Automated Fluid Management Systems

Abstract

To provide a fluid management system.SOLUTION: A fluid management system includes a pump configured to pump fluid through the system at a fluid flow rate. The system includes a processor including a user interface, the user interface allowing a user to input a set of system operating parameters, and the processor being configured to control the pump to maintain a target fluid flow rate based on the set of system operating parameters. The system further includes a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongated shaft extending from a distal end thereof, the elongated shaft including at least one sensor, and the sensor transmitting sensor data relating to the target surgical site to the processor. The processor automatically transmits to the pump signals for adjusting the fluid flow rate based on the sensor data.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] [Priority claim] This disclosure claims priority to U.S. Provisional Patent Application No. 62 / 521,898, filed June 19, 2017, and U.S. Provisional Patent Application No. 62 / 570,990, filed October 11, 2017, the disclosures of which are incorporated herein by reference. [Background technology]

[0002] Flexible ureteroscopy (fURS) procedures require circulation of fluids for several reasons. Today's surgeons deliver fluids in a variety of ways, such as by hanging a fluid bag and using gravity to deliver the fluid, by filling a syringe with the fluid and manually injecting it, or by using a peristaltic pump to deliver the fluid from a reservoir at a fixed pressure or flow rate. The drawback with these and other delivery methods is that the user is completely unaware of what the pressure accumulation system or anatomical structures (ureters, bladder, kidneys) are experiencing, which increases the risk of harming the patient. Prudent surgeons generally circulate fluids at low pressures. However, reducing the flow rate to keep the pressure low may directly affect visualization of the surgical field, as blood, clots, and particulate matter may not be adequately removed at low pressures. In contrast, a high perfusion flow rate may obtain the desired clear visibility, but may result in excessively high intraluminal pressures. High intraluminal pressures facilitate the absorption of bacteria and endotoxins into the blood, which may result in postoperative fever. Other conditions that may arise due to high intraluminal pressure include lymphatic and venous reflux causing fluid leakage, postoperative pain, urosepsis, and kidney damage. Summary of the Invention [Means for solving the problem]

[0003] The present disclosure relates to a fluid management system including a pump configured to pump fluid from a fluid supply through the system at a fluid flow rate, a processor including a user interface, the user interface allowing a user to input a set of system operating parameters, the processor configured to control the pump to maintain a target fluid flow range based on the set of system operating parameters, and a scope device coupled to the pump for delivering fluid to a target surgical site, the scope device including an elongated shaft extending from a distal end thereof, the elongated shaft including at least one sensor, the sensor transmitting sensor data related to the target surgical site to the processor, the processor automatically transmitting a signal to the pump to adjust the fluid flow rate based on the sensor data.

[0004] In an embodiment, the sensor is a pressure transducer.

[0005] In an embodiment, the system includes a heating assembly configured to heat the fluid to a target temperature.

[0006] In an embodiment, the processor further includes a display screen configured to display the fluid flow rate and the sensor data in real time.

[0007] In an embodiment, if the processor detects that the fluid flow rate is outside the target fluid flow range, a visual alarm is displayed on the display screen.

[0008] In embodiments, the scope device further includes a temperature sensor positioned on the elongate shaft.

[0009] In an embodiment, the fluid source is a fluid bag.

[0010] In an embodiment, the system includes a weight sensor for measuring the weight of the fluid bag in real time.

[0011] The present disclosure also relates to a fluid management system including a pump configured to pump fluid from a fluid source through the system at a fluid flow rate, a processor configured to control the pump, and a scoping device coupled to the pump for delivering fluid to a target surgical site, the scoping device including an elongated shaft extending from a distal end thereof, the elongated shaft including a camera that transmits video feedback related to the target surgical site to the processor, the processor including image recognition software that detects variations in the video feedback and automatically transmits a signal to the pump to adjust the fluid flow rate based on the variations.

[0012] In an embodiment, the processor includes a user interface that allows a user to input a set of system operating parameters.

[0013] In an embodiment, the processor includes a display screen configured to display the video feedback and the flow rate in real time.

[0014] In embodiments, the scope device further includes a temperature sensor positioned on the elongate shaft.

[0015] In an embodiment, the system includes a heating assembly configured to heat the fluid to a target temperature.

[0016] In an embodiment, the fluid source is a fluid bag.

[0017] In an embodiment, the device includes a weight sensor for measuring the weight of the fluid bag in real time. [Brief description of the drawings]

[0018] [Figure 1] 1 is a schematic diagram of a fluid management system according to an exemplary embodiment of the present disclosure. [Diagram 2] 2 is another schematic diagram of the fluid management system of FIG. 1 according to an exemplary embodiment of the present disclosure. [Diagram 3] FIG. 2 illustrates a touch screen interface of the system of FIG. 1 according to a first exemplary embodiment. [Figure 4] FIG. 2 illustrates a touch screen interface of the system of FIG. 1 according to a second exemplary embodiment. [Diagram 5] FIG. 2 illustrates a touch screen interface of the system of FIG. 1 according to a third exemplary embodiment. [Figure 6] 2 is a perspective view of a touch screen interface and pump system of the system of FIG. 1 in accordance with an exemplary embodiment. [Figure 7] 2 illustrates a visual feedback display of the system of FIG. 1 in accordance with an exemplary embodiment. [Figure 8] 2A-2C are perspective views of various manual user interfaces of the system of FIG. 1 in accordance with an exemplary embodiment. [Figure 9] 2 is a side view of a scope device of the system of FIG. 1 in accordance with an exemplary embodiment. [Figure 10] FIG. 10 is a top view of the scope device of FIG. 9. [Figure 11] 2 is a side view of a heater assembly of the system of FIG. 1 according to an exemplary embodiment. [Figure 12] 12 is a top view of a heater cassette of the heater assembly of FIG. 11 according to an exemplary embodiment. [Figure 13] 2 is a perspective view of a waste management system of the system of FIG. 1 according to an exemplary embodiment. [Figure 14] FIG. 2 is a schematic diagram of a waste management system of the system of FIG. 1 according to a second exemplary embodiment. [Figure 15] FIG. 2 is a schematic diagram of a waste management system of the system of FIG. 1 according to a third exemplary embodiment. [Figure 16] FIG. 2 is a schematic diagram of a waste management system of the system of FIG. 1 according to a fourth exemplary embodiment. [Figure 17] FIG. 13 is a schematic diagram of a waste management system of the system of FIG. 1 according to a fifth exemplary embodiment. [Figure 18] FIG. 13 is a schematic diagram of a waste management system of the system of FIG. 1 according to a sixth exemplary embodiment. [Figure 19] FIG. 1 illustrates a perspective view of a waste management system ceiling mount in accordance with an exemplary embodiment. [Figure 20] 1 is a perspective view of a waste management system mount according to another exemplary embodiment. [Figure 21] 1 is a perspective view of a waste management system mount according to another exemplary embodiment. [Figure 22] FIG. 2 is a perspective view of a waste collection module according to an exemplary embodiment of the present disclosure. [Diagram 23] FIG. 2 is a perspective view of a waste collection module according to another exemplary embodiment of the present disclosure. [Figure 24] FIG. 1 is a perspective view of a waste management system configuration according to an exemplary embodiment of the present disclosure. [Diagram 25] FIG. 1 is a perspective view of a waste management system arrangement according to another exemplary embodiment. [Figure 26] FIG. 13 is a perspective view of a waste management system arrangement according to a third exemplary embodiment. [Figure 27] FIG. 13 is a perspective view of a waste management system arrangement according to a fourth exemplary embodiment. [Figure 28] FIG. 13 is a perspective view of a waste management system arrangement according to a fourth exemplary embodiment. [Figure 29] FIG. 13 is a perspective view of a waste management system arrangement according to a fifth exemplary embodiment. [Diagram 30] FIG. 13 is a perspective view of a waste management system arrangement according to a sixth exemplary embodiment. [Diagram 31] FIG. 13 is a perspective view of a waste management system arrangement according to a seventh exemplary embodiment. [Diagram 32] FIG. 13 is a perspective view of a waste management system arrangement according to an eighth exemplary embodiment. [Diagram 33] FIG. 13 is a perspective view of a waste management system arrangement according to a ninth exemplary embodiment. [Diagram 34] FIG. 16 is a perspective view of a waste management system arrangement according to a tenth exemplary embodiment. [Diagram 35]FIG. 1 is a perspective view of a saline bag configuration according to an exemplary embodiment of the present disclosure. [Diagram 36] FIG. 13 is a perspective view of a saline bag configuration according to another exemplary embodiment. [Figure 37] FIG. 13 is a perspective view of a saline bag configuration according to a third exemplary embodiment. [Figure 38] FIG. 13 is a perspective view of a saline bag configuration according to a fourth exemplary embodiment. [Figure 39] FIG. 1 illustrates a fluid management system modular cart setup according to an exemplary embodiment of the present disclosure. [Diagram 40] FIG. 1 illustrates a fluid management system modular cart setup according to another exemplary embodiment. [Diagram 41] FIG. 13 illustrates a fluid management system modular cart setup according to a third exemplary embodiment. [Diagram 42] FIG. 13 illustrates a fluid management system modular cart setup according to a fourth exemplary embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0019] The present invention can be understood with reference to the following description and the accompanying drawings in which like elements are referenced with the same reference numerals. The present invention relates to systems, methods, devices, and kits for delivery of fluid with controlled flow rate and sensor feedback in fURS procedures. Exemplary embodiments describe a modular system including a pump, either user controlled or automatic, a ureteroscope device such as a LithoVue® scope device with a sensor at its tip, a fluid management system, and in some embodiments, a effluent collection system. The pump system can include a heating source to heat the fluid to body temperature if desired by the user. Other exemplary embodiments describe a fluid management system kit that can include any combination of any two or more of irrigation tubing, a tool with a pressure or temperature sensor, a drainage canister, and printed materials with one or more of storage information and instructions on how to configure the irrigation tubing. It should be noted that the terms "proximal" and "distal" as used herein are intended to mean directions toward (proximal) and away from (distal) the user of the device.

