert 331′, while the second opening 345′ extends through both the sidewall and end wall portions of the wall 343′ of the second body portion 340′. Thus, the first opening 325′ and the second opening 345′ are aligned with the longitudinal axis of the flow controller. In this example, relative rotation of second body portion 340' and / or first body portion 320' relative to one another changes the relative positions of first opening 325' and second opening 345', changing the area of ​​first opening 325' that is obstructed by the end wall portion of wall 343' of second body portion 340'.

[0304] In some examples, the length of the second opening 345 may extend at least partially in the direction of movement between the first body portion 320 and the second body portion 340. For example, in the illustrated example, the second opening 345 has a length that extends in a rotational direction. As a further example, if the movement between the first body portion 320 and the second body portion 340 is axial, the length of the second opening may extend at least partially in the axial direction. A secondary dimension (e.g., height or width) of the second opening 345 may vary along the second opening 340. For example, the second opening 345 may taper along its length. In some examples, the second opening 345 may taper in a generally linear manner. In other examples, the second opening 345 may vary non-linearly, as shown in FIGS. 71 and 72 . However, other methods of variation in the secondary dimension of the second opening 345 are also contemplated. In some examples, the second opening 345 may be discontinuous, e.g., comprise a series of apertures that may have varying sizes. For example, the second opening 345 may comprise a series of apertures that gradually increase or decrease in size.

[0305] In the example of FIGS. 46-50 , the second opening 345 is defined by a notch in the end of the wall 343 of the second body portion 340. The second opening 345 has a sloped base portion 346, as best shown in FIG. 47 , thereby giving the second opening 345 the shape of an inverted right triangle. As shown, the second opening 345 is adjacent to the open end of the second body portion 340, thereby defining an open shape with the notch. However, in other examples, the second opening 345 may comprise a “notch” or “punchout” surrounded by material from the wall 343 on all sides, defining a closed shape. Alternative shapes for the second opening 345 are also contemplated. For example, the second opening 345 may include alternative angles and / or curved portions, such as curved bases, sides, and / or corners. For example, Figures 71 and 72 show a second opening 345 having a base portion 346 that curves into an "S" shape and curved corner regions.

[0306] The first opening 325 may have at least one dimension that is shorter than the length of the second opening 345. The first body portion 320 and the second body portion 340 may be movable relative to one another to align the first opening 325 with a selected region of the second opening. The degree of obstruction of the first opening 325 by the wall 343 of the second body portion 320 may be variable depending on the region of the second opening 345 with which the first opening 325 is aligned. In the illustrated example, the first opening 325 has a circular shape. The diameter of the first opening 325 is smaller than the length of the second opening 345 and is equal to or smaller than the maximum height of the second opening 345. However, other shapes of the first opening 325 are also contemplated.

[0307] FIG. 47 diagrammatically illustrates the relative alignment of the first opening 325 and the second opening 345 in a first position (FIG. 47-A), a second position (FIG. 47-C), and an intermediate position between the first and second positions (FIG. 47-B), according to one example of the present disclosure.

[0308] In the first position (FIG. 47-A), the first opening 325 is offset from the second opening 345. That is, there is no overlap between the first opening 325 and the second opening 345. Thus, the first opening 325 is substantially obstructed by the wall 343 of the second body portion, and fluid flow therethrough is substantially prevented. In this position, the fluid flow path is closed.

[0309] In the second position (FIG. 47-C), the first opening 325 is aligned with the second opening 345 such that the first opening 325 is substantially unobstructed by the wall 343 of the second body portion 340. Thus, the first opening 325 is substantially unblocked or unimpeded by the wall 343 of the second body portion, allowing fluid to flow therethrough.

[0310] FIG. 47-B illustrates an intermediate position between the first and second positions. In this position, the first opening 325 is only partially obstructed by the wall 343 of the second body portion 340. That is, there is a partial overlap between the opening area of ​​the first opening 325 and the opening area of ​​the second opening 345. This partial obstruction of the first opening 325 acts to partially restrict fluid flow therethrough. The area of ​​the first opening 325 obstructed by the wall 343 of the second body portion 340 can change as the second body portion 340 moves between the first and second positions. In some examples, the change in the obstructed area of ​​the first opening 325 can be substantially linear between the minimum obstruction and the maximum obstruction. In other examples, such as the example of FIG. 47, the change is non-linear.

[0311] One or more parameters of fluid flow through the fluid flow path may be variable depending on the area of ​​the second opening 345 with which the first opening 325 is aligned. For example, varying the obstructed area of ​​the first opening 325 may change the flow rate, but not the fluid flow path.

