A cannula for guiding gas flow surgery to deliver gas to the patient.

Abstract

To provide humidifier systems and components of the humidifier systems configured to supply gases to a patient during a medical procedure.SOLUTION: A surgical cannula configured as an instrument retaining or centering apparatus is configured for providing insufflation gases to a surgical cavity of a patient (such as the pneumoperitoneum) and allowing insertion of medical instruments into the surgical cavity through the cannula. The cannula can include features to direct the gas flow in particular directions to prevent or reduce smoke, fog / condensation, or other unwanted media from contacting a portion of a medical instrument.SELECTED DRAWING: Figure 4B

Description

Technical Field

[0001] In some aspects, the present disclosure relates to a humidifier system configured to supply gas to a patient, particularly during a medical procedure, and components of the humidifier system.

Background Art

[0002] In various medical procedures, it is necessary to provide a gas, typically carbon dioxide, to a patient during the medical procedure. For example, in two general categories of medical procedures, often it is necessary to provide a gas to the patient. These include laparoscopic medical procedures and open medical procedures.

[0003] In laparoscopic medical procedures, a pneumoperitoneum device is placed to deliver gas into the patient's body cavity and inflate the body cavity during the medical procedure and / or to withstand collapse of the body cavity. Examples of such medical procedures include laparoscopy and endoscopy, although the pneumoperitoneum device may be used in any other type of medical procedure as needed. In an endoscopic procedure, an endoscope or the like is inserted through one or more natural openings, small perforations, or incisions to generate an image of the body cavity, enabling medical personnel to visualize the body cavity. In a laparoscopy procedure, medical personnel typically insert medical devices through natural openings, small perforations, or incisions and perform a medical procedure within the body cavity. In some cases, an endoscopic procedure may be performed first to evaluate the body cavity, and then a subsequent laparoscopy may be performed to perform surgery within the body cavity. Such procedures are widely used, for example, on the peritoneal cavity or during thoracoscopy, colonoscopy, gastroscopy, or bronchoscopy.

[0004] In open medical procedures, such as incision surgery, gas is used to fill the surgical cavity, and any excess gas overflows through the opening. Gas may also be used to provide a layer of gas covering exposed body parts, such as internal body parts without identifiable cavities. In these procedures, the gas may be used not to inflate cavities, but rather to prevent or reduce drying and infection by covering the exposed internal body parts with a layer of heated and humidified sterile gas.

[0005] Devices for delivering gas during these medical procedures may include a remote source of pressurized gas, such as an insufflation device positioned to connect to a hospital gas supply system. The device can operate to control the pressure and / or flow of gas from the gas source to a level suitable for delivery to a body cavity, typically via a cannula or needle connected to the device and inserted into the body cavity, or via a diffuser positioned to cover and diffuse the gas within a wound or surgical cavity.

[0006] The body temperature of a human patient is typically around 37°C. It may be desirable to match the temperature of the gas delivered from the device as closely as possible to a typical human body temperature. It may also be desirable to deliver the gas at a temperature above or below body temperature, for example, by 1°C, 2°C, 3°C, 4°C, 5°C, 6°C, 7°C, 8°C, 9°C, 10°C, or 15°C, or more or less, or within a range including any two of the aforementioned values. It may also be desirable to deliver a gas at a desired constant or variable humidity and / or a desired constant or variable temperature. A gas at a desired temperature and / or humidity (sometimes referred to as a standard herein) may be, for example, a dry low-temperature gas, a dry high-temperature gas, a humidified low-temperature gas, or a humidified high-temperature gas. Furthermore, the gas delivered to the patient's body may be relatively dry, potentially causing damage to body cavities, such as cell drying, cell death, or adhesions. In many cases, a humidifier is operationally coupled to the insufflation device. The device's controller can energize the heater of a humidifier located within the gas flow path, supplying a humidifying fluid to the gas stream before it enters the patient's body cavity. The humidifying fluid may be water.

[0007] The humidifying gas may be delivered to the patient via further tubing, which may also be heated. The insufflation device and humidifier may be located in separate housings connected together via appropriate tubing and / or electrical connections, or in a common housing arranged to be connected to a remote gas supply unit via appropriate tubing. [Overview of the project] [Problems that the invention aims to solve]

[0008] Condensation and / or fogging occur when the gas temperature falls below the dew point temperature at the humidity level the gas contains, and / or when there is a surface where the temperature is significantly below the dew point temperature. The human body is a warm, humid environment with a temperature of approximately 37°C. If a camera, scope, or other medical device at a low temperature (e.g., typical room temperature or below and / or below typical human body temperature) is inserted into this environment, condensation may form as fogging on the lens and / or as water droplets on the scope, which may drip onto the lens area. Further condensation and / or fogging may also form on the inner wall of the upper housing of the cannula, which may drip onto the lens area, for example. Furthermore, while humidifying and heating the supplying gas can reduce damage to the patient's tissue in the surgical cavity, humidifying and heating the gas may exacerbate the problem of condensation and / or fogging.

[0009] Fog and / or condensed droplets may obstruct the view, for example, of a surgeon or other medical personnel participating in a medical procedure (e.g., surgery). When fog and / or condensation occurs, it may be necessary to remove the camera and / or other medical devices and wipe them to remove the fog and / or droplets. However, removing medical devices from the surgical cavity may cause them to cool again to below the patient's body temperature. As a result, the fog and / or condensation problem may recur unless any other interventions, such as preheating the medical devices and / or using a light at the end of the camera to warm the lens, are performed. These interventions require additional products and / or costs. [Means for solving the problem]

[0010] This disclosure provides examples of cannulas configured for guided gas flow that can address the aforementioned problems and / or other problems (including, for example, preventing or at least reducing condensation and / or fogging). The guided gas flow cannula examples disclosed herein can prevent or at least reduce condensation and / or fogging by guided gas flow that heats the medical device more rapidly, and / or prevent or at least reduce condensation and / or fogging that has occurred by thermal radiation and conduction that causes the fluid to evaporate. Some configurations can also favorably guide the gas flow to control the environment / medical device around the scope. Smoke generated in the surgical cavity can potentially cause fogging or reduce visibility by accumulating on the instrument, for example, on the lens. Guided gas flow cannulas can guide the supply gas to keep smoke, condensation, or other unwanted media away from desired locations on the instrument.

[0011] In some embodiments, disclosed herein are surgical cannulas for supplying air gas to a surgical cavity and for providing a passage for inserting one or more medical devices. The cannula may include any number of cannula bodies including an inlet, and an elongated shaft extending from the cannula bodies, the shaft defining a lumen defined by its side walls, the lumen configured to supply insufflation gas to a surgical cavity between a gas inlet and an outlet near the distal end of the elongated shaft, the lumen being in fluid communication between the inlet and the outlet, and the lumen also being configured to receive a medical device within the lumen; and guiding elements positioned on, within, or around at least a portion of the lumen, the guiding elements configured to restrict the radial movement of the medical device within the lumen and prevent the medical device from contacting the side walls of the lumen, such that the gas flowing into the lumen flows around the medical device and creates an envelope of insufflation gas extending distally beyond the distal end of the device.

[0012] In some embodiments, disclosed herein are surgical cannulas for supplying air gas to a surgical cavity and for providing a passage for inserting one or more medical devices. A cannula may include a cannula body with an inlet of any number of elongated shafts extending from the cannula bodies, the shafts defining a lumen defined by side walls, the lumen configured to supply insufflation gas to a surgical cavity between a gas inlet and an outlet near the distal end of the elongated shaft, the lumen being in fluid communication between the inlet and the outlet, and the lumen also configured to receive a medical device within the lumen, and / or guide elements positioned on, within, or around at least a portion of the lumen, the guide elements configured to restrict the radial movement of the medical device within the lumen and prevent the medical device from contacting the side walls of the lumen, so that the gas flowing into the lumen flows around the medical device and creates an envelope of insufflation gas along and distal to the distal end of the device. The structure and stability of the flow along the device are affected by the presence of walls of the medical device.

