Smoke removal system and method in a gas recirculation system

Abstract

To provide a system for recirculating gas infused into a peritoneal cavity during surgery.SOLUTION: Gas recirculation systems for use in endoscopic surgical procedures including a gas recirculation pump are disclosed. The gas recirculation pump may work in conjunction with an insufflator used to inflate a patient's peritoneal cavity during surgery. The gas recirculation system may recirculate a flow of gas from and to the patient, based on a detected amount of smoke in the gas, while filtering particulate matter out of the gas and while maintaining an adequate moisture content in the gas. A controller may adjust the speed of a pump motor based on the detected amount of smoke, and may also open a suction exhaust path to vent gas and smoke if the amount of smoke detected exceeds a threshold.SELECTED DRAWING: Figure 26

Description

Technical Field

[0001] The present disclosure (the present invention) relates to a gas recirculation system used in minimally invasive surgical procedures.

[0002]

CROSS-REFERENCE TO RELATED APPLICATIONS

Background Art

[0003] Minimally invasive surgical procedures, including endoscopic surgical procedures such as laparoscopic surgical procedures, arthroscopic surgical procedures, hysteroscopic surgical procedures, and thoracoscopic surgical procedures, are becoming increasingly common in the surgical environment due to shorter recovery times, shorter surgical durations, and lower costs. Minimally invasive surgical procedures are typically performed with instruments inserted through small artificial openings or portals made in the patient's body.

[0004] In laparoscopic surgical procedures, gas is injected into the peritoneal cavity through an artificial opening made in the abdomen with a Veress needle. Typically, the type of gas injected is CO2 gas, although a mixture of two or more gases or a different gas may also be suitable depending on the surgical procedure. In laparoscopic techniques, CO2 gas is used to create pneumoperitoneum, thereby creating a space for the surgeon to visualize the organs and manipulate surgical instruments and the endoscope. The CO2 gas is injected into the peritoneal cavity under pressure by a blowing device. Examples of blowing devices suitable for this application are described in U.S. Patent No. 6,299,592 and U.S. Patent Application No. 62 / 037,893, which are hereby incorporated by reference in their entirety and made a part of this specification.

[0005] After initially inflating the abdominal cavity with pneumoperitoneum, an endoscope with a camera (connected to a monitor) is inserted into the abdominal cavity to visualize the inside of the abdominal cavity, particularly the surgical space. The endoscope typically remains inserted for the duration of the surgical procedure. Other openings may also be created to allow access to other surgical instruments within the abdominal cavity. [Prior art documents] [Patent Documents]

[0006] [Patent Document 1] U.S. Patent No. 6,299,592 [Patent Document 2] U.S. Patent Application No. 62 / 037,893 [Overview of the project] [Problems that the invention aims to solve]

[0007] When instruments are used to cut, cauterize, excise, or vaporize abdominal tissue during minimally invasive surgical procedures, such as laparoscopic procedures, surgical smoke may be generated, which can pose a health risk to the patient, and if some or all of the surgical smoke escapes into the operating room, it can pose a health risk to the surgeon and other individuals. The term "surgical smoke" as used herein includes, but is not limited to, gases or aerosols that may contain toxins, particulate matter, irritants, living cells or viruses, water vapor, and other contaminants. Surgical smoke also impairs the surgeon's visibility through the camera in the endoscope. This impairment of visibility may be further exacerbated by condensation or condensation on the camera lens due to CO2 gas entering the abdominal cavity at temperatures lower than body temperature. Impaired visibility can hinder surgical procedures, potentially resulting in a health risk to the patient. Furthermore, impaired visibility can also lead to delays in surgery, particularly in remotely performed robot-assisted surgical procedures. [Means for solving the problem]

[0008] From one perspective, the system includes a gas recirculation system used in endoscopic surgical procedures, comprising a first tube in fluid communication with a gas input connector, the first tube being connectable to a surgical instrument that can be inserted into the peritoneal cavity; a second tube in fluid communication with a gas output connector, the second tube being connectable to a surgical instrument that can be inserted into the peritoneal cavity; a motor-driven pump configured to draw gas from the peritoneal cavity through the first tube into the gas input connector and to discharge the gas through the second tube from the gas output connector into the peritoneal cavity; a smoke detection sensor positioned along the gas flow path formed by the first tube, the pump, and the second tube, configured to measure the amount of smoke present in the gas; a controller further comprising a controller configured to receive an output signal from the smoke detection sensor representing the amount of smoke detected; and a controller further configured to adjust the motor speed of the pump in response to the amount of smoke detected. It is advisable to increase the motor speed to quickly remove smoke from the peritoneal cavity and then rapidly filter out the gas by passing it through one or more filter mechanisms in the gas recirculation system.

[0009] From another perspective, the gas recirculation system may further include a gas discharge path that bypasses the recirculation system and rapidly removes smoke when the amount of smoke exceeds a threshold manageable by a filter in the recirculation system. The smoke detection sensor may be located in or along a first pipe, a second pipe, or a pump. In applications where the pump has a removable pump cartridge, the sensor may be located on or inside the removable pump cartridge. Various sensor technologies, such as electrochemical sensors, optical sensors, and photoelectronic sensors, can be embodied as smoke detection sensors. The smoke detection sensor may communicate with the controller or pump of the gas recirculation system by a wired connection or wirelessly.

[0010] Other systems, methods, features, and advantages will become apparent to those skilled in the art upon examination of the following figures and detailed description. All such additional systems, methods, features, and advantages are included within the scope of the disclosure herein, within the scope of the present invention, and are intended to be protected by the following claims. [Brief explanation of the drawing]

[0011] [Figure 1] This is a diagram illustrating an exemplary embodiment of a gas recirculation system. [Figure 2] This is a schematic diagram of an embodiment of a gas recirculation system. [Figure 3] This is an exemplary cross-sectional view of an embodiment of a gas recirculation pump cartridge. [Figure 4] This is another exemplary cross-sectional view of an embodiment of a gas recirculation pump cartridge. [Figures 5A-5D] Figures 5A to 5D are diagrams illustrating an embodiment of a gas recirculation pump cartridge. [Figures 6A-6D] Figures 6A to 6D illustrate another embodiment of the gas recirculation pump cartridge. [Figures 7A-7H] Figures 7A to 7H are diagrams illustrating an embodiment of a part of a gas recirculation pump cartridge. [Figures 8A-8E] Figures 8A to 8E illustrate an embodiment of a gas recirculation pump. [Figure 9] This is a block diagram of the gas recirculation system. [Figure 10A-10B] Figures 10A and 10B are diagrams illustrating an embodiment of a method for connecting a gas recirculation pump cartridge and a motor. [Figures 11A-11F] Figures 11A to 11F illustrate an embodiment of a connecting element used in a gas recirculation system. [Figure 12] This is a cross-sectional view of an embodiment of a connecting element used in a gas recirculation system. [Figure 13] This is a cross-sectional view of another embodiment of a coupling element used in a gas recirculation system. [Figure 14] It is a diagram of an example of an embodiment of a bypass valve used in a gas recirculation system. [Figures 15A-15B] Figures 15A and 15B are diagrams of an example of an embodiment of a moisture trap used in a gas recirculation system. [Figures 16A-16B] Figures 16A and 16B are diagrams of an example of another embodiment of a moisture trap used in a gas recirculation system. [Figures 17A-17C] Figures 17A to 17C are diagrams of an example of an embodiment of an enclosure for a gas recirculation system. [Figures 18A-18B] Figures 18A and 18B are diagrams of an example of another embodiment of an enclosure for a gas recirculation system. [Figures 19A-19B] Figures 19A and 19B are diagrams of an example of another embodiment of an enclosure for a gas recirculation system. [Figures 20A-20F] Figures 20A to 20F are diagrams of an example of another embodiment of an enclosure for a gas recirculation system. [Figure 21A-21H] Figures 21A to 21H are diagrams of an example of another embodiment of a gas recirculation pump cartridge. [Figures 22A-22B] Figures 22A and 22B are diagrams of an example of another embodiment of a coupling method between a gas recirculation pump cartridge and a motor. [Figures 23A-23F] Figures 23A to 23F are diagrams of an example of another embodiment of a coupling method between a gas recirculation pump cartridge and a motor. [Figures 24A-24B] Figures 24A and 24B are diagrams of an example of an embodiment of a three-way valve used in a gas recirculation system. [Figures 25A-25B] Figures 25A and 25B are diagrams of an example of another embodiment of a three-way valve used in a gas recirculation system. [Figure 26] It is a schematic diagram of an example of an embodiment of a gas recirculation system equipped with a smoke detection method and a ventilation function. [Figure 27] It is a diagram showing a smoke detection sensor used in the system of Figure 26. [Figure 28] This figure shows a modified embodiment of the smoke detection sensor shown in Figure 27. [Figure 29] Figure 26 is a schematic diagram of a modified embodiment of the gas recirculation system. [Figure 30] Figure 29 shows an embodiment of a gas pump cartridge equipped with a photoelectron smoke sensor that can be used in a gas recirculation system. [Figure 31] Figure 30 shows an array of photoelectron detectors that can be used as a smoke sensor for a gas pump cartridge. [Figure 32] This diagram shows an electrochemical smoke detector used in a gas recirculation system. [Figure 33] Figure 29 shows one embodiment of a gas pump cartridge equipped with an electrochemical smoke sensor that can be used in a gas recirculation system. [Figure 34] This figure shows a motor enclosure that can be connected to the removable pump cartridge shown in Figure 33. [Figure 35] This figure shows a modified embodiment of the assembly in Figure 22A, which can be used in the motor enclosure in Figure 34 and has been modified to be equipped with an electrical connector to accept the gas pump cartridge in Figure 33. [Figure 36] This figure shows a modified embodiment of the gas pump cartridge shown in Figure 33. [Figure 37] This figure shows a smoke sensor positioned inside the input male Luer valve of a gas recirculation pump tubing set. [Figure 38] This figure shows a smoke sensor positioned inside the output male Luer valve of a gas recirculation system tubing set. [Figure 39] This figure shows a method for adjusting the pump speed based on a smoke detection criterion to change the amount of smoke removed in the system shown in Figure 26 or Figure 29. [Figure 40] Figure 26 shows a valve for switching between the gas recirculation path and the suction / exhaust path. [Figure 41]This figure shows a method for adjusting the gas recirculation rate or withdrawing gas from the gas recirculation system in the system shown in Figure 26 based on the amount of smoke detected in the gas. [Modes for carrying out the invention]

[0012] The present invention relates to a system for recirculating gas injected into the peritoneal cavity during surgical procedures. The system includes a positive displacement pump for removing gas to eliminate smoke generated in the peritoneal cavity during surgical procedures, or for injecting gas into the peritoneal cavity.