[0312] 48 and 49 show the second body portion 340 in a first angular position, without and with the insert 331, respectively. As can be seen from FIG. 49, in the first position, the wall 343 of the second body portion 340 obstructs the first opening 325, closing the fluid flow path. FIGS. 50 and 51 show the second body portion 340 in a second angular position. In this example (and as shown in FIG. 46), the wall 343 still partially obstructs the first opening 325 in the second position. However, in other examples, the first opening 325 may not be substantially blocked in the second position, as shown, for example, in FIG. 47-C.

[0313] In some examples, the flow rate may be variable between a minimum flow rate and a maximum flow rate. The minimum flow rate may be approximately 0 liters per minute. The maximum flow rate may be approximately 3 liters per minute, approximately 4 liters per minute, approximately 5 liters per minute, approximately 6 liters per minute, approximately 7 liters per minute, approximately 8 liters per minute, approximately 9 liters per minute, approximately 10 liters per minute, or a maximum of greater than approximately 15 liters per minute. The maximum flow rate may be limited, at least in part, by the requirement to maintain body cavity pressure and / or volume within operational and safe limits and / or due to flow resistance within system components, such as, for example, tubing size. The minimum flow rate may be defined at a first position and the maximum flow rate may be defined at a second position. However, in other examples, the maximum flow rate may be defined at an intermediate position. However, other flow change profiles are contemplated. For example, depending on the shape of the first opening 325 and the second opening 345, the flow controller may be configured to quickly change the flow rate from a minimum flow rate (e.g., substantially no flow) to a maximum flow rate by moving the second body portion 340 relative to the first body portion 320, and then gradually decrease the flow rate thereafter.

[0314] The flow controller 300 may include a movement limiting device configured to limit relative movement between the first body portion 320 and the second body portion 340. The movement limiting device may be configured, for example, to limit movement between limits defined by a first position and a second position.

[0315] The movement limiting device may comprise a protrusion 327 on one of the first body portion 320 or the second body portion 340 and at least one stop 347 on the other of the first body portion or the second body portion. The protrusion 327 may be configured to abut the at least one stop 347 in the first position and the second position to prevent movement beyond said positions.

[0316] In the illustrated example, the movement limiting device is a rotation limiting device configured to limit relative rotation between the first body portion 320 and the second body portion 340 between a first angular position and a second angular position. The rotation limiting device includes a protrusion 327. The first body portion 330 includes the protrusion 327, and the second body portion 340 includes a pair of stops 347. In this example, the protrusion 327 is located on the insert 331, but may be located elsewhere on the first body portion 330. The protrusion 327 is configured to engage one of the pair of stops 347 in the first position and the other of the pair of stops 347 in the second position. This prevents rotation of the second body portion 340 beyond the first position or the second position and defines the movement of the first opening 325 relative to the second opening 345.

[0317] The flow controller may include one or more grip elements to facilitate manual rotation of the second body portion 340 relative to the first body portion 320 by a user. One or both of the first body portion 320 and the second body portion 340 may include one or more grip elements. If both the first body portion 320 and the second body portion 340 include grip elements, the grip elements may be the same, similar, or different. In some examples, the first body portion 320 may be provided with a grip element that is shaped differently from the second body portion 340, for example, to encourage a user to rotate either the first body portion 320 or the second body portion 340 relative to the other.

[0318] As best seen in FIG. 44 , in some examples, second body portion 340 includes a pair of fins 349 extending from second body portion 340. Fins 349 can facilitate a user applying a rotational force to second body portion 340. In other examples, flow controller 300 may include a single fin 349 or more than two fins 349. In the example shown, fins 349 are positioned opposite each other about longitudinal axis X and extend generally symmetrically about longitudinal axis X. However, in other examples, fins 349 may be asymmetric about longitudinal axis X and / or may not be positioned opposite each other.

[0319] First body portion 320 may also include one or more grip portions. Referring to FIG. 44 , first body portion 320 includes a pair of recessed regions 339 configured to facilitate gripping by a user. Recessed regions 339 are positioned opposite each other about longitudinal axis X. However, other positioning for recessed regions 339 are possible.