[0020] 1-2 illustrate an exemplary modular fluid management system 10. The fluid management system 10 allows for the flow of fluid therethrough and can be coupled to a surgical device including a pressure sensor, such as, for example, a LithoVue® scope device 20. In an exemplary embodiment, the device 20 further includes a temperature sensor for providing temperature feedback to the system 10 and / or a camera for providing visual feedback to the fluid management system 10. The fluid management system 10 further includes a fluid hanger module 100. The exemplary fluid hanger module 100 can include one or more fluid container supports, such as fluid bag hangers 102, each supporting one or more fluid bags 104. In some embodiments, the placement of the fluid bags 104 can be detected using a remote sensor. The fluid bag hangers 102 can receive fluid bags 104 of various sizes, such as, for example, bags from 1 liter (L) to 5 L. It will be appreciated that any number of fluid containers can be used. Additionally, any size of fluid container can be used depending on the procedure. The exemplary fluid management unit 100 can be mounted on a rolling stand that can include a pole 106 and / or a base 108. The base 108 can include a number of wheels to facilitate easy movement of the fluid management unit 100 when in use. However, it will be appreciated that the fluid bags 104 can also be hung from a ceiling or mid-level depending on clinical preference. The fluid bag hanger 102 can include one or more hooks 110 extending from the pole 106 and from which one or more fluid bags 104 can be suspended. The fluid used in the fluid management system 100 can be 0.9% saline. However, it will be appreciated that a variety of other fluids of various viscosities can be used depending on the procedure.

[0021] The fluid management system 10 may include one or more user interface components, such as a touch screen interface 112. The touch screen interface 112 includes a display screen 113 and may include switches or knobs in addition to touch functionality. The touch screen interface 112 allows a user to input / adjust various functions of the system 10, such as flow rate, pressure, or temperature. The user may also set parameters and alarms (such as maximum pressure alarms), information to be displayed, and procedure modes. The touch screen interface 112 allows a user to add, change, or discontinue use of various modular systems within the fluid management system 10. The touch screen interface 112 may be used to switch the system 10 between automatic and manual modes for various procedures.

[0022] 3-6 show an exemplary touch screen interface 112. Each portion of the touch screen interface 112 can be configured to look like a button and provide similar functionality to a physical button as would be understood by one of ordinary skill in the art. The display screen 113 can be configured to show icons 114 relating to modular systems and devices included within the fluid management system 10. For example, in FIG. 3, the display screen 113 provides the user with a live video feed 116 of the target tissue / vessel / cavity from the scope device or medical device 20. The display screen 113 can further include a flow rate display 118 as shown in FIG. 5. The flow rate display 118 can be determined based on a desired threshold or known general value for the flow rate set by the user prior to the procedure. In some embodiments, the operating parameters can be adjusted by touching the corresponding portion of the touch screen interface 112. Additionally, the exemplary flow rate display 118 provides a flow rate scale 120, for example with distinct low, medium, and high ranges based on the operating parameters entered by the user, as well as the actual flow rate 122. The flow rate display 118 adjusts both the actual flow rate 122 and the flow rate marker on the flow rate scale 120 in real time. In this embodiment, if the flow rate enters the high range, a visual alarm 125 and / or an audio alarm can be automatically activated, as shown in FIG. 5. A similar pressure display 119 can be provided on the display screen 113, as shown in FIG. 4. Again, the pressure scale 123 can be determined based on parameters previously entered by the user or known general values. The display screen 113 can also display the actual pressure 121 in real time. In other embodiments, the display screen 113 can further show the system power 127, the amount of fluid remaining in the fluid bag 131, as can be seen in FIG. 5, and any other information that the user may determine to be advantageous during the procedure.

[0023] In the exemplary embodiment, the fluid management system 100 also includes additional user interface components, such as a foot pedal 117, a heater interface 168, a fluid control interface 127, or other devices for manually controlling the various modular systems. For example, the foot pedal 117 can be used to manually control the flow rate.

[0024] The touch screen interface 112 is operatively connected to or integrally part of a main processing device 124, such as a computer. The main processing device 124 may be operatively connected to one or more system components, such as, for example, the pump assembly, the heating assembly, and the fluid shortage management system. The main processing device 124 may perform various functions, such as calculation, control, computation, display, and the like. The main processing device 124 may track and store data regarding the operation of the management system 10 and each of its components. In an exemplary embodiment, the main processing device 124 includes network communication capabilities, such as WiFi, allowing the device to connect to, for example, a social area network. The main processing device 124 may receive signals from sensors of the system 10. In an embodiment, the main processing device 124 may communicate with a database for best care recommendations and maintaining patient records, which may be displayed to a user on the display screen 113.

