Heated surgical cannula for providing gas to a patient

Abstract

To provide improved medical equipment.SOLUTION: A surgical cannula for providing insufflation gases to a surgical cavity of a patient (for example, the pneumoperitoneum) and allowing insertion of medical instruments into the surgical cavity through the cannula can include a heater within or coupled to the cannula. The heater can heat the gases and / or the instruments to raise the temperature of the gases and / or instruments above a dew point of the gases to prevent fogging. The heater can also help to defog a lens of a medical instrument by heating to clear the lens and improve optical clarity.SELECTED DRAWING: Figure 3A

Description

[Technical Field]

[0001] The present disclosure relates to humidifier systems and components of humidifier systems for gases delivered to a patient, particularly during a medical procedure. [Background technology]

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

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

[0004] In open medical procedures, e.g., open surgery, gas is used to fill the surgical cavity, with excess gas spilling out through the opening. Gas may also be used to provide a layer of gas over exposed body parts, including, for example, internal body parts without a discernible cavity. In these procedures, gas may not serve to insufflate a cavity, but may be used to prevent or reduce desiccation and infection by covering exposed internal body parts with a layer of heated, humidified, sterile gas.

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

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

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

[0008] Condensation can occur on various surfaces of a medical device. When condensation forms on a visible surface of a medical device, it is observed as a fogging effect that manifests as impaired visibility through a lens or any other visible surface of the medical device (e.g., a mirror or a transparent or translucent window, etc.). When condensation forms on various surfaces of a medical device, it can coalesce into droplets. This can occur directly on the visible surface or can occur on another surface and then migrate to or be deposited on the visible surface. Thus, as used herein, condensation and / or fogging refers to condensation in general and, in some cases, specifically to condensation (i.e., fogging) on ​​visible surfaces. Condensation and / or fogging occurs when the temperature of a gas is below the dew point temperature for the level of humidity contained in the gas and / or when a surface is present that is significantly below the dew point temperature. The human body is in a warm, humid environment with a temperature of approximately 37°C. When a camera or other medical device at a low temperature (e.g., at or below typical room temperature and / or below typical human body temperature) is inserted into this environment, condensation can form as fog on the lens and / or as water droplets on the scope, which can drip onto the lens area. The medical device can be a surgical device. Additional condensation can also form on the inner walls of the cannula at the top of the housing, for example, dripping onto the lens area. Furthermore, although humidifying and heating the insufflation gas can reduce damage to patient tissue within the surgical cavity, humidifying and heating the gas can exacerbate the condensation and / or fogging problem. Condensation can also occur in the absence of external heating or humidification. For example, condensation can result from the inherent temperature (body heat) and humidity (body water) of the surgical cavity and / or from the temperature and humidity of the insufflation fluid.

[0009] The fogging and / or droplets can obstruct visibility, for example, that of a surgeon or other medical personnel participating in a medical procedure (e.g., surgery). When fogging and / or condensation occurs, it may be necessary to remove the camera and / or other medical equipment and wipe it (or them) to remove the fogging and / or droplets. However, removing the medical equipment from the surgical cavity may cause them to cool again below the patient's body temperature. As a result, without any other intervention, for example, pre-heating the medical equipment and / or using a light at the end of the camera to warm the lens, the fogging and / or condensation problem may recur. These interventions require additional products and / or expensive surgical systems. The medical equipment may be surgical equipment. [Means for solving the problem]

[0010] The present disclosure provides examples of cannulas with heating (e.g., using built-in or removable heating elements) that can address the aforementioned and / or other challenges (including, for example, preventing or at least reducing condensation and / or fogging).

[0011] The example heated cannulas disclosed herein can, for example, heat the cannula, instruments, and / or gases entering the surgical cavity environment.

[0012] In some configurations, the gas may be heated by a humidifier before entering the cannula, which can reduce cell damage, reduce cell desiccation, and help reduce post-operative complications such as adhesions.

[0013] In some configurations, the heated cannulas described herein can help reduce fogging and / or condensation by increasing the dew point.

[0014] In some configurations, a portion of the medical device may also be heated during reintroduction of the medical device into the surgical cavity to raise the temperature of the medical device above the dew point. In some configurations, the medical device may be a surgical device.

[0015] In some configurations, the cannula may include additional elements, such as an exhaust passageway configured to exhaust smoke and / or other gases from the surgical cavity.

[0016] In some configurations, a heating element may also be positioned on, within, or around the exhaust passage to heat the exhaust gases and prevent condensation and / or fogging within the exhaust passage.

[0017] In some configurations, the heating element may also be configured to heat a filter located within or adjacent to the cannula. The filter may be located within the gas inlet passage. The filter may filter gases delivered to the surgical cavity. Alternatively or additionally, the filter may also be located within the exhaust passage prior to the exhaust opening. The filter may filter out smoke and / or odors in the exhaust gases before releasing them into the ambient air.

[0018] In some configurations, the heating elements disclosed herein may be configured to heat a filter in the inlet and / or a filter in the exhaust passage.

[0019] In some configurations, the cannula may include a single heater positioned to contact and heat both the inlet filter and the outlet filter simultaneously, or the cannula may include multiple heating elements, at least one associated with the inlet filter and one associated with the outlet filter.

[0020] In some configurations, the heating elements may be independently controlled to heat the inlet and exhaust filters independently.

[0021] In certain instances, a heating element associated with the exhaust filter may be activated during exhaust or when a vent is opened, and a heater associated with the inlet filter may be activated as gas enters the surgical cavity.

[0022] In some configurations, the controller configured to control the heater or heating element may be a controller within the humidifier or may be a separate or independent controller for the heater or heating element.

[0023] In some configurations, the heaters or heating elements disclosed herein may be incorporated into an insufflation cannula configured to deliver insufflation gas to a surgical cavity, an evacuation cannula configured to evacuate gas from a surgical cavity, and / or a cannula having both a gas delivery passageway and an evacuation passageway.

[0024] In some configurations, the cannula may also include retention features that maintain a medical device in a substantially concentric arrangement within the cannula (e.g., within the delivery passage of the cannula) or at least limit radial movement of the medical device. The retainer mechanism may help to allow gas to flow around the medical device when the medical device is inserted within the cannula. As disclosed herein, gas delivered around the medical device and / or within the cannula may be warmed by a heater within the cannula.

[0025] In some configurations, the cannula may also include one or more of the seals.

[0026] In some configurations, the seal may include a heating element.

[0027] In some configurations, the seal can contact a medical instrument inserted into the cannula, which may be a surgical instrument.

[0028] In some configurations, a heating element within the seal can heat the device to reduce and / or remove fogging on the device.

[0029] In some configurations, the heating element can also heat the gas passing through the seal.

[0030] In some configurations, the cannula may also include separate lumens for gas delivery and instrument insertion.

[0031] In some configurations, the heating element may also be configured to heat the gas within the gas delivery lumen to a temperature greater than the standard insufflation gas temperature. When an instrument inserted within the instrument lumen comes into contact with the heated gas, for example, near the exit of the cannula, the heated gas can absorb moisture on the instrument.

[0032] In some configurations, the cannula may include an upper housing defining an inlet and a shaft extending from the housing.

[0033] In some configurations, the shaft may include multiple lumens, i.e., a first lumen for carrying insufflation gases delivered to the surgical cavity and a second lumen for carrying exhaust gases and / or smoke away from the surgical cavity.

[0034] In some configurations, one or more heating elements may be disposed within each lumen and configured to heat the delivered gases and the exhausted gases and / or smoke.

[0035] In some configurations, the cannula may include an upper housing, a shaft extending from the housing, the shaft defining a lumen, a retention mechanism disposed within the lumen for retaining a medical device inserted within the lumen, and a heating element disposed within the lumen or on the retention mechanism for heating the device and / or insufflation gas within the lumen. In some configurations, the medical device may be a surgical device.

[0036] In some configurations, the shaft may include multiple lumens, i.e., a first lumen for carrying insufflation gases delivered to the surgical cavity and a second lumen for carrying exhaust gases and / or smoke away from the surgical cavity.

[0037] In some configurations, the lumen configured to deliver insufflation gas may include a retention mechanism.

[0038] In some configurations, one or more heating elements may be disposed within each lumen and configured to heat the delivered gases and the exhausted gases and / or smoke.

[0039] In some configurations, example heated cannulas disclosed herein can include a guiding element configured to guide a medical instrument, such as a scope or another surgical instrument, within the cannula to hold the medical instrument in a substantially concentric orientation. The guiding element can help hold the medical instrument within the cannula so that the medical instrument does not contact the cannula walls, allowing the medical instrument to be surrounded by gas.

[0040] In some configurations, the heating element may be flexible.

[0041] In some configurations, the heating element may include an arcuate shape.

[0042] In some configurations, the heating element may include a flexible band.

[0043] In some configurations, the heating element may include a heater wire. In some configurations, the heater wire may spiral along the elongate shaft or the cannula upper housing. In some configurations, the heating element may include a flexible or rigid PCB. In some configurations, the heating element may include a thermoelastic plastic material. In some configurations, the thermoelastic plastic material may include a bendable and / or malleable flat sheet.

[0044] The example heated cannulas disclosed herein can prevent condensation and / or fogging by heating the medical device via thermal radiation and / or conduction and / or further heating the insufflation gas, reducing the likelihood that the humidified and heated insufflation gas will fall below (and / or near) the dew point, maintaining the gas temperature for improved heating and humidity therapy, and / or can remove condensation and / or fogging once it has occurred via thermal radiation and conduction, which causes fluid evaporation.

[0045] The example heated cannulas disclosed herein can also reduce and / or prevent condensation within any filters that may be attached to the cannula.

[0046] The example heated cannulas disclosed herein may be advantageous compared to current surgical mitigation techniques that completely remove the medical device from the cannula in order to apply an anti-fogging solution and wipe the medical device because the defogging process is more simplified.

[0047] Because cannulas are a necessary part of certain surgical procedures, e.g., laparoscopic procedures, heated cannulas can allow for cleaning of medical instruments, such as a scope or another surgical instrument, without affecting surgical performance or adding any additional components or complications to the procedure.

[0048] In some configurations, a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passageway for insertion of one or more medical instruments can include a cannula upper housing including an opening. The cannula can include an elongate shaft extending from the cannula upper housing. The shaft can define a hollow passageway for supplying insufflation gas to the surgical cavity. The passageway can also be configured to receive a medical instrument. The cannula can include a heating element disposed on or within at least a portion of the cannula along a longitudinal axis of the cannula. The heating element can be configured to transfer heat to the insufflation gas passing through a portion of the cannula and / or medical instrument, increasing the temperature of the insufflation gas and / or instrument to reduce condensation of the insufflation gas and / or reduce condensation on the medical instrument.

[0049] In some configurations, a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passageway for insertion of one or more medical instruments can include a cannula upper housing including an opening. The cannula can include an elongate shaft extending from the cannula upper housing. The shaft can define a hollow passageway for supplying insufflation gas to the surgical cavity. The passageway can also be configured to receive a medical instrument. The cannula can include a heating element disposed on or within at least a portion of the cannula along a longitudinal axis of the cannula. The heating element can be configured to transfer heat to the insufflation gas passing through a portion of the cannula and / or medical instrument, increasing the temperature of the insufflation gas and / or instrument to reduce and / or prevent condensation of the insufflation gas and / or to reduce and / or prevent condensation and / or fogging on the medical instrument.