[0013] To address the challenge of filtering or otherwise removing smoke from the peritoneum during surgical procedures, a system and method for detecting the amount of smoke, automatically adjusting the filtration process, and recirculating gas based on the detected amount of smoke is described herein. The system and method described can provide a rapid response to the handling of smoke removal generated in the peritoneum, and such handling does not require manual adjustment and is independent of the surgical procedure. In various embodiment examples, the gas recirculation system of the present invention detects the density and amount of smoke in the pneumoperitoneum and correlates this information with visibility within the peritoneal cavity. Many types of smoke detection sensors, such as sensors using optical detection technology, can be used to calculate the amount of smoke. The sensor can also be placed in the pneumoperitoneum or in line with a tubing set used to enable CO2 (or other types of gas) exhaust or circulation. The system can then rapidly remove the smoke by increasing or decreasing the amount of CO2 moving within the peritoneal cavity using the calculated smoke density.

[0014] The present invention provides a safe and cost-effective gas recirculation system that includes components that can be reused without sterilization. The cost-effective system utilizes a controller rather than sensors to monitor pump operation and detect malfunctions. The system can achieve high removal and injection flow rates, e.g., 4-10 liters per minute, which ensures that any surgical smoke is quickly and effectively removed from the surgeon's field of view while minimizing any pressure changes within the peritoneal cavity.

[0015] Referring to Figure 1, an embodiment of the gas recirculation system 100 is shown. The gas recirculation system 100 preferably includes a recirculation pump 105, a primary inlet trocar 110, a secondary output trocar 115, an input tubing 120, and an output tubing 125. The output tubing 125 preferably includes a filter and / or moisture trap 130. The input tubing 120 and output tubing 125 preferably resemble the blown tubing sets manufactured by Northgate Technologies.

[0016] The gas recirculation system 100 can be used in conjunction with the blowing systems described, for example, U.S. Patent No. 6,299,592 and U.S. Patent Application No. 62 / 037,893, which are referenced by reference and whose entire contents are incorporated herein by reference. The blowing system may include a blower 127, a blowing trocar 128, a blowing tubing 129 connecting the blower 127 to the blowing trocar 128, and an electronic communication line 129 between the gas recirculation system 100 and the blower 127. The gas recirculation system 100 may include a controller for communicating with the blower 127 via the communication line 129. Information or commands, such as start, stop, increase flow rate, decrease flow rate, or other functions of the gas recirculation controller, may be present in the blower 127 and communicated to the gas recirculation controller. Additionally or alternatively, the gas recirculation controller may be incorporated into and shared with the blower 127. The gas recirculation system 100 and the blower 127 can share, to name a few, a power supply, processor, graphic user interface, heating function, and humidity function.

[0017] The recirculation pump 105 removes gas from the patient through the secondary output trocar 115, output tubing 125, and filter / moisture trap 130. It is preferable that a valve 135 connects the secondary output trocar 115 to the output tubing 125. When the output tubing 125 is connected to the secondary output trocar 115 through the valve 135, the valve stem of the valve 135 can be deflected to the open position. When the valve 135 is disconnected from the secondary output trocar 115, the valve stem of the valve 135 can return to its original closed position. The valve 135 can allow gas to flow through the valve when the output tubing 125 is connected to the secondary output trocar 115. The valve 135 can prevent gas from flowing into the output tubing 125 when the output tubing 125 is disconnected from the secondary output trocar 115. The valve 135 can close automatically when the output tubing 125 is disconnected from the secondary output trocar 115. Valve 135 is preferably a lure valve, such as a closed male lure of the Texium® or Halkey / Roberts® brand.

[0018] The recirculation pump 105 also injects gas into the patient's body through the primary inlet trocar 110 and input tubing 120. A valve similar to valve 135 can be connected to the primary inlet trocar 110 and input tubing 120, which can be closed when input tubing 120 is disconnected from the primary inlet trocar 110.

[0019] The recirculation pump 105 recirculates the gas from the peritoneal cavity back into the peritoneal cavity through the filter / moisture trap 130. The flow rate of gas removed from the patient through the output tubing 125 is the same as, or substantially the same as, the flow rate of gas injected into and returned to the patient through the input tubing 120. The filter / moisture trap 130 can remove liquid from the gas and particulate matter such as surgical smoke particles from the gas. The filter / moisture trap 130 may contain a medium that readily absorbs liquid, preferably 15-20 mL of liquid, and readily releases moisture into the gas flowing over or through the medium. Suitable mediums for use include materials of the Crystar® brand. The size of the medium is preferably 1 to 2.5 inches (2.54 to 6.35 cm) in length and 0.5 to 2.0 inches (1.27 to 5.08 cm) in diameter, most preferably 1.5 to 2.0 inches in length and 1 to 1.5 inches (2.54 to 3.81 cm) in diameter. In one embodiment, the medium may have a serrated outer surface and a central opening. When housed in a filter housing, the serrated outer surface defines multiple channel openings through which the gas can flow, and the central opening is preferably filled with a rod made of charcoal. The charcoal can capture particulate matter in the gas as it passes through the central opening and is effective in removing undesirable odors from the gas at the same time. Additionally or alternatively, odor removal can be achieved using other substances, such as enzyme materials, vinegar, and water-filled cartridges, or the odor can be masked using fragrances. The filter / moisture trap 130 can enable the recirculating gas to maintain moisture within a relative humidity range of 50-70%. Preferably, the gas recirculation system 100 will enable the recirculation of gas to and from the patient while the gas is at a normal operating room temperature of 60°F (15.6°C) to 75°F (23.9°C), passively maintaining a gas humidity level of at least 70% relative humidity.By utilizing the gas recirculation system 100, the need for the blower 127 to inject additional CO2 gas into the peritoneal cavity can be reduced or eliminated. Furthermore, it is preferable to maintain an appropriate moisture level in the peritoneal cavity, in contrast to additional CO2 gas which would generally become very dry with 0% relative humidity unless first passed through a gas heating and humidifying device (additional cost). Gas recirculation not only reduces the inflow of gas with 0% relative humidity, but also prevents the respiratory effect caused by the blower 127 attempting to maintain pressure in the peritoneal cavity, thus preventing the release of large amounts of CO2 gas into the operating room. For example, a passive smoke removal system that enables a leakage rate of 6 liters per minute may release up to 270 liters of CO2 gas into the operating room during a typical 45-minute gallbladder procedure. Therefore, the gas recirculation system 100 is a cost-effective way to maintain sufficient humidity of the gas in the peritoneal cavity.

[0020] Referring to Figure 2, an embodiment of the gas recirculation system 200 is shown. The gas recirculation system 200 may include some of the same components and operating characteristics as the gas recirculation system 100. The gas recirculation system 200 may include a recirculation pump 205, an input trocar 210, an output trocar 215, an input tubing 220, and an output tubing 225. The output tubing 225 may include a filter and / or a fluid trap 230. The input tubing 220 may include a filter 232. Valve 235 may connect the output trocar 215 to the output tubing 225. Valve 236 may connect the input trocar 210 to the input tubing 220. Valves 235 and 236 may be operated in the same manner as valve 135, using the same characteristics such as automatically closing when disconnected.

[0021] The recirculation pump 205 is preferably a diaphragm pump or any other suitable positive displacement pump comprising a cartridge 206 and a motor 207. The cartridge 206 is preferably separable from the motor 207. The motor 207 may be any type of motor. The motor 207 is preferably a direct current ("DC") motor, but is not limited to this. The cartridge 206 is sealable to prevent gas from escaping the cartridge 206 except at the connections to the input tubing 220 and output tubing 225. The cartridge 206 is preferably composed of multiple components attached to each other by ultrasonic welding, adhesive, laser welding, mechanical snap-fit ​​connections with or without gaskets, or any other known method of sealing mating surfaces together. The cartridge 206 is sealable such that it is in fluid communication only with the openings to the input tubing 20 and output tubing 225. Thus, the gas in the cartridge 206 cannot come into contact with the motor 207 or any other part of the recirculation pump 205. The gas recirculation system is an inexpensive method for removing surgical smoke from a patient's peritoneal cavity because the motor 207 is not contaminated by contact with gas from the peritoneal cavity, and therefore can be reused without requiring sterilization. It is preferable that parts such as the cartridge 206 of the recirculation pump 205, which may be contaminated by contact with gas from the peritoneal cavity, be disposable.

[0022] The gas recirculation system 200, when in operation, removes gas containing surgical smoke from the peritoneal cavity at a flow rate of preferably 4–10 liters per minute, most preferably 6–8 liters per minute, and after filtration, this gas can be injected back into the peritoneal cavity at a flow rate of preferably 4–10 liters per minute, most preferably 6–8 liters per minute. The gas from the peritoneal cavity first passes through the output trocar 215 and then through the valve 235 into the output tubing 225. Where a charcoal rod (as described above) or a separate or integrated activated carbon filter is used, the gas can move through a fluid trap 230 which can remove condensates / liquids formed due to its temperature change (i.e., from body temperature to room temperature). The gas then moves through the cartridge 206 of the recirculation pump 205. The gas can move through filters such as the filter 230 or 232 located before or after the recirculation pump 205. The filters can remove particulate matter and other contaminants from the gas. The filter is preferably made of a material that provides a pressure drop not exceeding 12.3 mmHG at a flow rate of 20 liters per minute. The gas can be injected into the peritoneal cavity through the input tubing 220, valve 236, and input trocar 210.

[0023] The recirculation system 200 may include a controller 240 for controlling the operation of the motor 207. The controller 240 may be used in combination with or in conjunction with a blower connected to the recirculation system 200. The controller 240 may be a Tiva® (Texas Instruments) brand controller. The controller 240 may be used to detect operating and / or failure conditions of the motor 207 and / or safety problems within the gas recirculation system 200. The controller 240 may detect the amount of power consumed by the motor 207, for example, by measuring the voltage to the motor 207. The controller 240 may detect or determine that a failure or safety problem has occurred within the gas recirculation system 200 based on the amount of power consumed by the motor 207. For example, the controller 240 may determine that a failure condition or safety problem has occurred if the motor 207 is consuming more power than expected, such as by an increase in voltage or current above a predetermined amount. The controller 240 can trigger the shutdown of the motor 207 if a fault condition or safety problem occurs. Using the controller 240 to detect fault conditions or safety problems in the gas recirculation system 200 is more cost-effective than using sensors.

[0024] Valves 235 and 236 can be configured to close when disconnected from the output trocar 215 and the input trocar 210, respectively. Closing valve 235 when disconnected from the output trocar 215 limits the ingress of outside air into the suction side of the gas recirculation system 200. Any outside air that enters the gas recirculation system 200 will be injected into the peritoneal cavity by the recirculation pump 205. Closing valve 236 when disconnected from the input trocar 210 prevents gas from being released from the peritoneal cavity into the surrounding environment.