[0025] The fluid management system 10 may be user selectable between different modes based on the procedure, patient characteristics, etc. For example, the different modes may include, i.e., fURS mode, BPH mode, hysteroscopy mode, cystoscopy mode. Once a mode is selected by the user, the flow rate, pressure, fluid deficit, and temperature are shown to the user through the display screen. Exemplary parameters for a particular mode may be pre-determined and loaded onto the main processing device 124, for example, using software. Thus, when the user selects a procedure from an initial display on the touch screen interface display screen 113, these known parameters are loaded from the processor into the various components of the fluid management system B, i.e., the pump, heating assembly, and fluid deficit management system. The fluid management system 10 may be user selectable between an automatic mode and a manual mode. For example, for certain procedures, the user may wish to manually adjust the flow rate, pressure, or other parameters. Once the user selects the manual mode, for example, on the touch screen interface 112, the user may adjust the flow rate or pressure through the foot pedal 117 or other manual interface, such as the fluid control interface 127.

[0026] The main processing device 124 can be configured to include vision / image recognition software that can detect visual noise based on variations in brightness (i.e., light monitor), contrast, or color pixilation. If it is determined that the image provided to the main processing device 124 is not clear or sharp enough, the fluid management system 10 increases the flow rate of fluid to flush out the debris 129 and sharpen / clarify the image. The flow rate is increased for a temporary period of time (i.e., a predetermined period of time) or until the field of view is deemed clear enough. This temporary increase ensures that the time the flow rate is increased is limited to ensure that the pressure does not exceed safety limits. For example, the system 10 can recognize a red hue (indicative of blood) in the wash as shown in FIG. 7 and signal the peristaltic pump set 126 to increase the flow rate until the blood is cleared from the field of view. Alternatively, the processor can provide a visual alert on the display screen 113 or an audible alert to the doctor or nurse that a cloudy visual image has been detected. In another example, in cases where there is a lot of debris, the light reflected from the debris will make the image substantially brighter. In this situation, the main processing device 124 detects this excessive brightness and signals the pump 126 to increase the flow rate to remove the debris. With the reflected light reduced as the debris is washed out of the field of view of the vision system, the pump 126 is controlled by the main processing device 124 to reduce the flow rate. Preferably, the physician can generate a baseline level for visibility at which he or she would like to initiate the clarity fluid flow and input these parameters into the system 10 through the touch screen interface 112 prior to the procedure. With a baseline generated, the system 10 monitors the visual feed for image fluctuations and adjusts the flow rate as needed.

[0027] To regulate the flow rate of fluid through the system 10, the fluid management unit 100 can include one or more pressurizing devices, such as a pump 126. An exemplary pump 126 can be a peristaltic pump. The pump 126 can be electrically powered and can receive power from a power line, such as a wall outlet, or from an external or internal power storage device, such as a disposable or rechargeable battery. The peristaltic pump 126 can be operated at any desired speed sufficient to deliver fluid at a target pressure, such as, for example, from 5 mmHg to 50 mmHg. As previously discussed above, the pump 126 can be automatically adjusted, for example, based on pressure and temperature readings within the patient's body and visual feedback from the scope 20. The pump 126 can be adjusted manually, for example, through a foot pedal 117, a touch screen interface 112, or a separate fluid controller 127 (shown in FIG. 4). The fluid controller 127 can be a separate user interface that includes buttons that allow a user to turn each individual pump 126 on or off. It will be appreciated that any number of pumps can be used. In an embodiment, the system 10 may include multiple pumps with different flow capabilities, with flow meters positioned before or after the pumps.

[0028] In this embodiment, the flow rate of the fluid at any given time is displayed on the display screen 113 for the operating room (OR) to view any fluctuations. If the OR personnel notices a fluctuation in the flow rate that is either too high or too low, the user can manually adjust the flow rate back to a preferred level. This may occur, for example, when a physician inserts or removes a tool into or from the working channel of the scope 20. The system 10 can monitor and automatically adjust the flow rate based on pre-set parameters as discussed above. This feature can also be beneficial when the flow is manually delivered, such as when an assistant injects irrigation fluid with a syringe.

[0029] As mentioned above, in an embodiment, the system 10 can include vision software or image recognition and analysis software. In this embodiment, the system 10 can detect whether a tool is inserted and which tool is being used by a camera 128 positioned on the intracorporeal scope 20. The tool can have an identifiable marker that the vision software can see, for example, to inform the user of what type of tool is being used. The fluid management system 10 can then automatically adjust the flow rate based on the tool identified by the vision software. When the tool retracts from the working channel, the fluid management system 10 reduces the pump flow rate accordingly.

[0030] In another embodiment, the system 10 automatically adjusts the flow rate based on pressure and / or temperature detected within the patient's body. The pressure and / or temperature can in turn be measured by a tool, such as a scope 20, used in conjunction with the system 10. The system 10 can include pressure monitor software that allows a user to configure the pump 126 so that the system 10 automatically starts, stops, and / or speeds the pump to maintain the fluid pressure delivered to the surgical site within a target pressure and / or a predetermined pressure band. For example, a scope pressure sensor can detect pressure inside the kidney and automatically change the flow rate within the system 10 based on the monitored internal pressure. If the internal pressure is too high, the system 10 will reduce the flow rate and vice versa. In an exemplary temperature control mode, as described in more detail below, the system 10 can include temperature monitor software that can control (e.g., start, stop, and temperature adjust) the heater to maintain the fluid temperature delivered to the surgical site approximately within a target temperature and / or a predetermined temperature pressure band. For example, temperature can be monitored in vivo or ex vivo and fluid flow can be altered based on temperature feedback provided. In an exemplary embodiment, the system 10 can compare the temperature and pressure sensed within the kidney to known values ​​and provide an alert when the parameters are outside of a predetermined safe region. The alert can be a visual or audio alert.

[0031] In an embodiment, the system 10 can monitor the movement of a target structure, such as a kidney stone. The system can calculate the rate of movement based on the original and new location of the stone. If the movement exceeds a predefined threshold, the user can be alerted to manually adjust the flow rate of the system. As described above, the flow rate can be manually adjusted through the foot pedal 117, the touch screen interface 112, or the pump interface. In an embodiment, when the system 10 is in an automatic mode, the system 10 can automatically adjust the irrigation flow as needed. This feature can be very beneficial during procedures such as lithotripsy to control stone retropulsion.

[0032] The scope device 20 can be, for example, a ureteroscope, such as a LithoVue® scope, as shown in FIGS. 9-10. The LithoVue® scope is lighter than many existing models, reducing the clinician's workload. The scope 20 delivers fluid from the fluid management system 10 through a scope shaft 169 to the target tissue. The scope 20 is connected to the fluid management system 10 through a supply line (i.e., tubing) as described above. The supply line from the fluid management system 10 to the scope 20 is preferably formed of a material that helps to dampen the peristaltic movement generated by the pump 126. As shown in FIG. 9, the scope 20 can include a pressure transducer 170 at the distal tip of the scope shaft 169 to measure, for example, pressure within the kidney. The scope 20 can include other sensors, such as, for example, a temperature sensor. In an exemplary embodiment, the distal end 172 of the scope 20 can include at least one camera 128 to provide a visual feed to the user on the display screen 113. In another embodiment, the scope 20 can include two cameras 128 with different communication requirements so that each camera 128 can convey different information to the user. In this embodiment, the user can intentionally alternate between the cameras 128 via the touch screen interface 112. The scope 20 includes a handle 174. The handle 174 can have a fluid flow on / off switch 176 that allows the user to control when fluid flows through the scope 20 and into the patient's body. The handle 174 can also include other buttons 177 that perform various other functions. For example, in one embodiment, the scope handle 174 can include buttons to control the temperature of the scope or the fluid. In another embodiment, the scope handle 174 can include a laser to allow the user to emit laser energy. In an exemplary embodiment, the laser can be a Lumenis laser or a StarMed Tech laser. "A laser fiber can be connected to the laser system and inserted through the ureteroscope working channel.The user can fire the laser so that energy exits the laser fiber tip and strikes and destroys the debris / stone. In an exemplary embodiment that includes a laser button on the scope, a line of communication (i.e., wired or wireless) is maintained between the laser system and the scope. While this exemplary embodiment describes a ureteroscope, it will be understood that the features detailed above can be incorporated directly into a cystoscope, hysteroscope, or virtually any device with imaging capabilities. The scope 20 can include a drainage port 178 that can be connected to a drainage system, which is described in more detail below.