[0013] In some configurations, the guide element may be further configured to maintain the medical device substantially coaxially and / or concentrically within the lumen.

[0014] The guide element may also be configured so that the envelope maintains the temperature of a portion of the instrument above the dew point.

[0015] In some configurations, the envelope reduces or prevents the formation of fogging and / or condensation on the medical device.

[0016] In some configurations, the envelope reduces or prevents smoke from coming into contact with medical equipment.

[0017] In some configurations, the envelope reduces or prevents smoke from obstructing the view of medical equipment.

[0018] In some configurations, the guide element is configured such that the envelope substantially surrounds the entire medical device or a portion thereof (e.g., the distal end of the medical device).

[0019] In some configurations, the envelope extends beyond the exit of the elongate shaft and surrounds the medical device distally beyond the exit of the elongate shaft.

[0020] In some configurations, the medical device extends beyond the exit of the elongate shaft and the envelope extends distally beyond the exit of the elongate shaft and the medical device.

[0021] In some configurations, the envelope concentrically surrounds the medical device within the lumen and distally beyond the outside of the shaft.

[0022] In some configurations, the envelope concentrically surrounds the medical device within the lumen and beyond the exit of the elongate shaft.

[0023] In some configurations, the envelope extends distally beyond the exit a predetermined distance.

[0024] In some configurations, the envelope extends a predetermined distance beyond the exit of the shaft.

[0025] In some configurations, the envelope maintains a temperature-controlled environment around the elongate shaft and the exit of the elongate shaft, and the envelope maintains the temperature above the dew point.

[0026] In some configurations, the envelope is created by the Coanda effect of a gas passing along the medical device.

[0027] In some configurations, the envelope is affected by the Coanda effect as the gas passes beyond the distal end of the medical device.

[0028] In some configurations, the guiding element includes a plurality of, for example, two or more ribs that extend radially inwardly from the inner sidewall of the lumen towards the center of the lumen.

[0029] In some configurations, the guide element includes a plurality of, for example, two or more ribs that extend inwardly from the inner sidewall of the lumen towards the center of the lumen.

[0030] In some configurations, two or more ribs can be configured to contact a medical device and grip the device concentrically within the lumen and / or to limit the radial movement of the medical device and prevent the medical device from contacting the sidewall of the lumen.

[0031] In some configurations, the guide element can maintain the medical device in a state where the axis is offset 0 to 30 degrees with respect to the lumen.

[0032] In some configurations, the guide element can include radially or axially spaced ribs that are approximately or at least about 2, 3, 4, 5, 6, 7, 8, 9, 10, or more.

[0033] In some configurations, the guide element can include at least four spaced ribs.

[0034] In some configurations, the ribs can be axially disposed at any position on a elongate shaft, including but not limited to, the distal end of the elongate shaft. The ribs can be molded or overmolded within the cannula.

[0035] In some configurations, the surgical cannula can further include a removable insert disposed within the lumen, and the plurality of ribs can be disposed on the removable insert.

[0036] <00,00117>In some configurations, the removable insert can include a top portion, with a shaft portion extending distally from the top portion.

[0037] In some configurations, the guide element may be configured to prevent the scope from contacting the wall adjacent to the cannula exit. This prevents the creation of flow inhomogeneities (which may also be called stagnant zones). The guide element can ensure that the scope is guided / held within the cannula so that gas surrounds the scope at the distal end of the medical device.

[0038] In some configurations, the ribs may include at least a first rib set and a second rib set, which are axially separated by a gap between them.

[0039] The gap between the first rib set and the second rib set can be sized such as to reduce the flow velocity of the supplied gas and / or reduce flow turbulence, and can be configured to reduce the flow velocity of the supplied gas and / or reduce flow turbulence.

[0040] In some configurations, the first rib set may contain additional ribs, the same number of ribs, or fewer ribs compared to the second rib set.

[0041] In some configurations, the guide element may also include vanes.

[0042] In some configurations, the guide element may also include a disc.

[0043] In some configurations, the guiding element may also include a flange with an opening that communicates with the cannula inlet, and the opening is configured to receive a medical device within the opening.

[0044] In some configurations, the guide element may also include a flange with an opening that communicates with the cannula inlet and fluid, and the opening is configured to receive a medical device within the opening.

[0045] The guide element may also be configured such that the opening is concentric with respect to the lumen.

[0046] In some configurations, the disc or flange may be, for example, flexible, rigid, or semi-rigid, and may include multiple apertures arranged around the opening.

[0047] In some configurations, multiple apertures can be configured to allow gas to flow through multiple apertures, concentrically directing the supplied gas around the medical device and forming an envelope around the medical device.

[0048] In some configurations, apertures can include arches, polygons, or other shapes and may be evenly spaced around the opening.

[0049] In some configurations, the lumen may include vanes or a series of vanes connected to the side walls of the lumen.

[0050] In some configurations, a vane or a series of vanes may be configured to partially or completely block the flow within the lumen so that the supplied gas is diverted to an unblocked area of ​​the lumen.

[0051] In some configurations, the vane may include a flexible wall and may be configured to block approximately or at least approximately 5% of the lumen.

[0052] In some configurations, the vane may be configured to remove at least one stagnant flow zone distal to the medical device in order to prevent fogging.

[0053] In some configurations, the vane may be configured to eliminate at least one stagnant flow zone at the distal end of the medical device in order to prevent condensation and / or fogging.

[0054] In some configurations, the guide element may include multiple pins extending inward from the medial lateral wall of the lumen toward the center of the lumen.

[0055] In some configurations, multiple pins may be configured to contact a medical device and concentrically grasp the device within its lumen.

[0056] In some configurations, multiple pins may be configured to restrict the radial movement of the medical device and prevent it from contacting the side walls of the lumen.

[0057] In some configurations, the guide element may include at least four radially spaced pins, which are either flexible or rigid.

[0058] In some configurations, the pin can be flexible and can be positioned on a ring located on the outer surface of the cannula body, and the pin can be configured to extend through the opening of the cannula.

[0059] In some configurations, the guide elements may include radially spaced projections.

[0060] In some configurations, the guide element may include multiple fins extending inward and distally from the distal end of a long shaft.

[0061] In some configurations, the guide element may include multiple flexible fins extending radially inward within the cannula.

[0062] In some configurations, the guide element may include a bellows and a ring with a pin, the bellows being attached to the distal end of a long shaft and the ring being attached to the distal end of the bellows.

[0063] In some configurations, the guide element may include a non-circular, elongated shaft cross-section.

[0064] In some configurations, the guide element may include multiple rigid ridges.

[0065] In some configurations, the guide element may include multiple swivel structures within a long shaft, which may be configured to rotate as the medical device is inserted into or removed from the cannula.

[0066] In some configurations, the guide element may include foam material.

[0067] In some configurations, the guide element may include an adjustable structure, which is spring-loaded and configured to rotate to support a medical device within the lumen.

[0068] In some configurations, the guide element may include a seal at the entrance of the cannula body.

[0069] In some configurations, the guide element may include an interlocking channel that aligns with the entrance of the cannula body.

[0070] In some configurations, the medical device may be, for example, a laparoscope, camera, video laparoscope, electrocautery device, hand instrument, choledoscope, and / or any other suitable instrument.