[0025] Closing valve 235 or 236 may create a pressure difference within the gas circuit of the gas recirculation system 200. This pressure difference may increase the load on motor 207, which is measured by the increase in voltage or current consumed by motor 207. If the increase in voltage or current exceeds a predetermined threshold, controller 240 can detect a fault condition or safety problem within the gas recirculation system 200. Controller 240 can trigger a shutdown of motor 207 when a fault condition or safety problem is detected within the gas recirculation system 200. For example, valve 235 will close if valve 235 and output tubing 225 are disconnected from output trocar 215. Closing valve 235 forces the recirculation pump 205 to exert a suction force against the closed tube, thereby forcing the recirculation pump 205 to operate more vigorously and forcing motor 207 to consume more power to maintain its proper speed. The increase in power consumed by motor 207 may result in a fault condition if the increase in voltage or current exceeds a predetermined value. When a fault condition is detected that is caused by disconnecting valve 235 from output trocal 215, the controller 240 can trigger the recirculation pump 205 to stop. Similarly, valve 236 closes when valve 236 and input tubing 220 are disconnected from input trocal 210. Closing valve 236 forces the recirculation pump 205 to pump against a closed pipe or "deadhead," thereby forcing the recirculation pump 205 to operate more vigorously and forcing motor 207 to consume more power to maintain its proper speed. The increased power consumed by motor 207 may lead to a fault condition if the voltage or current exceeds a predetermined value. When a fault condition is detected that is caused by disconnecting valve 236 from input trocal 210, the controller 240 can trigger the recirculation pump 205 to stop. Thus, the recirculation system 200 can monitor the status of output tubing 225 and input tubing 220 by monitoring motor 207 using the controller 240.

[0026] The gas recirculation system 200 can similarly monitor the connection status between the input trocar 210 and output trocar 215 and the peritoneal cavity. Removing the input trocar 210 or output trocar 215 from the peritoneal cavity changes the pressure at the suction or discharge source of the recirculation pump, affecting the operation of the recirculation pump 205 and motor 207. The controller 240 can detect the change in the operation of the motor 207 and confirm that the input trocar 210 or output trocar 215 has been removed from the peritoneal cavity. For example, removing the input trocar 210 from the peritoneal cavity means that the recirculation pump 205 no longer pumps to overcome the intraperitoneal pressure, thus reducing the power required for the motor 207 to maintain the same speed. The controller 240 can detect the decrease in power consumed by the motor 207 and confirm that the input trocar 210 has been disconnected from the peritoneal cavity. Next, the controller 240 can trigger and stop the recirculation pump 205, thereby preventing gas from flowing from the peritoneal cavity into the surrounding environment.

[0027] The gas recirculation system 200 may include a user interface 245, such as a computer, to allow the operator to determine or confirm the status of the gas recirculation system 200. For example, if the controller 240 stops the recirculation pump 205 due to the valve 235 being disconnected from the output trocar 215, the user interface 245 can indicate that the recirculation pump 205 has stopped and that the most likely cause is the output tubing 225 being disconnected from the output trocar 215. The operator can confirm that the output tubing 225 has been disconnected from the output trocar 215 and reconnect the output tubing 225 to restart the recirculation pump 205. Similarly, the operator can determine whether other failure conditions have occurred, such as blockage in the gas path, excessive flow restriction, or leakage in the gas path, such as tubing disconnection or damage.

[0028] Referring to Figures 3 and 4, embodiments of a cartridge 306 used in a recirculation pump are shown. The cartridge 306 is preferably used in a recirculation pump such as the recirculation pump 205 described with reference to Figure 2. Figures 3 and 4 are partial cross-sectional views of the cartridge 306. Arrows indicating gas flow paths are provided to more clearly illustrate the operation of the cartridge 306. The cartridge 306 has an output tubing, for example, the output tubing 225 in Figure 2, which is preferably connected to the peritoneal cavity. The cartridge 306 also has a connection to an input tubing 352, for example, the input tubing 220 in Figure 2, which is preferably connected to the peritoneal cavity.

[0029] Gas from the peritoneal cavity flows into the cartridge 306 through the connecting portion 350, as indicated by the arrows in Figure 3. The cartridge 306 preferably includes valves 354 and 360. The gas enters the cartridge 306 and enters the diaphragm chamber 356 through valve 354, as indicated by the arrows in Figure 3. The gas exits the cartridge 306 through valve 360 ​​from the diaphragm chamber 356, as indicated by the arrows in Figure 4 (this will be described later). Valves 354 and 360 preferably are umbrella-type valves. The diameter of the gas opening 362 that penetrates valves 354 and 360 is preferably 0.05 inches (1.27 mm) to 0.15 inches (3.81 mm), and preferably 0.085 inches (2.159 mm). The gas opening 362 preferably includes two or more concentric openings, so that the total area of ​​the gas opening 362 can be set to enable the realization of various flow rates. For example, these openings are preferably set to allow flow rates in the range of 4 to 10 liters per minute and a first preferred range of 7 to 8 liters per minute. While a flow rate of 4 to 10 liters per minute is a reasonable range, to achieve higher or lower flow rates, it is preferable to increase or decrease the cartridge size, increase or decrease the motor stroke length to change the volume obtained in the diaphragm cavity, or increase the motor speed. For example, in another embodiment, a second preferred flow rate range of 10 to 12 liters per minute can be achieved by adjusting one or more of the gas opening size, cartridge size, motor stroke length, or motor speed. The higher flow rate range of 10 to 12 liters per minute is preferable when implementing the smoke detection and filtration / exhaust technologies described below.

[0030] The cartridge 306 preferably has a diaphragm 358 within a diaphragm chamber 356. The movement of the diaphragm 358 away from the valve 354 opens the valve 354, drawing gas through the valve 354 into the diaphragm chamber 356 as indicated by the arrows in Figure 3. When the diaphragm 358 moves away from the valves 354, 360, the valve 354 can be pulled open, thereby drawing gas from the peritoneal cavity through the output tubing into the diaphragm chamber 356 as indicated by the arrows in Figure 3. When the diaphragm 358 moves away from the valves 354, 360, the valve 360 ​​can be pulled closed, thereby preventing gas from flowing out of or into the diaphragm chamber 356 through the valve 360.

[0031] The movement of the diaphragm 358 toward valves 354 and 360 opens valve 360, and as indicated by the arrows in Figure 4, gas is pushed out from the diaphragm chamber 356 through valve 360 ​​and then through the connector 352 and out of cartridge 306. The movement of the diaphragm 358 toward valves 354 and 360 closes valve 354, thereby preventing gas from being pushed out from the diaphragm chamber 356 through the connector 350. The reciprocating motion of the diaphragm 358 toward and away from valves 354 and 360 draws gas out of the peritoneal cavity through either the filter or the liquid trap, and pushes it back into the peritoneal cavity through the input tubing.

[0032] Figures 5A–5D, 6A–6D, and 7A–7H show other exemplary embodiments of the cartridge for use in a gas recirculation pump, such as the recirculation pump 205 described with reference to Figure 2. The components and operating characteristics of the cartridges shown in Figures 5A–5D, 6A–6D, and 7A–7H are preferably similar to those of the cartridge 306 described above.

[0033] Figure 5A is an exploded assembly diagram of cartridge 506. Cartridge 506 includes connectors 550, 552, valves 554, 560, a diaphragm 558, and a plunger 564. Valves 554, 560 are preferably umbrella-type valves. Connector 550 is preferably a gas inlet into cartridge 506. Connector 552 is preferably a gas outlet from cartridge 506. The plunger 564 can move the diaphragm 558 toward valves 554, 560 to recirculate gas through the peritoneal cavity as described above with reference to Figures 3 and 4.

[0034] Figure 5B is a non-disassemblable assembled perspective view of cartridge 506. Figure 5C is a front view of cartridge 506. Figure 5D is a side view of cartridge 506.

[0035] Figure 6A is an exploded assembly diagram of cartridge 606. Cartridge 606 includes connectors 650 and 652, valves 654 and 660, a diaphragm 658, and a plunger 664. Valves 654 and 660 are preferably umbrella-shaped valves. Connector 650 is preferably a gas inlet into cartridge 606. Connector 652 is preferably a gas outlet from cartridge 606. The plunger 664 is preferably designed to move the diaphragm 658 toward valves 654 and 660 in order to recirculate gas through the peritoneal cavity as described above with reference to Figures 3 and 4.

[0036] Figure 6B is a non-disassemblable assembled perspective view of cartridge 606. Figure 6C is a front view of cartridge 606 with exemplary dimensions. Figure 6D is a side view of cartridge 606 with exemplary dimensions. The dimensions and orientation of cartridge 606 may vary depending on operational requirements.

[0037] Figures 7A to 7H show multiple views of the gas inlet / outlet section of cartridge 706. Figure 7A shows a perspective view of the gas inlet / outlet section of cartridge 706. Figure 7B shows a front view of the gas inlet / outlet section of cartridge 706. Figure 7C shows a bottom view of the gas inlet / outlet section of cartridge 706 with exemplary dimensions. Figure 7D shows a side view of the gas inlet / outlet section of cartridge 706. Figure 7E shows a rear view of the gas inlet / outlet section of cartridge 706 with exemplary dimensions. Figure 7F shows a side section of the gas inlet / outlet section of cartridge 706 with exemplary dimensions. Figure 7G shows another side section of the gas inlet / outlet section of cartridge 706 with exemplary dimensions. Figure 7H shows a bottom section of the gas inlet / outlet section of cartridge 706. The dimensions and orientation of cartridge 706 may vary depending on operational requirements.

[0038] Referring to Figures 8A to 8E, embodiments of the recirculation pump 805 are shown. The recirculation pump 805 preferably includes a cartridge 806, a motor 807, a crank assembly 866, a lock arm 868, and a cartridge holder 870. The components and operating characteristics of the recirculation pump 805 preferably are the same as those of the recirculation pump 305 described above. The motor 807 is preferably connected to the crank assembly 866 by a mechanical coupling. The motor 807 can impart rotational motion to the crank assembly 866. The crank assembly 866 can convert the rotational motion into reciprocating motion. The reciprocating motion of the crank assembly 866 can move the diaphragm within the cartridge 806 as described above with reference to Figure 3. Figure 8A shows the cartridge 806 detached from the recirculation pump 805. The cartridge 806 can be detached from the recirculation pump 805 for the purpose of sterilizing or disposing of the cartridge 806. Since cartridge 806 is the only component of the recirculation pump 805 that comes into contact with gas from the patient's peritoneal cavity, the remaining components of the recirculation pump 805 can be reused for another patient without jeopardizing the patient's safety. Cartridge 806 should be sterilized or disposed of after use in a patient, and a new cartridge 806 should be inserted into the recirculation pump 805 for the next patient.

[0039] Figure 8B shows a cartridge 806 inserted into a cartridge holder 870 of a recirculation pump 805. The cartridge 806 can be secured within the recirculation pump 805 using a locking arm 868. The locking arm 868 preferably includes a projection 872 designed to fit into a recess 874 located in the cartridge 806. The projection 872 is most clearly visible in Figure 8D. The recess 874 is most clearly visible in Figure 8C. The cartridge 806 can be secured within the cartridge holder 870 when the projection 872 is positioned in the recess 874, as shown in Figure 8F. The cartridge 806 can be released from the cartridge holder 870 by pressing down the end of the locking arm 868 and then lifting the cartridge 806 from the cartridge holder 870. The method of securing and releasing the cartridge 806 from the recirculation pump 805 may vary depending on the operational requirements.