[0050] In some configurations, the medical device may be a surgical device.

[0051] In some configurations, the heating element can extend along at least a portion of the length of the elongate shaft, hi some configurations, the heating element can extend along substantially the entire length of the elongate shaft.

[0052] In some configurations, the heating element may be disposed within the wall of the elongate shaft.

[0053] In some configurations, the heating element may be positioned closer to the inner surface of the elongate shaft than to the outer surface.In some configurations, the heating element may be positioned closer to the outer surface of the elongate shaft than to the inner surface.

[0054] In some configurations, the heating element may be located on an inner surface of a sleeve that circumferentially surrounds at least a portion of the elongate shaft.

[0055] In some configurations, the position of the sleeve along the longitudinal axis of the cannula may be variable.

[0056] In some configurations, the heating element may extend the length of at least a portion of the cannula upper housing.

[0057] In some configurations, the heating element may be located within the wall of the cannula upper housing.

[0058] In some configurations, the heating element may be configured to heat the medical device as it is removed from the cannula.

[0059] In some configurations, the heating element may be isolated from the insufflation gas such that the heating element is out of the insufflation gas flow path.

[0060] In some configurations, the heating element may correspond to the cross-sectional profile of the hollow passage and / or opening.

[0061] In some configurations, the heating element may extend at least substantially circumferentially around the hollow passageway of the elongate shaft or the opening in the cannula upper housing.

[0062] In some configurations, the heating element may be flexible.

[0063] In some configurations, the heating element may include an arcuate shape.

[0064] In some configurations, the heating element may include a flexible band.

[0065] In some configurations, the heating element may include a heater wire.

[0066] In some configurations, the heater wire may spiral along the elongate shaft or upper housing of the cannula.

[0067] In some configurations, the heating element may include a flexible or rigid PCB.

[0068] In some configurations, the heating element may include a thermoelastic plastic material.

[0069] In some configurations, the thermoelastic plastic material may comprise a flat sheet that is bendable and / or malleable.

[0070] In some configurations, the cannula may include one or more electrical wires in electrical communication with the heating element. The one or more electrical wires may extend along and / or through the wall of the cannula.

[0071] In some configurations, the cannula may include an inlet for receiving insufflation gas, which may be in fluid communication with an opening in the cannula upper housing and / or a hollow passage in the elongate shaft.

[0072] In some configurations, the inlet may include an electrical connector that may be in electrical communication with one or more electrical wires that may be configured to mate with a corresponding connector on the gas supply tube and provide power to the heating element via the electrical wires.

[0073] In some configurations, the connection between the electrical connector and the corresponding connector may include a socket connection.

[0074] In some configurations, the heating element may be powered by the humidifier controller, an independent controller, or the insufflator controller.

[0075] In some configurations, the elongate shaft can include a second hollow passage.

[0076] In some configurations, the cannula may include a second heating element extending around the second hollow passage.

[0077] In some configurations, the second hollow passage may be offset from the hollow passage and adjacent to a portion of the heating element.

[0078] In some configurations, the elongate shaft may include multiple lumens.

[0079] In some configurations, a heating element may be disposed within one or more lumens to heat gas passing through one or more lumens.

[0080] In some configurations, the elongate shaft can include two lumens, and the heating element can include a first heating element and a second heating element disposed within both lumens, respectively.

[0081] In some configurations, a first heating element can heat the insufflation gases and a second heating element can heat the emitted gases and / or smoke.

[0082] In some configurations, the cannula may include a filter disposed on or within the cannula.

[0083] In some configurations, a heating element may be positioned to heat the filter.

[0084] In some configurations, the heating element may be positioned so that it contacts the filter.

[0085] In some configurations, a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passageway for insertion of one or more medical instruments can include a cannula upper housing including an opening. The cannula can include an elongate shaft extending from the cannula upper housing. The shaft can define a hollow passageway for supplying insufflation gas to the surgical cavity. The passageway can also be configured to receive a medical instrument. The cannula can include a heating element disposed on or within at least a portion of the cannula along a longitudinal axis of the cannula. The heating element can be configured to raise the temperature of the insufflation gas passing through the cannula and / or the instrument above the dew point to reduce condensation of the gas and / or on the medical instrument.

[0086] In some configurations, a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passageway for insertion of one or more medical instruments can include a cannula upper housing including an opening. The cannula can include an elongate shaft extending from the cannula upper housing. The shaft can define a hollow passageway for supplying insufflation gas to the surgical cavity. The passageway can also be configured to receive a medical instrument. The cannula can include a heating element disposed on or within at least a portion of the cannula along a longitudinal axis of the cannula. The heating element can be configured to raise the temperature of the insufflation gas passing through the cannula and / or the instrument above the dew point to reduce and / or prevent condensation of the gas and / or to reduce and / or prevent condensation and / or fogging on the medical instrument.

[0087] In some configurations, the medical device may be a surgical device.

[0088] In some configurations, the heating element can extend along at least a portion of the length of the elongate shaft, hi some configurations, the heating element can extend along substantially the entire length of the elongate shaft.

[0089] In some configurations, the heating element may be disposed within the wall of the elongate shaft.

[0090] In some configurations, the heating element may be positioned closer to the inner surface of the elongate shaft than to the outer surface.In some configurations, the heating element may be positioned closer to the outer surface of the elongate shaft than to the inner surface.

[0091] In some configurations, the heating element may be located on an inner surface of a sleeve that circumferentially surrounds at least a portion of the elongate shaft.

[0092] In some configurations, the position of the sleeve along the longitudinal axis of the cannula may be variable.

[0093] In some configurations, the heating element may extend the length of at least a portion of the cannula upper housing.

[0094] In some configurations, the heating element may be located within the wall of the cannula upper housing.

[0095] In some configurations, the heating element may be configured to heat the medical device as it is removed from the cannula.

[0096] In some configurations, the heating element may be isolated from the insufflation gas such that the heating element is out of the insufflation gas flow path.

[0097] In some configurations, the heating element may correspond to the cross-sectional profile of the hollow passage and / or opening.

[0098] In some configurations, the heating element may extend at least substantially circumferentially around the hollow passageway of the elongate shaft or the opening in the cannula upper housing.

[0099] In some configurations, the heating element may be flexible.

[0100] In some configurations, the heating element may include an arcuate shape.

[0101] In some configurations, the heating element may include a flexible band.

[0102] In some configurations, the heating element may include a heater wire.

[0103] In some configurations, the heater wire may spiral along the elongate shaft or upper housing of the cannula.

[0104] In some configurations, the heating element may include a flexible or rigid PCB.

[0105] In some configurations, the heating element may include a thermoelastic plastic material.

[0106] In some configurations, the thermoelastic plastic material may comprise a flat sheet that is bendable and / or malleable.

[0107] In some configurations, the cannula may include one or more electrical wires in electrical communication with the heating element. The one or more electrical wires may extend along and / or through the wall of the cannula.

[0108] In some configurations, the cannula may include an inlet for receiving insufflation gas, which may be in fluid communication with an opening in the cannula upper housing and / or a hollow passage in the elongate shaft.

[0109] In some configurations, the inlet may include an electrical connector that may be in electrical communication with one or more electrical wires that may be configured to mate with a corresponding connector on the gas supply tube and provide power to the heating element via the electrical wires.

[0110] In some configurations, the connection between the electrical connector and the corresponding connector may include a socket connection.

[0111] In some configurations, the heating element may be powered by the humidifier controller, an independent controller, or the insufflator controller.

[0112] In some configurations, the elongate shaft can include a second hollow passage.

[0113] In some configurations, the cannula may include a second heating element extending around the second hollow passage.

[0114] In some configurations, the second hollow passage may be offset from the hollow passage and adjacent to a portion of the heating element.

[0115] In some configurations, the elongate shaft may include multiple lumens.

[0116] In some configurations, a heating element may be disposed within one or more lumens to heat gas passing through one or more lumens.

[0117] In some configurations, the elongate shaft can include two lumens, and the heating element can include a first heating element and a second heating element disposed within both lumens, respectively.

[0118] In some configurations, a first heating element can heat the insufflation gases and a second heating element can heat the emitted gases and / or smoke.

[0119] In some configurations, the cannula may include a filter disposed on or within the cannula.

[0120] In some configurations, a heating element may be positioned to heat the filter.

[0121] In some configurations, the heating element may be positioned so that it contacts the filter.

[0122] In some configurations, a surgical system for supplying insufflation gas to a surgical cavity may include a gas supply configured to provide the insufflation gas. The surgical system may be an insufflation system. The system may include a humidifier in fluid communication with the gas supply and configured to humidify the insufflation gas received from the gas supply. The system may include any of the surgical cannulas disclosed herein. The system may include gas delivery tubes extending between the humidifier and the surgical cannula and in fluid communication with the humidifier and the surgical cannula, respectively. The gas delivery tubes may be in electrical communication with the humidifier and the surgical cannula, respectively. The gas delivery tubes may conduct the insufflation gas to the surgical cannula and conduct electrical current from the humidifier to a heating element within the surgical cannula.

[0123] In some configurations, the humidifier may be a pass-over humidifier that includes a water chamber configured to hold a quantity of humidifying fluid. In some configurations, the humidifier may be a pass-over humidifier that includes a water chamber configured to hold a quantity of water.

[0124] In some configurations, the humidification chamber may be in fluid communication with the gas supply such that the insufflation gas is humidified by water vapor drawn from a volume of water.

[0125] In some configurations, the humidifier may include a heater plate including a heater plate heating element and a humidification chamber positionable on the heater plate.

[0126] In some configurations, the humidification chamber can be configured to hold a quantity of humidifying fluid that is heated by the heater plate heating element to produce water vapor. The humidification chamber can be in fluid communication with the gas supply such that the insufflation gas is humidified by the water vapor. In some configurations, the humidification chamber can be configured to hold a quantity of water that is heated by the heater plate heating element to produce water vapor. The humidification chamber can be in fluid communication with the gas supply such that the insufflation gas is humidified by the water vapor.

[0127] In some configurations, the humidifier may be located outside the sterile zone.

[0128] In some configurations, the humidifier may be located adjacent to the gas supply.

[0129] In some configurations, the gas supply may be an insufflator.

[0130] In some configurations, the insufflator may be configured to provide a continuous or intermittent flow of gas.

[0131] In some configurations, the gas delivery tube may be a spirally wound tube.

[0132] In some configurations, the electrical circuitry may be located within the wall of the gas delivery tube.

[0133] In some configurations, the surgical cannula may include a filter module removably coupled to or built into the surgical cannula.

[0134] In some configurations, the heating element of the surgical cannula may be placed in contact with or extend into the filter module.

[0135] In some configurations, a method of reducing condensation on a medical device in a body cavity may include inserting a cannula into the body cavity, inserting a medical device through a channel in the cannula, flowing an insufflation gas through the cannula, and heating the insufflation gas immediately adjacent to the medical device sufficiently above a predetermined dew point to prevent or reduce condensation on the medical device.

[0136] In some configurations, a method for reducing condensation and / or fogging on a medical device within a body cavity may include inserting a cannula into the body cavity, inserting a medical device through a channel in the cannula, flowing an insufflation gas through the cannula, and heating the insufflation gas directly adjacent to the medical device sufficiently above a predetermined dew point to prevent or reduce condensation and / or fogging on the medical device.