[0071] In some configurations, cannulas are disclosed for supplying insufflation gas to a surgical cavity and for providing a passage for inserting one or more medical devices. The cannula may include one or more of the following: a cannula body including an inlet; and an elongated shaft extending from the cannula body, the elongated shaft having an inner wall and an outer wall, with a first lumen defined by the side walls of the inner wall and a second lumen located between the inner wall and the outer wall.

[0072] In some configurations, the first lumen and the second lumen may be concentric or substantially concentric.

[0073] In some configurations, the first lumen may include a first lumen inlet and a first lumen outlet, and may be configured to house a medical device within the first lumen.

[0074] In some configurations, the second lumen may be configured to supply insufflation gas to the surgical cavity between the second lumen inlet and the second lumen outlet near the distal end of the elongated shaft, such that the gas flowing out from the second lumen outlet creates an envelope of insufflation gas that flows around the medical device and extends distally beyond the end of the device.

[0075] In some configurations, the second lumen may also be configured so that the envelope maintains the instrument's temperature above the dew point.

[0076] In some configurations, the envelope removes fogging and reduces or prevents the formation of fogging and / or condensation on or around medical devices.

[0077] In some configurations, the envelope reduces or prevents smoke from coming into contact with medical equipment.

[0078] In some configurations, the envelope effectively surrounds the medical device.

[0079] In some configurations, the envelope extends beyond the exit of the elongated shaft and surrounds the medical device beyond the exit of the elongated shaft.

[0080] In some configurations, the envelope extends beyond the exit of the elongated shaft and surrounds the medical device distally beyond the exit of the elongated shaft.

[0081] In some configurations, the envelope concentrically surrounds the medical device within the hollow passage and distally beyond the outside of the shaft.

[0082] In some configurations, the envelope concentrically surrounds the medical device within the lumen and distally beyond the exit of the elongated shaft.

[0083] In some configurations, the envelope extends a predetermined distance distal to the exit of the elongated shaft.

[0084] In some configurations, the envelope maintains a temperature-controlled environment around the elongated shaft and its outlet.

[0085] In some configurations, the envelope maintains a temperature above the dew point.

[0086] In some configurations, the envelope is created by the Coanda effect of gas passing along the medical device.

[0087] In some configurations, the envelope is affected by the Coanda effect as the gas passes beyond the distal end of the medical device.

[0088] In some configurations, the second lumen may have a smaller diameter than the first lumen.

[0089] In some configurations, the outlet of the elongated shaft may include, for example, an outlet for a first lumen and an outlet for a second lumen.

[0090] In some configurations, the outlets of the first lumen and the second lumen may lie on the same plane.

[0091] In some configurations, the outlet of the second lumen can be angled radially inward with respect to the longitudinal axis of the elongated shaft, such that the insulated gas exiting the second lumen outlet flows radially inward toward the medical device.

[0092] In some configurations, the medical device may be positioned 0 to 30 degrees off-axis relative to the first lumen.

[0093] In some configurations, the cannula may include an additional lumen defined within the elongated shaft. This additional lumen may be a drainage passage.

[0094] In some configurations, the cannula may include an exhaust element. The exhaust element may include, for example, one or more filter elements located within the gas path.

[0095] In some configurations, the cannula may include one or more heating elements positioned on or inside the cannula.

[0096] In some configurations, the heating element can heat the pathway that delivers gas to the surgical cavity.

[0097] In some configurations, the heating element may also be in thermal communication with the exhaust path to heat the exhaust gas or exhaust smoke to prevent condensation in the exhaust path.

[0098] In some configurations, the heating element may also be in thermal communication with the filter element to prevent condensation on the filter.

[0099] In some configurations, disclosed herein are surgical cannulas for supplying insufflation gas to a surgical cavity and providing a passage for inserting one or more medical devices, namely, a cannula body including an inlet; and an elongated shaft extending from the cannula body, the shaft comprising one or more elongated shafts, the shaft comprising a first lumen including a first lumen inlet and a first lumen outlet, configured to house a medical device within the first lumen; and a second lumen extending substantially parallel to the first lumen, the second lumen configured to supply insufflation gas to a surgical cavity between the second lumen inlet and the second lumen outlet near the distal end of the elongated shaft.

[0100] In some configurations, the second lumen outlet may include a lateral outlet so that the gas flowing out of the second lumen outlet flows over a portion of the medical device to reduce or prevent fogging and / or condensation.

[0101] In some configurations, the second luminal outlet is oriented radially inward.

[0102] In some configurations, the gas can flow across the distal end of the medical device once the medical device is partially withdrawn from the first lumen.

[0103] In some configurations, the gas can flow across the distal end of the medical device once the medical device is partially drawn in from the outlet of the first lumen.

[0104] In some configurations, the second lumen may include an arc defined between the concentric inner and outer walls of the cannula.

[0105] In some configurations, the second lumen may, for example, surround and / or be concentric with the first lumen.

[0106] In some configurations, the second lumen outlet may be configured such that the supplied gas exiting the second lumen outlet is directed from all sides of the device across a portion of the medical device, or across the end of the medical device.

[0107] In some configurations, the inner wall may contain multiple apertures, which are configured to allow the supplied gas to enter the first lumen through the multiple apertures.

[0108] In some configurations, multiple apertures can be sized and configured to allow the supplying gas to flow radially inward relative to the cannula.

[0109] In some configurations, the outer wall may include one or more apertures configured to allow the supplying gas to exit into the surgical cavity.

[0110] In some configurations, one or more medical devices may be 0 to 30 degrees off-axis relative to the first lumen.

[0111] In some configurations, disclosed herein are surgical cannulas for supplying aeration gas to a surgical cavity and providing a passage for inserting one or more medical devices, the cannula comprising, namely, a cannula body including an inlet, and an elongated shaft extending from the cannula body, the shaft comprising one or more elongated shafts including a first lumen, a second lumen, and a third lumen. The first lumen may be configured to house a medical device within the first lumen. The second lumen may be configured to be connected to a source of dry gas. The third lumen may be configured to be connected to a source of humidifying gas. The second lumen may include an outlet, which is configured so that when a medical device is inserted into the first lumen, dry gas flowing out from the second lumen outlet flows over a portion of the medical device.

[0112] In some configurations, the second lumen may be located between the first lumen and the third lumen.

[0113] In some configurations, the third lumen can be isolated from the first lumen by the second lumen.

[0114] In some configurations, the second lumen may be configured to guide a dry gas around or across the medical device.

[0115] In some configurations, the second lumen can surround the first lumen so that the first lumen is nested inside the second lumen.

[0116] In some configurations, the second lumen may be concentric with respect to the first lumen.

[0117] In some configurations, the second lumen may also be configured to guide the dry gas and form an envelope that extends distally beyond the outlets of the first lumen and the second lumen.

[0118] In some configurations, the envelope may be configured to maintain a controlled gas environment and / or reduce, clear, and / or reduce smoke contact with medical equipment.

[0119] In some configurations, the envelope may be configured to reduce fogging, clear fogging, reduce condensation, reduce particulate matter, and / or reduce smoke contact with medical devices.

[0120] In some configurations, the medical device may include a lens, and the envelope is configured to reduce fogging, clear fogging, reduce condensation, reduce particulate matter, and / or reduce smoke entering the area near the lens.

[0121] In some configurations, the first and second lumens can be nested within a third lumen.

[0122] In some configurations, the first lumen, the second lumen, and the third lumen can be concentric with one another.

[0123] In some configurations, the first lumen may have a smaller diameter than the second lumen.

[0124] In some configurations, the second lumen has a smaller diameter than the third lumen.

[0125] In some configurations, the second lumen may be configured to isolate the humidifying gas from the third lumen from the medical device.