[0040] Referring to Figure 9, an embodiment of the gas recirculation system 900 is shown. The gas recirculation system 900 may include components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 8. The gas recirculation system 900 may include a recirculation pump 905, a pump cartridge 906, a motor 907, an input trocar 910, an output trocar 915, valves 935, 936, a fluid trap 930, a filter 932, a controller 940, a user interface 945, and a power supply 976. The controller 940 may include a DC motor control circuit 978 and a processor circuit 980. The user interface 945 may include a computer with software, such as LabVIEW®, for controlling some or all of the components of the gas recirculation system 900.

[0041] The gas recirculation system 900 can monitor the load applied to the motor 907 in order to detect any associated faults or safety problems. The load on the motor 907 can be monitored by measuring the change in current across a resistor located in the power path of the motor 907, for example, by connecting the resistor to an AD converter to measure the current. The current changes as the load on the motor 907 changes. Current measurements can be taken in real time or may include a delay. A current change greater than or less than a predetermined value may indicate that the gas recirculation system 900 has a fault or safety problem, and the recirculation pump 905 can be initiated to stop. It is preferable to incorporate software, for example, in the controller 940, to sense the current change and initiate the stopping of the motor 907.

[0042] The predetermined current value that defines the point in time when a failure or safety problem occurs should preferably be based on the average current when the gas recirculation system 900 is operating normally. Current measurements greater than the average may indicate a failure or safety condition such as a disconnected valve 935 or 936, or an obstruction in the tubing connecting the recirculation pump 905 to the patient's peritoneal cavity. For example, if the average current measured while the motor 907 was driving the diaphragm in the cartridge 906 during normal operation was 0.3A, a measured current of 0.4A may indicate an obstruction in the tubing connecting the recirculation pump 905 to the patient's peritoneal cavity, and a measured current of 0.5A may indicate that either valve 935 or 936 has disconnected. Other methods or statistics, such as using the variance of the measured current or using comparisons against stored time templates or frequency templates, will be used to define when a failure or safety condition occurs. Additionally or alternatively, the computer in the controller 940 may enable a Fast Fourier Transform to analyze the frequency components of the current measurement signal.

[0043] The interface M1 between the pump cartridge 906 and the motor 907 is preferably a mechanical interface. Interface M1 can be designed to operate reasonably well over a continuous period longer than the duration for which the gas recirculation system is used during the surgical procedure. For example, if the maximum duration for the surgical procedure is 4 hours, interface M1 can be designed to operate continuously without malfunction for 8 hours.

[0044] The speed of motor 907 can be specified to enable the delivery of CO2 gas at a rate of 7 liters per minute. Suitable motors for motor 907 may include high-speed motors of the Moog® brand. Important operating parameters for motor 907 include torque, speed, and failure conditions. The operating current of motor 907 can be specified in several ways, such as normal operating current, failure current, inflation current, and deflation current. These current values ​​are best used to determine when motor 907 will stop due to failure or safety conditions.

[0045] Interface E1 is located between the motor 907 and the DC motor control circuit 978. It is preferable to have eight wires within interface E1. These eight wires may include wires for each of the three drive phases of the motor 907, wires for the three Hall sensor pickups, a wire for powering the Hall sensors, and a ground wire. These eight wires may be common across multiple motor manufacturers.

[0046] Interface E3 is located between the DC motor control circuit 978 and the processor circuit 980. Within this interface, it is preferable to have multiple lines depending on the speed control and feedback methods.

[0047] The speed of motor 907 can be controlled using two methods: voltage control and digital control. The first method, using voltage control, involves a processor circuit 980 that sends a voltage to the control circuit 978 via a potentiometer or pulse-width modulated signal. For example, in this method, the maximum speed of motor 907 can be reached by having the processor circuit 980 supply a voltage of 3.25V to the motor control circuit. The second method involves sending a digital signal to the motor control circuit 978 within the processor circuit 980.

[0048] The gas recirculation system 900 can detect two recoverable failure conditions, such as an inflated failure condition and a deflate failure condition. Other unrecoverable failure conditions may occur, such as a problem associated with the motor 907. An inflated failure condition may occur when the gas circuit fails on the suction side of the gas recirculation pump 905, thereby drawing outside air into the gas recirculation system 900, for example, when the valve 935 is disconnected from the output trocar 915. This condition is called "inflated" because if the recirculation pump 905 is not stopped, it may inflate the patient's peritoneal cavity with outside air. An alternative to stopping the recirculation pump 905 in the event of an inflated failure condition is to reduce the gas flow through the recirculation pump 905 to a small amount in order to minimize the amount of outside air being introduced into the peritoneal cavity. A deflate failure may occur when the gas circuit fails on the discharge side of the gas recirculation pump 905, thereby allowing gas from the peritoneal cavity to be pumped into the surrounding environment, for example, when valve 936 is disconnected from the input trocar 910. This condition is called "deflate" because the peritoneal cavity may begin to deflate due to the loss of gas from the gas recirculation system 900. A deflate failure may trigger the activation of a blower connected to the peritoneal cavity to maintain a desired inflation level or pressure within the peritoneal cavity.

[0049] The gas recirculation system 900 can be controlled by a user interface 945. The user interface 945 can be located within the gas recirculation system 900 and / or within a computer connected to the gas recirculation system 900. The user interface is preferably a multimode interface that can be controlled by software such as LabView®. The first mode can be "output" and the second mode can be "control". In "output" mode, the processor in the controller 940 can output information for monitoring the motor 907. Such information may include motor speed (RPM), current (mA), voltage (V), and motor status.

[0050] Referring to Figures 10A and 10B, embodiments of the gas recirculation system 1000 are shown. The gas recirculation system 1000 preferably includes components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 9. The gas recirculation system 1000 preferably includes a magnetic coupling between the diaphragm actuator 1081 and the motor coupling arm 1082 such that when the pump cartridge 1006 is inserted into position, the magnet on the diaphragm actuator 1081 is attracted to the magnet on the motor coupling arm 1082. With the magnets attracted to each other, the diaphragm actuator 1081 will follow the motor coupling arm 1082 up and down as the motor coupling arm 1082 moves up and down, causing a pumping action within the pump cartridge 1006. The magnetic coupling preferably consists of an electromagnet that cycles on and off to create and release the coupling between the diaphragm actuator 1081 and the motor coupling arm 1082 for removal of the pump cartridge 1006, etc. As an alternative, the magnetic coupling may be non-electromagnet. Figure 10A shows a pump cartridge 1006 with a magnet on the diaphragm actuator 1081 before it is inserted into and coupled to the motor coupling arm 1082. Figure 10B shows the pump cartridge 1006 after it has been inserted and the diaphragm actuator 1081 has been magnetically coupled to the motor coupling arm 1082.

[0051] As a variation, instead of using a motor with a crank arm to move the diaphragm actuator 1081 up and down, it is preferable to use an oscillating magnetic field to move a magnet attached to or embedded in the diaphragm actuator 1081 to move the diaphragm actuator 1081 up and down, thereby producing a pumping action within the pump cartridge 1006. Additionally or alternatively, a motor with a crank arm can provide downward motion, while a spring positioned within the pump cartridge 1006 can provide upward motion of the diaphragm. Such an arrangement eliminates the need to couple the diaphragm with the motor crank arm.

[0052] Figures 11A to 11F disclose embodiments of valves for connecting input and output tubing to a trocar, for example, valves 135, 235, 236, 935, and 936. Valve 1135 in Figure 11A preferably has a rotatable collar with a movable section, so that when valve 1135 is tightly coupled, it opens and gas flows, and when it is uncoupled, it blocks the flow of gas. Figure 11A is an exploded view of valve 1135, which preferably includes a male luer lock fitting 1137 that connects to a female luer fitting (not shown) and rotates to allow gas flow. Valve 1135 preferably further includes a sleeve and tubing connector 1138 for coupling to the input or output tubing, an O-ring for preventing leakage, and a part for holding the remaining components in place. Figure 11B is an end view of valve 1135, and Figure 11C is a side view of valve 1135. Figures 11D, 11E, and 11F are cross-sectional views of valve 1135. Figure 11F shows a tab 1139 that prevents over-rotation of the male Luer lock 1137 attachment portion of valve 1135.

[0053] Figure 12 shows a cross-sectional view of valve 1135 in its open configuration. The arrows in Figure 12 reveal the gas flow path through valve 1135 when the male Luer lock fitting 1137 is rotated to allow gas flow. When valve 1135 is connected to a trocar, the male Luer lock fitting 1137 rotates inside the stationary sleeve 1138, aligning the opening in the male Luer lock fitting 1137 with the opening in the sleeve 1138 to allow gas to pass through. When valve 1135 is disconnected, the openings become misaligned, blocking the gas flow.

[0054] Figure 13 discloses a cross-sectional view of valve 1135 in a closed configuration. The arrows in Figure 13 disclose the gas flow path that stops within valve 1135 when the male Luer lock accessory 1137 is rotated to block the fluid flow.

[0055] Figure 14 shows an embodiment of the gas recirculation system 1400. The gas recirculation system 1400 preferably includes components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 13. The gas recirculation system 1400 preferably includes a bypass valve 1483 positioned between the output tubing 1425 and the input tubing 1420. The arrows shown in Figure 14 may indicate gas flow paths. The bypass valve can normally be closed so that there is no gas flow path between the output tubing 1425 and the input tubing 1420. When the bypass valve 1483 is opened, this can create a gas flow path from the input tubing 1420 to the output tubing 1425, as indicated by the arrows in Figure 14. The gas flow path from the input tubing 1420 to the output tubing 1425 can create a circulating gas loop around the pump cartridge 1406 that can limit the downstream pressure that may occur during the pumping cycle. For example, by opening the bypass valve 1483, a portion of the gas flow can be diverted from the pump cartridge 1406 into the output tubing 1425, thereby preventing a pressure increase downstream of the bypass valve 1483. The bypass valve 1483 is preferably a one-way pressure relief valve such as a Minivalve valve or a Halkey / Roberts® valve, for example, a duckbill valve or a spring-loaded valve. The bypass valve 1483 can be selected to open automatically based on the pressure present on its inlet side or elsewhere downstream of the pump cartridge 1406. For example, the bypass valve 1483 can be selected to open at pressures ranging from as low as 0.1 psi to over 10 psi, depending on the application. It may be preferable for the bypass valve 1483 to open when the pressure is in the range of approximately 0.15 psi to 0.55 psi.