[0320] Additionally or alternatively, one or more grip portions may include surface features configured to increase friction between the grip portion and a user's hand. For example, a further exemplary flow controller 3300 is shown in FIGS. 56-59. The flow controller 3300 may share one or more features of the flow controller 300 as described herein. The flow controller 3300 comprises a first body portion 3320 and a second body portion 3340. The first body portion 3320 may include a grip portion. For example, as best shown in FIG. 59, the first body portion 3320 includes a grip portion 3339 including a textured grip surface. The grip portion 3339 may or may not be concave. As best shown in FIG. 59, the grip portions 3339 each include a plurality of protrusions in a patterned arrangement. The grip portion 3339 can increase the user's grip on the first body portion 3320 when rotating the second body portion 3340 relative to the first body portion 3320 .

[0321] The flow controller 300 may include one or more indicators to indicate the relative positions of the first body portion 320 and the second body portion 340. The indicators may include visual, audio, tactile, and / or haptic indicators. In some examples, the indicators may include indicia on one or both of the first body portion 320 and the second body portion. For example, the flow controller 300 may include a first indicia on the first body portion 320 and a second indicia on the second body portion 340. The indicia may be configured such that the relative alignment of the first indicia and the second indicia provides a visual indication of the position of the first opening relative to the second opening. As shown in FIG. 44 , the first body portion 320 includes a flow indicator 338 on the outer surface of the housing 330. The relative alignment between the nearest fin 349 of the second body portion 340 and the flow indicator 338 provides a visual indication of the position of the first opening relative to the second opening and the flow rate through the fluid flow path.

[0322] In other examples, first body portion 320 may also include one or more fins. In such examples, relative alignment between at least one of fins 349 of second body portion 340 and at least one of the fins of the first body portion may provide a visual indication of the position of first opening 325 relative to second opening 345.

[0323] In some examples, the flow controller 300 may include one or more retention elements configured to hold the first and second body portions in relative alignment at one or more predetermined positions. The one or more predetermined positions may include a first position, a second position, and / or one or more intermediate positions between the first and second positions. In some examples, the flow controller 300 includes a plurality of retention elements configured to hold the first and second body portions in relative alignment at a corresponding plurality of positions.

[0324] The retaining element may be configured, for example, to provide frictional resistance to relative movement between the first and second body positions, which may be overcome by the user by applying a force (such as a rotational force) between the first and second body portions 320, 340.

[0325] The flow controller 300 may include one or more protrusions 341 on one of the first body portion 320 and the second body portion 340, which are receivable into at least one recess on the other of the first body portion 320 and the second body portion 340 and provide resistance to movement between the first body portion 320 and the second body portion 340.

[0326] One or more protrusions and / or recesses may be arranged such that the protrusions are received in the recesses at one or more predetermined positions of the second body portion 340 relative to the first body portion 320. For example, as shown in FIG. 54 , the second body portion 340 includes a pair of protrusions 341 extending outward from the outer surface of the cylindrical wall 343. The protrusions 341 are configured to be received in corresponding recesses 321 of the insert 331. However, the reverse configuration of the recesses and protrusions is also contemplated. The protrusions 341 are positioned to engage the recesses 321 when the second body portion 340 is in the first position or the second position relative to the first body portion 320. Another example may include additional protrusions for positioning the second body portion 340 at one or more intermediate positions between the first and second positions. In another example, the flow controller may include a single protrusion engageable with multiple recesses to hold the second body portion 340 in the first and second positions and / or any intermediate positions.

[0327] The flow controllers described herein may not have a filter within the body of the flow controller. The illustrated example flow controllers 300, 3300 do not include a filter or filter material. In such examples, the narrowest passage of the fluid flow path may be defined by the first opening 325 and / or the second opening 345 (e.g., not by a filter material). In some examples, a system including the flow controllers 300, 3300 described herein (e.g., system 1 described above) may include one or more filters, such as filter 25, separate from the flow controller 300. As shown in the surgical system 100 of FIG. 43, the filter 25 may be separated from the flow controller 300 by a length of tubing in the exhaust line 23. The filter 25 may be located outside the sterile surgical zone. This allows for the size of the flow controller to be minimized, minimizing disruption to the sterile zone.

[0328] Fluid Line Connector Example Some surgical procedures may require the suction of surgical fluids (e.g., irrigation fluid) from the body cavity 2. This may be in addition to the evacuating of surgical gases and / or smoke from the body cavity 2. This may require two exhaust lines: a first fluid exhaust line 23 configured for the evacuating of gases during the surgical procedure (including, for example, the elimination of smoke and / or particulate matter), and a second fluid exhaust line 28 for the evacuating of irrigation fluid during the procedure. In conventional systems, each exhaust line 23, 28 is connected to a separate suction canister 26, as shown, for example, in FIG. 64. The canister 26 may be connected to a suction source 24, such as a vacuum or a wall suction port.