[0126] In some configurations, the surgical cannula may also include a controller configured to deliver dry gas as a continuous or substantially continuous and / or intermittent (e.g., periodic) flow.

[0127] In some configurations, the medical device may be positioned 0 to 30 degrees off-axis relative to the first lumen.

[0128] Also disclosed herein is a method for inducing a gas flow over a medical device in a body cavity. This method may include inserting a cannula into a body cavity, inserting a medical device through a first lumen of the cannula, flowing humidified insulated gas through a second lumen of the cannula, and / or flowing dry gas through a third lumen of the cannula so as to form an envelope of dry gas extending distally beyond the outlets of the first and second lumen.

[0129] In some configurations, the flow of dry gas through the third lumen is performed continuously, substantially continuously, or intermittently.

[0130] In some configurations, circulating a dry gas may be sufficient to isolate the humidifying gas from the third lumen from the medical device, and / or to reduce or eliminate fogging and / or reduce contact of smoke with the distal end of the medical device.

[0131] In some configurations, the medical device may be positioned 0 to 30 degrees off-axis relative to the first lumen.

[0132] In some configurations, disclosed herein are surgical cannulas for supplying insufflation gas to a surgical cavity and for providing a passage for inserting one or more medical devices. The cannula may include a cannula body including an inlet, and an elongated shaft extending from the cannula body, the shaft comprising a first wall and a second wall, defining a first lumen between the first wall and the second wall, the second lumen being defined by the inner surface of the second wall.

[0133] In some configurations, the second wall may include a first diameter section and a second diameter section distally separated from it.

[0134] In some configurations, the second diameter can be smaller than the first diameter.

[0135] In some configurations, the second diameter section may be configured to create a first flow limiter sufficient to create a venturi effect that draws the supplied gas out of the second lumen.

[0136] In some configurations, the first lumen and the second lumen are concentric with each other.

[0137] In some configurations, the second lumen can be nested within the first lumen.

[0138] In some configurations, the first and second walls can be consecutive.

[0139] In some configurations, the surgical cannula may include an outlet opening within a second wall adjacent to the second diameter section.

[0140] In some configurations, the first wall may include a flow limiting section adjacent to the flow limiting section of the second wall, configured to create another Venturi effect.

[0141] In some configurations, the first flow limiting section and the second flow limiting section can have the same diameter, forming a continuous flow limiting section.

[0142] In some configurations, one or more medical devices may be 0 to 30 degrees off-axis relative to the first lumen.

[0143] Also disclosed herein is a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passage for inserting one or more medical devices, the cannula comprising one or more of: a cannula body containing a cavity; and an elongated shaft extending from the cannula body, the shaft defining a first wall defining a first lumen for receiving insufflation gas into a surgical cavity, the lumen also configured to receive a medical device. The inner surface of the first wall may include one or more features that create turbulence in the insufflation gas flow, the turbulence reducing stagnant zones around the device.

[0144] Also disclosed herein is a surgical cannula for supplying insufflation gas to a surgical cavity and providing a passage for inserting one or more medical devices, the cannula comprising one or more of: a cannula body containing a cavity; and an elongated shaft extending from the cannula body, the shaft defining a first wall defining a first lumen for receiving insufflation gas into a surgical cavity, the lumen also configured to receive a medical device. The inner surface of the first wall may include one or more features that create turbulence in the insufflation gas flow, the turbulence reducing non-uniformity of the flow around the device.

[0145] In some configurations, features may include recesses.

[0146] In some configurations, the features may also include radially outward and / or inwardly extending surfaces configured to create turbulence.

[0147] In some configurations, the shaft may also include a second wall, the first and second walls being concentric with each other, and the first and second walls defining a second lumen between them.

[0148] In some configurations, the second lumen can be an aerated gas lumen, which spirals around the second wall, thereby creating a vortex gas channel.

[0149] In some configurations, the vortex path can be configured to create a vortex flow from the cannula.

[0150] In some configurations, one or more medical devices may be 0 to 30 degrees off-axis relative to the first lumen.

[0151] Also disclosed herein is a surgical cannula for supplying aeration gas to a surgical cavity and providing a passage for inserting one or more medical devices, the cannula comprising: a cannula body including an inlet; an elongated shaft extending from the cannula body, the shaft comprising a lumen defined by a side wall and configured to accommodate one or more medical devices within the lumen; and / or a vane comprising a continuous helical wall within the lumen, the vane extending substantially along the entire axial length of the lumen and configured to guide gas in a vortex around one or more medical devices.

[0152] Also disclosed herein is a surgical cannula for supplying aeration gas to a surgical cavity and providing a passage for inserting one or more medical devices, the cannula comprising: a cannula body including an inlet; an elongated shaft extending from the cannula body, the shaft comprising a lumen defined by a side wall and configured to accommodate one or more medical devices within the lumen; and / or a vane comprising a continuous helical wall within the lumen, the vane extending at least partially along the axial length of the lumen and configured to guide gas in a vortex around one or more medical devices.

[0153] In some configurations, the vanes may be configured to restrict the radial movement of one or more medical devices.

[0154] In some configurations, the vane may also be configured to guide the gas in a vortex beyond the lumen outlet, creating a zone of controlled temperature and humidity distal to the distal end of the cannula.

[0155] In some configurations, the vane may also be configured to guide the gas in a vortex beyond the lumen outlet, creating a zone of controlled temperature and humidity beyond the distal end of the cannula.

[0156] In some configurations, one or more medical devices may be 0 to 30 degrees off-axis relative to the first lumen.

[0157] Also disclosed herein is a medical device holder comprising a body including a wall defining a lumen, and one or more ribs or fins extending from the wall. The medical device may be a surgical instrument. The body may include a tube that can be removably inserted into the lumen of a cannula. The holder may include a first rib set and a second rib set. The first rib set may be separated from the second rib set via a ribless region located between the first and second rib sets.

[0158] In some configurations, the cannula may include a heating element. The heating element may be embedded in the wall, positioned on the inner surface, or wrapped around the outside of the cannula.

[0159] In some configurations, the heating element may be, for example, a heater wire, conductive ink, a discrete positive temperature coefficient ("PTC") heater, a conductive plastic / polymer, or a flexible or rigid PCB. The heating element may include an inductive heating element. The heating element may include, but is not limited to, a chemical heating element, such as silica beads. The cannula may be preheated before insertion.

[0160] In some configurations, the heating element may extend to a portion of the cannula's shaft, such as the entire length of the cannula.

[0161] In some configurations, the heating element may be located in the upper region of the cannula adjacent to the instrument inlet.

[0162] In some configurations, the heating element may be located inside the cannula to heat the lumen of the cannula, thereby raising the dew point of the gas inside the cannula.

[0163] In some configurations, a heating element or a portion of a second heating element may be placed within the discharge passage to prevent condensation within the discharge passage. Furthermore, a heating element or another heating element may be placed in contact with the filter to prevent condensation on the filter.

[0164] In some configurations, the cannula may also include one or more drainage passages defined within the cannula. For example, the cannula may include one, two, or more additional passages / lumens that define drainage passages for removing gas / smoke from the surgical cavity.

[0165] In some configurations, the discharge lumen may be concentric with, for example, the gas supply lumen and / or the equipment holding lumen, offset, or share a common lumen.

[0166] In some configurations, the cannula may include a filter built into the cannula for filtering the gas delivered to it.

[0167] In some configurations, the filter may also be positioned in fluid communication with the discharge passage (if one exists) so that the discharged gas / smoke is filtered.