[0033] The fluid management system 10 may include a fluid shortage monitor system 130. In an exemplary embodiment, the fluid shortage monitor system 130 monitors the amount of fluid (i.e., saline) in the fluid bag 104 by weight. In this embodiment, a weight sensor 132, such as a scale, hangs from the hook 110. The weight sensor 132 may further include a hook 134 from which one or more fluid bags 104 are suspended. The weight sensor 132 determines the weight of the fluid bag 104 attached to the hanger module 100 and compares the initial amount of fluid in the fluid bag 104 to the current amount of fluid remaining in the fluid bag 104. As shown in FIGS. 4-5, the scale reading is presented to the user on the display screen 113. As the procedure progresses, the scale reading is updated in real time to inform the physician how much fluid remains in the fluid bag 104, which can then be used to determine the amount of fluid infused into the patient. In an exemplary embodiment, the system 10 provides an amount of time remaining before a new bag is needed based on the weight of the bag 104 and the rate at which the bag 104 is emptying, i.e., the flow rate. In another embodiment, the amount of fluid remaining can be shown as a low fluid bar 131, which can be seen in FIG. 6. For example, an alarm can be shown on the display screen 113 with an audible signal when 10% of the saline remains in the bag 104. In an exemplary embodiment, the weight sensor 132 can be connected to the display screen 113 through a WiFi signal. In another exemplary embodiment, the weight sensor 132 can be connected to the display screen 113 through a wired connection.

[0034] In another exemplary embodiment, the fluid shortage monitor system 130 can include a pressure sensor connected in line between the fluid bag 104 and the device 20. In this embodiment, the pressure is determined based on the height of the fluid bag 104. The amount of head pressure decreases as the bag empties. If the pressure is less than a threshold set by the user, an alarm is shown on the display screen 113 and an audible signal is generated. In another exemplary embodiment, the fluid shortage monitor system 130 can be set to a particular flow rate based on the amount of time that has passed. The physician can input the bag fluid volume into the system 10, which then calculates the amount of fluid that has been used and how much is left based on the known flow rate and the amount of time the system 10 has been in use.

[0035] The fluid management system 10 can utilize small diameter pump tubing 136 to connect to the various components. Exemplary tubing 136 for irrigation procedures can be less than or equal to 1 / 16 inch in diameter. However, it will be understood that the size of the tubing can vary based on the application. The tubing can be disposable and provided sterile and ready to use. Different types of tubing can be used for various functions within the system 10. For example, one type of tubing can be used for heating the fluid and controlling fluid flow to the device 20, while another type of tubing can be used for internal irrigation.

[0036] In an exemplary embodiment, as shown in Figures 11-12, the fluid management system 10 may optionally include a heater assembly 138 for heating fluid delivered to the patient. The heater assembly 138 includes a heater 140, a heater cassette 142, and a fastening mechanism 144 for the cassette 142. The exemplary cassette 142 may include a fluid inlet port 146 and a fluid outlet port 148 located on a side thereof. Each of the fluid inlet and outlet ports 146, 148 includes an inlet connector and an outlet connector 150, 152, respectively, extending from a side of the cassette 142. The connectors 150, 152 may be in the form of a luer lock fitting, a valve fitting, a quick connect fitting, or the like. The connectors 150, 152 connect the heater assembly 138 to other components of the fluid management system 10. For example, the fluid inlet port 146 can be connected to the pump 126 through the fluid tubing 136, whereas the fluid outlet port 148 is connected to the device 20. In an exemplary embodiment, as shown in FIG. 12, the cassette 142 includes an internal flow path along with a channel 154 through which fluid can flow from an inlet connector 150 to an outlet connector 152. The cassette 142 can include one flow path or multiple flow paths. When multiple flow paths are present, one or more walls 156 can separate the various fluid channels 154. The exemplary fluid channel 154 includes a horizontal section 158 and a vertical section 160, forming a complex flow path between the fluid inlet port 146 and the fluid outlet port 148. The fluid channel 154 is configured to provide a substantial amount of outwardly facing surface area to the interior volume and to facilitate efficient heating of the fluid by the heater 140. In an exemplary embodiment, the fluid enters the cassette 142 through the inlet port 146 and further into the lower horizontal section 158a. The fluid flows through the vertical section 160a, then reverses direction to flow through the first intermediate horizontal section 158b. The fluid thus follows the channel 154 until it flows out the exit port 148. The sections 158, 160 of the channel 154 are separated by a horizontal wall 156.The cassette 142 can be formed, for example, from polycarbonate or any high thermal rated biocompatible plastic and can be formed as a single piece or multiple pieces permanently joined together. The inlet and outlet connectors 150, 152 can be integrally formed with the cassette 142 or can be separately installed pieces as will be understood by those skilled in the art.

[0037] The cassette 142 is coupled to the heater 140 through a fastening mechanism 144. In the exemplary embodiment of FIG. 11, the fastening mechanism 144 is configured as two side plates 162 having a slot 164 extending therebetween for receiving the cassette 142. In the exemplary embodiment, the slot 164 may include a guide (not shown) to assist a user in inserting the cassette 142 into the slot 164. Once inserted into the slot 164, the side plates 162 are fastened around the cassette 142 by two knobs 166. Rotation of the knobs 166 in a first direction moves the side plates 162 closer together to fasten the cassette 142 in position therebetween, whereas rotation of the knobs 166 in a second direction moves the side plates 162 apart to allow the cassette 142 to slide out of the slot 164. The fastening mechanism 144 may be attached to the pole 106 by any means, such as, for example, an adjustable pole clamp, so that the fastening mechanism 144 and heater assembly 138 may be slid along the pole 106 to a desired location.

[0038] The cassette 142 is designed such that the channel sections 158, 160 are substantially aligned with the heater 140 when the cassette 142 is inserted into the slot 164 of the heater assembly 138, as shown in FIG. 11. The heater 140 may include one or more heat sources, such as a series coil using electrical energy in a platen system or fluid supply lines. The heating may be specifically designed and adapted to the flow rate required in a particular application of the system 10. The heater 140 may be located in one or both of the side plates 162. In an exemplary embodiment, the heater 140 covers the entire inner surface area of ​​the plate 162. In another exemplary embodiment, the heater 140 may be located only on the upper portion of one or both of the plates 162. It will be appreciated that the heater 140 may be located anywhere in the heater assembly 138 adjacent to the fluid flowing therethrough.

[0039] The heater assembly 138 can include a heater user interface 168. The heater user interface 168 can simply be a display screen (not shown) that can provide a digital display of the internal temperature of the heater. In another embodiment, the user interface 168 can include temperature adjustment buttons to increase or decrease the temperature of the heater 140. In this embodiment, the heater display screen (not shown) can show the current temperature of the heater as well as the target temperature to be reached. It should be noted that all information output from the heater assembly 138 can be sent directly to the display screen 113 so that the heater user interface 168 is not required.