[0329] Examples of the present disclosure provide a combined gas / smoke and irrigation fluid evacuation system. One example of a fluid evacuation system 4 is shown in FIG. 65. The fluid evacuation system 4 is configured to fluidly couple a first fluid evacuation line 23 and a second fluid evacuation line 28 to a common suction canister 26, which is in fluid communication with a suction source 24 (e.g., a suction pump, a wall port) via a suction line 27.

[0330] The fluid discharge system 4 may include a fluid line connector 400, for example, as shown in FIG.

[0331] 66-70, the fluid line connector 400 includes a connector body 402. The body 402 includes a first inlet port 410 for fluid connection with the first fluid discharge line 23 and a second inlet port 420 for fluid connection with the second fluid discharge line 28. The body 402 further includes an outlet port 430 for fluid connection with the suction source 26. The inlet ports 410, 420 and the outlet port 430 are fluidly connected by a junction region 440.

[0332] In some examples, when the second exhaust line 28 is not present or in use, a plug or cap may be removably coupled to the second inlet port 420. In some examples, a connector 431 may be connectable to the outlet port 430, for example, as shown in FIG. 65. The connector 431 may be configured to mate with a port on the suction canister 26.

[0333] By providing fluid line connector 400 in surgical system 100, irrigation fluid exhaust line 28 and smoke exhaust line 23 are consolidated into one fitting that can connect to a single suction canister 26. This can reduce costs by reducing the number of suction canisters required and / or can facilitate use of system 100 with conventional single canister irrigation devices.

[0334] In the example shown, the first inlet port 410 is generally perpendicular to the second inlet port 420 and outlet port 430, which are axially aligned with one another; however, other angles between the ports 410, 420, 430 are possible. The connector 400 may be configured for use in an orientation such as that shown in FIGS. 65-70 , with the first inlet port 410 positioned above the second inlet port 420 and outlet port 430. However, other configurations and positioning for the first and second inlet ports 410, 420, and outlet port 430 are also contemplated. For example, if the fluid line connector 400 includes one or more valves, the relative orientation of the ports 410, 420, 430 may be less important.

[0335] In some circumstances, irrigation fluid may unintentionally enter first drain line 23 at junction 440. This may occur due to a pressure differential created in fluid connection system 4 when second drain line 28 is active and the fluid flow rate through first drain line 23 is zero or less than a threshold value (e.g., 0.5 LPM).

[0336] When no suction is applied, the pressure throughout the first exhaust line 23, the second exhaust line 28, the suction canister 26, and the suction line 27 (between the suction canister and the suction source) may be approximately equal to (in equilibrium with) the pressure of the applied vacuum. However, when the second exhaust line 28 is activated / opened (e.g., to apply suction), the pressure in the second exhaust line 28 becomes similar to atmospheric pressure. For a certain period of time, the pressure in the first exhaust line 23 and the suction line 27 is still maintained at vacuum. Therefore, fluid in the second exhaust line 28 may be undesirably drawn into the suction canister 26 and / or the first exhaust line 23.

[0337] The pressure in the system 4 then stabilizes after a period of time, and the pressure differential between the second exhaust line 28 and the suction line 27 becomes greater than between the filter 425 and the suction line 27, causing fluid to flow towards the suction canister as opposed to through the first exhaust line 23 and / or the filter 425. However, when the second exhaust line 28 is deactivated and then activated again, for example, if the user pulses the second exhaust line 28, the problem may repeat.

[0338] Additionally, the physical orientation of the first drain line 23 may cause irrigation fluid to enter the first drain line 23. For example, if the first drain line 23 is directed below the second drain line 28, fluid may inadvertently pool or transfer into the first drain line 23 under the influence of gravity.

[0339] Fluid entering first exhaust line 23 may completely or partially obstruct exhaust line 23, affecting flow through first exhaust line 23. Additionally or alternatively, fluid may block a filter (e.g., filter 425) connected to first exhaust line 23. In some cases, fluid may flow along exhaust line 23 back into body cavity 2, which may increase the risk of introducing contamination into the body cavity.

[0340] To avoid or ameliorate one or more of the above problems, in some examples, a one-way valve 450 may be positioned in connection with the first exhaust line 23 of the fluid connection system 4 to prevent fluid from entering the first exhaust line 23. Any filter in connection with the fluid exhaust line 23 may be positioned upstream of the one-way valve 450.

[0341] 69 and 70, a one-way valve 450 may be integrated into the fluid line connector 400. The one-way valve 450 may be configured to prevent fluid flow from the junction area 440 through the first fluid exhaust line 23.