[0168] In some configurations, the cannula may be configured to create a gas envelope or shroud that is formed while the gas is delivered through the cannula, while the device is held concentrically. The gas envelope or shroud can form a protective zone and a controlled temperature and humidity area around the distal end of the cannula and / or the distal end of the medical device, etc.

[0169] Disclosed herein is a surgical cannula comprising a body including an opening formed within the body, and a shaft extending from the body. The shaft includes an outlet of an elongated shaft. The shaft defines a lumen within the shaft. The lumen terminates at the outlet of the elongated shaft, and the lumen is positioned in fluid communication with the opening. The shaft and / or body includes at least one guide element protruding from the inner surface or structure of the shaft and / or body. The at least one guide element may be configured to hold a device received in the lumen so that the medical device does not physically contact the inner surface of the shaft and / or body.

[0170] In some configurations, the body may include a first seal configured to prevent the supply gas from leaking when the device is inserted, or the first seal configured to prevent the supply gas from leaking before the device is inserted.

[0171] In some configurations, the body may include at least a first seal and a second seal configured to prevent the supply gas from leaking when the device is inserted or before the device is inserted.

[0172] In some configurations, at least one guide element within the main body may be located proximal to the first seal.

[0173] In some configurations, at least one guide element within the main body may be located distal to the second seal.

[0174] In some configurations, at least one guide element within the main body may be located between the first seal and the second seal.

[0175] In some configurations, at least one guide element may be integrated with the first seal and / or the second seal.

[0176] Also disclosed herein is a surgical cannula which may include a body including an opening formed within the body, and a shaft extending from the body, the shaft including an outlet of an elongated shaft, the shaft defining a lumen within the shaft, the lumen terminating at the outlet, and the lumen being in fluid communication with the opening. The body includes a first sealing structure positioned to limit gas leakage, and a second sealing structure for providing an instrument seal when a medical device is inserted into the lumen. The shaft and / or body may include at least one guide element protruding from the inner surface or structure of the shaft and / or body. The at least one guide element may be configured to hold the instrument received in the lumen so that the medical device does not physically contact the inner surface of the shaft.

[0177] In some configurations, the first sealing structure may be a seal configured to form a seal on the cannula when no medical device is present inside the cannula.

[0178] In some configurations, the second sealing structure may be an instrument seal configured to form a seal around a medical device inserted into the cannula.

[0179] In some configurations, at least one guide element within the main body may be located proximal to the first sealing structure.

[0180] In some configurations, at least one guide element within the main body may be distal to the second sealing structure.

[0181] In some configurations, at least one guide element within the main body may be located between the first sealing structure and the second sealing structure.

[0182] In some configurations, at least one guide element may be integrated with the first and / or second sealing structure.

[0183] These and other features, aspects, and advantages of the present disclosure are described with reference to drawings of specific embodiments, which are intended to schematically illustrate certain embodiments and are not limiting to the present disclosure. In some cases, "slices" are shown for clarity in some cross-sectional and transverse views of three-dimensional cannulas. Those skilled in the art will understand that these figures represent slices of three-dimensional cannulas. In some cases, protruding surfaces are not shown for clarity. For example, protruding hole surfaces are not shown in some figures. [Brief explanation of the drawing]

[0184] [Figure 1] A schematic diagram of an exemplary medical gas delivery device used in surgery is shown. [Figure 2] A schematic diagram of an exemplary medical gas delivery device is shown. [Figure 3A] A schematic diagram of one embodiment of a cannula configured to guide gas flow within a surgical cavity is shown. [Figure 3B] A schematic diagram of one embodiment of a cannula configured to guide gas flow within a surgical cavity is shown. [Figure 3C] A schematic diagram of one embodiment of a cannula configured to guide gas flow within a surgical cavity is shown. [Figure 3D] A schematic diagram of one embodiment of a cannula configured to guide gas flow within a surgical cavity is shown. [Figure 4A] Various diagrams of embodiments of a cannula having a guided gas flow lumen and a medical device guide element are shown. [Figure 4B] Various diagrams of embodiments of a cannula having a guided gas flow lumen and a medical device guide element are shown. [Figure 4C] Various diagrams of embodiments of a cannula having a guided gas flow lumen and a medical device guide element are shown. [Figure 4D] A diagram shows another embodiment of a cannula having a guided gas flow lumen and a medical device guide element. [Figure 4E]A diagram shows another embodiment of a cannula having a guided gas flow lumen and a medical device guide element. [Figure 5A] A partial longitudinal cross-sectional view of one embodiment of a cannula having multiple seals configured to guide a gas flow to a medical device is shown. [Figure 5B] Figure 5A shows a cross-sectional view of an embodiment of the cannula. [Figure 5C] Figures 5A and 5B show schematic diagrams of partial cutouts in the cannula. [Figure 6A] A partial longitudinal cross-sectional view of an embodiment of a cannula having dual concentric lumens is shown. [Figure 6B] A partial longitudinal cross-sectional view of an embodiment of a cannula having dual concentric lumens is shown. [Figure 7A] A partial longitudinal cross-sectional view of an embodiment of a cannula having a dual lumen is shown. [Figure 7B] A partial longitudinal cross-sectional view of an embodiment of a cannula having a dual lumen is shown. [Figure 8A] A partial longitudinal cross-sectional view is shown of an embodiment of a cannula having one or more lumens configured to function as a gas blade. [Figure 8B] A partial longitudinal cross-sectional view is shown of an embodiment of a cannula having one or more lumens configured to function as a gas blade. [Figure 9A] This shows a longitudinal cross-sectional view of one embodiment of a cannula having a series of gas blades spaced apart in the axial direction. [Figure 9B] This shows a longitudinal cross-sectional view of one embodiment of a cannula having a series of gas blades spaced apart in the axial direction. [Figure 10] A partial longitudinal cross-sectional view of an embodiment of a cannula having multiple lumens is shown. [Figure 11A] A partial longitudinal cross-sectional view of an embodiment of a cannula having three lumens is shown. [Figure 11B] A partial longitudinal cross-sectional view of an embodiment of a cannula having three lumens is shown. [Figure 12A]A longitudinal cross-sectional view of an embodiment of a cannula configured to create a Venturi effect is shown. [Figure 12B] A longitudinal cross-sectional view of an embodiment of a cannula configured to create a Venturi effect is shown. [Figure 13] This shows a partial longitudinal cross-sectional view of one embodiment of the distal end of a cannula configured to block gas flow over a portion of its lumen. [Figure 14A] A diagram shows one embodiment of the distal end of a cannula that includes an irregular section configured to create turbulence. [Figure 14B] A diagram shows one embodiment of the distal end of a cannula that includes an irregular section configured to create turbulence. [Figure 15A] A diagram shows one embodiment of the distal end of a cannula containing a vortex lumen configured to create vortex luminal flow. [Figure 15B] A diagram shows one embodiment of the distal end of a cannula containing a vortex lumen configured to create vortex luminal flow. [Figure 16] A diagram shows one embodiment of a cannula containing a single continuous helical vane configured to create intra-vortex lumen flow. [Figure 17] A diagram shows one embodiment of a cannula containing a single continuous helical vane configured to create intra-vortex lumen flow. [Figure 18A] This diagram shows a cannula insert configured to be placed inside the cannula. [Figure 18B] This diagram shows a cannula insert configured to be placed inside the cannula. [Figure 18C] This diagram shows a cannula insert configured to be placed inside the cannula. [Figure 19A] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 19B] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 20A]The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 20B] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 21A] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 21B] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 22A] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 22B] The vertical cross-sectional view of the cannula wall and the horizontal cross-sectional view of the cannula shaft are shown. [Figure 23A] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23B] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23C] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23D] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23E] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23F] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23G] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23H] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23I]The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23J] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23K] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23L] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23M] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23N] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23O] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23P] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23Q] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23R] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23S] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 23T] The diagram shows an embodiment of a cannula with a flexible feature at its distal end to assist in the concentricity of a medical device. [Figure 24A]The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24B] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24C] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24D] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24E] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24F] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24G] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24H] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24I] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24J] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24K] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24L] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24M]The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 24N] The diagram shows an embodiment of a cannula that has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 25A] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25B] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25C] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25D] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25E] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25F] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25G] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25H] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25I] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25J] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25K] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 25L] The diagram shows an embodiment of a cannula having a flexible continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device inside the cannula. [Figure 26A] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26B] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26C] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26D] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26E] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26F] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26G] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26H]The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26I] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26J] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26K] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26L] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26M] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26N] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26O] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26P] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26Q] The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 26R]The diagram shows an embodiment of a cannula having a rigid, continuous structure along the elongated shaft of the cannula to assist in the concentricity of the medical device within the cannula. [Figure 27A] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27B] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27C] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27D] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27E] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27F] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27G] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27H] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27I] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27J] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27K] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27L] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27M] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27N] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27O] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27P] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27Q] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27R] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27S]The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 27T] The diagram shows an embodiment of a cannula having a non-circular inner cross-section of the cannula wall to assist in the concentricity of medical devices within the cannula along the elongated shaft of the cannula. [Figure 28A] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28B] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28C] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28D] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28E] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28F] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28G] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28H] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28I] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28J]The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28K] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28L] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28M] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28N] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28O] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28P] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 28Q] The diagram shows an embodiment of a cannula having a flexible structure within the cannula body to assist in the concentricity of the medical device inside the cannula. [Figure 29A] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29B] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29C] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29D] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29E] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29F] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29G] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29H] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29I] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29J] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29K] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29L] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 29M] The diagram shows an embodiment of a cannula in which the body of the cannula has rigid features to assist in the concentricity of the medical device inside the cannula. [Figure 30A] The diagram shows an embodiment of a cannula having flexible features at its proximal and distal ends to assist in the concentricity of medical devices within the cannula. [Figure 30B] The diagram shows an embodiment of a cannula having flexible features at its proximal and distal ends to assist in the concentricity of medical devices within the cannula. [Figure 30C]Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 30D] Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 30E] Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 30F] Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 30G] Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 30H] Figure showing an embodiment of a cannula having flexibility features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31A] Figure showing an embodiment of a cannula having rigidity features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31B] Figure showing an embodiment of a cannula having rigidity features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31C] Figure showing an embodiment of a cannula having rigidity features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31D] Figure showing an embodiment of a cannula having rigidity features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31E] Figure showing an embodiment of a cannula having rigidity features at the proximal and distal ends thereof to assist in the concentricity of medical devices within the cannula. [Figure 31F]The diagram shows an embodiment of a cannula having rigid features at its proximal and distal ends to assist in the concentricity of the medical device inside the cannula. [Figure 31G] The diagram shows an embodiment of a cannula having rigid features at its proximal and distal ends to assist in the concentricity of the medical device inside the cannula. [Figure 31H] The diagram shows an embodiment of a cannula having rigid features at its proximal and distal ends to assist in the concentricity of the medical device inside the cannula. [Modes for carrying out the invention]