[0137] In some configurations, the medical device may be a surgical device.

[0138] In some configurations, the medical device may include optical elements, and heating the insufflation gas may be sufficient to prevent or reduce condensation and / or fogging on the optical elements.

[0139] In some configurations, the method may further include measuring a temperature near the optical element and adjusting heating of the insufflation gas sufficiently to maintain a temperature near the optical element above a predetermined dew point.

[0140] In some configurations, a surgical cannula for providing insufflation gases to a surgical cavity and for receiving surgical instruments therein comprises an elongate outer tubular member having opposed proximal and distal end portions and a longitudinal axis extending through the proximal and distal end portions, an elongate inner tubular member having opposed proximal and distal end portions and coaxially disposed within the outer tubular member, the inner tubular member defining a central lumen for introducing surgical instruments, and a distal end portion extending from the outer tubular member. and a plurality of apertures extending within the wall of at least a distal portion of the outer tubular member and in fluid communication with the insufflation passage, the plurality of apertures defining exits for the insufflation gas from the insufflation passage to the surgical cavity; and a heating element may be positioned between the outer surface of the outer tubular member and the inner surface of the inner tubular member, generally parallel to the longitudinal axis.

[0141] In some configurations, the multiple apertures may define a single exit for insufflation gas from the insufflation passageway into the surgical cavity.

[0142] In some configurations, the apertures may be configured to allow insufflation gas to be discharged laterally or obliquely relative to the insufflation passageway.

[0143] In some configurations, the heating element may be embedded in the wall of the outer tubular member or the wall of the inner tubular member.

[0144] In some configurations, the heating element may be located within the air delivery passageway.

[0145] In some configurations, the central lumen may be configured to recirculate gases and / or smoke within the surgical cavity to seal the surgical cavity from ambient air.

[0146] In some configurations, gases and / or smoke within the surgical cavity that recirculate into the central lumen can be configured to provide an air barrier to ambient air.

[0147] In some configurations, the heating element may be powered by a battery, a power plug, or a gas delivery tube coupled to the inlet for insufflation gas.

[0148] In some configurations, a surgical cannula for providing insufflation gases to a surgical cavity and for receiving surgical instruments therein comprises an outer body located at a proximal end of the cannula, an outer elongate shaft extending distally from the outer body, an inner body located at the proximal end of the cannula, and an inner elongate shaft extending distally from the inner body, the inner body and the inner elongate shaft being coaxially disposed within the outer body and the outer elongate shaft, the inner body and the inner elongate shaft defining a central lumen for introducing surgical instruments, and an outer surface of the inner body and the inner elongate shaft. and an inner surface of the outer body and the outer elongate shaft, the delivery passageway communicating with a source of insufflation gas via an insufflation gas inlet; and a plurality of apertures extending within a wall of at least a distal portion of the outer elongate shaft and in fluid communication with the delivery passageway, the plurality of apertures defining exits for the insufflation gas from the delivery passageway to the surgical cavity; and a heating element disposed between the outer surface of the outer elongate shaft and / or outer body and the inner surface of the inner elongate shaft and / or inner body, generally parallel to the longitudinal axis of the cannula.

[0149] In some configurations, the multiple apertures may define a single exit for insufflation gas from the insufflation passageway into the surgical cavity.

[0150] In some configurations, the apertures may be configured to allow insufflation gas to be discharged laterally or obliquely relative to the insufflation passageway.

[0151] In some configurations, the heating element may be embedded in the wall of the outer elongate shaft and / or outer body or the wall of the inner elongate shaft and / or inner body.

[0152] In some configurations, the heating element may be located within the air delivery passageway.

[0153] In some configurations, the central lumen may be configured to recirculate gases and / or smoke within the surgical cavity to seal the surgical cavity from ambient air.

[0154] In some configurations, gases and / or smoke within the surgical cavity that recirculate into the central lumen can be configured to provide an air barrier to ambient air.

[0155] In some configurations, the heating element may be powered by a battery, a power plug, or a gas delivery tube coupled to the inlet for insufflation gas.

[0156] These and other features, aspects, and advantages of the present disclosure will be described with reference to drawings of certain embodiments that are intended to illustrate certain embodiments in a simplified manner and not to limit the disclosure. In some cases, "slices" are shown for clarity in some cross-sectional and transverse views of a three-dimensional cannula. Those skilled in the art will understand from the disclosure herein that these views represent slices of a three-dimensional cannula. In some cases, protruding surfaces are not shown for clarity. For example, protruding hole surfaces are not shown in some views. Certain features, such as any protruding surfaces, including but not limited to protruding hole surfaces, may not be shown in the slices. Those skilled in the art will understand from the disclosure herein that such slices of a three-dimensional cannula may include these features. [Brief explanation of the drawings]

[0157] [Figure 1] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Figure 2A] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Figure 2B] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Figure 2C] 1 illustrates a schematic diagram of an exemplary medical gas delivery device for use in surgery. [Figure 3A]1 shows a perspective view of a cannula with a shaft heater cut along the central longitudinal plane. [Figure 3B] FIG. 1 shows a partial front view of a cannula with a shaft heater taken along a central longitudinal plane. [Figure 3C] 3B shows a cross-sectional view of the cannula of FIG. 3A. [Figure 4A] 1 shows a partial longitudinal cross-sectional view of a cannula having dual concentric lumens. [Figure 4B] 4B shows a cross-sectional view of the cannula of FIG. 4A. [Figure 5A] 1 shows a partial longitudinal cross-sectional view of a cannula having dual offset lumens. [Figure 5B] 5B shows a cross-sectional view of the cannula of FIG. 5A. [Figure 6A] 10 shows a perspective view of another cannula having a heater associated with a portion of the cannula shaft taken along a central longitudinal plane. [Figure 6B] 10 shows a partial front view of another cannula having a heater associated with a portion of the cannula shaft taken along a central longitudinal plane. [Figure 6C] 6B shows a cross-sectional view of the cannula of FIG. 6A. [Figure 7A] 10 shows a perspective view of another cannula having a heater associated with a portion of the cannula shaft taken along a central longitudinal plane. [Figure 7B] 10 shows a partial front view of another cannula having a heater associated with a portion of the cannula shaft taken along a central longitudinal plane. [Figure 7C] 7B shows a cross-sectional view of the entire cannula of FIG. 7A. [Figure 8A] FIG. 1 shows a perspective view of a cannula with a heater sleeve. [Figure 8B] 1 shows a partial longitudinal cross-sectional view of a cannula having a heater sleeve. [Figure 8C] 8B shows a cross-sectional view of the cannula of FIG. 8A. [Figure 9A] FIG. 1 shows a perspective view of a cannula with a body heater cut along the central longitudinal plane. [Figure 9B] FIG. 1 shows a partial front view of a cannula with a body heater taken along a central longitudinal plane. [Figure 9C] 9B shows a cross-sectional view of the cannula of FIG. 9A. [Figure 10A] 1 shows an example of a heat seal within a cannula. [Figure 10B] 1 shows an example of a heat seal within a cannula. [Figure 10C] 1 shows an example of a heat seal within a cannula. [Figure 10D] 1 shows an example of a heat seal within a cannula. [Figure 10E] 1 shows an example of a heat seal within a cannula. [Figure 10F] 1 shows an example of a heat seal within a cannula. [Figure 10G] 1 shows an example of a heat seal within a cannula. [Figure 10H] 1 shows an example of a heat seal within a cannula. [Figure 11A] 1 illustrates heated gas flow within a concentric multi-lumen cannula. [Figure 11B] 1 illustrates heated gas flow within a concentric multi-lumen cannula. [Figure 11C] 1 illustrates heated gas flow within a concentric multi-lumen cannula. [Figure 12A] 1 shows an example of a heating element within a cannula. [Figure 12B] 1 shows an example of a heating element within a cannula. [Figure 12C] 1 shows an example of a heating element within a cannula. [Figure 12D] 1 shows an example of a heating element within a cannula. [Figure 13A] 10 shows a further example of a separate configuration of the power supply to the heating element. [Figure 13B] 10 illustrates a further example connection configuration of a power supply to a heating element. [Figure 14A] 10A-10C illustrate schematic power supply options for the heating element within the cannula. [Figure 14B] 10A-10C illustrate schematic power supply options for the heating element within the cannula. [Figure 14C] 10A-10C illustrate schematic power supply options for the heating element within the cannula. [Figure 15A] 10A-10C show schematic diagrams of heating effect options for heated cannulae. [Figure 15B] 10A-10C show schematic diagrams of heating effect options for heated cannulae. [Figure 15C] 10A-10C show schematic diagrams of heating effect options for heated cannulae. [Figure 16A] 1 shows a schematic cross-sectional view of a pneumatically sealed heated cannula. [Figure 16B] 1 shows a schematic cross-sectional view of a pneumatically sealed heated cannula. [Figure 16C] 1 shows a schematic cross-sectional view of a pneumatically sealed heated cannula. [Figure 16D] 1 shows a schematic cross-sectional view of a pneumatically sealed heated cannula. DETAILED DESCRIPTION OF THE INVENTION

[0158] While specific embodiments and examples are described below, those skilled in the art will recognize that the present disclosure extends beyond the specifically disclosed embodiments and / or uses and obvious modifications and equivalents thereof. Accordingly, it is not intended that the scope of the disclosure disclosed herein be limited by any particular embodiments described below.

[0159] Exemplary Medical Gas Delivery System Fluids, such as gas, can be introduced into a surgical cavity, such as the peritoneal cavity, through a cannula inserted through an incision made in the patient's body (e.g., the abdominal wall). The cannula can be coupled to an insufflator. Gas flow from the insufflator can be increased to inflate the surgical cavity (e.g., to maintain pneumoperitoneum, a gas-filled cavity within the abdomen). The introduced gas can inflate the surgical cavity. Medical instruments can be inserted into the inflated surgical cavity through the cannula. The medical instruments may be surgical instruments. For example, an endoscope, another visual system, including but not limited to a scope or camera unit, can be inserted into the cavity, and visibility within the cavity can be aided by the insertion of gas, which can be air and / or other fluids, such as carbon dioxide. After initial insufflation through the cannula and insertion of instruments (e.g., a laparoscope), additional cannulas can be inserted into the surgical cavity under laparoscopic observation. At the end of the surgical procedure, all instruments and cannulas are removed from the surgical cavity, the gas is vented, and each incision is closed. For thoracoscopy, colonoscopy, sigmoidoscopy, gastroscopy, bronchoscopy, and / or others, the same or substantially similar procedures can be followed to introduce gas into the surgical cavity. The amount and flow of gas can be controlled by the clinician performing the procedure and / or automatically by the surgical system. The surgical system can be an insufflation system.

[0160] 1 and 2A-2B schematically illustrate the use of an exemplary surgical system 1 during a medical procedure. Features of FIG. 1 and FIG. 2A-2B may be incorporated into one another. Like features have like reference numerals in FIG. 1 and FIG. 2A-2B. As shown in FIG. 1, patient 2 may have a cannula 15 inserted into a cavity of patient 2 (e.g., the abdomen of patient 2 in the case of laparoscopic surgery), as described above.

