Insufflation device and method of operation that can be performed using the insufflation device

Abstract

The present invention relates to an insufflator with an integrated fume extractor. A new type of valve control mechanism allows gas flow to be introduced into a body cavity through two tubes. The new type of device also allows for improved body cavity pressure measurement, reduces body cavity pressure fluctuations, and allows for greater volumetric flow rate leakage compensation. [Selected Figure] Figure 1

Description

[Technical Field]

[0001] The present invention relates to an insufflator with integrated exhaust gas extraction. A new valve control system allows gas to flow into the body cavity via two tubes. The new device also allows for improved pressure control of the body cavity. [Background technology]

[0002] Insufflators with the possibility of simultaneous exhaust gas extraction are known in the art (see, for example, WO 2015 / 043570). The insufflators comprise a tube through which medical gas is introduced into a body cavity (e.g., the abdominal cavity). The gas generates a positive pressure, which expands the body cavity to provide sufficient space for visual inspection or intervention. Via a second tube, the gas is again extracted from the abdominal cavity. In the case of electrosurgery or laser intervention, harmful exhaust gases are generated, which can be evacuated and filtered by the insufflator via this second tube. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] International Publication No. 2015 / 043570 Summary of the Invention [Problem to be solved by the invention]

[0004] In fact, in certain situations, insufflators known from the prior art have been found to have drawbacks. For example, larger leaks can occur during surgery, where a gas volume flow is required that significantly exceeds the maximum power of known devices, which is 20-30 liters / minute. For safety reasons, this limitation cannot be easily overcome by adjusting for a higher input pressure. An increase in input pressure can pose an increased risk to the patient. [Means for solving the problem]

[0005] Accordingly, the present invention relates to an insufflator for minimally invasive surgery, the insufflator comprising: a) a gas connection (1) to a gas bottle or domestic gas; b) a first pressure and flow control unit (3) equipped with a proportional valve and a pressure sensor; b) an infeed line (4, 6) with a filter (5) and a connection to a first trocar (7); c) a second trocar (8) with a tube (9) and a filter (10) connected to an extraction device (14) with variable extraction force; d) an electrical control unit; Equipped with The insufflator is characterized by another line (19, 17) branching between the gas supply (1) and the first pressure and flow control unit (3) and leading via a second pressure and flow control unit (18) to an extraction line between the filter (10) and the extraction device (14), thereby enabling further gas supply to the patient via the tube (9) and trocar (8), and optionally provided with a shut-off valve (13) between the filter (10) and the extraction device (14). [Brief explanation of the drawings]

[0006] [Figure 1] 1 is a schematic diagram of a device according to the present invention; [Figure 2] FIG. 10 shows a filter housing (23). DETAILED DESCRIPTION OF THE INVENTION

[0007] In contrast to prior art insufflators, the insufflator according to the invention comprises two pressure and flow control units, each with a proportional valve and a pressure sensor.

[0008] Typically, the insufflator is operated as described in the prior art (WO 2015 / 043570). The gas connection extends to a first infeed line via a first pressure and flow control unit. In the pressure and flow unit, a pressure sensor is provided to monitor the pressure in the line. Furthermore, a filter is provided to protect the patient. The first infeed line terminates in a first trocar, which can fill the body cavity with gas. The insufflator further comprises a second tube, which typically serves as an extraction tube. The second trocar, which is introduced into the body cavity, is connected to the insufflator by this extraction tube. The extraction tube, which is also provided with a filter, leads to an extraction pump. The extraction power of the extraction pump is electrically variable. The control unit is configured to keep the pressure in the body cavity as constant as possible.

[0009] In an optional embodiment of the invention, the insufflator does not have an extraction pump. Instead, an external pump is used, such as a wall-mounted extraction system common in hospitals. In this case, the housing of the insufflator is equipped with a control valve that controls the extraction gas flow. Of course, it is also possible for the insufflator to have both options (extraction pump and connection to an external pump).