[0185] While specific embodiments and examples are described below, those skilled in the art will understand that this disclosure extends beyond the specifically disclosed embodiments and / or uses and their obvious modifications and equivalents. Therefore, the scope of the disclosure disclosed herein should not be limited by any specific embodiments described below.

[0186] Exemplary medical gas delivery system A fluid, such as gas, can be introduced into a surgical cavity, such as the peritoneal cavity, through a cannula inserted through an incision made in the patient's body (e.g., the abdominal wall). The cannula may be coupled to a pneumoperitoneum. The gas flow from the pneumoperitoneum can be increased to inflate the surgical cavity (e.g., to maintain pneumoperitoneum, which is a gas-filled cavity within the abdomen). The introduced gas can inflate the surgical cavity. Medical devices can be inserted into the inflated surgical cavity through the cannula. For example, an endoscope, another visual system, including but not limited to a scope or camera unit, can be inserted into the cavity, and visibility within the cavity may be assisted by the introduction of a fluid (gas or liquid), which may be air, carbon dioxide, saline, or any other suitable gas or liquid. In some cases, the terms gas or gases may be used to refer to a fluid introduced through a cannula and / or into the cavity as described herein, but it is understood that any fluid containing any gas or liquid may also be used. After the initial insufflation of air through the cannula and insertion of an instrument (e.g., a laparoscope), additional cannulas may be inserted into the surgical cavity under laparoscopic observation. At the end of the surgical procedure, all instruments and cannulas are removed from the surgical cavity, the gas is released, and each incision is closed. In some embodiments, the pressure in the surgical cavity is maintained substantially constant by an insufflation device. The system may also include one or more vents for removing (e.g., venting) smoke and gas from the cavity. In some cases, the vents may include a stopper that is manually operated by a medical professional. The insufflation device may be controlled to compensate for the pressure drop during venting, for example, by controlling the delivery of fresh insufflation gas to the cavity. For thoracoscopy, colonoscopy, sigmoidoscopy, gastroscopy, bronchoscopy, and / or other procedures, the same or substantially similar procedures may be followed to introduce gas into the surgical cavity. The amount and flow of gas may be automatically controlled by the clinician performing the procedure and / or by the surgical system.

[0187] In some of the figures described herein, slices of the cannula may be shown rather than cross-sectional views.

[0188] Figures 1 and 2 schematically illustrate the use of an exemplary surgical, for example, air supply system 1 during a medical procedure. Features of Figure 1 and Figure 2 can be combined with each other. In Figures 1 and 2, the same features have the same reference numerals. As shown in Figure 1, patient 2 may have a cannula 15 inserted into the cavity of patient 2 (for example, the abdomen of patient 2 in the case of laparoscopic surgery), as described above.

[0189] As shown in Figures 1 and 2, the cannula 15 may be connected to the gas delivery conduit 13 (for example, via a Luer lock connector 4). The cannula 15 may be used, for example, to deliver gas to a surgical site in the cavity of a patient 2. The cannula 15 may include one or more passages for introducing gas and / or one or more medical devices 20 into the surgical cavity. The medical devices may be surgical instruments. The medical devices may, among other things, be scopes, electrocautery instruments, electrosurgical instruments, energy and laser excision and / or cauterization instruments, or any other devices. The medical device 20 may be coupled to an imaging device 30 which may have a screen. The imaging device 30 may be part of a surgical system which may include multiple surgical instruments and / or devices. The application of a fluid surrounding the medical device, such as gas, is described as important for visualization of the surgical area by a scope or other visualization device, but the application of fluids described herein may be used in applications such as electrocautery instruments, gripping devices, and other devices.

[0190] The system may also include a drainage cannula 22. The drainage cannula 22 may have substantially the same characteristics as the cannula 15. The drainage cannula may include a valve that enables drainage. The valve may be automatically controlled by a controller associated with a gas supply source (e.g., an insufflation chamber), a humidifier, or another independent controller of the system. The valve may also be operated manually (e.g., by turning a stopper by hand, a foot pedal, or by other means). The drainage cannula 22 may be coupled to a filtration system for filtering smoke, etc. Alternatively, the drainage cannula 22 may also be coupled to a recirculation system configured to recirculate gas from the surgical cavity to the insufflation chamber for redelivery to the surgical cavity. The gas may be filtered and / or dehumidified before being returned to the insufflation chamber. Alternatively, the system may include a drainage attachment configured to be detachably coupled to a standard cannula. The drainage attachment may include one or more passages that have fluid communication with the surgical cavity. The discharge attachment may include one or more filter elements for filtering smoke and other gases from the surgical cavity before releasing them into the atmosphere. The discharge attachment may be coupled to the outside of the cannula, inserted into the cannula, or surround a portion of the cannula.