[0056] Figures 15A and 15B disclose embodiments of moisture traps, e.g., moisture traps 130, 230, and 930. It is preferable to position the moisture trap 1530 in Figures 15A and 15B in the output tubing (not shown), where the gas flows from the patient to a recirculation pump (not shown), as indicated by the arrow in Figure 15B. Figure 15B is a cross-sectional view of the moisture trap 1530 including a tube 1584 extending within the moisture trap 1530. The tube 1584 preferably begins on the gas inlet side of the moisture trap 1530 and extends toward the outlet of the moisture trap 1530, but preferably not in contact with the outlet of the moisture trap 1530, resulting in a gap between the end of the tube 1584 and the outlet of the moisture trap 1530. This gap allows any liquid present in the gas to drip out before the gas reaches the outlet of the moisture trap 1530. The liquid removed from the gas can be collected within the moisture trap 1530. The size of the gap between the end of pipe 1584 and the outlet of moisture trap 1530 may vary depending on the application. For example, in applications with a high gas velocity, a wider gap may be required to allow liquid in the gas to drip out, while in applications with a relatively low gas velocity, a narrower gap may be required to allow liquid in the gas to drip out. Moisture trap 1530 does not necessarily have to contain an absorbent medium for collecting liquid within it. Moisture trap 1530 and its components may be made of any suitable material to keep in contact with the liquid, such as plastic or metal.

[0057] Figures 16A and 16B disclose other embodiments of the moisture trap, e.g., moisture traps 130, 230, 930, and 1530. The moisture trap 1630 in Figures 16A and 16B is preferably positioned in the input tubing (not shown), where the gas flows from a recirculation pump (not shown) to the patient, as indicated by the arrows in Figure 16B. Figure 16B shows a cross-sectional view of the moisture trap 1630, both including an input tube 1685 and an output tube 1685 extending within the moisture trap 1630. The input tube 1684 is preferably positioned to begin on the gas inlet side of the moisture trap 1630 and extend toward the outlet side of the moisture trap 1630. The output tube 1685 is preferably positioned to begin on the gas outlet side of the moisture trap 1630 and extend toward the inlet side of the moisture trap 1630. The input tube 1685 and the output tube 1685 are preferably arranged to extend beyond each other within the moisture trap 1630, creating an overlap as shown in Figure 16B. As a result, gas entering the moisture trap 1630 from the input tube 1684 cannot flow directly into the output tube 1685, but must first flow through the inside of the moisture trap 1630. As shown in Figure 16B, the input tube 1684 and the output tube 1685 are preferably arranged with bends such that parts of these tubes overlap while the inlet of the input tube 1684 and the outlet of the output tube 1685 remain axially aligned. The liquid in the gas can drip out as it flows through the inside of the moisture trap 1630, after which the gas flows out of the moisture trap 1630 through the output tube 1685. The liquid removed from the gas can collect inside the moisture trap 1630. The moisture trap 1630 does not necessarily have to contain an absorbent medium for collecting the liquid inside the moisture trap 1630. The moisture trap 1630 and its components may be made of any suitable material, such as plastic or metal, to keep them in contact with the liquid.

[0058] Figures 17A to 17C show embodiments of the gas recirculation system 1700. The gas recirculation system 1700 may include components and operating characteristics similar to those of the gas recirculation system described in Figures 1 to 16B. The gas recirculation system 1700 may include a recirculation pump enclosure 1786 which contains some of the components of the gas recirculation system 1700, such as the recirculation pump 1705, pump cartridge 1706, motor 1707, controller 1740, user interface 1745, power supply 1776, DC motor control circuit 1778, and processor circuit 1780.

[0059] Figure 17A shows the gas recirculation system 1700 with the cartridge door open and the pump cartridge 1706 installed inside the enclosure 1786. Figure 17C is a detailed cross-sectional view of the gas recirculation system 1700 showing the pump cartridge locking mechanism 1787. The pump cartridge locking mechanism 1787 preferably includes a spring 1788 with a ball 1789 positioned at one end of the spring 1788. The spring 1788 can exert force on the pump cartridge 1706 via the ball 1789, thereby locking the pump cartridge 1706 inside the enclosure 1786. In a modified example, the spring 1788 may exert force directly on the pump cartridge 1706 without the ball 1789.

[0060] Figure 18A is a perspective view of the gas recirculation system 1700 with the pump cartridge 1706 in its pre-insertion position. Figure 18B is a perspective view of the gas recirculation system 1700 with the pump cartridge 1706 installed inside the enclosure 1786.

[0061] Figure 19A is a perspective view of the gas recirculation system 1700 with the cartridge door closed. Figure 19B is a perspective view of the gas recirculation system 1700 with the cartridge door open and the pump cartridge 1706 not installed.

[0062] Figures 20A to 20F show the gas recirculation system 1700 with the cartridge door closed. The dimensions shown in Figures 20A to 20F are illustrative and can be changed depending on the application of the gas recirculation system 1700.

[0063] Figures 21A to 21H show embodiments of the gas recirculation system 2100. The gas recirculation system 2100 may include components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 20. The gas recirculation system 2100 may include a pump cartridge 2106 having a coded connector 2190. The connector 2190 may be the one described in U.S. Patent No. 9,283,334, which is incorporated herein by reference. The connector 2190 can identify whether the correct pump cartridge 2106 is connected to the recirculation pump 2105, or whether the pump cartridge 2106 has been used in the past, or can select and configure the gas recirculation system 2100 to operate according to a special setting, for example, according to a flow rate. Figures 21A to 21H show perspective views of the pump cartridge 2106 having the connector 2190.

[0064] Figures 22A and 22B show embodiments of the gas recirculation system 2200. The gas recirculation system 2200 preferably includes components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 21. The gas recirculation system 2200 preferably includes a component that allows the pump cartridge 2206 (not shown) to be coupled to the motor coupling arm 2282 in a "blind" manner, so that the user does not know the exact location of the motor coupling arm 2282 and does not have to bend over to look inside the gas recirculation system enclosure 2286 (not shown) to confirm the location of the motor coupling arm 2282. Figure 22A shows a coupling shaft 2291 extending from the front of the motor coupling arm 2282. The coupling shaft 2291 preferably has a tapered end portion to assist in the insertion of the coupling shaft 2291 into a corresponding opening in the diaphragm actuator 2281 (not shown in Figure 22, but shown in Figures 5, 6, 8, and 21). The diaphragm actuator 2281 preferably has a corresponding tapered opening (as shown in Figure 21). A positioning pin 2292 preferably extends from the rear of the motor coupling arm 2282. The positioning pin 2292 can be fitted into a positioning slot 2293. Figure 22B is a detail view of the coupling shaft 2291 and the positioning pin 2292 extending from the motor coupling arm 2282. The positioning slot 2292 is found within a mount to the motor 2207 or other stationary part of the enclosure 2286. The positioning pin 2292 can move up and down within the positioning slot 2293 when the motor 2207 is moving the motor coupling arm 2282 up and down. The positioning slot 2293 will restrict the lateral movement of the positioning pin 2292.Since the positioning pin 2292 is connected to the motor coupling arm 2282, the limitation of the lateral movement of the positioning pin 2292 ensures that the motor coupling arm 2282 and the coupling shaft 2291 remain in substantially the same vertical plane, regardless of the position of the motor coupling arm 2282 when the motor 2207 is stopped. Therefore, the user can easily insert the pump cartridge 2206 into the enclosure 2286 and easily couple the diaphragm actuator 2281 to the motor coupling arm 2282.

[0065] Figures 23A to 23F show diagrams of various parts of the gas recirculation system 2200. Figure 22A shows a front view of the mount for the motor 2207 and the motor coupling arm 2282 with coupling shaft 2291. Figure 23B shows a side section view of the mount for the motor 2207 together with the motor 2207, coupling shaft 2291, and positioning pin 2292. Figure 23C shows detailed views of the coupling shaft 2291 and positioning pin 2292 as seen from the front and rear of the motor coupling arm 2282, respectively. Figure 23D shows a side view of the mount for the motor 2207 together with the motor 2207 and positioning pin 2292 extending through the positioning slot 2293. Figure 23E shows a rear view of the mount for the motor 2207 together with the motor 2207 and positioning pin 2292 extending through the positioning slot 2293. Figure 23F shows a detailed rear view of the positioning pin 2292 with the positioning pin 2292 extending through the positioning slot 2293.

[0066] Figures 24A and 24B show embodiments of the gas recirculation system 2400. The gas recirculation system 2400 preferably includes components and operating characteristics similar to those of the gas recirculation systems described in Figures 1 to 23. The gas recirculation system 2400 preferably includes components for exhausting CO2 gas from the patient's peritoneal cavity after laparoscopic surgery is completed. Typically, after laparoscopic surgery is completed, a Luer connector on the trocar that was inserted into the patient opens, allowing the CO2 gas to escape from the patient's peritoneal cavity into the operating room. Undesirably, the escaping CO2 gas is not filtered and may therefore contain fuzzy chemicals, particles, bacteria, etc., remaining from the surgical procedure.

[0067] The gas recirculation system 2400 preferably includes a three-way valve 2494 located within the input tubing 2420. The input tubing 2420 provides flow to the patient. As shown in Figure 24A, the three-way valve 2494 is preferably located downstream of the filter 2432, so that any gas flowing through the three-way valve 2494 is already filtered and free of impurities. Figure 24B is a detailed diagram of the gas recirculation system 2400, showing the three-way valve 2494, input tubing 2420, output tubing 2425, and filter 2432. At the end of the surgical procedure, before the recirculation tubings 2420, 2425 are removed and while the recirculation pump 2405 is still operating, the three-way valve 2494 is preferably configured to block the flow of gas to the patient and allow gas to flow back into the operating room. Thus, the recirculation pump 2405 pumps CO2 gas out of the patient's peritoneal cavity, ensuring that the filter 2432 does not allow any contaminants to escape from the patient. Rather than simply disconnecting the input tubing 2420 from the patient, the three-way valve 2494 is used to allow gas flow into the operating room, so that only gas from the patient entering the operating room is passed through and filtered by the filter 2432, and as a means to this end, all gas connections with the patient that were present during the initial surgical procedure are maintained. By using the three-way valve 2494 to remove CO2 gas from the patient, the risk to operating room staff can be reduced without requiring additional measures to ensure the cleanliness of escaping CO2 gas.

[0068] Figures 25A and 25B show a three-way valve 2494 isolated from the input tubing 2420. The three-way valve 2494 preferably has two in-line spike fittings 2495 for coupling to the input tubing 2420. The three-way valve 2494 preferably further has a female Luer connector 2496 directed perpendicularly to the two in-line spike fittings 2495. The female Luer connector 2496 may be used for pressure relief purposes, for example, to release CO2 gas into the operating room. The three-way valve 2494 preferably further has a stopcock 2497 that rotates to adjust the open flow path of the three-way valve 2494. As shown in Figure 25, the closed flow path through the three-way valve 2494 is indicated by the "off" portion of the stopcock 2497. Figure 25A shows a three-way valve 2494 configured to allow gas flow through two in-line puncture fittings 2495, which are preferably connected to an input tubing 2420 leading to the patient. The configuration in Figure 25A is preferably used when the recirculation function is being performed. The configuration of the three-way valve 2494 in Figure 25A can prevent gas from being released into the operating room. Figure 25B shows a three-way valve 2494 configured to allow gas flow out through a female Luer connector 2496 and into the operating room. Figure 25B is preferably used at the end of a surgical procedure when gas is being discharged from the patient. The configuration of the three-way valve 2494 in Figure 25B can prevent gas from flowing into the patient.