[0161] As shown in FIGS. 1 and 2A-2B, a cannula 15 may be connected to a gas delivery conduit 13 (e.g., via a Luer lock connector 4). The cannula 15 may be used to deliver gas to a surgical site, for example, within a cavity of a patient 2. The cannula 15 may include one or more passageways for introducing gas and / or one or more surgical instruments 20 into the surgical cavity. The surgical instruments may be, among others, a scope, an electrocautery instrument, an electrosurgical instrument, an energy and laser ablation and / or cauterization instrument, or any other instrument. The surgical instruments 20 may be coupled to an imaging device 30, which may have a screen. The imaging device 30 may be part of a surgical system, which may include multiple surgical instruments and / or devices. The surgical system may be a surgical stack.

[0162] As shown in FIG. 2A , the system may also include a drainage cannula 22. The drainage cannula 22 may have substantially the same features as the cannula 15. The drainage cannula may include a valve to allow drainage. The valve may be automatically controlled by a controller associated with the gas source (i.e., the insufflator), a controller within the humidifier, or an independent controller for the system. The valve may also be manually actuated (e.g., by turning a stopcock by hand, foot pedal, or other means). The drainage cannula 22 may be coupled to a filtration system for filtering smoke, etc. Alternatively, the drainage cannula 22 may also be coupled to a recirculation system configured to recirculate gas from the surgical cavity to the insufflator for redelivery to the surgical cavity. The gas may be filtered and / or dehumidified before being returned to the insufflator. In certain configurations, the cannula 15 may include two or more passageways. One passageway may be configured to deliver gas and / or medical devices to the surgical cavity. Another passageway may be configured to evacuate gas from the surgical cavity. The evacuation passageway may include a valve and / or a passive evacuation opening. The cannula 15 may also include a retention feature (e.g., ribs, etc.) to hold a medical instrument (e.g., a scope or another surgical instrument) in a substantially concentric orientation relative to the delivery passageway. As shown in Figures 2B and 2C, the same cannula 15 can be used for both gas delivery and evacuation.

[0163] The gas delivery conduit 13 may be made of flexible plastic and may be connected to the humidifier chamber 5. Optionally or preferably, the humidifier chamber 5 may be connected in series to the gas supply 9 via a further conduit 10. The gas supply or gas source may be an insufflator, bottled gas, or a wall gas source. The gas supply 9 may provide gas without humidification and / or heating. A filter 6 may be connected downstream of the humidifier outlet 11. A filter may also be located along the further conduit 10 or at the inlet of the cannula 15. The filter may be configured to filter out pathogens and particulate matter to reduce infection or contamination of the surgical site by the humidifier or gas source. The gas supply may provide a continuous or intermittent flow of gas. The further conduit 10 may also preferably be made of flexible plastic tubing.

[0164] The gas supply 9 can provide one or more insufflation fluids, including liquids and / or gases, such as carbon dioxide, to the humidifier chamber 5. The gas supply can provide a continuous or intermittent gas flow. The gas can be humidified as it passes through the humidifier chamber 5, which can contain a volume of water or any other type of humidifying fluid 8. As shown in FIG. 2C, the gas supply can also be connected directly to the cannula 15 without a humidifier unit. The gas can be a dry, cold gas, a dry, hot gas, a humidified gas, or others. The gas supply 9 can include two gas sources.

[0165] A humidifier incorporating the humidifier chamber 5 can be any type of humidifier. The humidifier chamber 5 can include a chamber formed of plastic having a metal or other conductive bottom 14 sealed thereto. During use, the bottom can be in contact with a heater plate 16. A quantity of water 8 contained within the chamber 5 can be heated by the heater plate 16. The heater plate 16 can be under the control of a humidifier controller or control means 21. The quantity of water 8 within the chamber 5 can be heated to vaporize, causing the water vapor to mix with the gas flowing within the chamber 5, heating and humidifying the gas.

[0166] The controller or control means 21 may be housed within the humidifier base unit 3. The humidifier base unit 3 may also house the heater plate 16. The heater plate 16 may have an electric heating element within it or in thermal contact with it. One or more insulating layers may be located between the heater plate 16 and the heater element. The heater element may be a base element (or core) with a wire wound around it. The wire may be nichrome wire (or nickel-chromium wire). The heater element may also include a multilayer substrate with electrodeposited or etched heating tracks. The controller or control means 21 may include electronic circuitry, which may include a microprocessor, for controlling the supply of energy to the heating element. The humidifier base unit 3 and / or heater plate 16 may be removably engageable with the humidifier chamber 5. Alternatively or additionally, the humidifier chamber 5 may include a built-in heater. Alternatively, the controller or control means 21 may be housed or partly housed external to the humidifier base unit 3 .

[0167] The heater plate 16 may include a temperature sensor, such as a temperature transducer or otherwise, that may be electrically connected to the controller 21. The heater plate temperature sensor may be located within the humidifier base unit 3. The controller 21 may monitor the temperature of the heater plate 16, thereby estimating the temperature of the water 8.

[0168] A temperature sensor may also be located at or near the outlet 11 to monitor the temperature of the humidified gas exiting the humidifier chamber 5 through the outlet 11. The temperature sensor may also be connected (e.g., by cable or wirelessly) to the controller 21. Additional sensors may also be incorporated to detect properties of the gas (e.g., temperature, humidity, flow, or other) at the patient end of the gas delivery conduit 13, for example.

[0169] Gas can exit through the humidifier outlet 11 and enter the gas delivery conduit 13. The gas can pass through the gas delivery conduit 13 and enter the surgical cavity of the patient 2 via the cannula 15, thereby expanding the cavity and maintaining intracavity pressure. The gas delivery conduit 13 can be made of plastic or other suitable material. Preferably, the gas exiting the humidifier chamber 5 outlet 11 can have a relative humidity of up to 100%, e.g., about 100%. As the gas travels along the gas delivery conduit 13, additional condensation can occur, causing water vapor to condense on the walls of the gas delivery conduit 13. Additional condensation can have undesirable effects, such as adversely reducing the moisture content of the gas delivered to the patient. To reduce and / or minimize the occurrence of condensation within the gas delivery conduit 13, a heater wire 14 can be provided within, throughout, or around the gas delivery conduit 13. To power the heater wire 14, the heater wire 14 may be electronically connected to the humidifier base unit 3, for example by an electrical cable 19.

[0170] The heater wire 14 may include insulated copper alloy resistance wire, other types of resistance wire, or other heater elements, and / or may be made of any other suitable material. The heater wire may be a straight or spirally wound element. An electrical circuit including the heater wire 14 may be located within the wall of the gas delivery tube 13. The gas delivery tube 13 may be a spirally wound tube. The heater wire 14 may be spirally wound around an insulating core of the gas delivery conduit 13. The insulating coating around the heater wire 14 may include a thermoplastic material. The thermoplastic material may be heated to a predetermined temperature, allowing it to change shape, and upon cooling, may substantially elastically retain the new shape. The heater wire 14 may be wound into a single or double helix. Measurements by the temperature sensor at the patient end of the conduit 13 and / or additional sensors may provide feedback to the controller 21 so that the controller 21 can energize the heater wire to increase and / or maintain the temperature of the gas in the gas delivery conduit 13 (e.g., above or below a body temperature of about 37°C, e.g., above or below body temperature by, for example, 1°C, 2°C, 3°C, 4°C, 5°C, 6°C, 7°C, 8°C, 9°C, 10°C, or 15°C, or above or below 15°C, or above or below a range including any two of the foregoing values).

[0171] The controller or control means 21 may include, for example, a microprocessor or logic circuit with associated memory or storage means capable of holding a software program. When executed by the control means 21, the software can control the operation of the surgical system 1 according to the instructions set therein and / or in response to external inputs. The surgical system may be an air delivery system. For example, the heater plate 16 may provide input to the controller or control means 21, providing the controller or control means 21 with information regarding the temperature and / or power usage of the heater plate 16. The controller or control means 21 may provide an input of the temperature of the gas flow. For example, a temperature sensor may provide an input indicating the temperature of the humidified gas flow as the gas exits the outlet 11 of the humidifier chamber 5. A flow sensor may also be provided at or near the same location as the temperature sensor or at another suitable location within the surgical system 1. The controller 21 may control a flow controller that regulates the flow of gas through the system 1. The flow controller may be a flow regulator. The flow controller may include a flow inducer and / or inhibitor, such as, for example, an electrically operated fan. Additionally or alternatively, valves and / or vents may be used to control the flow rate of the gas.

[0172] A patient input 18 located on the humidifier base unit 3 may allow a user (e.g., a surgeon or nurse) to set the desired gas temperature and / or gas humidity level to be delivered. Other functions may also be controllable by the user input 18, such as control of the heating delivered by the heater wire 14. A controller 21 may control the system 1, and in particular, the flow rate, temperature, and / or humidity of the gas delivered to the patient, as appropriate for the type of medical procedure for which the system 1 is being used.

[0173] The humidifier base unit 3 may also include a display for displaying to the user the characteristics of the gas flow being delivered to the patient 2 .

[0174] Although not shown, the humidifier may also be a pass-over or bypass humidifier that may include a chamber with a volume of water or any other type of humidifying fluid, but may not include a heater plate for heating the humidifying fluid. The chamber may be in fluid communication with a gas supply such that the insufflation gas is humidified by the humidifying fluid wicked up from the volume of water as the insufflation gas passes over the volume of humidifying fluid.

[0175] In use, the humidifier described above can be located outside the operating sterile zone and / or adjacent to the insufflator. As a result, medical personnel do not need to touch the humidifier when moving a cannula to manipulate medical instruments within the surgical cavity during surgery. The medical instruments may include surgical instruments. The humidifier may not need to be as sterilized as the medical instruments. Furthermore, a humidifier located outside the operating sterile zone reduces obstacles to medical personnel that may limit their and / or medical instrument movement within an already crowded space during a surgical procedure.

[0176] Example of a heated cannula Condensation and / or fogging occurs when the temperature of the gas falls below the dew point temperature for the humidity level contained in the gas and / or when surfaces are present that are significantly below the dew point temperature. Referring to FIGS. 1 and 2, as insufflation gas travels from gas delivery tube 13 to cannula 15, the heated and humidified gas may cool to near the dew point within cannula 15 if cannula 15 is not heated. Furthermore, as discussed above, one or more medical devices, such as a camera, surgical scope, and / or other surgical instruments, that are at a lower temperature than the human body, may be inserted into the surgical cavity via cannula 15. This can cause humidified gas to condense as fogging on lenses and / or as droplets on the surgical scope, potentially dripping onto the lens area. The fogging and / or droplets can obstruct vision, for example, that of a surgeon or other medical personnel participating in the procedure. Removal of the medical device to wipe off the condensation and / or droplets can delay the surgical procedure and / or result in further condensation and / or condensation occurring repeatedly upon reinsertion of the medical device, which may have cooled when removed from the surgical cavity.

[0177] The present disclosure provides examples of cannulas that can be used as the cannulas 15 disclosed herein and that include built-in heating to reduce, prevent, and / or remove condensation and / or fogging on medical devices without the need for additional components or tools. The medical devices may include surgical devices. The cannulas may be single-use (disposable) or reusable. Alternatively, parts of the cannulas may be single-use (disposable) or reusable. The cannulas may be made of biocompatible and / or sterilizable materials. Features of different examples of heated cannulas may be incorporated or combined with each other in the present disclosure.