[0191] The gas delivery conduit 13 can be made of flexible plastic and may be connected to the humidifier chamber 5. Optionally or preferably, the humidifier chamber 5 may be connected in series to the gas supply unit 9 via a further conduit 10. The gas supply unit or gas source may be a pneumoperitoneum, a gas cylinder, or a wall gas source. The gas supply unit 9 may provide gas without humidification and / or heating. A filter 6 may be connected downstream of the humidifier outlet 11 or upstream of the humidifier inlet. The filter may also be located along the further conduit 10 or at the inlet of the cannula 15. The filter may be configured to filter and remove pathogens and particulate matter to reduce infection or contamination of the surgical site by the humidifier or gas source. The gas supply unit may provide a continuous or intermittent (e.g., periodic) flow of gas. The further conduit 10 may also preferably be made of flexible plastic tubing.

[0192] The gas supply unit 9 can supply one or more liquid and / or gas fluids, such as carbon dioxide, to the humidifier chamber 5. The gas may be humidified as it passes through the humidifier chamber 5, which can contain a certain amount of humidifying fluid 8, such as water. The gas may be a dry low-temperature gas, a dry high-temperature gas, a humidifying gas, or something else. The gas supply unit 9 may include two gas sources.

[0193] Any type of humidifier may be configured to incorporate a humidifier chamber 5. The humidifier chamber 5 may include a chamber made of plastic. The plastic chamber has a metal or other conductive bottom 14 sealed to it. During use, the bottom may be in contact with a heater plate 16. A certain amount of water 8 contained in the chamber 5 may be heated by the heater plate 16. The heater plate 16 may be under the control of the humidifier controller or control means 21. A certain amount of humidifying fluid in the chamber 5, e.g., water 8, may be heated to evaporate, and the water vapor or other humidifying fluid may be mixed with the gas flowing through the chamber 5 to heat and humidify the gas. The illustrated humidifier is a heated passover humidifier. A heated passover humidifier may be adapted to humidify a gas by heating a humidifying fluid (e.g., water) in the chamber and passing the gas over the heated humidifying fluid. The gas is humidified as it passes over the heated humidifying fluid.

[0194] The controller or control means 21 may be housed within the humidifier base unit 3. The humidifier base unit 3 may also house a heater plate 16. The heater plate 16 may have an electrically heated element within the heater plate 16 or an electrically heated element that is in thermal contact with the heater plate 16. One or more insulating layers may be located between the heater plate 16 and the heater element. The heater element may be a base element (or core) with a wire wound around it. The wire may be a nichrome wire (or nickel-chromium wire). The heater element may also include a multilayer substrate with a heating track electrodeposited or etched onto it. The controller or control means 21 may include electronic circuitry that may include a microprocessor for controlling the supply of energy to the heating element. The humidifier base unit 3 and / or the heater plate 16 may be detachably engaged with the humidifier chamber 5. Alternatively or additionally, the humidifier chamber 5 may include a built-in heater. Alternatively, the controller or control means 21 may be housed outside or partially outside the humidifier base unit 3.

[0195] The heater plate 16 may include a first temperature sensor, such as a temperature transducer or other, which can be electrically connected to the controller 21. The heater plate temperature sensor may be located within the humidifier base unit 3. The controller 21 can monitor the temperature of the heater plate 16, thereby estimating the temperature of the water 8.

[0196] In some embodiments, the system may include a further, for example, second temperature sensor located at the outlet 11 of the chamber 5. Furthermore, additional sensors may be configured to monitor temperature and / or other parameters (e.g., humidity, flow, gas concentration, and other parameters). This includes patient end sensors. Patient end sensors may be located, for example, adjacent to the cannula, within the cannula, or within the cannula connector. The patient end temperature sensor and the chamber outlet temperature sensor may be configured to communicate electronically with a controller. The controller may be configured to control the energization of the heater plate and / or heater wires based on the sensor values.

[0197] The gas can exit through the humidifier outlet 11 and enter the gas delivery conduit 13. The gas can then travel through the gas delivery conduit 13 and enter the surgical cavity of the patient 2 via the cannula 15, thereby expanding the cavity and maintaining the pressure within it. The gas delivery conduit 13 may be made of plastic or other suitable material. Preferably, the gas exiting the outlet 11 of the humidifier chamber 5 may have a relative humidity of up to 100%, for example, about 100%, or a therapeutically effective level of humidity. As the gas travels along the gas delivery conduit 13, further condensation and / or fogging may occur, causing water vapor to condense on the walls of the gas delivery conduit 13. Further condensation and / or fogging may have undesirable effects, for example, adversely reducing the moisture content of the gas delivered to the patient. To reduce and / or minimize the occurrence of condensation within the gas delivery conduit 13, a heater wire 14 may be provided within the gas delivery conduit 13, along the entire gas delivery conduit 13, or around the gas delivery conduit 13. To power the heater wire, the heater wire 14 may be electronically connected to the humidifier base unit 3, for example, by an electrical cable 19.

[0198] Condensation can occur on various surfaces of medical devices. When condensation forms on the visible surfaces of a medical device, it is perceived as a fogging effect that impairs visibility through lenses or any other visible surfaces of the medical device (e.g., mirrors or transparent or translucent windows). When condensation forms on various surfaces of a medical device, it can combine to form water droplets. These may occur directly on the visible surface or on another surface and then migrate to or accumulate on the visible surface. Therefore, as used herein, condensation and / or fogging means general condensation and, in some cases, in particular, condensation on visible surfaces (i.e., fogging).

[0199] The heater wire 14 may include an insulated copper alloy or nichrome resistance wire, other types of resistance wire, or other heater elements, and / or may be made of any other suitable material. The heater wire may be a straight or spirally wound element. The electrical circuit including the heater wire 14 may be located within the wall of the gas delivery tube 13. The gas delivery tube 13 may be a helical-wound tube. The heater wire 14 may be spirally wound around the insulating core of the gas delivery conduit 13. The insulating coating around the heater wire 14 may include a thermoplastic material. When heated to a predetermined temperature, the thermoplastic material may become capable of changing its shape, and upon cooling, the new shape may be substantially elastically retained. The heater wire 14 may be wound as a single or double helical wire. Measurements by the temperature sensor and / or additional sensors at the patient end of the conduit 13 can provide feedback to the controller 21, which may energize the heater wire to raise and / or maintain the temperature of the gas in the gas delivery conduit 13 (for example, above or below the body temperature of approximately 37°C, for example, above or below the body temperature by, for example, 1°C, 2°C, 3°C, 4°C, 5°C, 6°C, 7°C, 8°C, 9°C, 10°C, or 15°C, or more or less than 15°C, or within a range including any two of the aforementioned values).

[0200] The controller or control means 21 may include, for example, a microprocessor or logic circuit having associated memory or storage means capable of holding software programs. When executed by the control means 21, the software can control the operation of the system 1 according to a set of instructions within the software and / or in response to external inputs. For example, inputs can be provided to the controller or control means 21 from the heater plate 16 so that information regarding the temperature and / or power usage of the heater plate 16 can be provided to the controller or control means 21. Inputs regarding the temperature of the gas flow can be provided to the controller or control means 21. For example, a temperature sensor can provide an input indicating the temperature of the humidified gas flow as the gas exits the outlet 11 of the humidifier chamber 5. A flow sensor can also be provided at or near the same location as the temperature sensor, or at other suitable locations within the system 1. The controller 21 can control a flow regulator that adjusts the flow rate of the gas within the system 1. The regulator can include a flow inducer and / or an inhibiter, such as an electric fan or pump. Additionally or alternatively, valves and / or vents can be used to control the gas flow rate.