[0010] The maximum volumetric flow of such devices is typically 20-30 lpm (liters per minute) due to various limitations. A larger volumetric flow requires a larger pressure and / or a larger-diameter trocar, both of which are undesirable for safety and handling reasons. However, in practice, situations arise where the maximum volumetric flow is insufficient to maintain the desired target pressure in the body cavity. In this case, the procedure must now be stopped and the leak closed. Alternatively, the procedure can be continued with a lower pressure in the body cavity. For such situations, the insufflator of the present invention includes a second pressure and flow control unit with a proportional valve. The control valve allows the extraction pump to be separated from the extraction tube and the extraction tube to be used instead as a second supply tube. Consequently, gas can also be supplied through the second tube, thereby doubling the maximum total volumetric flow to 40-60 lpm.

[0011] Improved pressure measurement The insufflator of the present invention also allows for improved pressure control and measurement during insufflation. In conventional insufflators, pressure measurement to measure the pressure in the body cavity is performed by a sensor located at the insufflator end of the tubing in the pressure and flow control unit. To allow the pressure in the body cavity to be measured, insufflation is interrupted for several hundred milliseconds. During this time, pressure equalization between the body cavity and the contents of the tubing occurs, which can then be measured. Thus, the pressure in the body cavity can be determined quite accurately without the use of a pressure sensor in the body cavity. After pressure measurement is completed, insufflation continues. In this way, a pulsatile gas supply is created by alternating measurement and insufflation phases. This variation is not significant for normal-sized body cavities (e.g., the abdominal cavity). However, for smaller body cavities, such as the rectum, this mode of operation induces pressure fluctuations in the body cavity.

[0012] The insufflator according to the invention allows for an improved operating mode. In the insufflator according to the invention, the gas supply in the infeed line is also interrupted during the time of pressure measurement. Simultaneously with the interruption, the gas supply passes through the second line. This type of gas supply allows the pressure in the body cavity to be measured uninterrupted by the first pressure sensor while simultaneously continuing the inflow of gas.

[0013] The device according to the invention is shown in FIG. 1. First, a gas supply (1) is shown (e.g., a CO2 container). The gas supply line (2) leads inside the insufflator to a first pressure and flow control unit (3). In the pressure and flow unit, a proportional valve, a pressure sensor, and a flow sensor are present. A line (4) runs to a filter (5) at the outlet of the housing. A tube (6) connects a trocar (7), which directs the gas flow into the patient's body cavity. A second trocar (8) is provided in the patient's body cavity. This second trocar (8) is typically used to perform gas extraction. For this purpose, the trocar (8) is connected by a tube (9) to another filter (10). A line (11), via an optional shut-off valve (13), leads to an extraction pump (14), from which, via a line (15), leads to an outlet (16) for the extracted waste gas. Between the filter (10) and the shut-off valve (13) a second pressure and flow control unit (18) is positioned by a T-piece (17) which is also connected to the gas connection (1) via a line (19).

[0014] Via this second line (9), insufflation gas can be supplied to the second trocar (8). When parallel insufflation through the second trocar (8) is performed, the shut-off valve (13) must be closed. This can be done without a shut-off valve if the extraction pump has sufficient resistance or inertia so that pressure cannot be reduced through the pump. This parallel insufflation through both trocars (7 and 8) can achieve a volumetric insufflation flow that is essentially twice as large as with only one line. This parallel insufflation makes it possible to maintain sufficient pressure for the patient in special cases, such as in the case of a large leak. The electronic control unit is not shown in FIG. 1.

[0015] In actual operation, the filter 10 becomes contaminated by the release of waste gases. To prevent these particles, especially bacteria, from returning to the patient's abdominal cavity, when a second air delivery path is used from the filter 10 through the trocar 8, it is naturally conceivable to connect the line of the second pressure and flow control unit 18 only to the line to the trocar 8 behind the filter 10. For this purpose, a corresponding filter housing 23 is designed. This simultaneously allows the filtering of waste gases through the filter 20, but also allows the gas flow of the second pressure and flow control unit 18 to be connected to the trocar 8 via the filter 21. Such a solution is shown, for example, in FIG. 2.

[0016] The insufflation unit according to the present invention also allows for improved pressure measurement during normal operation. As explained above, for the purpose of pressure measurement, the valve in the pressure sensor of the pressure and flow unit (3) is closed for several hundred milliseconds. After equalization of pressure between the patient's body cavity and the line system, the pressure is detected by the pressure sensor. After the pressure measurement, the proportional valve in the pressure and flow unit (3) is reopened and insufflation continues. During the pressure measurement, further insufflation by a conventional insufflator is not possible. The insufflator according to the present invention allows for continuous insufflation by the following operating method.