[0178] The exemplary heated cannula disclosed herein can be implemented into existing surgical systems without the need for custom and / or more expensive surgical systems. The surgical system can be an insufflation system. Accordingly, the exemplary heated cannula disclosed herein can improve the optical clarity of camera lenses and / or maintain clear vision, help minimize surgical time and postoperative pain and / or complications, and / or make it easier for medical personnel, e.g., surgeons, to manipulate the cannula within a surgical cavity during a medical procedure. Heating the cannula can also allow for better control of insufflation therapy, for example, by increasing or maintaining the temperature and / or humidity of the gas delivered to the patient. Heat transferred to the cannula can be transferred via the heated gas to a medical device inserted within the cannula. Thus, for example, heating the gas flow using the exemplary heating elements disclosed herein can maintain therapeutic temperatures and / or conditions of the insufflation gas, reduce and / or prevent condensation in the exhaust path, reduce and / or prevent condensation in the delivery path, and / or maintain therapeutic effectiveness. The medical device may be a surgical device.

[0179] An exemplary heated cannula may have any of the features of the cannula 15 described above. For example, the heated cannula may have a cannula upper housing 102 connected to an elongate shaft 104. The cannula upper housing 102 may house one or more instrument seals. The upper housing 102 may define an opening. The elongate shaft 104 may have a tapered end so that the cannula can function as a trocar to more easily insert the cannula 15 into a surgical cavity. The trocar may include a cannula and an obturator. The cannula upper housing 102 may have a larger cross-sectional dimension than the elongate shaft 104 to more easily insert a medical instrument. The medical instrument may include a surgical instrument. As shown in FIG. 2A , the cannula upper housing 102 may have a generally funnel-shaped cross-sectional dimension (e.g., diameter) that decreases from a position distal to the elongate shaft 104 to a position proximal to the elongate shaft 104. The gas inlet 106 may be located in the cannula upper housing 102. The cannula upper housing 102 may include a cavity. The elongate shaft 104 may include a hollow passageway. The cavity and hollow passageway may be in fluid communication. The heated cannula may include a heating element removably coupled to or built into the heated cannula (e.g., via a sleeve) (e.g., at least a portion of the cannula upper housing 102 and / or a portion of the elongate shaft 104). The heated cannula may include a filter module removably coupled to or built into the cannula (e.g., located proximally in the cannula upper housing 102 or in a sleeve (described below) attached to or connected to the cannula via tubing). The heating element may be positioned to contact the filter module or extend into the filter module.

[0180] A surgical system for supplying insufflation gas to a surgical cavity, such as any of the surgical systems disclosed above (which may include an insufflation system), can incorporate any of the exemplary heated cannulas disclosed herein. As described above, the system can include a gas supply configured to provide insufflation gas, a humidifier in fluid communication with the gas supply and configured to humidify the insufflation gas received from the gas supply, and a gas delivery tube extending between the humidifier and the cannula and in fluid communication with the humidifier and the cannula, respectively. The gas delivery tube can also be in electrical communication with the humidifier and the cannula, respectively. When the system is in use, the gas delivery tube can conduct insufflation gas to the surgical cannula and can conduct electrical current from the humidifier to a heating element within the cannula. The heating element may be configured to transfer heat to the insufflation gas passing through the cannula and / or a portion of the medical device inserted into and / or removed from the cannula, raising the temperature of the gas and / or device and reducing and / or preventing condensation and / or fogging. The temperature of the insufflation gas and / or device may be raised above the dew point to prevent condensation of the gas and / or reduce and / or prevent condensation and / or fogging on the medical device (and / or remove already formed condensation and / or fogging by evaporation). The temperature of the insufflation gas and / or device (on or near optical elements, e.g., a camera lens, or other areas of the device) may also be measured, for example, by thermocouples and / or other sensors, and closed-loop feedback may be provided to the controller to maintain the temperature near the device at a predetermined or calculated value, e.g., at or above the dew point. The medical device may be a surgical device.

[0181] The heating elements disclosed herein can also be mounted within an evacuation cannula configured to evacuate gases and / or smoke from a surgical cavity, such as evacuation cannula 22. Heating the evacuated gases and / or a filter within the evacuation cannula can reduce and / or prevent condensation and / or clogging of the evacuation filter.

[0182] More detailed examples of heating elements are described below with reference to Figures 3A-11B. As described herein, a proximal direction relative to a medical device may generally refer to the upper end of the medical device body, while a distal direction relative to a medical device may generally refer to the lower end of the medical device body, which is configured to be the first section of the medical device inserted into a cannula and / or surgical cavity. Reference numbers for the same or substantially the same features share the same last two digits.

[0183] Example of a cannula shaft and associated heater Figures 3A-8C show examples of cannulas with heating elements located along the elongate shaft. Figures 3A, 6A, and 7A show perspective views of cannulas 300, 600, 700 cut along the central longitudinal plane to better show the heating elements 310, 610, 710.

[0184] As shown in FIGS. 3A-3C , the cannula 300 may include a cannula upper housing 302 and an elongate shaft 304 extending from the cannula upper housing 302. The free end 308 of the elongate shaft 304 may have a tapered or sharp end 308 or a square tip. The cannula upper housing 302 may have a cavity 312, which may be in fluid communication (e.g., connected or continuous) with a hollow passage 314 of the elongate shaft 304. The cannula 300 may include a gas inlet 306 coupled to a wall of the cannula upper housing 302. The gas inlet 306 may be connected to a gas delivery tube of a surgical system (e.g., an insufflation system and / or any of the systems disclosed herein). As shown in FIG. 3B, the inlet 306 can be in fluid communication with a cavity 312 in the cannula upper housing 302 and / or a hollow passage 314 in the elongate shaft 304 .

[0185] The heating element 310 can be embedded in the wall of the elongate shaft 304. The heating element 310 can be molded into the wall of the elongate shaft 304. As described in the present disclosure, when a component, such as a heating element, is molded into the wall of the elongate shaft, the component can be at the edge of the wall of the elongate shaft or embedded within the wall of the elongate shaft. As shown in FIGS. 3A and 3B, the heating element 310 can extend substantially along the entire length of the elongate shaft 310. The heating element 310 can be flexible. As shown in FIG. 3C, the heating element 310 can conform to the cross-sectional profile of the elongate shaft 304. The heating element 310 can extend circumferentially or at least substantially circumferentially around the hollow passage 314 of the elongate shaft 304. The heating element 310 can also extend at least about halfway around the circumference of the elongate shaft 304. The heating element 310 may also include additional circuitry and / or electrical insulation to avoid short circuits or shocking the patient or user. The heating element 310 can be removed from the insufflation gas flow path and does not contact the insufflation gas or medical equipment inserted through the hollow passage 314. The medical equipment may include surgical equipment. Isolating the heating element 310 from the insufflation gas flow path by embedding the heating element 310 within the wall of the elongate shaft 304 can reduce and / or avoid contamination from, for example, connecting the heating element 310 to wiring that may not be sterile. Isolating the heating element 310 by embedding the heating element 310 within the wall of the elongate shaft 304 can also help reduce short circuits.

[0186] The electrical wires 316 can be in electrical communication with the heating element 310. The electrical wires 316 can be connected to the end of the heating element 310 closest to the cannula upper housing 302. This allows the wires 316 to be further away from the patient than if they were connected closer to the free end 308 of the elongate shaft 304. The electrical wires 316 can be in electrical communication with the electrical circuitry of a surgical system, such as a humidifier in any of the surgical systems described above (e.g., an insufflation system), so that the heating element 310 is powered by the humidifier's controller. More than one electrical wire can also be connected to the heating element 310. Alternatively, the heating element 310 can be powered by an additional independent controller housed within the humidifier or housed within the insufflator. In yet another configuration, the heating element 310 can be powered by any other controller within the surgical system. In the present disclosure, any heating element within the cannula may be controlled by a controller within the insufflator, cannula, humidifier, or any other controller external to the insufflator, cannula, and humidifier.

[0187] The heating element 310 may be configured to transfer heat to the insufflation gas passing through the elongate shaft before the insufflation gas exiting the elongate shaft reaches a medical device and / or portion of a medical device inserted within the hollow passage 314 of the elongate shaft 304 of the cannula 300, raising the temperature of the gas and / or device to reduce and / or prevent condensation (e.g., within the lumen of the elongate shaft 304 and / or on the medical device) and / or fogging (e.g., on a lens of the medical device). The medical device may be a surgical device. The heating element 310 may raise the temperature of the insufflation gas and / or medical device above the dew point to reduce and / or prevent condensation of the gas and / or reduce (and / or eliminate) condensation and / or fogging on the medical device. The heating element 310 may also enable better control of the therapy provided by the surgical system.

[0188] 4A-4B and 5A-5B show surgical cannulas 400, 500 which may have any of the features of cannula 300, except that cannula 400, 500 may include second hollow passages or lumens 418, 518 extending along cavities 412, 512 and hollow passages 414, 514.

[0189] As shown in FIGS. 4A and 4B , the second lumen 418 may be located within and generally concentric with the cavity 412 and hollow passage 414. The inlet 406 may not be in fluid communication with the second lumen 418, such that insufflation gas cannot enter the second lumen 418. The cannula 400 may include a second heating element 420 located within the wall of the second lumen 418. The second heating element 420 may have any of the features of the heating elements 310, 410 disclosed herein. For example, the second heating element 420 may extend around the circumference of the second lumen 418, or may extend substantially around the circumference of the second lumen 418, or may extend partially around the circumference of the second lumen 418. The second heating element 420 may be located along the length of the elongate shaft 404 and / or may have substantially the same length as the heating element 410. When one or more medical devices are inserted into the second lumen 418, the second heating element 420 may heat the medical devices (e.g., a medical scope, including but not limited to optical lenses, sensors, or other elements on the scope) to ensure that fogging and / or condensation on the medical devices is prevented, reduced, and / or eliminated. The medical devices may include surgical instruments. As described above, one or more electrical wires 416 may connect to the heating element 410 and the second heating element 420 and energize the heating element 410 and the second heating element 420.

[0190] As shown in FIGS. 5A and 5B , the second lumen 518 can be offset from the cavity 512 and the hollow passage 514. The inlet 516 can be out of fluid communication with the second lumen 518, such that insufflation gas cannot enter the second lumen 518. As shown in the cross-sectional view of FIG. 5B , the wall of the elongate shaft 504 can have a thicker or bulged section 519 relative to the remainder of the wall to accommodate the offset second lumen 518. The heating element 510 can extend around, or at least substantially around, the hollow passage 514, such that the heating element 510 extends into the thicker section 519 of the wall. The close proximity of a portion of the heating element 510 to the offset second lumen 518 can ensure that a medical device advanced within the hollow passage 514 and / or second lumen 518 can be heated, preventing, reducing, and / or eliminating condensation and / or fogging on the medical device. The medical device may include a surgical device.

[0191] The exemplary cannulas shown in Figures 4A-4B and 5A-5B can be used to deliver gases to and evacuate gases from the surgical cavity. A dual lumen cannula can be used to deliver gases and evacuate smoke / gas simultaneously. A dual lumen cannula can provide a single cannula that can both deliver gases and evacuate gases.