[0069] Now, we will describe another form of gas recirculation system that has automatic response capabilities to changes in detected smoke content and can include any one or more of the features of the gas recirculation systems shown in Figures 1 to 25 above. The illustrative gas recirculation system 2600 in Figure 26, which has a smoke detection method, includes many of the same features and components as those described in Figure 2 for the gas recirculation system 200. In Figure 26, components identical to those in Figure 2 are labeled with the same identification numbers shown in Figure 2. However, unlike the gas recirculation system 200, the gas recirculation system 2600 further includes a smoke detection sensor 2602 in contact with the controller 240. Also provided is a valve 2604, which can be controlled by the controller 240 to either send the gas from the tubing exiting the peritoneal cavity to a recirculation pump 205, or to a suction exhaust pipe 2606 that receives suction force from a suction source 2608 and extracts the gas and smoke to a destination outside the closed system, as shown in Figure 26. As illustrated by the following different concrete examples, the valve 2604, the suction / exhaust pipe 2606, and the suction source 2608 may be omitted in some embodiments.

[0070] The gas recirculation system 2600 preferably includes a smoke detection mechanism that automatically starts, stops, or adjusts the amount of smoke filtration generated by the procedure. A smoke detection sensor 2602, which can be positioned within the gas pump 205 or even within the peritoneum itself (as shown in the figure) along the gas passage between the gas recirculation device and the peritoneum, is in contact with the controller 240. To provide a well-equipped environment for smoke measurement, the smoke detection sensor 2602 is preferably embodied as a standalone sensor positioned along the path of the gas tubing exiting the peritoneum rather than within the peritoneum or within the SRS itself, although other placement locations are also conceivable. The controller 240 can use the amount of smoke detected by the sensor 2602, or information regarding the amount and duration, to automatically adjust the speed of motor 207 of the gas recirculation motors in the pump 205 based on the calculated amount and / or duration of the detected smoke. The gas recirculation system 2600 may optionally further include a valve 2604, which can be selectively controlled by the controller 240 to choose between operating in a closed system consisting of input and output tubing 220, 225 and gas removal filters 230, 232 located within them, or operating in a state where a suction exhaust pipe 2606 coupled to the suction source 2608 rapidly removes gas and smoke when smoke density increases beyond a predetermined maximum value. Any of the many known suction sources, including a standalone pump or a built-in wall-mounted suction port provided in a medical facility, can be used as the suction source 2608.

[0071] The suction source 2608 may be fixed at a predetermined flow rate or adjustable to any of a number of flow rates. In one embodiment, a flow rate in the range of 10 to 12 liters per minute may be acceptable for the suction source 2608, but it is assumed that the suction source 2608 can provide a minimum flow rate of 12 liters per minute (lpm). In some embodiments, a minimum flow rate of 15 lpm for the suction source is planned to provide a flow faster than the motor-assisted flow if the smoke accumulation is too rapid for the pump to handle on its own. In embodiments where the suction source is a fixed flow source, the suction source may be always on or controlled by the controller 240 to be either on or off. In embodiments where the suction source 2608 is either always on or only controllable between on and off, the valve 2604 is adjustable by the controller 240 to adjust the suction flow rate applied to the recirculating gas during removal. In another concrete example, the suction source 2608 may be a variable flow rate suction source adjustable by the controller 240.

[0072] Various forms of smoke detection technology are conceivable for the smoke detection sensor 2602. Examples of these distinct technologies include electrochemical sensors, chromatographic sensors, optical sensors, photoelectronic sensors, sound sensors, or electrical pairings. Suitable electrochemical sensors include ionization smoke detector circuits, such as detectors using americium 241, which ionizes a gas to generate an electric current in adjacent electrodes. Any of the many other electrochemical gas sensors available, such as the Figaro TGS5342 or TGS5141-P00 electrochemical sensors available from Figaro USA Inc., Arlington Heights, Illinois, are also available. Chromatographic sensors, photoelectronic sensors, or photoelectronic smoke detectors that detect direct or reflected light from a light source, such as a light-emitting diode (LED), can be embodied in various embodiments. Sound detectors can be embodied to detect the sound of a smoke-generating appliance (e.g., a cauterizing appliance) while operating to trigger the smoke exhaust function described herein. Furthermore, direct electrical pairing between the smoke generating device and the smoke exhaust device can be used, resulting in a signal being sent to the smoke exhaust system by the operation of the smoke generating device, which then stops or starts the smoke exhaust system in coordination with the surgeon's cauterization or use of the smoke generating device. In one embodiment, only one sensor technology may be implemented as the smoke sensor. In other embodiments, two or more combinations of sensor technologies may be implemented.

[0073] An example of a photodetection sensor using a photoelectron sensor configuration is shown in Figure 27. In the embodiment of Figure 27, the sensor 2702 is positioned inline along a gas channel, for example, adjacent to, on, or within a tubing 2703 that carries gas from the peritoneum. The sensor has a housing 2704 that houses a light source 2706, such as an infrared laser or a high-brightness LED, which emits light across the gas channel. A photoreceptor 2708 is preferably positioned in close proximity to the light source 2706 within the housing in a scattering detection configuration, so that no light reaches the photoreceptor 2708 that is in the direct path from the light source 2706. Rather, the photoreceptor 2708 is positioned at an angle that allows it to receive only light from the light source 2706 that has been reflected from the gas after it has left the light source. Thus, when smoke enters the gas channel, light from the light source 2706 is reflected by particulate matter in the smoke and reaches the photoreceptor 2708, which then generates an output signal that is transmitted to the controller 240. The photodetector can transmit this output signal to the controller 240 via wired or wireless connection means 2710. In various embodiments, the output signal can be further improved by using two or more photoreceptors 2708 within the smoke detection sensor 2702 to capture a large portion of the dispersed light.

[0074] In a modified embodiment, the infrared light source 2706 and the photoreceptor 2708 are preferably oriented to face each other directly, so that a direct beam of infrared light from the light source reaches the photoreceptor. In this direct beam configuration, if there is smoke in the gas flow, the smoke will reflect some or all of the light, resulting in less light reaching the photoreceptor 2708. The output signal magnitude is preferably used by the controller 240 to determine the amount of smoke present in the gas. In some embodiments, the circuit meter in the sensor 2702 is preferably configured so that the output signal magnitude increases as the smoke density increases. As a variation, a known decrease in the magnitude of the initial output signal level may indicate the amount of smoke present in the gas flow.

[0075] In yet another embodiment of the chromatography / photoelectron sensor configuration shown in Figure 28, the smoke detection sensor 2802 is preferably a dual-wavelength / dual-detection sensor based on the non-dispersive infrared (NDIR) principle. This modified sensor 2802 is also preferably positioned along a gas flow path and has a housing 2804 with two photoreceptors 2808, 2809 in the direct path of a powerful broadband light source 2806 that generates the wavelengths necessary for CO2 detection, the powerful broadband light source 2806 may be referred to herein as the emitter. For example, in a system that recirculates CO2 gas, one of the photoreceptors, i.e., the first photoreceptor 2808, is preferably configured to detect a 4.2 μm wavelength absorbed by the CO2 gas, and the second photoreceptor 2809 is preferably configured to detect a 3.9 μm wavelength that is unaffected by any gas but affected by particulate matter in any smoke. In this case, the controller 240 can determine the quality of the CO2 gas in parts per million (PPM) depending on the combination of photoreceptor outputs. In one modified example, photoreceptors 2808 and 2809 may each have different thin-film filters (TFFs), each having a wavelength band pass-through profile tuned to detect different component gases or particles in the smoke, such as carbon monoxide.

[0076] Referring to Figure 29, the smoke sensor 2902 is preferably positioned within or adjacent to the pump 205, rather than within or adjacent to the input or output tubing. In some embodiments utilizing one or more photoelectron emitters and one or more photoelectron detectors as smoke detection sensor technology, the sensor 2902 is preferably located within the pump, for example, in a removable cartridge 2606 of the pump 205. As shown in Figure 30, one or more photoelectron emitters 3006 and a number of detectors 3008 are preferably positioned adjacent to the cartridge 506, so that the circulating flow passes through an optical path 3009 between the emitters 3006 and the detectors 3008. The emitters 3006 and detectors 3008 are not in fluid contact with the recirculating gas, but are isolated by the cartridge material, which is transparent to the wavelengths delivered by the photoelectron emitters, at least in the region adjacent to the photoelectron emitters 3006 and detectors 3008. Thus, physical isolation of the sensor from the gas can improve the risk of biocompatibility of the system and the relationship with fluid-contact sensors. In addition, this isolation method can improve system robustness by protecting the sensor from performance degradation due to corrosion and contamination associated with water condensation of smoke and other chemical components during surgery. A modified form of cartridge 506 in Figure 5 is shown in Figure 30, but any of the pump cartridges shown earlier may be modified to have the sensor disclosed herein.

[0077] The electrical contacts supplying power to the sensor's emitter 3006 and detector 3008 should be located where the cartridge is inserted into the recirculation unit. Placing the detector 3008 proximally to the recirculation pump reduces signal transmission distance and electromagnetic interference. Furthermore, placing the detector 3008 proximally to the pump minimizes the need for wires that could impair flow or biocompatibility if routed through the tubing set. In addition, placing the sensor near the cartridge helps avoid clutter in the operating room and eliminates the risk of entanglement / tripping caused by long wires running outside the tubing set from sensors located far from the pump along the tubing.

[0078] Referring to Figure 31, an exemplary detector 3008 is shown, which is an array of smoke sensors 2902. Each of the sensor detectors may be equipped with a thin-film filter (TFF) 3001, each of which has a wavelength band pass-through profile tuned to detect different component gases or particles in the smoke, for example. The signal levels from each of these detectors are synchronized by a recirculation pump controller, thereby enabling the detection of various gas component signatures and concentrations. Power to supply the sensors 2902 is obtained by a wired connection, for example, by electrical contacts on a removable cartridge 506 that mate with electrical contacts on the housing of the pump 205. The data signals from the detectors 3008 may be transmitted to the controller 240 by wire or wirelessly. For example, instead of wires to transmit data to the controller or other parts of the smoke removal system, a printed circuit board assembly (PCBA) 3003 containing an integrated circuit may be electrically connected to each detector 3008, or it may be a series of integrated circuits, each dedicated to each corresponding detector 3008. The PCBA may be configured to wirelessly transmit signals to and from the recirculation pump and / or pump controller, thereby transmitting the locally detected output of the photoelectron sensor.