[0342] In the example shown, one-way valve 450 is located within the connector body and is configured to prevent fluid flow from junction region 440 to and / or through first inlet port 410. In use, the one-way valve is configured to be positioned upstream of second inlet port 420 and above outlet port 430.

[0343] In other examples, the one-way valve 450 may be spaced apart from the junction 440. For example, the one-way valve 450 may be provided separate from the fluid line connector 400 and spaced apart from the connector body 402. The one-way valve 450 may be connected to the fluid exhaust line 23 and may be spaced apart from the connector body 402 only by a connection portion, e.g., a length of tubing. The connection portion may connect the one-way valve 450 to the first inlet port 410. The one-way valve 450 may be configured to prevent fluid flow from the body 402 through the first fluid exhaust line 23 past the one-way valve 450.

[0344] The fluid line connector 400 may include at least one filter 425 fluidly connected to the first inlet port 410. The filter 425 comprises a filter material. The filter 425 may include a filter housing, with the filter material located within the filter housing. The filter 425 (i.e., at least the filter material) may be located upstream of the one-way valve 450, for example, as shown in FIG. 65 . The filter 425 may be configured to filter smoke and / or particulate matter contained in the fluid flowing through the first fluid exhaust line 23. In some examples, the filter 425 may be located within the connector body 402. The filter 425 may be fixed to the connector body 402. In some examples, the filter 425 may be removably connectable to the connector body 402. The fluid line connector 400 may be configured such that the filter 425 is located upstream of the second inlet port 420 and / or upstream of the outlet port 430 during use. The filter may be positioned upstream of the one-way valve 450 .

[0345] It should be emphasized that many variations and modifications may be made to the examples described herein, and elements thereof are understood to be particularly acceptable examples. All such modifications and variations are intended to be included herein within the scope of this disclosure and protected by the following claims. Moreover, the above disclosure is not intended to imply that any particular component, feature, or process step is required or essential.

Claims

1. 1. An accessory for a medical instrument for providing fluid to a body cavity of a patient during a surgical procedure, comprising: The medical instrument is attachable over at least a portion of the shaft of the medical instrument; an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect the lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; A main body equipped with Equipped with the sealing element is configured to allow rotation of the medical instrument accessory relative to the medical instrument shaft, whereby rotational movement of the fluid connection portion is decoupled from rotational movement of the medical instrument shaft; Medical equipment accessories.

2. the sealing element is configured to allow relative rotation of the fluid connection portion about a longitudinal axis of the medical instrument shaft.

2. The medical instrument accessory of claim 1.

3. the fluid-tight seal is substantially maintained during relative rotation between the medical instrument shaft and the medical instrument accessory.

3. An accessory for a medical instrument according to claim 1 or 2.

4. the sealing element is configured to hold the medical instrument in place within the medical instrument accessory. The medical instrument accessory according to any one of claims 1 to 3.

5. the sealing element is provided at or adjacent to the proximal end of the lumen and / or above the fluid connection portion; The medical instrument accessory according to any one of claims 1 to 4.

6. at least one guide element on or within the inner wall of the accessory; Further provided with The medical instrument accessory according to any one of claims 1 to 5.

7. the at least one guide element comprises a plurality of guide elements; 7. The medical instrument accessory of claim 6.

8. the at least one guide element is configured to position the shaft of the medical instrument within the lumen.

8. An accessory for a medical instrument according to claim 6 or 7.

9. the at least one guide element maintains the medical instrument shaft substantially concentrically within the lumen; 9. The medical instrument accessory of claim 8.

10. the at least one guide element comprises one or more ribs extending inwardly from the inner wall; The medical instrument accessory according to any one of claims 6 to 9.

11. the one or more ribs are located at or adjacent the distal end of the lumen; 11. The medical instrument accessory of claim 10.

12. The sealing element a first resistance upon insertion of the medical instrument into the lumen; a second resistance when withdrawing the medical instrument from the lumen; and configured to provide The medical instrument accessory according to any one of claims 1 to 11.

13. the second resistance is greater than the first resistance; 13. An accessory for a medical instrument according to claim 12.

14. the sealing element providing a substantially fluid-tight seal with the medical instrument shaft; An accessory for a medical instrument according to any one of claims 1 to 13.

15. the body including a guide portion at the proximal end for guiding a medical instrument into the lumen; An accessory for a medical instrument according to any one of claims 1 to 14.