[0192] 6A-6C and 7A-7C, cannulae 600, 700 may have any of the features of cannulae 300, 400, 500, except as described below. Features of cannulae 600, 700 may be incorporated into features of cannulae 300, 400, 500, and features of cannulae 300, 400, 500 may be incorporated into features of cannulae 600, 700. Heating element 610, 710 may extend along a shorter portion of elongate shaft 604 compared to the heating element shown in FIGS. 3A-5B.

[0193] 6A-6C, the heating element 610 can be embedded in the wall of the elongate shaft 604 and can extend from the free end 608 of the shaft 604 for a predetermined length of the elongate shaft 604. The heating element 610 can be positioned adjacent the exit of the cannula. The heating element may also extend only a short distance along the shaft to provide more localized heating (e.g., at or near the lens of a scope inserted in the cannula).

[0194] As shown in FIGS. 7A-7C , the elongate shaft 704 may include multiple (e.g., two, three, or more) instrument holders or ribs 722 extending radially inward from the inner surface of the hollow passage 714. The ribs 722 may be shorter than the elongate shaft 704. The ribs 722 may be substantially evenly distributed around the hollow passage 714 or may be irregularly spaced apart. The instrument holders or ribs 722 may be configured to radially stabilize a medical instrument inserted into the hollow passage 704. The medical instrument may be a surgical instrument. The ribs 722 may be located closer to the free end 708 of the elongate shaft 704 than the portion of the shaft 704 connected to the cannula upper housing 702. Each rib 722 may include a heating element 710 embedded therein such that the heating element 710 may be isolated from the gas path. One or more electrical wires 716 can be connected to each of the heating elements 710. The ribs 722 are therefore configured to heat the gas and are structured to heat a medical device inserted within the cannula by conduction. The ribs 722 may grip the medical device or act as a limit to the radial movement of the medical device within the cannula. The ribs 722 can prevent the medical device from resting on the walls of the cannula. The ribs 722 can maintain the medical device in a substantially concentric arrangement with respect to the hollow passage 714. The ribs 722 can ensure that the heated gas flows around the medical device when the medical device is inserted within the hollow passage 714.

[0195] The ribs may also be elongate and extend the entire length of the cannula shaft. Heating elements within the ribs may transfer heat to the cannula by conduction (e.g., by contact with gases and / or medical devices). Ribs may also optionally be present near the exit of the cannula, near the entrance of the cannula shaft, or in other areas along the cannula shaft.

[0196] The cannula may also include multiple rib sets. Each rib set may include multiple ribs. One or more ribs in each set may include a heating element disposed therein. For example, every other rib in each set may include a heating element. A first rib set may be located in an upper region closer to (e.g., adjacent to) the entrance of the cannula shaft. A second rib set may be located closer to (e.g., adjacent to) the exit of the cannula. The multiple rib sets may be spaced apart from one another.

[0197] One or more electrical wires 616, 716 connecting to the heating element 610, 710 may extend along and / or within (e.g., be overmolded onto) the wall of the elongate shaft 604, 704. The electrical wires 616, 716 may extend from the heating element 610, 710 toward the cannula top housing 602, 702. The one or more electrical wires 616, 716 may exit the wall of the elongate shaft 604, 704 at or near the bottom of the cannula top housing 602, 702 and may be in electrical communication with the humidifier's electrical circuitry to energize the heating element 610, 710. The heating element may be controlled by a controller within the insufflator, the cannula, the humidifier, or any other controller external to the insufflator, cannula, and humidifier. The exit location of one or more electrical wires 616, 716 on the elongate shaft 604, 704 can ensure that the wires 616, 716 extend from the elongate shaft 604, 704 at a location further away from the patient than the location of the heating element 610, 704, reducing the likelihood of the wires 616, 716 contacting the patient and / or the outer surface of the elongate shaft 604, 704.

[0198] The location and / or length of the heating element 610, 710 may allow the heating element 610, 710 to be closer to where the lens of the medical scope is located, and thus the heating element 610, 710 may heat a more localized area of ​​the cannula 600, 700 than the heating elements 310, 410, 510 described above to more directly and / or effectively and / or target fogging and / or condensation with reduced potential harm to the patient (e.g., by providing reduced power to the heating element so that portions of the elongate shaft within the surgical cavity cannot get too hot).

[0199] 8A-8C illustrate another exemplary cannula 800 having a heating element 810 configured to provide more localized heating along a portion of the length of an elongate shaft 804. Cannula 800 may have any of the features of cannulae 300, 400, 500, 600, and 700 described above. Features of cannula 800 may be incorporated into features of cannulae 300, 400, 500, 600, and 700, and features of cannulae 300, 400, 500, 600, and 700 may be incorporated into features of cannula 800.

[0200] The heating element 810 may be located within a sleeve attachment 824 configured to be coupled to the elongate shaft 804. The sleeve attachment 824 may include one or more vents 830 for venting gases and / or surgical smoke. Insufflation gases may enter the surgical cavity via a cannula. The vents 830 (e.g., located at or near both the proximal and distal ends of the sleeve attachment 824) may define a fluid path for smoke and / or other gases to exit the surgical cavity. The sleeve attachment 824 may include one or more filter elements within the attachment 824 (e.g., proximal to the vents 830 at or near the proximal end of the attachment 824). The filter elements may, for example, filter out undesirable smoke, gases, and / or odors. A heating element within sleeve attachment 824 can heat the filter element to reduce and / or prevent condensation and / or clogging within the filter element. Sleeve attachment 824 can have features that aid in positioning and / or retaining cannula 800 within the surgical cavity. For example, sleeve attachment 824 can have a generally funnel-shaped profile and / or include a plurality of ridges 832 on the outer surface of the sleeve attachment. Ridges 832 can assist in retaining cannula 800 and / or sleeve attachment 824 within the surgical cavity. Sleeve attachment 824 can include an inner lumen configured to slidably receive elongate shaft 804 such that sleeve attachment 824 circumferentially surrounds a portion of elongate shaft 804. Sleeve attachment 824 can be securely attached to elongate shaft 804 by set screw 828. The set screw 828 can provide radial pressure against the outer surface of the elongate shaft 804 when the screw 828 is tightened onto the elongate shaft 804. Other locking features can also be used to secure the sleeve attachment 824 to the shaft 804.

[0201] As shown in FIGS. 8B and 8C , the heating element 810 can be located adjacent to the inner wall of the sleeve attachment 824 and can be in electrical communication with one or more electrical wires 816 extending from the outer surface of the sleeve attachment 824. This location of the heating element 810 can allow the heating element 810 to be as close as possible to the elongate shaft 804 while still being outside of the gas flow path. The heating element 810 can transfer heat to gas passing within the hollow passage 814 and / or over the medical device to prevent, reduce, and / or eliminate fogging and / or condensation on the lens. The medical device may be a surgical device. The sleeve attachment 824 can be mounted at a position on the elongate shaft 804 such that the heating element 810 is close to the lens of the medical device to more efficiently prevent, reduce, and / or eliminate fogging and / or condensation. Sleeve attachments 824 may also be attachable to other locations on the elongate shaft 804 to provide more localized heating at those locations.

[0202] Example of a heater associated with the cannula upper housing 9A-9C show an exemplary cannula 900 having a heating element 910 located along the cannula upper housing 902. FIG. 9A shows a perspective view of the cannula 900 cut along a central longitudinal plane to better show the heating element 910. The cannula 900 can have any of the features of the cannulae 300, 400, 500, 600, 700, and 800 described above. Features of the cannula 900 can be incorporated into features of the cannulae 300, 400, 500, 600, 700, and 800, and features of the cannulae 300, 400, 500, 600, 700, and 800 can be incorporated into features of the cannula 900.

[0203] As shown in FIGS. 9A-9C , the cannula 900 can include a cannula upper housing 902 and an elongated body 904 extending from the housing 902. The cannula upper housing 902 can house one or more instrument seals. The free end 908 of the elongated body 904 can have a tapered or sharp end 908 or a square tip. The cannula upper housing 902 can have an opening 912. The opening 912 can be in fluid communication (e.g., connected or continuous) with a hollow passage 914 of the elongated shaft. The cannula 900 can include a gas inlet 906 coupled to a wall of the cannula upper housing 902. The gas inlet 906 can be connected to a gas delivery tube of a surgical system (e.g., an insufflation system or any of the systems disclosed herein). As shown in FIG. 9B, the inlet 906 can be in fluid communication with an opening 912 in the cannula upper housing 902 and / or a hollow passage 914 in the elongate shaft 904 .

[0204] The heating element 910 may be embedded in the wall of the cannula upper housing 902. The heating element 910 and / or other heating elements of the present disclosure may be mounted and / or disposed on the inner wall of the cannula (e.g., the inner wall of the upper housing and / or the inner wall of the shaft). Alternatively, example heating elements may be wrapped around the outer surface of the cannula shaft. The heating element 910 may be molded to the wall of the cannula upper housing 902. As shown in FIGS. 9A and 9B, the heating element 910 may extend at least along the length of the cannula upper housing 902. The heating element 910 may be flexible. As shown in FIG. 9C, the heating element 910 may conform to the cross-sectional profile of the cannula upper housing 902. The heating element 910 may extend circumferentially or at least substantially circumferentially around the opening 912 in the cannula upper housing 902. The heating element 910 may be out of the insufflation gas flow path and not contact the insufflation gas or a medical device inserted through the opening 912. The medical device may include a surgical device. The heating element 910 may also include a gap 934 to allow the inlet 906 to extend into the wall of the cannula upper housing 902. Isolating the heating element 910 from the air delivery flow path by embedding the heating element within the wall of the elongate shaft may reduce and / or avoid contamination.

[0205] The electrical wires 916 can be in electrical communication with the heating element 910. The electrical wires 916 can be connected to an end of the heating element 910 (e.g., the end closer to the elongate shaft 910 as shown in FIG. 9B ). The electrical wires 916 can be routed further away from the patient than the wires connecting to the shaft heating element, such as those described above, to reduce the likelihood of the wires 916 coming into contact with the patient. The electrical wires 916 can be in electrical communication with the electrical circuitry of the surgical system, such as the insufflation system or humidifier of any of the surgical systems described above, so that the heating element 910 is powered by the humidifier's controller. More than one electrical wire can also be connected to the heating element 910. The heating element can be controlled by a controller in the insufflator, the cannula, the humidifier, or any other controller external to the insufflator, cannula, and humidifier.

[0206] The heating element 910 may be configured to transfer heat to the insufflation gas delivered from the inlet 906 into the opening 912 and / or to a portion of a medical device inserted in the opening 912 (e.g., as the device is advanced into and / or removed from the cannula 900), raising the temperature of the device and reducing and / or preventing condensation and / or fogging (e.g., on a lens). The heating element 910 may raise the temperature of the insufflation gas and / or medical device above the dew point, preventing condensation of the gas and / or reducing (and / or eliminating) condensation and / or fogging on the medical device. The heating element 910 may also allow for better control of the therapy provided by the surgical system. Positioning the heating element 910 within the cannula upper housing 902 may allow the cannula 900 to be heated in a manner that is safer for the patient, since the cannula 900 will not get as hot at or near the free end 908 (or patient interface end), and / or may be heated to higher temperatures to prevent, reduce, and / or eliminate fogging and / or condensation.