[0040] In an exemplary embodiment, temperature sensors are mounted within the heater assembly 140 to detect the temperature of the fluid flowing through the cassette 142. The sensors may be located at or near the fluid inlet port 146 and the fluid outlet port 148. In an exemplary embodiment, the temperature sensors may be mounted to detect the temperature of the fluid flowing through the cassette 142 before the fluid enters the channel 154 and after the fluid exits the fluid channel 154. In some embodiments, additional sensors may be located in the middle portion of the channel 154 to detect the progression of the temperature rise of the fluid in the cassette 142. The sensors may remotely send any information to the display screen 113 or may send information to a heater user interface display screen. In another embodiment, the sensors are wired to the heater user interface 168, which may in turn remotely send the desired information to the system display screen 113.

[0041] The fluid management system 10 may include a waste management system 200. An exemplary waste management system may simply be tubing from a fluid waste port in the scope 20 to a drainage bag or collection container 180. Collection of waste may be through a canister on the platform or directly to an alternative system. For example, in the embodiment shown in FIG. 13, one or more waste collection containers or canisters 202 (five in this embodiment) may be used in combination with a vacuum pump (not shown) to draw waste from the patient into the collection containers 202. Although the embodiment herein shows five collection containers, it will be understood that any number of containers may be used. For example, FIG. 34 shows another exemplary embodiment using three collection containers. Tubing 236 connects each of the collection containers 202 to one another in a straight line so that they fill one at a time. In particular, when the first collection container 202 is full, waste begins to flow into the subsequent collection containers until each of the collection containers is full. However, one concern with this "chain" system is that the vacuum (not shown) must be shut off to move a filled waste collection container 202 out of the system and replace it. Additionally, the system 200 is not easily pre-plumbed to be installed and removed as a set when full, potentially increasing vacuum interruption times.

[0042] In FIG. 14, an alternative embodiment waste management system 300 is shown that addresses the concerns of a "chained" system. In this embodiment, five collection containers 302A-302E and a vacuum pump 304 are used, similar to waste management system 200. However, it will be understood that any number of collection containers can be used depending on the procedure. In this embodiment, an intermediate holding chamber 306, a two-position valve 308, and a conventional pinch valve 310 are further included in the system. The intermediate holding chamber 306 is connected to the patient, a first collection container 302A, and a two-position pinch valve 310. The pinch valve 310 is positioned between the intermediate holding chamber 306 and the first collection container 302A, and can be actuated to allow or block the flow of fluid waste into the first collection container 302A. The first collection container 302A is connected to a second container 302B, which is connected to a third container 302C, and so on. Vacuum pump 304 is connected to both the intermediate holding chamber 306 and the final collection vessel 302E through tubing 336 and a two-position pinch valve 308, which is a Y-pinch valve, as shown in Figure 14. The two-position pinch valve 308 can be actuated to allow flow to either the waste collection vessels 302A-302E or the intermediate holding chamber 306.

[0043] In use, waste fluid is pumped from the patient through the intermediate holding chamber 306 and into the waste collection container 302. When the waste collection container 302 becomes full, the pinch valve 310 and two-position valve 308 are actuated to cut off the connection between the patient and the waste collection container 302, preventing the flow of waste into the collection container 302 and allowing the user to replace the full container with an empty one or empty the full container and return it to its original location. When this occurs, the intermediate holding chamber 306 collects waste from the patient until the pinch valves 308, 310 are switched back to again allow flow into the collection container 302. The system 300 thus allows the user to easily replace a used collection container 302 without having to turn off the vacuum 304 or stop the waste flow from the patient.

[0044] 15, in an exemplary embodiment, a two-manifold waste management system 400 is shown. In this embodiment, the waste management system uses one manifold 406 for waste and another manifold 408 for a vacuum pump 404. In particular, one tubing line 410 extends from the patient and branches into individual tubes 410A-410E, each of which extends to a corresponding one of the collection receptacles 402. A second tubing line 412 extends from the vacuum pump 404 and also branches into individual tubes 412A-412E, each of which extends to a corresponding one of the collection receptacles 402A-402E. In this manner, both the patient and the vacuum 404 are individually and separately connected to each of the collection receptacles 402A-402E. As shown in Figure 15, a number of pinch valves 414A-414E, each positioned on a corresponding one of the tubing lines 410A-410E, 412A-412E, are positioned to control waste flow and vacuum suction to a corresponding collection vessel 402A-402E. In use, the pinch valves 414A-414E can be actuated to stop both the vacuum pump 404 and waste flow to an unused collection vessel, controlling flow to only one collection vessel at a time. Similarly, when a collection vessel 402 becomes full, the corresponding pinch valve 414 is actuated to stop the vacuum and waste flow to the full collection vessel, allowing removal of the full collection vessel without impeding waste flow to other collection vessels that have free space.

[0045] FIG. 16 illustrates an exemplary embodiment having a single manifold waste management system 402'. In this embodiment, the waste management system uses a single tubing manifold 406' that connects both the patient and the vacuum pump to each of the individual collection receptacles. In particular, two tubing lines 410' extending from the patient to the vacuum pump 404' branch into individual tubes 410A'-410E' that each extend to a corresponding one of the collection receptacles 402'. As with system 400, each collection receptacle 402A'-402E' has an associated pinch valve 414A'-414E' that controls flow to the corresponding collection receptacle, for example, such that flow can only be allowed to one collection receptacle at a time. That is, the pinch valves can be actuated to allow or block flow to the collection receptacles in any desired combination, allowing removal of a full collection receptacle without impeding waste flow to other collection receptacles that have remaining space.

[0046] In another exemplary embodiment according to FIG. 17, the waste management system 500 includes three vacuum pumps 504 and a two-position pinch valve 506. In this embodiment, each set 502, 502' of two collection containers (502A and 502B in set 502 and 502A' and 502B' in set 502') has its own vacuum pump 504. The individual collection containers 502'' include a pump 504 for the drape. A tubing line 510 extends from the patient and branches at the pinch valve 506 into individual tubes 510', 510'', each of which extends to a corresponding one of the collection container sets 502, 502'. That is, the first collection container 502B, 502B' of each collection container set 502 is connected to the patient through tubes 510' and 510'', respectively, while the second collection container 502A, 502A' of each set 502 is connected to the first collection container 502A, 502A' through tubes 511 and 511', respectively, and to a vacuum pump 514 through tubes 513, 513'. A two-position pinch valve 506 is positioned between the patient and the collection container sets 502 and is actuated to only allow waste to flow into one collection container at a time. This waste flow restriction allows a full waste collection container to be replaced or emptied while flow to the other container continues. In another exemplary embodiment shown in FIG. 18, the system can be used as a two-vacuum system without a drape vacuum.

[0047] In use, the components of the waste management system 200-500 can be arranged in various configurations depending on the procedure to improve accessibility and functionality. In a first embodiment shown in FIG. 19, the waste management system 200 can be mounted to a ceiling 192. It will be understood that any of the waste management systems 300, 400, 400', and 500 can be arranged using various configurations described herein. In this embodiment, the waste collection containers 202 can be snapped into a front shelf 194 and aligned with each other for ease of access and removal. This ceiling mounting assembly 190 keeps floor space clutter-free where space is limited during procedures. In another exemplary embodiment shown in FIG. 20, discussed in more detail below, the waste management system 200 can include a universal mount (not shown) to facilitate mounting, for example, to an IV pole. It will be further understood that the universal mount can be used to mount the waste management system 200 to a wall mount or can be used in a tabletop configuration. In another exemplary embodiment, as can be seen in FIG. 21, the waste collection containers in use can be attached to the IV pole 106 at waist height to allow for easier removal and disposal. In this embodiment, two or four waste collection containers 202 are held within each waist level assembly 196, while standby (not in use) waste collection containers 202 are located on a lower storage platform 198. In another exemplary embodiment shown in FIG. 22, the waste management system can include separate modules for the waste collection containers 202, such as a floor caddy 190'. In this embodiment, the floor caddy 190' can include individual compartments 192' for each of the waste collection containers 202. However, it will be appreciated that the floor caddy 190' can alternatively include a single compartment that holds all of the waste collection containers or a single disposable waste bag 196' as shown in FIG. 23. The floor caddy 190' can be rolled around as needed to get out of the way within the operating room.