16. 1. An accessory for a medical instrument for providing fluid to a body cavity of a patient during a surgical procedure, comprising: The medical instrument is attachable over at least a portion of the shaft of the medical instrument; an interior wall defining a lumen; a proximal end; a distal end defining an opening; a first portion including a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; a second portion comprising a fluid connection portion configured to connect the lumen in fluid communication with a fluid source; A main body equipped with Equipped with the second portion is rotatably coupled to the first portion; Medical equipment accessories.

17. the second portion is rotatable relative to the first portion about the longitudinal axis of the body; 17. An accessory for a medical instrument according to claim 16.

18. the first and second portions comprising respective coupling elements configured to engage with one another such that the first and second portions are rotatable relative to one another; 18. An accessory for a medical instrument according to claim 16 or 17.

19. the coupling elements comprising respective mating surfaces configured to mate to provide a substantially fluid-tight seal; 19. The medical instrument accessory of claim 18.

20. the coupling element comprises a protrusion and a circumferential groove for receiving the protrusion; 20. An accessory for a medical instrument according to claim 18 or 19.

21. the coupling elements are configured to engage with one another to form a permanent connection; The medical instrument accessory according to any one of claims 18 to 20.

22. the body further comprising a third portion rotatably coupled to the second portion; An accessory for a medical instrument according to any one of claims 16 to 21.

23. The second portion is located between the first portion and the third portion.

23. The medical instrument accessory of claim 22.

24. the third portion is rotatably fixed relative to the first portion; 24. An accessory for a medical instrument according to claim 22 or 23.

25. at least one guide element on or within the inner wall of the accessory; Further provided with An accessory for a medical instrument according to any one of claims 16 to 24.

26. the at least one guide element comprises one or more ribs extending inwardly from the inner wall; 26. The medical instrument accessory of claim 25.

27. the one or more ribs are located at or adjacent the distal end of the lumen; 27. The medical instrument accessory of claim 26.

28. The sealing element a first resistance upon insertion of a medical instrument into the lumen; a second resistance when withdrawing the medical instrument from the lumen; and configured to provide An accessory for a medical instrument according to any one of claims 16 to 27.

29. the second resistance is greater than the first resistance; 29. The medical instrument accessory of claim 28.

30. 1. An accessory for a medical instrument for providing fluids to and / or from a body cavity of a patient during a surgical procedure, comprising: The medical instrument is attachable over at least a portion of the shaft of the medical instrument; an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect the lumen in fluid communication with a fluid delivery tube; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; a fixation element configured to maintain the position of the medical instrument shaft relative to at least a portion of the medical instrument accessory; A main body equipped with Equipped with the body is configured such that the rotational movement of the fluid connection portion is decoupled from the rotational movement of the sealing element and / or the fixing element. Medical equipment accessories.

31. at least one guide element on or within the inner wall of the accessory; Further provided with 31. The medical instrument accessory of claim 30.

32. the at least one guide element comprises one or more ribs extending inwardly from the inner wall; 32. The medical instrument accessory of claim 31.

33. the one or more ribs are located at or adjacent the distal end of the lumen; 33. The medical instrument accessory of claim 32.

34. the fixation element is configured to maintain the position of the shaft of the medical instrument within the medical instrument accessory. An accessory for a medical instrument according to any one of claims 30 to 33.

35. the fixing element is the sealing element; An accessory for a medical instrument according to any one of claims 30 to 33.

36. The body comprises: a first conduit component; and a second conduit component; and Equipped with the first conduit component comprises the sealing element and / or the fixing element; the first conduit component and the second conduit component are configured to be connected together; When connected, the first conduit component and the second conduit component are configured to be rotatable relative to one another. An accessory for a medical instrument according to any one of claims 30 to 34.

37. the second conduit component is configured to receive at least a portion of the first conduit component; 37. The medical instrument accessory of claim 36.

38. the first conduit component and the second conduit component include respective connecting features engageable with each other to form a permanent connection; 38. An accessory for a medical instrument according to claim 36 or 37.

39. one of the first conduit component and the second conduit component comprises a protrusion and the other of the first conduit component and the second conduit component comprises a ledge; the ledge is configured to engage the protrusion to provide the permanent connection; 39. The medical instrument accessory of claim 38.

40. The sealing element a first resistance upon insertion of the medical instrument into the lumen; a second resistance when withdrawing the medical instrument from the lumen; and configured to provide An accessory for a medical instrument according to any one of claims 30 to 39.

41. the second resistance is greater than the first resistance; 41. The medical instrument accessory of claim 40.