[0017] For the purpose of pressure measurement, the proportional valve in the first pressure and flow control unit (3) is closed. At the same time, the valve in the second pressure and flow control unit (18) is opened, thereby allowing insufflation through the trocar (8) at the same insufflation force for several hundred milliseconds. When exhaust gas extraction occurs, the shut-off valve (13) can be closed for the time of pressure measurement. After the pressure measurement is completed, the proportional valve in the second pressure and flow control unit (18) is closed again, and the proportional valve in the first pressure and flow control unit (3) is reopened. If necessary, the control valve (13) is also reopened, thereby allowing exhaust gas extraction. The advantage of this operating method is that continuous insufflation is achieved, thereby significantly reducing pressure fluctuations in the body cavity compared to conventional methods.

Claims

1. 1. An insufflator for minimally invasive surgery, comprising: a) a gas connection (1) to a gas bottle or domestic gas; b) a first pressure and flow control unit (3) equipped with a first proportional valve and a first pressure sensor; b) an infeed line (4, 6) with a connection to a filter (5) and a first trocar (7); c) a second trocar (8) with a tube (9) and a filter (10) connected to an extraction device (14) with variable extraction force; d) an electrical control unit; e) another line (19, 17) in the insufflator, branching between the gas connection (1) and the first pressure and flow control unit (3) and leading via a second pressure and flow control unit (18) equipped with a second proportional valve and a second pressure sensor to an extraction line between the filter (10) and the extraction device (14), thereby allowing further gas supply to the patient via the tube (9) and trocar (8), optionally with a shut-off valve (13) between the filter (10) and the extraction device (14); Equipped with When the first pressure and flow control unit (3) closes the first proportional valve to measure the pressure of the patient's body cavity by the first pressure sensor, the second pressure and flow control unit (18) opens the second proportional valve; An insufflator characterized in that when the first pressure and flow control unit (3) and the second pressure and flow control unit (18) open the first proportional valve and the second proportional valve, respectively, a volumetric flow of insufflation is substantially doubled compared to when only the first pressure and flow control unit (3) opens the first proportional valve.

2. An insufflator as described in claim 1, comprising a filter housing (23) for connection to the insufflator housing, two gas pipes extending from the insufflator housing into the filter housing, one gas pipe being an extraction line and the other being a gas supply line, and further comprising at least one filter (20) in the extraction line and a second filter (21) in the gas supply line, both lines extending to a common outlet of the filter housing, the common outlet being connected to the second trocar (8).

3. The device comprises a gas connection (1) to a gas bottle or domestic gas, a first pressure and flow control unit (3) equipped with a first proportional valve and a first pressure sensor, an infeed line (4, 6) with a filter (5) and a connection to a first trocar (7), a second trocar (8) with a tube (9) and a filter (10) connected to an extraction device (14) with variable extraction force, an electric control unit, and further lines (19, 17) in the insufflator branching between the gas connection (1) and the first pressure and flow control unit (3). a second pressure and flow control unit (18) equipped with a second proportional valve and a second pressure sensor, and a second line (19, 17) leading to the extraction line between the filter (10) and the extraction device (14), thereby allowing a further gas supply to the outside via the tube (9) and the trocar (8), and optionally a shut-off valve (13) between the filter (10) and the extraction device (14), said second line (19, 17) being provided, said second pressure and flow control unit (18) being equipped with a second proportional valve and a second pressure sensor, said second line (19, 17) leading to the extraction line between the filter (10) and the extraction device (14), - the first pressure and flow control unit (3) closes the first proportional valve while the second pressure and flow control unit (18) opens the second proportional valve in order to deliver insufflation gas with the same insufflation force through the second trocar (8); - optionally, said shut-off valve (13) closing itself; - after the step of closing the first proportional valve and the step of opening the second proportional valve, the first pressure and flow control unit (3) waits for pressure equalization and measures the pressure outside the insufflator by means of the first pressure sensor; - after the step of measuring the pressure, the first pressure and flow control unit (3) opens the first proportional valve and the second pressure and flow control unit (18) closes the second proportional valve; - optionally causing said shut-off valve (13) to open itself.

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