[0079] In other embodiments, sensors 2602, 2902 may be electrochemical sensors 3200, as shown in Figure 32. Similar to the photoelectronic sensor configuration, the electrochemical sensors 3200 may be located along or within the tubing (output or input) or at the pump. The electrochemical sensors 3200 may have one or more counter electrodes 3202 in an electrically powered state with an working electrode 3201 and an electrochemical sensor circuit 3203. In embodiments in which the electrochemical sensors 3200 or at least electrodes 3201, 3202 of the electrochemical sensors are located within the input tubing, the working electrode 3201 of the electrochemical sensors may be in fluid contact with the recirculating gas, and a wire may be used to make an electrical connection to the controller 240 and the rest of the smoke recirculation system. In modified embodiments, a wireless configuration of the electrochemical sensor may be implemented instead of the wired configuration. For example, a wireless communication circuit may be integrated with the electrochemical sensor instead of wires for transmitting data to the controller or other parts of the smoke removal system. Similar to the photoelectronic sensor configuration described above, the wireless communication circuit for the electrochemical sensor configuration may be a discrete circuit provided on an integrated circuit or printed circuit board assembly, wherein an embedded wireless transmitter is electrically connected to the electrochemical sensor. The wireless transmitter is preferably configured to transmit a signal wirelessly to a receiver provided on the recirculation pump and / or pump controller, thereby transmitting the locally detected output of the electrochemical sensor 3200. The wired or wireless configuration of the electrochemical sensor embodiment may, in various embodiments, be located along or within the input tubing or output tubing, or along or within the pump cartridge of the pump. For example, the electrochemical sensor 3200 may be located within the wall of the pump cartridge, for example, the wall of cartridge 506 (Figure 5B), in which case the working electrode 3201 makes fluid contact with the recirculating gas at the proximal portion of the tubing set. In this case, the electrochemical sensor 3200 may make electrical contact with the pump or other parts of the gas recirculation device at the insertion site.

[0080] As shown in Figures 33 to 35, the electrochemical sensor 3200 is preferably positioned within the bottom wall 3305 of the gas recirculation pump cartridge 3306. The electrochemical sensor 3200 is preferably oriented so that the working electrode 3201 faces the gas contact area inside the cartridge 3306, so that the electrochemical sensor is positioned close to the gas flow (indicated by arrow 3307). The working electrode 3201 is preferably in fluid contact with the recirculating gas at the proximal portion of the tubing set and at the counter electrode 3202 of the sensor (the two electrical leads of the sensor), which is exposed so that an electrical connection is made with the corresponding mating pad inside the pump when the pump cartridge 3306 is inserted into the pump.

[0081] Figure 34 shows a motor enclosure 3400 with a modified motor assembly 3500 of the gas recirculation system's pump motor, and Figure 35 shows the modified motor assembly 3500 of the gas recirculation system removed from the motor enclosure 3400. The motor enclosure 3400 and the modified motor assembly 3500 in Figures 34 and 35 are coupled to a pump cartridge 3306, but the pump cartridge 3306 is omitted to better show the location of the conductive mating pads 3401 and 3402 corresponding to the electrodes 3201 and 3202 provided on the bottom wall of the pump cartridge 3306. In this case, the pump cartridge 3306 is removable and can be inserted into the motor enclosure and motor assembly in the same manner as cartridge 1706 was shown inserted in Figure 18A above. The modified pump enclosure 3400 and modified motor assembly 3500 are shown as modified forms of the pump and motor system shown in Figures 19B and 22A above, but any of a number of different pump housing and recirculation system configurations that can work with the removable pump cartridge are envisioned. Also, as understood in the embodiment of Figure 36, other locations for the electrochemical sensor 3200 are envisioned on the cartridge 3606, such as on the side wall of the cartridge 3606 rather than on the bottom as shown in Figure 33. In this case, complementary mating pads in the motor enclosure and / or motor assembly are relocated to the corresponding side walls of such components.

[0082] In yet another concrete example, as shown in Figures 37 and 38, a smoke detection sensor, such as an electrochemical sensor 3200, is preferably located within an input male Luer valve 3701 of a gas recirculation pump tubing set. In this manner, the working electrode is preferably in fluid contact with the recirculating gas at the proximal portion of the tubing set. A wire 3700 extending from the electrochemical sensor 3200 to the recirculation pump allows for the electrical transmission of signals from the sensor 3200 to the pump. Figure 37 shows the sensor 3200 in an input Luer valve 3701 receiving gas from the patient, and Figure 38 shows the sensor 3200 in an output Luer valve 3801 for the gas line to the patient. In different embodiments, one or both Luer valves may house an electrochemical sensor 3200 or other types of smoke detection sensors. Furthermore, unlike the wire 3600 which extends through the pipe from the sensor 3200 to the pump, the wire 3600 may exit the pipe at or near the Luer valve and extend outside the pipe to the pump, pump controller, or other destination. Placing the sensor within the Luer connection provides certain advantages compared to other placement locations within the smoke removal system, such as reduced response time and / or increased sensitivity due to its close proximity to the cauterization area. In addition, compared to placement within the pump, this arrangement can extend the sensor's lifespan and reduce the risk of wear by physically isolating the sensor from the pump's mechanical vibrations.

[0083] Using the gas recirculation systems shown in Figures 26 to 38, the operation method of the gas recirculation systems 2600 and 2900 will be described below. In the first concrete example, as shown in Figure 39, the controller 240 of the gas recirculation system can monitor the output signals of the smoke detection sensors 2602 and 2902 to detect the smoke density of the gas in the output pipe 225 (in step 3902). If the detected gas density is greater than a predetermined threshold (in step 3904), the controller 240 can communicate with the motor 207 of the pump 205 to increase the gas circulation speed, thereby increasing the speed at which smoke is filtered out of the gas (in step 3906). In one embodiment, if the smoke detection sensor is a light-based sensor (for example, for detecting light from a light source, such as an LED or source), the predetermined threshold is actually a plurality of thresholds associated with different motor speed changes, each based on the amount of light attenuation or reflection caused by smoke in the gas. For example, the motor 207 of pump 205 should be set to a default speed that increases towards the default speed or decreases back towards the default speed if it has already increased based on detected light attenuation / reflection.

[0084] After increasing the gas circulation speed, the controller 240 may check sensors 2602, 2902 to determine whether the smoke density has decreased to the same (or different) threshold density (in step 3908). The controller may continue to check for further decreases in smoke density until the smoke density falls below a predetermined threshold, at which point the controller reduces the motor speed (in step 3910). This process is repeatable. The timing at which the controller 240 checks sensors 2602, 2902 and compares the detected density to an appropriate threshold may be continuous or at predetermined time intervals. In one embodiment, the pump may be turned on or off in response to the detected smoke density. In a modified example, the pump 205 may be configured to allow continuous operation, and the controller may increase the motor speed from the default speed to a higher speed, and then decrease it back to the default speed. In a modified embodiment, the motor 207 can perform variable speed adjustment beyond an on or off setpoint, or between an initial non-zero speed and a higher speed setpoint. In this modified embodiment, the controller is configured to change the motor speed in a step-by-step manner, limited only by the speed adjustment accuracy of the motor 207, in proportion to the smoke detection density (e.g., the magnitude of the output signals received from sensors 2602 and 2902) between the minimum and maximum speeds. The motor may be a continuously variable speed motor or may have a wide range of speeds accessible to the controller.

[0085] In one specific example, the relationship between increasing the pump motor speed and the detected smoke in the recirculating gas should be based on the light attenuation detected by sensors 2702 and 2802. For example, starting from the default pump motor speed, the controller should not change the motor speed if the detected attenuation of light projected into the gas is 1% or less. It should be increased by 10% if the detected attenuation is greater than 1% but 3% or less, and by 25% if the detected attenuation is greater than 3% but 10% or less. Finally, in this specific example, it should be increased by 40% if the detected light attenuation is greater than 10%. The available default flow rate (when the detected light attenuation is 1% or less) should be 12 liters per minute (lpm) for the gas recirculation system, and the increased pump motor speed based on the detected smoke should increase the flow rate from the default flow rate. Although the relationship between the increase in pump motor speed and the increase in flow rate is not linear, it is expected that the controller 240 may be set to increase the motor speed by a desired percentage, or in other embodiments, compensation may be provided by adjusting the motor speed to achieve a desired increase in flow rate. In another embodiment, the default motor speed or flow rate may be adjustable by the user, and the range of increase in motor speed or flow rate may be determined by the user via the controller.

[0086] More complex and sophisticated smoke detection criteria beyond the instantaneous smoke density detection criteria described above can be embodied by the controller 240 in various embodiments. For example, the on / off or slow / fast decision of Figure 39 performed by the controller 240 can be combined with a number of separate measurements performed continuously, which are taken when a duration factor, such as elapsed time or detected smoke density, exceeds or falls below a predetermined threshold. Thus, the method of Figure 29 is preferably modified in steps 3904 and 3908 to require that the detected smoke (in the case of step 3904) exceeds a predetermined level for a predetermined time before triggering an increase in motor speed. Similarly, with respect to step 3908, the controller is preferably configured to reduce the motor speed only if the combination of smoke density and duration satisfies a predetermined low threshold. Furthermore, the density-time analysis of the two factors yields a range of different combinations—for example, the controller may increase the motor speed as a result of either an extremely high smoke density for a short duration or a slightly lower smoke density for a long duration. The controller is preferably programmed to execute code stored in this memory or a separate memory to process the sensor output from the smoke detection sensor with an internal clock signal or counter to determine whether predetermined threshold requirements have been met to increase or decrease the motor speed of the pump 205. Similarly, as described with respect to the smoke density-only embodiment in Figure 39, the motor is preferably equipped with a continuously variable speed adjustment (or just three or more speed adjustments) function that can use the integral data of the smoke density and the duration of that smoke density. Thus, the controller 240 is preferably programmed to execute a density and duration algorithm or lookup table to perform continuously variable speed adjustment of the pump motor 207. Thus, during surgical procedures, the smoke detection sensor can detect smoke in the gas in the abdominal cavity, and the controller 240 can correlate the detected smoke amount and control the circulation speed to filter out the smoke in the pneumoperitoneum, the purpose of which is to obtain an ideal surgical field at all times.The smoke density (e.g., light attenuation) and predetermined or user-selectable ranges of pump motor speed or flow rate are preferably stored in volatile or non-volatile memory within the controller 240 or are accessible to the controller 240.

[0087] Embodiments that adjust the pump and speed to rapidly circulate the gas when smoke is detected to exceed a certain threshold do not always provide a sufficiently rapid smoke removal function. Referring again to Figure 26, the system 2600 optionally includes a valve 2604 that switches to an exhaust mode, which can rapidly divert smoke-filled gas from a closed recirculation system that filters out smoke and is located at the gas flow path output section 225 to a suction exhaust pipe 2606 to obtain a high smoke removal rate.