42. 1. A swivel connector for a medical instrument accessory, comprising: a first conduit component; and a second conduit component; and Equipped with the first conduit component comprises a sealing element and / or a fixing element; the first conduit component and the second conduit component are configured to be connected together; When connected, the first conduit component and the second conduit component are configured to be rotatable relative to one another. Swivel connector.

43. the fixing element is the sealing element; 43. The swivel connector of claim 42.

44. the second conduit component is configured to partially receive the first conduit component; 44. A swivel connector according to claim 42 or 43.

45. the first conduit component and the second conduit component include respective connecting features engageable with each other to form a permanent connection; A swivel connector according to any one of claims 42 to 44.

46. one of the first conduit component and the second conduit component comprises a protrusion and the other of the first conduit component and the second conduit component comprises a ledge; the ledge is configured to engage the protrusion to provide the permanent connection; 46. ​​The swivel connector of claim 45.

47. the second conduit component comprises a fluid connection portion configured to connect the swivel connector in fluid communication with a fluid source; A swivel connector according to any one of claims 42 to 46.

48. 1. An accessory for a medical instrument for providing fluid to a body cavity of a patient during a surgical procedure, comprising: The medical instrument is attachable over at least a portion of the shaft of the medical instrument; an interior wall defining a lumen; a proximal end; a distal end defining an opening; a fluid connection portion configured to connect the lumen in fluid communication with a fluid source; a sealing element configured to provide a substantially fluid-tight seal with the medical instrument; A main body equipped with Equipped with the sealing element is further configured to provide resistance to longitudinal movement of the medical instrument shaft relative to the sealing element. Medical equipment accessories.

49. The sealing element a first resistance upon insertion of the medical instrument into the lumen; a second resistance when withdrawing the medical instrument shaft from the lumen; and is configured to provide the second resistance is greater than the first resistance; 49. The medical instrument accessory of claim 48.

50. the sealing element comprising a proximal surface, a distal surface, and an intermediate surface; 50. A medical device according to claim 48 or 49.

51. the proximal and / or distal surfaces are tapered, angled, curved, or otherwise shaped to extend away from the surface of the medical instrument shaft when the accessory is worn over the medical instrument; 51. The medical instrument accessory of claim 50.

52. Configuring the sealing element to provide resistance; adjusting the width of the sealing element; adjusting the surface area of ​​the contact surface that contacts the outer wall of the medical instrument shaft; and selecting material properties of said seal; [0033] An accessory for a medical instrument according to any one of claims 48 to 51.

53. the body including a seal retaining structure configured to limit deformation of the seal element in at least the proximal direction. An accessory for a medical instrument according to any one of claims 48 to 52.

54. the seal retention structure is configured as an abutment surface extending radially inward from the inner surface of the lumen; Proximal sliding movement of the medical instrument shaft compresses at least a portion of the sealing element against an abutment surface.

54. The medical instrument accessory of claim 53.

55. the proximal surface is configured to at least partially define a proximal gap between the proximal surface and the exterior surface of the medical instrument, and compression of the sealing element against the abutment surface urges the sealing element partially into the proximal gap.

55. An accessory for a medical instrument according to claim 53 or 54.

56. at least one guide element on or within the inner wall of the accessory; Further provided with An accessory for a medical instrument according to any one of claims 48 to 55.

57. the at least one guide element comprises one or more ribs extending inwardly from the inner wall; An accessory for a medical instrument according to any one of claims 48 to 56.

58. the one or more ribs are located at or adjacent the distal end of the lumen; 58. The medical instrument accessory of claim 57.

59. configuring the sealing element to provide resistance includes treating the surface of the sealing element to modify the friction characteristics of the surface. An accessory for a medical instrument according to any one of claims 48 to 58.

60. the sealing element is configured to allow the medical instrument to rotate within the medical instrument accessory; An accessory for a medical instrument according to any one of claims 48 to 59.

61. 1. A flow controller for controlling flow in a fluid drain line for a surgical system, comprising: a first body portion including a first fluid connection portion configured for connection with a first portion of the fluid exhaust line, the first body portion defining a first opening in fluid communication with the first fluid connection portion; a second body portion coupled to the first body portion, the second body portion including a second fluid connection portion configured for connection with a second portion of the fluid discharge line and defining a second opening in fluid communication with the second fluid connection portion; A main body equipped with Equipped with the second body portion is movable relative to the first body portion to bring the first opening into or out of fluid communication with the second opening, thereby selectively opening, closing, and / or altering a fluid flow path between the first fluid connection portion and the second fluid connection portion; Flow controller.