[0207] In some configurations, a filter or filter element may be connected to cannula top housing 902, for example, prior to gas inlet 906. Alternatively, the filter may be built into the cannula (e.g., in cannula top housing 902) and located in the gas flow path. One or more heater elements, e.g., heating element 910, may be placed in contact with or built into the filter or filter element to heat the filter or filter element and prevent clogging of the filter or filter element. Heating the filter or filter element to prevent condensation and / or clogging can extend the life of the filter or filter element and maintain the efficiency of the filter or filter element.

[0208] Further examples of cannula heaters As shown in FIGS. 10A-10H, one or more internal flaps can be included within cannula 1000. Cannula 1000 can have any of the features of cannulae 300, 400, 500, 600, 700, 800, and 900 described above, and cannulae 300, 400, 500, 600, 700, 800, and 900 can have any of the features of cannula 1000. One or more of the seals can include a heating element. The seal can contact a medical instrument inserted into the cannula. The medical instrument can be a surgical instrument. The heating element within the seal can heat the instrument to reduce and / or remove fogging on the instrument. The heating element can also heat gas passing through the seal.

[0209] One or more internal flaps may be incorporated into the cannula 1000 (e.g., overmolded onto the inner wall of the elongate shaft 1004) or may be removably inserted into the cannula 1000. As shown in FIGS. 10A and 10B , the internal flaps may form a heated helical instrument holder 1010A. The helical instrument holder 1010A may extend radially inward from the inner wall of the elongate shaft 1004 of the cannula 1000. The helical instrument holder 1010A may extend, for example, along substantially the entire length of the elongate shaft 1004 (as shown in FIG. 10A ), or along only a portion or portions of the elongate shaft 1004. When the instrument 20 is inserted into the cannula 1000, the helical instrument holder 1010A may helically wrap around the instrument 20 and heat the instrument 20. The internal flaps may also be attached to a scope, cannula, or the like.

[0210] 10C and 10D, the interior flap can include multiple heated vanes 1010B, which can be distributed along substantially the entire length of the elongate shaft 1004. The heated vanes 1010B can also be distributed along one or more portions of the elongate shaft 1004. As shown in FIGS. 10E and 10F, a single heated vane 1010C can be located at or near the exit of the cannula 1000. When the instrument 20 is inserted into the cannula 1000, the heated vanes 1010B, 1010C can seal around and heat the instrument 20.

[0211] 10G and 10H, a standard cannula seal 1010D located at the opening of the cannula upper housing 1002 can function as an internal flap. When the instrument 20 is inserted into the cannula 1000, the standard cannula seal 1010D seals around the instrument 20 and can heat the instrument 20.

[0212] In some configurations, a cannula can incorporate two or more of the internal flaps disclosed herein. For example, a standard cannula seal 1010D can be used in combination with a helical instrument holder 1010A or heated vanes 1010B, 1010C. As another example, a helical instrument holder 1010A can be used in combination with an additional heater vane 1010C.

[0213] 11A-11C illustrate heating of gas flowing over a cannula 1100 having concentric multiple lumens. Arrows indicate the direction of gas flow. The cannula 1100 may have an inner lumen 1118 and an outer lumen 1114. As shown in FIGS. 11A and 11B, a heating element 1110 may be located (e.g., molded) within a wall (e.g., an outer wall) of the outer lumen 1114. Gas (e.g., humidified insufflation gas) may be introduced into the outer lumen 1114 of the cannula 1100. The medical device 20 may be inserted within the inner lumen 1118. The heating element 1110 may be configured to heat the gas to a temperature and / or relative humidity higher than a standard therapeutic gas temperature, which may be, for example, a dry cryogenic gas, a dry hot gas, a humidified cryogenic gas, or a humidified hot gas. When the heated gas contacts the device 20 , for example, near the exit of the cannula 1100 , the heated gas can absorb moisture on the device 20 .

[0214] As shown in FIG. 11C , the cannula 1100 can have an inner lumen 1118, an intermediate lumen 1115, and an outer lumen 1114. The heating element 1110 can be located (e.g., molded) into a wall (e.g., an outer wall) of the intermediate lumen 1115. Gas (e.g., humidified insufflation gas) can be introduced into the outer lumen 1114 and the intermediate lumen 1115 of the cannula 1100. The heating element 1110 can be configured to heat the gas in the intermediate lumen 1115 to a temperature higher than a standard therapeutic gas temperature. When the heated gas in the intermediate lumen 1115 contacts the device 20, for example, near the exit of the cannula 1100, the heated gas can absorb moisture on the device 20. The gas in the outer lumen 1114 can be insulated from the heating element 1110 so that the gas in the outer lumen 1114 can be delivered at a standard therapeutic temperature and / or relative humidity.

[0215] 16A-16D illustrate heating of gas flowing over a cannula 1600 having substantially concentric multiple lumens. Arrows indicate the direction of gas flow, including insufflation gas flow and gas flow from the surgical cavity. The cannula 1600 can include an inner tubular member and an outer tubular member. The outer tubular member can include an outer body 1602A and an outer elongate shaft 1604A extending distally from the outer body 1602A. The inner tubular member can include an inner body 1602B and an inner elongate shaft 1604B extending distally from the inner body 1602B. The lumen of the inner tubular member can define an inner lumen 1618. A medical instrument (e.g., a scope or any other instrument disclosed herein) can be inserted into the inner lumen 1618. The medical instrument may be a surgical instrument.

[0216] The outer surface 1632 of the inner tubular member and the inner surface 1630 of the outer tubular member can define an outer lumen 1614 of the cannula 1600. In some configurations, the inner lumen 1618 and the outer lumen 1614 can be substantially coaxial (e.g., coaxial, etc.). In some configurations, the inner lumen 1618 and the outer lumen 1614 can be substantially concentric (e.g., concentric, etc.).

[0217] Fluids, including liquids or gases, such as humidified insufflation gas, can be introduced into the outer lumen 1614 of the cannula 1600. The outer lumen 1614 can define an insufflation passageway having an insufflation gas entry through an insufflation port 1606. As shown in FIGS. 16A-16D , the outer lumen 1614 can terminate at its distal end in an opening 1607. The opening 1607 can be the only exit point for the insufflation gas from the insufflation passageway. The opening 1607 can also include multiple apertures. The opening or multiple apertures can be located in the wall of the outer tubular member, for example, at least in the distal portion of the cannula 1600, or anywhere along the outer elongate shaft 1604A configured to be inserted into the surgical cavity.

[0218] The cannula 1600 can be pneumatically sealed to prevent ambient air from entering the surgical cavity, for example, through the inner lumen 1618. The inner lumen 1618 can allow gases within the surgical cavity to travel proximally toward the inner body 1602B. The cannula 1600 can be coupled to an aspiration and / or filtration unit to allow gases from the surgical cavity to travel proximally within the inner lumen 1618. At least a portion of the gases from the surgical cavity that are returned to the inner body 1602B are directed by a recirculation loop toward the inlet 1609 leading from the aspiration and / or filtration unit and back to the inner body 1602B. The recirculated gases can create a region resembling an air curtain or barrier that substantially prevents entrainment of room or ambient air into the inner lumen 1618.

[0219] A heat exchange process may occur between the input insufflation gas and the recirculated gas. There may be a net heat transfer between the outer lumen 1614 and the inner lumen 1618. Condensation may form when the temperature of the insufflation gas falls below the dew point. For example, insufflation gas humidified above the temperature of the gas in the surgical cavity entering the outer lumen 1614 may be cooled by the cooler recirculated gas. This cooling may cause condensation to form within the outer lumen 1614. Condensation may reduce the therapeutic effectiveness of the input insufflation gas.

[0220] A heating element may be located within the cannula 1600. The heating element may be used to advantageously maintain or raise the temperature of the input insufflation gas above the dew point. The heating element may be located within the upper housing and / or the cannula shaft. The heating element may be located within the inner tubular member and / or the outer tubular member. As shown in FIGS. 16A-16C , the heating element 1610 may be located (e.g., molded) anywhere between the outer surface 1638 of the outer tubular lumen comprising at least a portion of the outer body 1602A and / or the outer elongate shaft 1604A and / or the inner surface 1634 of the inner tubular lumen comprising at least a portion of the inner body 1602B and / or the inner elongate shaft 1604B. The heating element may be partially or completely embedded within the wall of the outer tubular lumen, including at least a portion of the outer body 1602A and / or outer elongate shaft 1604A, and / or within the wall of the inner tubular lumen, including at least a portion of the inner body 1602B and / or inner elongate shaft 1604B. The heating element may also be located within the insufflation passageway rather than embedded within the wall. The heating element may extend generally parallel to the insufflation passageway. Thus, the heating element may be embedded within the wall in contact with or in close proximity to the input insufflation gas.

[0221] Power may be supplied to the heating element 1610 via an internal power source, such as a battery 1642 in or on the cannula (FIG. 16B), or via an electrical connector or power plug 1644 (FIG. 16C), for example, via a gas delivery conduit disclosed herein having leads 1640 extending from the heating element 1610 to the insufflation port 1606 (FIG. 16A).

[0222] As shown in Figure 16D, the heating element 1610 may be located away from and may be isolated from the input insufflation gas. As shown in Figure 16D, the heating element 1610 may be located on or near the inner surface of the inner body 1602B. The heating element 1610 may heat a medical instrument inserted into the surgical cavity via the inner lumen 1618. The medical instrument may be a surgical instrument, such as an imaging unit (e.g., a scope, a camera, etc.), or otherwise.

[0223] Heating Element Example 12A-12D, exemplary heating elements are described. These exemplary heating elements may be implemented as the only or first heating element and / or second heating element, or more than two heating elements, in any of the exemplary heated cannulas disclosed herein. The heating elements may have an arcuate shape.

[0224] As shown in FIG. 12A, the heating element can include a heater wire 1210. The heater wire 1210 can be spirally wound and / or can spiral around the hollow passage of the elongate shaft, the second lumen, and / or the cavity of the cannula upper housing. As shown in FIG. 12B, the heating element can include a flexible band heater 1220. As shown in FIG. 12C, the heating element can include a flexible printed circuit board (“PCB”) 1230 or a rigid PCB preformed into an arcuate shape. As shown in FIG. 12D, the heating element can include a thermoelastic and / or thermal-electric plastic material (e.g., conductive plastic). The thermoelastic and thermoelectric plastic material can form a bendable and / or malleable flat sheet 1240 and / or can generate or dissipate heat when an electric current is applied to the material. Dimensions of exemplary heating elements can be varied to accommodate different locations of the cannulas (and / or sleeve attachments) disclosed herein.

[0225] Additional power supply example The exemplary cannulas disclosed herein may also include a socket connection for supplying power to the heating element via one or more electrical wires. As shown in FIGS. 13A-13B, the gas inlet 1306 of the cannula may include an electrical connector 1336. The electrical connector 1336 may be in electrical communication with one or more electrical wires 1316. The one or more electrical wires 1316 may be embedded within (e.g., overmolded into) the wall of a portion of the length of the cannula upper housing 1302 and may also be embedded within (e.g., overmolded into) the wall of a portion of the length of the elongate shaft extending within the cannula between the heating element and the electrical connector 1336.