[0048] To optimize the ergonomics, accessibility, and functionality of the fluid management system 10, the major subsystems, components, and modules of the fluid management system 10 can be arranged in various configurations depending on the procedure. For example, the locations of the pump, saline bags, touch screen, etc. can be arranged in any configuration desired to optimize access by the surgeon or surgical assistant depending on the procedure being performed. In the exemplary embodiment shown in FIGS. 24-34, the fluid management system 10 is arranged as a vertical stack of major components and modular options on a vertical IV pole 106 having a rolling base 108. This vertical component stack reduces the width of the fluid management system 10 (i.e., the fluid management system 10 is narrower), making the system 10 more compact so that it can be placed in tight areas, e.g., in an operating room. In these embodiments, the pole 106 can include a bend 602 so that each of the components and modular options can be coupled to the front of the pole 106 without disturbing the weight distribution of the system 10 on its lower portion.

[0049] The collection container 202 is positioned in this embodiment in a compact configuration around the bottom of the pole 106. In the exemplary embodiment shown in FIG. 24, the collection container is weighed by a weight hanging mechanism 604. The weight hanging mechanism 604 is coupled to the pole 106 and can include a plurality of individual compartments 606 for loading the collection container 202. In the embodiment of FIG. 24 and FIG. 26, the weight hanging mechanism 604 includes five compartments 606. However, it is understood that any number of collection container compartments 606 can be used depending on the procedure and fluid waste level. Each of the compartments 606 includes a hole (not shown) into which the collection container 202 can be placed. The weight hanging mechanism 604 can include a weight sensor (not shown). In another embodiment, the individual compartments 604 can include a weight sensor (not shown) for detecting a fluctuation in the weight of the container 202 loaded in the respective compartment. In another embodiment shown in FIG. 26-27, the collection container 202 can be loaded onto an individual base plate 610. Each of the base plates 610 can include a weight sensor (not shown) that detects variations in the weight of the collection receptacles 202 loaded on the respective base plate 610. In another exemplary embodiment, the collection receptacles can be loaded into a rotating cartridge 612 as shown in FIG. 28. The cartridge 612 can be rotated manually or automatically. Additional supports 614 can be added to stabilize the cartridge 612 and collection receptacles 202. In this embodiment, the collection receptacles can be weighed in groups or individually. Alternatively, changes in the level of fluid in the collection receptacles can be monitored using an optical level sensor (not shown).

[0050] Based on user preferences or available space constraints, the display unit 616 may or may not be integral to the vertical component stack. For example, it may be preferable to have the display unit 616 positioned on the table at a different viewing angle than any that could be provided if the display were coupled to the pole 106. Alternatively, in another example, integrating the display unit 616 with the stacked components may increase the height of the vertical stack to such an extent that it would not fit within the designated space within the operating room. In these cases, for example, in the embodiment shown in Figures 24 and 27, the display unit 616 is not integrated into the IV pole, but is a separate display unit that would be positioned in a desired location. However, in other embodiments, as can be seen in Figures 25, 28, the display unit 616 may be coupled to the top of the bent IV pole 106. This location of the display unit 616 at the top of the IV pole 106 allows for high visibility by the user while preventing the display unit 161 from being occluded by other components of the system 10. In some embodiments, multiple display screens may be used for multiple imaging schemes. For example, in the embodiment shown in Figures 31 and 34, the system 10 can include an operator display 618 and a surgical display 620. In this embodiment, the display screens 618, 620 can be positioned to improve visibility within the operating room. The display screens 618, 620 can be coupled to the system 10 by a swing hinge 617 to allow the user and / or support staff to move the screen to a desired angle for improved visibility, as shown in Figures 31, 34. In another embodiment shown in Figure 32, the operator display screen 618 can be coupled to the system 10 through a pivot hinge 619. The pivot hinge 619 is a multi-directional hinge that gives the screen more mobility allowing the user to position the screen 618 more easily.

[0051] The positioning of the fluid saline bag 104 may also vary depending on the loading method, height, visualization, and access preferences. In some cases, it may be preferable for the fluid bag 104 to be easily visible by the user. For example, a physician may want to see the rate at which the saline is being used or the level of saline remaining in each fluid bag 104 to know when to change the fluid bag 104. In another example, a procedure may require top or back access for a Y-pinch valve in the tubing. In these embodiments shown in Figures 24-28 and 34, the fluid bag 104 may be mounted on the top of an IV pole. This high mounting allows the user or support staff to easily see the fluid bag 104 while also allowing the tubing 136 to hang down for easy fluid flow. In one embodiment shown in Figure 28 where an external display is mounted on the top of an IV pole, the fluid bag 104 may be positioned behind the display. This rear access allows support staff to access the fluid bags 104 from behind the system 10 without impeding the user's access to the modular components of the system 10. In another exemplary embodiment, the fluid bags 104 can be mounted at the bottom of the modular components of the system 10. For example, as shown in FIG. 35, the fluid bags 104 can be mounted at the bottom of the pump 126. This embodiment includes the best loading access for the user / physician while also allowing good visibility of the fluid bags 104. In another exemplary embodiment shown in FIG. 36, the fluid bags 104 can be mounted in corners. That is, each of the fluid bags 104 can be mounted at an angle to the rear of the modular system. This configuration provides good loading height and rear access for setting or changing the bags by support staff. In another exemplary embodiment shown in FIG. 37, the fluid bags 104 can also be mounted in corners. However, the fluid bags 104 are mounted coaxially to the rear of the modular system instead of at an angle as in FIG. 36.As with the embodiment of FIG. 36, this configuration provides good loading height and rear access for easy setup and saline bag exchange. In some exemplary embodiments, the saline bag hanger can be a retractable hanger. For example, the arms of the hanger can rotate / pivot inwardly to pull the bag closer to the main body. In another example, the arms could themselves be able to extend and retract. This retractable hanger allows for ease of loading and space minimization, especially when multiple bags are hung.

[0052] In vertical stacked embodiments, as can be seen in FIGS. 24-34, the pumps 126 can be organized into vertical groups, horizontal groups, or a combination thereof. That is, in systems 10 where the fluid management unit 100 includes multiple inflow and / or outflow pumps, the pumps 126 can be organized into different groups to promote good fluid flow and provide different fluid flow paths and efficiencies. For example, the high / low flow outflow pumps 622 can be grouped vertically, or the high / low flow outflow pumps 622 can be grouped horizontally, as shown in FIGS. 24-26 and 28. Similarly, the high / low outflow pumps 622 can be grouped vertically with the inflow pumps 624, or can be horizontally aligned with the inflow pumps 624 as in FIG. 27. Furthermore, in some embodiments shown in FIGS. 27-28, the inflow / outflow pumps 624, 622 can have a symmetrical layout with respect to the overall system 10, with the inflow pumps 624 separated from the outflow pumps. Alternatively, the inflow and outflow pumps 624, 622 can be positioned adjacent to one another as shown in Figures 24 and 26. In the exemplary embodiment of Figure 24, the inflow pump 624 can be positioned in a different plane from the rest of the outflow components, including the outflow pump 622. For example, the high / low outflow pump can be positioned at the front or first side of the system, while the inflow pump is positioned on the opposite side of the system. In the exemplary embodiment, the high / low outflow pump is retractable or covered for proper setup. In each of the pump configurations, the connections between the pumps and other modular components of the system 10 are grouped together with the inflow and outflow pump sets.