62. 1. A flow controller for controlling flow in a fluid drain line for a surgical system, comprising: a first body portion configured for fluid communication with a first portion of the fluid exhaust line; a first opening in fluid communication with the first portion of the fluid exhaust line; a second body portion coupled to the first body portion, the second body portion configured for connection with a second portion of the fluid discharge line; a second opening in fluid communication with the second portion of the fluid exhaust line; A main body equipped with Equipped with the first body portion and the second body portion are movable relative to one another to place the first opening in or out of fluid communication with the second opening, thereby selectively opening, closing, and / or altering a fluid flow path between the first and second portions of the fluid exhaust line; Flow controller.

63. the second body portion is movable relative to the first body portion from a first position in which the first opening and the second opening are offset from one another and the fluid flow path is closed, to a second position in which the first opening and the second opening are at least partially aligned with one another and the fluid flow path is at least partially open.

63. A flow controller according to claim 61 or 62.

64. the second opening has a length, and the height of the second opening varies along the length; 64. A flow controller according to any one of claims 61 to 63.

65. the second opening is defined by a notch in one end of the wall of the second body portion; 65. A flow controller according to any one of claims 61 to 64.

66. an internal flow directing element for directing flow through said fluid flow path; Including, 66. A flow controller according to any one of claims 61 to 65.

67. the flow directing element is positioned at least adjacent the second opening; 67. The flow controller of claim 66.

68. the first fluid connection portion and the second fluid connection portion are aligned with the longitudinal axis of the body; 68. A flow controller according to any one of claims 61 to 67.

69. the flow controller does not include a filter; 69. A flow controller according to any one of claims 61 to 68.

70. the first body portion comprises a housing and an intermediate portion, the intermediate portion being rotationally and axially fixed relative to the housing; 70. A flow controller according to any one of claims 61 to 69.

71. the first body portion further comprising a rotation prevention element for preventing relative rotation of the housing and the intermediate portion.

71. The flow controller of claim 70.

72. the first fluid connection portion is axially aligned with the second fluid connection portion; 72. A flow controller according to any one of claims 61 to 71.

73. the first fluid connection portion and the second fluid connection portion are aligned with the longitudinal axis of the body; 73. A flow controller according to any one of claims 61 to 72.

74. the narrowest passage of the fluid flow path is defined by the first opening and / or the second opening; Flow controller. A flow controller according to any one of claims 61 to 73.

75. a fluid line connector for connecting a first fluid discharge line and a second fluid discharge line to a suction canister, a first inlet port for fluid connection with the first exhaust line; a second inlet port for fluid connection with the second fluid exhaust line; an outlet port for fluid connection with the suction canister; a junction region fluidly connecting the first inlet port, the second inlet port, and the outlet port; A connector body comprising: Equipped with a one-way valve positioned within the connector body and configured to prevent fluid flow from the interface region to the first inlet port; Fluid line connector.

76. 1. A fluid drainage system for draining gases and irrigation fluids from a body cavity of a patient, comprising: a first fluid exhaust line in fluid communication with the body cavity for exhausting the gas from the body cavity; a second fluid drain line in fluid communication with the body cavity for draining the irrigation fluid from the body cavity; Equipped with the first fluid discharge line and the second fluid discharge line are connected to a single connection port for connection to a suction canister; Fluid discharge system.

77. 76. The fluid line connector of claim 75, 77. The fluid ejection system of claim 76.

78. a one-way valve connecting with the first fluid discharge line upstream of the connection with the second fluid discharge line; further comprising:

78. A fluid ejection system according to claim 76 or 77.

79. at least one filter in fluid communication with the first fluid exhaust line; Equipped with the at least one filter is positioned upstream of the one-way valve; 79. The fluid discharge system of claim 78.

80. the filter is removably connectable to the connector body; 80. The fluid discharge system of claim 79.

81. 1. A system for providing fluid to and draining fluid from a body cavity of a patient during a surgical procedure, comprising:

1. A medical instrument accessory for providing fluid to the body cavity, comprising: The medical instrument is attachable over at least a portion of the shaft of the medical instrument; an inner wall defining a lumen; Proximal end, an open distal end, a fluid connection portion configured to fluidly connect the lumen with a fluid source; and At least one structure configured to position the medical instrument shaft within the lumen such that a fluid flow path is defined between the inner lumen wall and the medical instrument shaft, and such that fluid can be directed to or from the open distal end and around the end of the medical instrument. A main body equipped with a medical instrument accessory comprising: a first fluid exhaust line configured for connection to an outlet port in fluid communication with the body cavity for exhausting fluid from the body cavity; Including, system.

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