[0088] As shown in Figure 40, it is preferable that the valve 2604 is controllable by the controller 240 to swing the valve door 4002 from a position where all the gas is delivered through the tubing of the closed system recirculation path to a second position (dotted line) where, unlike this, the gas is diverted to the suction / exhaust pipe 2606. The suction / exhaust pipe defines the exhaust / removal path leading to the suction source 2608 as described above. In a modified embodiment, the valve 2604 can receive an operating signal directly from the smoke detection sensor 2602, and in this embodiment, a sufficiently high output signal received directly from the sensor 2602 causes the valve to open the suction / exhaust path. While the embodiment in Figure 40 focuses on the embodiment in Figure 26 where the smoke sensor is located inside the pipe, the embodiment in Figure 29 where the smoke detection sensor 2902 is located inside the pump or pump housing is also preferable to have the suction / exhaust pipe, valve and suction source inside either the gas input pipe or the gas output pipe, similar to the embodiment shown in Figure 26, and this embodiment operates as described in Figure 40.

[0089] As shown in Figure 41, in several embodiment of the gas detection type gas recirculation system 2600, the suction exhaust pipe 2606 and valve 2604 are preferably used at various smoke detection levels to provide a smoke removal option faster than the speed available in the form of increasing the recirculation pump speed by the smoke removal filter. Figure 41 shows how smoke is removed in system 2600 which includes both an adjustable gas recirculation speed in closed gas reuse mode and a selectable suction exhaust for expelling smoke-filled gas outside the closed recirculation system. In the first step of this process, smoke in the gas is detected using the gas sensor 2602 (in step 4102). Next, it is determined whether there is enough smoke to accelerate (in the on / off embodiment as described above) or increase (in the embodiment where the pump is always on, whether having limited speed steps or being continuously variable) the speed of the pump motor (in step 4104). If the amount of smoke is large enough to accelerate or increase the pump speed but does not exceed the higher threshold requiring the use of the suction / exhaust path (in step 4106), the controller 240 may accelerate or increase the pump motor speed in a timely manner (in step 4108). If the amount of smoke detected is sufficient to trigger the higher threshold suction path (in step 4106), the controller 240, however, acts on valve 2604 to extract the gas and smoke into the suction source 2608 and bypass the closed recirculation path of system 2600 (in step 4114). The controller then uses measurements from smoke sensor 2602 (in steps 4104, 4110) to slow down or turn off the pump motor 2007 if the amount of smoke decreases (in step 4112).

[0090] As noted in the previous smoke detection embodiment, different smoke measurement criteria can be used. In one embodiment, the amount of smoke may be a single instantaneous measurement. In a variation, the smoke measurement may be a combination of smoke amounts measured over a period of time, in which case the average amount over a given time is used. In addition, a combination of different smoke densities and the associated duration of such smoke densities may be good for triggering an increase or decrease in the pump motor speed or satisfying a threshold for triggering use by the controller of the suction and exhaust path.

[0091] Referring to the above examples of light attenuation and pump motor speed (or flow rate), the threshold for opening valve 2604 to exhaust the gas into the suction source is preferably a light attenuation greater than the amount set for the highest motor speed setting (for example, in the previous example, 20% light attenuation for the valve to exhaust to the suction source compared to 10% attenuation to achieve the highest motor speed). As a variation or combination example, the threshold for activating the valve to exhaust the gas into the suction source may include the threshold duration of the detected percentage-expressed light attenuation. For example, if the duration of a predetermined detected light attenuation due to smoke in the gas exceeds a certain time limit, the controller 240 can trigger valve 2604 to connect to the suction source 2608 and bypass the pump to exhaust the smoke-filled gas through the suction source.

[0092] Furthermore, other detection criteria for gas from the peritoneum can be used in combination with or separately from gas density and / or duration measurements. For example, systems 2600, 2900 may include a temperature sensor positioned within the ridge or along the path of the suction / filtration tubing to enable real-time calculation of the ridge temperature. This temperature measurement then allows the controller to initiate gas movement as needed to cool the gas. The temperature sensor may be integrated into the pump 205, attached to a smoke detection sensor 2602, 2902 mounted on another instrument used in the laparoscopic procedure, or it may be a standalone sensor positioned within the tubing of the recirculation system. The temperature sensor can be used to detect differences in heat transfer rates in the gas related to the amount of smoke present. For example, the heat transfer rate of smoke-filled carbon dioxide gas may have different heat flux characteristics compared to smokeless carbon dioxide. In a more specific example, carbon dioxide has a K factor of 0.658 relative to nitrogen, and carbon monoxide has a K factor of 1.00 relative to nitrogen (in this case, K = 1 / ((gas density) × (specific heat coefficient)). Thus, by keeping the flow rate constant but increasing the concentration of carbon monoxide, the heat flux decreases.

[0093] Other sensors described herein, and other sensor technologies intended for use alone or in combination, include chemical detection for detecting the expected chemical composition of smoke produced during surgery (e.g., carbon monoxide), acoustic or ultrasonic sensors, magnetic sensors, chromatographic sensors, and cauterization instrument usage signal and activity sensors (e.g., sensors tuned to a specific voice signature known to be emitted by a cauterization instrument during operation, detectable by a distinctive voice signature microphone-type sensor, and usable to trigger an increase in pump speed in a gas recirculation system). For example, with respect to acoustic sensors, an electrosurgical unit emits a continuous 3 kHz voice tone when actively performing cauterization, and this voice tone is detectable by a voice receiver circuit utilizing a band-pass filter tuned to the same frequency. The duration of this tone can be measured to calculate the duration of cauterization. Alternatively, the electrosurgical unit may emit this 3 kHz three-pulse tone when cauterization begins and similarly detect another tone when it stops, and the time between the two three-pulse tone sequences can be calculated to determine the duration of cauterization. Using the calculation as a result of the cauterization duration, the motor speed can be adjusted, or both the motor speed can be adjusted and smoke emission bypass can be triggered at different thresholds, similar to how smoke density can be used in the smoke sensor embodiment described above.

[0094] Various placement locations for one or more smoke detection sensors in a smoke removal system—for example, within or along the tubing, within or along the pump or pump cartridge, or within the connector—all offer different potential advantages. For placement within or along the tubing compared to within one of the Luer connectors, the advantages include a reduced risk of sensor damage while the user is manually operating (disconnecting / connecting) the Luer connector, and a reduction in the amount of equipment at the surgical site for improved usability and ergonomics. Similarly, placement within or along the tubing compared to placement within the pump can offer similar advantages to placement within the Luer connector, such as reduced response time and / or improved sensitivity due to closer contact with the cauterization site, while potentially reducing the risk of sensor wear by physically isolating the sensor from the pump's mechanical vibrations.

[0095] Although various embodiments of the present invention have been described, as will be apparent to those skilled in the art, many further embodiments and examples are possible within the scope of the invention. The components of the various embodiments disclosed can be combined and configured to make a system having some or all of the operational characteristics and advantages of such embodiments. All such combinations are disclosed herein.

Claims

1. A gas recirculation system used to manage gas flow in endoscopic surgical procedures, wherein the system is It includes a gas input connection and a first tube in fluid communication, the first tube being configured to be connectable to a surgical instrument that can be inserted into the peritoneal cavity, It includes a gas output connector and a second tube in fluid communication, the second tube being configured to be connectable to a surgical instrument that can be inserted into the peritoneal cavity, The system includes a pump equipped with a motor, which is configured to draw gas from the peritoneal cavity through the first tube into the gas input connection and to discharge the gas through the second tube from the gas output connection into the peritoneal cavity. The system includes a smoke detection sensor positioned along the gas flow path formed by the first pipe, the pump, and the second pipe, and configured to measure the amount of smoke present in the gas. Including a controller, the controller is The smoke detection sensor receives an output signal representing the amount of smoke detected, and The pump is configured to increase the speed of the motor in response to an increase in the amount of smoke detected. The valve is positioned along the first pipe between the smoke detection sensor and the pump, and the valve is adjustable by the controller to bypass the pump and direct the gas flow from the first pipe to the suction exhaust pipe. The system includes filters positioned along the first and second pipes, the filters being configured to remove smoke from the gas flow by passing it through the first and second pipes, A gas recirculation system, wherein the smoke detection sensor is configured such that when it detects an amount of smoke exceeding a first threshold, the controller increases the speed of the motor of the pump, and when the smoke detection sensor detects an amount of smoke exceeding a second threshold greater than the first threshold, the controller adjusts the valve to direct the gas flow towards the suction exhaust pipe in response to the output signal indicating an amount of smoke exceeding the second threshold.

2. The gas recirculation system according to claim 1, wherein the smoke detection sensor is positioned along the first pipe.

3. The gas recirculation system according to claim 1, wherein the smoke detection sensor is positioned along the second pipe.

4. The gas recirculation system according to claim 1, wherein the smoke detection sensor is positioned within the pump.

5. The gas recirculation system according to claim 1, wherein the smoke detection sensor has an ionized smoke detector circuit.

6. The gas recirculation system according to claim 1, wherein the smoke detection sensor includes an optical sensor.

7. The gas recirculation system according to claim 6, wherein the light sensor has a light source and a photoreceptor positioned to receive light emitted from the light source.

8. The gas recirculation system according to claim 7, wherein the photoreceptor is positioned at an angle to the light source such that the photoreceptor can receive only the light from the light source that has been reflected from the smoke in the gas.

9. The gas recirculation system according to claim 1, wherein the smoke detection sensor is configured to wirelessly transmit the output signal to the controller.

10. The gas recirculation system according to claim 7, wherein the light source is an infrared light source.

11. A gas recirculation system used in endoscopic surgical procedures, wherein the system is It includes a gas input connection and a first tube in fluid communication, the first tube being configured to be connectable to a surgical instrument that can be inserted into the peritoneal cavity, It includes a gas output connector and a second tube in fluid communication, the second tube being configured to be connectable to a surgical instrument that can be inserted into the peritoneal cavity, The system includes a pump equipped with a motor, which is configured to draw gas from the peritoneal cavity through the first tube into the gas input connection and to discharge the gas through the second tube from the gas output connection into the peritoneal cavity. The system includes a smoke detection sensor positioned along the gas flow path formed by the first pipe, the pump, and the second pipe, and configured to measure the amount of smoke present in the gas. Including a controller, the controller is The smoke detection sensor receives an output signal representing the amount of smoke detected. The system includes filters positioned along the first and second pipes, the filters being configured to remove smoke from the gas flow by passing it through the first and second pipes, A gas recirculation system wherein, when the smoke detection sensor detects an amount of smoke exceeding a first threshold, the controller increases the speed of the motor of the pump in accordance with the detected amount of smoke, and when the smoke detection sensor detects an amount of smoke exceeding a second threshold greater than the first threshold, the controller is configured to direct the gas from the first pipe to the suction source in response to confirmation that the detected amount of smoke has exceeded the second threshold.

12. The gas recirculation system according to claim 11, wherein the smoke detection sensor is positioned along the first pipe or the second pipe.

13. The gas recirculation system according to claim 11, wherein the smoke detection sensor is positioned within the pump.

14. The gas recirculation system according to claim 12, wherein the smoke detection sensor includes a photoelectron sensor.

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