[0053] In some embodiments of the vertically stacked fluid management system 10, various additional features can be integrated. For example, in one embodiment shown in Figures 29-30, the system 10 can include a filter nest for the irrigation tubing that runs from the patient. The filter nest is used to hold a cylindrical filter that filters the fluid returning from the patient so that it can be reused and pumped back into the patient. In other exemplary embodiments shown in Figures 30-31, the system 10 can include a pinch valve to allow the user to stop the saline flow from the fluid bag 104. In these embodiments, the fluid bag 104 is positioned directly above the rest of the system 10 to create a direct flow path from the fluid bag to, for example, the pump system 126. In the embodiment of Figure 30, the fluid bag hanger 102 can be tilted forward from the pole 106 so that the fluid bag 104 hangs at the front of the unit, allowing for easier flow of fluid as well as better visibility and access by the user.

[0054] In another exemplary embodiment shown in FIGS. 39-42, the fluid management system 10 can be positioned on a modular cart 630 that includes a rolling base 608. The modular cart 630 includes a pole 632 coupled to the side of the modular cart 630 and a flat, clean top surface 634 for placement of the individual modular units. In one embodiment shown in FIG. 39, the individual modular units can be stacked vertically. In particular, the collection container 202 can be positioned below the flat surface 634 at the bottom of the modular cart 630. The collection container 202 can be snapped into a covered container compartment 636 with exposed connections (not shown) to connect the collection container to the patient and the remainder of the fluid management system 10. The fold-out touch screen 638 and the inflow and outflow pumps 624, 622 can be positioned on the clean top surface 634, with the inflow and outflow pumps 624, 622 separated by the touch screen 638. This layout is optimal for a small modular cart and fluid management system 10. In this embodiment, the display unit 616 can be integrated into the modular cart 630 and coupled to the top of a pole 632, with the fluid bag 104 hanging from the bottom of the display unit 616 for easy access by either the user or support staff. By hanging the fluid bag 104 from the display unit 616, the bag 104 is positioned at a preferred loading height. For example, the saline bag can be positioned approximately 48 inches from the ground.

[0055] In another exemplary embodiment of the modular cart-based system shown in FIG. 40, individual modular functional units can be stacked horizontally on a clean top surface 634. In this embodiment, a pole 632 can be coupled to the side of the modular cart 630, and the fluid bags 104 hang from the top of the pole 632. A second side pole 640 for the display unit 616 is positioned on the opposite side of the cart 634. The fluid bags 104 and the display unit 616 are positioned on either side of the modular cart 630 to counterbalance each other and give the modular cart 630 greater stability. The inflow pumps 624 and outflow pumps 622 can be arranged in vertical groups on a flat top surface 634 with a mechanical cover (not shown) or storage mechanism (not shown) for proper configuration. The connections (not shown) are grouped together with the inflow pumps 624 and outflow pumps 622 sets. A touch screen 638 can be positioned on the flat top surface 634. In this embodiment, the collection receptacles 202 may be grouped within a covered compartment 642 positioned on the flat top surface 634, as shown in Figure 40. This elevated positioning of the collection receptacles 202 on the flat top surface 634 allows for easier observation and replacement of the collection receptacles 202 within the compartment 642.

[0056] In some cases, it may be beneficial to have a smaller modular cart configuration. For example, a small cart may be needed when there is very little available space in the operating room. In the exemplary embodiment of FIG. 41, a minimal modular cart arrangement can be seen, including a flat top surface 634 and cart poles 632. In this embodiment, the flat top surface 634 can be positioned approximately 16 inches above the ground, providing just enough space below for the collection containers 202. The collection containers 202 can be grouped in a front section 636 with exposed connections (not shown) for connecting the collection containers 202 to the rest of the fluid management system 10. The poles 632 in this embodiment are positioned at the rear center of the cart 630, and the fluid bags 104 hang by their top portion from the fluid bag hanger 102 for balance reasons and to further increase the stability of the cart 630. All of the functional modular components, i.e., pumps, touch screen, and connections, are positioned in a compact arrangement on the flat top surface 634. In particular, the inflow pump 624 and outflow pump 622 are positioned horizontally and the touch screen 638 is a fold-down touch screen to facilitate a small cart layout. To keep the cart layout as compact as possible, this embodiment uses a separate external display unit 616 that can be placed anywhere else in the room.

[0057] In another exemplary embodiment according to FIG. 42, the modular cart configuration can include multiple stacked modules 644 that can be added or removed depending on the application. The modular cart 630 in this embodiment includes a pole 632 for hanging the fluid bags 104 and a collection container compartment 636 located at the bottom of the cart 630. Each of the modular devices or systems can be positioned on an individual flat top 634 similar to a shelf configured to be coupled to the pole 632. For example, the touch screen 638 can be positioned on one removable flat top 634, the inflow pump 624 and the outflow pump 622 on a second flat top 634, and the heater on a third flat top 634. This removable nature of the flat tops 634 increases the flexibility of the system 10 and allows components of the system 10 to be replaced depending on the patient or procedure. Additionally, accessibility to support staff is increased since fluids can be managed on the cart 630 separately from the modular components of the system. The flat top can be connected to the pole through any suitable coupling mechanism, for example, the flat top can be attached to the pole using screws or mounting hardware.

[0058] The fluid management system 10 can be an open loop system or a closed loop system. As mentioned above, the fluid management system 10 is a modular system that allows for the addition, replacement, or discontinuation of various modular components within the system 10. For example, the system 10 can be configured to include a heater assembly 138 for one application, and the heater assembly 138 can be removed for a different application. The touch screen interface 112 allows for the addition and removal of various modular items, such that feedback and alerts regarding each modular item are displayed to the user on the display screen 113.

[0059] Power may be provided to the fluid management system 10 in any known manner, for example, through a detachable cord. In embodiments, some components may receive power from more than one power source. For example, one or more power supply units may provide appropriate voltages and currents to the various electrical loads. The main processing device 124 may be protected by a backup battery in the event of a power failure or accidental disconnection.

[0060] In an exemplary method of operating the fluid management system 10, a user may hang one or more fluid bags 104 on one or more of the weight sensor hooks 134 extending from the weight sensor 132. The fluid bags 104 are connected to a peristaltic pump 126 through tubing 136. The pump 126 may be connected to a fluid flow inlet port 146 of a heater assembly 138 through another tubing 136. Another tubing 136 may connect a fluid outlet port 148 of the heater assembly 138 to the scope device 20. The operator may then utilize the touch screen interface 112 to configure the fluid management system 10, which may include selecting the surgical regimen, procedure type, modular system being used, and preset fluid pressure, temperature, and flow rate settings, and / or other parameters (e.g., alarm settings, display content and / or configuration). Once the scope 20 is inserted into the target channel (i.e., bladder, ureter) in the patient's body, the user can initiate fluid circulation using the fluid flow on / off button 176 on the scope 20 or a touch button on the touch screen interface 112. Sensors positioned on the scope 20 provide feedback regarding the status of the target anatomical structure within which the scope is positioned, which is then displayed on the display screen 113. If the user selects to place the system 10 in an automatic mode, pump / flow changes can be automatically triggered if pressure, temperature changes, or internal visual feedback from the sensors exceed or fall below certain set points. Such changes can be made, for example, to improve visualization, to flush out blood, urine, clots, or debris, or to compensate for low flow space in the working channel when a tool is inserted through the scope. At the same time, the user and / or the entire surgical team can be alerted to the change by audio or visual alarms. Once the sensors detect that conditions have normalized (ie, the obstruction or tool has been removed), the system 10 will reduce the pump / flow rate.At any point during the procedure, the user can switch the system 10 through the touch screen interface 112 or other physical switches to manually adjust components of the system 10, such as the pump 126. Manual adjustments can be made using the foot pedal 117 or by touch buttons on the display screen 113.