[0226] The electrical connector 1336 can be configured to mate with a corresponding connector 1338 (e.g., a socket connector) on the gas delivery tube 13 of a surgical system (e.g., an insufflator system or any other surgical system disclosed herein) to provide power to the heating element. The gas delivery tube 13 can include a spirally wound tube molded to the corresponding connector 1338, which can include a hard plastic material. Alternatively, the gas delivery tube 13 can include a non-helical or straight tube. The gas delivery tube 13 can be corrugated or non-corrugated. The socket connection can secure the gas delivery tube 13 to the cannula. As shown in FIGS. 13A and 13B , the electrical connector 1336 can include pins 1340 configured to be coupled to a PCB edge connector 1342 of the corresponding connector 1338 and establish electrical communication between the heating element and the heater wire circuit 14 of the gas delivery tube 13.

[0227] As shown in Figures 14A-14C, the heating elements disclosed herein may be powered by one or more power options, such as by an external power supply unit (Figure 14A), by electrical connection to a heater wire in the gas delivery tube 13 (Figure 14B), and / or by a battery unit 1446 mounted on the cannula (e.g., in the upper housing 1402 as shown in Figure 14C). The heating element may include an induction heating element. The heating element may include a chemical heating element, such as, but not limited to, silica beads. The cannula may be preheated prior to insertion.

[0228] As shown in FIGS. 15A-15C, the heating effect of the heating elements disclosed herein can be varied. The heating elements can provide gradient heating. For example, as shown by heating element 1510 located in a portion of cannula shaft 1504, the amount of heat transferred can decrease toward the exit of cannula 1508. The amount of heat transferred can also increase toward the exit of cannula 1508. The heating elements can provide substantially constant or uniform heating along the longitudinal axis of the cannula (FIG. 15B). The heating elements can also provide localized heating (e.g., by a localized heating element disclosed herein), as shown in FIG. 15C. The example heating elements shown in FIGS. 15A-15C can also be incorporated into the interior flaps of FIGS. 10C and 10D.

[0229] Heating can be varied across the cannula shaft. Alternatively, heating can be varied temporally, i.e., over time. For example, the cannula can be rapidly heated to a set point, and then heating can be controlled to maintain the set point. Alternatively, the heating element within the cannula can undergo a warm-up function that slowly increases the temperature. Alternatively, heating can be ramped up over a specified warm-up period.

[0230] The heating elements disclosed herein can be controlled by and in communication with a controller within the humidifier. Alternatively, the heating elements disclosed herein can be controlled by a separate, independent control unit. The heating elements can also be in communication with and controlled by a controller within the insufflator.

[0231] term Examples of medical gas delivery systems and related components and methods have been described with reference to the figures. The figures illustrate various systems and modules and the connections between them. The various modules and systems can be combined in various configurations, and the connections between the various modules and systems may represent physical or logical links. The representations in the figures are presented for clarity of the principles, and details regarding the division of modules or systems are provided for ease of explanation rather than for the purpose of detailing separate physical embodiments. The examples and illustrations are intended for illustrative purposes and do not limit the scope of the inventions described herein. For example, the principles herein may be applied to other types of humidification systems, including respiratory humidifiers as well as surgical humidifiers. However, the humidification systems and methods may also, optionally, not involve the patient's respiratory system or be located within a portion of the airway (e.g., nose, mouth, trachea, and / or bronchi).

[0232] As used herein, the term “processor” broadly refers to any suitable device, logic block, module, circuit, or combination of elements for executing instructions. For example, controller 8 may include any conventional general-purpose single- or multi-chip microprocessor, such as a Pentium® processor, a MIPS® processor, a Power PC® processor, an AMD® processor, an ARM® processor, or an ALPHA® processor. Additionally, controller 122 may include any conventional special-purpose microprocessor, such as a digital signal processor or a microcontroller. The various illustrative logic blocks, modules, and circuits described in connection with the embodiments disclosed herein may be implemented or executed with a general-purpose processor, a digital signal processor (DSP), an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA), or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein, or pure software within a main processor. For example, a logic module may be a software-implemented functional block that does not utilize any additional and / or specialized hardware elements. A controller may be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a combination of a microcontroller and a microprocessor, multiple microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration.

[0233] Data storage can refer to electronic circuitry that allows data to be stored and retrieved by a processor. Data storage can refer to external devices or systems, such as disk drives or solid-state drives. Data storage can also refer to high-speed semiconductor storage (chips), such as random access memory (RAM) or various forms of read-only memory (ROM), that are directly connected to a communication bus or controller. Other types of data storage include bubble memory and core memory. Data storage can be physical hardware configured to store data on a non-transitory medium.

[0234] Although specific embodiments and examples are disclosed herein, the subject matter of the present invention extends to other alternative embodiments and / or uses other than those specifically disclosed, as well as modifications and equivalents thereof. Accordingly, the scope of the claims or embodiments appended hereto is not limited by any of the specific embodiments described herein. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as multiple separate operations, as this may be useful in understanding particular embodiments. However, the order of description should not be construed as implying that these operations are order-dependent. Furthermore, structures described herein may be embodied as integrated components or as separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily achieved by any particular embodiment. Thus, for example, various embodiments may be practiced in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0235] As used herein, conditional language such as, inter alia, "can," "could," "might," "may," "eg," and the like, unless otherwise stated or understood within the context of use, is intended to generally convey that certain embodiments include particular features, elements, and / or conditions, while other embodiments do not include particular features, elements, and / or conditions. Thus, such conditional language does not generally imply that one or more embodiments require a feature, element, and / or condition. As used herein, the terms "comprises," "comprising," "includes," "including," "has," "having," or any other variation thereof, are intended to include a non-exclusive inclusion. For example, a process, method, article, or apparatus that includes a list of elements is not necessarily limited to only those elements and may include other elements not expressly listed or inherent in such process, method, article, or apparatus. Also, the term "or" is used in its inclusive (rather than its exclusive) sense, for example, when used to connect a list of elements, so that the term "or" refers to one, some, or all of the elements in the list. Connecting terms such as "at least one of X, Y, and Z" are understood in their common context to convey that an item, term, etc. can be either X, Y, or Z, unless otherwise indicated. Thus, such connecting terms do not generally imply that a particular embodiment requires that at least one X, at least one Y, and at least one Z, respectively, be present. As used herein, the terms "about" or "approximately" can mean that a value is within ±10%, ±5%, or ±1% of the stated value.

[0236] The methods and processes described herein may be embodied in, and partially or fully automated via, software code modules executed by one or more general-purpose and / or special-purpose computers. The term "module" refers to logic embodied in hardware and / or firmware, or a collection of software instructions, possibly with entry and exit points, written in a programming language such as C or C++. Software modules may be compiled and linked into an executable program, installed in a dynamically linked library, or written in an interpreted programming language such as BASIC, Perl, or Python. It will be understood that software modules may be callable from other modules or from themselves, and / or may be invoked in response to detected events or interrupts. Software instructions may be embedded in firmware, such as erasable programmable read-only memory (EPROM). It will further be understood that hardware modules may include connected logic units, such as gates and flip-flops, and / or may include programmable units, such as programmable gate arrays, application-specific integrated circuits, and / or processors. The modules described herein may be implemented as software modules, but may also be represented in hardware and / or firmware. Further, in some embodiments, the modules may be separately compiled, while in other embodiments, the modules may represent a subset of instructions of a separately compiled program and may not have an interface available to other logical program units.

[0237] In particular embodiments, code modules may be embodied in and / or stored on any type of computer-readable medium or other computer storage device. In some systems, data (and / or metadata) input to the system, data generated by the system, and / or data used by the system may be stored in any type of computer data repository, such as a relational database and / or a flat file system. Any of the systems, methods, and processes described herein may include interfaces configured to enable interaction with users, operators, other systems, components, programs, etc.

[0238] It should be emphasized that many variations and modifications may be made to the embodiments described herein, and these elements should be understood to be particularly permissible examples. All such modifications and variations are intended to be included herein within the scope of this disclosure and protected by the following claims. Moreover, nothing in the foregoing disclosure should be construed as implying that any particular component, feature, or process step is required or essential.

Claims

1. 1. A surgical cannula for supplying insufflation gas to a surgical cavity and for providing a passageway for insertion of medical instruments, comprising: an inner tubular member having an inner body and an inner elongate shaft extending from the inner body; an outer tubular member having an outer body and an outer elongate shaft extending from the outer body; an inner lumen defined by the inner tubular member, the inner lumen providing the passageway for insertion of the medical device; an outer lumen defined by an outer surface of the inner tubular member and an inner surface of the outer tubular member, the outer lumen defining an insufflation passageway for receiving insufflation gas; a wall of the outer tubular member having a plurality of apertures in fluid communication with the air delivery passageway and defining an outlet for the air delivery passageway; A surgical cannula, wherein a heating element is disposed between the outer surface of the outer tubular member and the inner surface of the inner tubular member.

2. The surgical cannula of claim 1 , wherein the heating element extends parallel to the air delivery passageway.

3. 3. The surgical cannula of claim 1, wherein the heating element extends the length of at least a portion of the air delivery passageway.

4. The surgical cannula of any one of claims 1 to 3, wherein the heating element extends circumferentially relative to the inner tubular member.

5. The surgical cannula according to any one of claims 1 to 4, wherein the heating element is disposed within a housing of the surgical cannula.

6. A surgical cannula according to any one of claims 1 to 5, wherein the heating element is disposed within the inner tubular member.

7. 7. The surgical cannula of claim 6, wherein the heating element is embedded within a wall of the inner tubular member.

8. The surgical cannula according to any one of claims 1 to 5, wherein the heating element is disposed within the outer tubular member.

9. 9. The surgical cannula of claim 8, wherein the heating element is embedded within a wall of the outer tubular member.

10. 6. The surgical cannula according to claim 1, wherein the heating element is disposed in the air delivery passage.

11. 11. A surgical cannula according to any one of claims 1 to 10, wherein the plurality of apertures are configured to allow the insufflation gas to be discharged laterally or obliquely relative to the insufflation passage.

12. The surgical cannula of any one of claims 1 to 11, wherein the plurality of apertures are disposed along a distal portion of the outer elongate shaft.

13. The surgical cannula of any one of claims 1 to 12, further configured to be coupled to a suction unit and / or a filtration unit via a suction outlet in fluid communication with the inner lumen.

14. 14. The surgical cannula of claim 13, further comprising a recirculation inlet in fluid communication with the inner lumen and configured to receive and deliver recirculated gas from the suction unit and / or the filtration unit to the inner body.

15. A surgical cannula according to any preceding claim, further comprising a socket connection configured to connect with a gas delivery tube.

16. 16. The surgical cannula of claim 15, wherein power is supplied to the heating element via the gas delivery tube.

17. 17. The surgical cannula of claim 16, further comprising wiring electrically connected to the heating element, the wiring extending to the gas delivery tube.

18. A surgical cannula according to any preceding claim, wherein the heating element is powered by one or more of an internal power source, a battery, an electrical connector, or a power plug.

19. A surgical cannula according to any one of claims 1 to 18, wherein the heating element is isolated from the insufflation gas so as to be out of the insufflation passage.

20. A surgical cannula according to any one of claims 1 to 19, wherein the inner lumen is arranged coaxially with the outer lumen.

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