[0061] At the same time, various other modular devices and systems, such as the heater assembly 138, the pump 126, and the fluid shortage monitor system 130, can provide information to the user on the display screen 113 regarding the operating conditions of each system. For example, the heater assembly can display the internal temperature of the heater and of the fluid flowing through the heater assembly 138. In another example, the pump 126 can provide the pump speed to the display screen, and the fluid shortage system can provide the amount of time remaining before the existing fluid bag 104 must be replaced, as discussed above. The user can switch the system 10 to manual mode at any time to manually control each of the modular systems.

[0062] It will be appreciated by those skilled in the art that the present devices and methods are not limited to the disclosed embodiments. For example, the disclosed fluid management system 10 can be used for a variety of other procedures, such as, for example, hysteroscopy, cystoscopy, TURP, etc. That is, the system 10 is not limited to use with ureteroscopes, but rather can be used with other devices, such as cystoscopes, hysteroscopes, or any other device having sensor and imaging capabilities.

[0063] It will be appreciated by those skilled in the art that modifications may be made to the above-described embodiments without departing from the inventive concept thereof. It should be further appreciated that structural features and methods associated with one of the embodiments may be incorporated in other embodiments. It is therefore understood that the present invention is not limited to the specific embodiments disclosed, but rather that modifications are intended to be included within the scope of the present invention as defined by the appended claims. The following describes embodiments of the present invention. (Embodiment 1) A fluid management system comprising: a pump configured to pump fluid from a fluid source through the system at a fluid flow rate; a processor including a user interface to allow a user to input a target pressure and configured to control the pump to maintain a target fluid flow range based on the target pressure; a scoping device coupled to the pump for delivering fluid to a target surgical site, the scoping device including an elongated shaft extending from a distal end thereof, the elongated shaft including at least one sensor that transmits sensor data related to the target surgical site to the processor; Including, The processor automatically sends a signal to the pump to adjust the fluid flow rate based on the sensor data. (Embodiment 2) The system described in embodiment 1, wherein the sensor is a pressure sensor. (Embodiment 3) A system described in embodiment 1 or 2, further comprising a heating assembly configured to heat the fluid to a target temperature. (Embodiment 4) A system described in any one of embodiments 1 to 3, wherein the processor further includes a display screen configured to display the fluid flow rate and sensor data in real time. (Embodiment 5) A system as described in embodiment 4, wherein a visual alarm is displayed on the display screen if the processor detects that the fluid flow rate is outside the target pressure range. (Embodiment 6) A system described in any one of embodiments 1 to 5, wherein the scope device further includes a temperature sensor positioned on the elongated shaft. (Embodiment 7) A system described in any one of embodiments 1 to 6, configured for use in one of a flexible ureteroscopy, hysteroscopy, or cystoscopy procedure. (Embodiment 8) A system described in any one of embodiments 1 to 7, further comprising a weight sensor for measuring the weight of the fluid bag in real time. (Embodiment 9) A fluid management system comprising: a pump configured to pump fluid from the fluid source through the system at a fluid flow rate; a processor configured to control the pump; a scoping device coupled to the pump for delivering fluid to a target surgical site, the scoping device including an elongated shaft extending from a distal end thereof, the elongated shaft including a camera that transmits video feedback related to the target surgical site to the processor; Including, The fluid management system, wherein the processor includes image recognition software for detecting variations in the video feedback and automatically sends a signal to the pump to adjust the fluid flow rate based on the variations. (Embodiment 10) The system described in embodiment 9, wherein the processor includes a user interface that allows a user to input a set of system operating parameters. (Embodiment 11) A system described in embodiment 9 or 10, wherein the processor includes a display screen configured to display the video feedback and the flow rate in real time. (Embodiment 12) A system described in any one of embodiments 9 to 11, wherein the scope device further includes a temperature sensor positioned on the elongated shaft. (Embodiment 13) A system described in any one of embodiments 9 to 12, further comprising a heating assembly configured to heat the fluid to a target temperature. (Embodiment 14) A system described in any one of embodiments 9 to 13, wherein the fluid supply source is a fluid bag. (Embodiment 15) A system described in any one of embodiments 9 to 14, further comprising a weight sensor for measuring the weight of the fluid bag in real time. [Explanation of symbols]

[0064] 10 Modular Fluid Management Systems 20 Scope Device 100 Fluid Management Unit 106 Paul 132 Weight Sensor

Claims

1. 1. A fluid management system comprising: a pump configured to pump fluid from a fluid source through the fluid management system at a first fluid flow rate selected for therapeutic purposes; a processor configured to control the pump; a scoping device coupled to the pump for delivering fluid to a target surgical site, the scoping device including an elongated shaft extending from a distal end thereof, the elongated shaft including a camera that transmits video feedback related to the target surgical site to the processor; Including, the processor includes image recognition software for detecting variations in the video feedback and is configured to automatically send a signal to the pump to adjust from pumping at the first fluid flow rate to pumping at a second fluid flow rate for a predetermined period of time based on the variations in the video feedback to improve images from the camera, and at the end of the predetermined period of time, the pump returns to pumping fluid at the first fluid flow rate; A fluid management system, wherein the variations in the video feedback include variations in brightness, contrast, or color pixelation in an image of the target surgical site.

2. The system of claim 1 , wherein the processor includes a user interface that allows a user to input a set of system operating parameters.

3. 3. The system of claim 1 or 2, wherein the processor includes a display screen configured to display the video feedback and at least one of the first fluid flow rate or the second fluid flow rate in real time.

4. The system of any one of claims 1 to 3, wherein the scope device further comprises a temperature sensor.

5. The system of any one of claims 1 to 4, wherein the scope device further comprises a pressure sensor.

6. The system of claim 5 , wherein the processor automatically sends a signal to the pump to pump fluid at a rate higher or lower than the first fluid flow rate based on data from the pressure sensor.

7. The system of any one of claims 1 to 6, wherein the fluid source is a fluid bag.

8. The system of any preceding claim, wherein the first fluid flow rate and the second fluid flow rate are each greater than zero.

9. The system of claim 1 , wherein the processor is configured to detect a red hue in the image of the target surgical site.

10. The system of claim 1 , wherein the processor is configured to detect excessive brightness in an image of the target surgical site.

11. The system of claim 1 , wherein the processor is configured to detect a cloudy image of the target surgical site.

12. The system of any one of claims 1 to 11, wherein the processor is configured to detect a tool in an image of the target surgical site.

13. The system of claim 12 , wherein the processor automatically sends a signal to the pump to pump fluid at a rate higher than the first fluid rate based on detection of the tool in the image of the target surgical site.

14. The system of any one of claims 1 to 13, wherein the processor is configured to detect a kidney stone at the target surgical site and calculate a rate of migration of the kidney stone.

Images