[0201] The patient input 18 located on the humidifier base unit 3 can enable a user (such as a surgeon or nurse) to set the desired gas temperature and / or gas humidity level to be delivered. Other functions, such as control of the heating delivered by the heater wire 14, may also be controllable by the user input 18. The controller 21 can control the system 1, specifically, the flow rate, temperature, and / or humidity of the gas delivered to the patient, so as to be appropriate for the type of medical procedure for which the system 1 is being used.

[0202] The humidifier base unit 3 may also include a display for presenting to the user the characteristics of the gas flow being delivered to the patient 2.

[0203] Although not shown in the diagram, the humidifier may also optionally be a passover humidifier. A passover humidifier may include a chamber containing a certain amount of water, but may not include a heater plate for heating the water. The chamber may be in fluid communication with a gas supply unit such that the supplied gas is humidified by water vapor drawn up or evaporated from a certain amount of water as the supplied gas passes over that amount of water.

[0204] When in use, the humidifier described above may be located outside the "operating sterile zone" and / or adjacent to the insufflation device. As a result, medical personnel do not need to touch the humidifier when moving the cannula to manipulate surgical instruments in the surgical cavity during surgery. The humidifier may not need to be sterilized to the same extent as the medical instruments. Furthermore, the humidifier located outside the "operating sterile zone" reduces obstacles to medical personnel that may restrict the movement of medical personnel and / or medical instruments in an already crowded space during surgical procedures. As described herein, the proximal direction to the cannula may generally mean the upper end of the cannula body, while the distal direction to the cannula may generally mean the lower end of the cannula shaft, which is configured to be the first section of the cannula inserted into the surgical cavity. A more detailed example of a guided gas flow cannula is described below. As described herein, the proximal direction to a medical device may generally mean the upper end of the medical device body, while the distal direction to a medical device may generally mean the lower end of the medical device body, which is configured to be the first section of the medical device inserted into a cannula and / or surgical cavity. Reference numbers of the same or substantially the same features may share the same last two digits.

[0205] Examples of induction gas flow cannulas Condensation and / or fogging occur when the gas temperature falls below the dew point temperature at the humidity level the gas contains, and / or when there is a surface where the temperature is significantly below the dew point temperature. In Figures 1 and 2, as the supplied gas moves from the gas delivery conduit 13 to the cannula 15, the heated and humidified gas may cool to near the dew point within the cannula 15 if the cannula 15 is not heated. Furthermore, one or more medical devices, such as cameras and / or surgical scopes, which are at a lower temperature than the human body, may be inserted into the surgical cavity through the cannula 15. As a result, the humidified gas may condense as fogging on the lens and / or as water droplets on the surgical scope, which may drip onto the lens area. Fogging and / or droplets may obstruct the view of the surgeon or other medical personnel participating in the surgery. Removing a medical device to wipe away condensation and / or droplets may delay the surgical procedure and / or may result in recurrence of droplet precipitation when the medical device, which may have cooled down when removed from the surgical cavity, is reinserted.

[0206] This disclosure provides examples of cannulas (e.g., surgical cannulas) that include an inductive gas flow for reducing, preventing, and / or eliminating condensation and / or fogging of medical devices, which can be used as the cannula 15 disclosed herein and without requiring any additional components or instruments. The exemplary inductive gas flow cannulas disclosed herein can be implemented in existing surgical air supply systems, for example, without requiring custom and / or more expensive systems. Thus, the exemplary inductive gas flow cannulas disclosed herein can improve the optical clarity of the lens and / or maintain a clear field of view, which can help minimize surgical time and postoperative complications (e.g., pain, adhesions and / or other), and / or make it easier for medical personnel such as surgeons to manipulate the cannula during medical procedures. The inductive gas flow helps prevent condensation from forming by affecting the zone around the scope lens and manipulating the flow, temperature and / or humidity. This can advantageously have the effect of maintaining the temperature of the scope lens (or sensor or other desired element) above the dew point of the gas in the zone adjacent to the scope lens. Inductive gas flow cannulas can also help prevent smoke particles, condensates, and / or other debris from accumulating on the instrument, for example, on the lens of the scope. Cannulas may be single-use (disposable) or reusable. Alternatively, cannula components may be single-use (disposable) or reusable. Cannulas may be made of biocompatible and / or sterilizable materials. Features of different examples of heated cannulas may be incorporated or combined within this disclosure.

[0207] An exemplary guided gas-flow cannula may have any of the features of cannula 15. For example, a guided gas-flow cannula may have a cannula body 102 connected to an elongated shaft 104. The elongated shaft 104 may have a tapered end to facilitate insertion of the cannula 100 into the surgical cavity. In some cases, the elongated shaft 104 of the cannula may be used in combination with an occlusion device and function as a trocar. A trocar may include a cannula and an occlusion device. The cannula body 102 may have guiding features to assist in the insertion of a medical device into the cannula. As used herein, guiding element, guiding feature, guide element, and / or guide feature are interchangeable herein and refer to features used to assist in insertion or to provide support for a medical device within the cannula.

[0208] As shown in Figure 2, the cannula body 102 may have a substantially funnel shape in which the cross-sectional dimensions (e.g., diameter) decrease from a position farther from the elongated shaft 104 to a position closer to the elongated shaft 104. The gas inlet 106 may be located in the cannula body 102. The cannula body 102 may include a cavity. The elongated shaft 104 may include a hollow passage. The cavity and the hollow passage can communicate with the fluid. The induction gas flow cannula may include a heating element that is detachably coupled (e.g., via a sleeve) or built into the induction gas flow cannula (e.g., in at least a portion of the cannula body 102 and / or a portion of the elongated shaft 104). The heating element may be located at any desired position, for example, inside the shaft, built into the wall, or wrapped around the outside of the shaft. The heating element can raise the temperature of the cannula and therefore also raise the temperature of the gas as it moves through the cannula. Heating the gas can reduce and / or prevent condensation because it raises the temperature of the cannula and allows the gas temperature to be maintained above the dew point. The induction gas flow cannula may also include a filter module that is detachably coupled to or built into the cannula (for example, located proximal to the cannula body 102 or to a sleeve attached to or coupled to the cannula via a tube (described below)). The heating element may be positioned to be in contact with the filter module or to extend into the filter module. The cannulas disclosed herein may include, for example, an angled (inclined) distal end or a right-angled (flat) distal end.

[0209] A surgical insufflation system for supplying an insufflation gas to a surgical cavity, such as any surgical insufflation system disclosed herein, may incorporate one of the exemplary guided gas flow cannulas disclosed herein. As described above, the system may include a gas supply unit configured to provide an insufflation gas; a humidifier fluidly communicating with the gas supply unit and configured to humidify the insufflation gas received from the gas supply unit; and gas delivery tubes extending between the humidifier and the cannula, each fluidly communicating with the humidifier and the cannula. The gas delivery tubes may also be able to electrically communicate with the humidifier and the cannula, respectively. When the system is in use, the gas delivery tubes may guide the insufflation gas to the surgical cannula and may also guide an electric current from the humidifier to a heating element within the cannula. The heating element may be configured to transfer heat to the supply gas passing through the cannula and / or a portion of the medical device inserted into and / or removed from the cannula, thereby raising the temperature of the gas and / or the device, reducing and / or preventing condensation. The temperature of the supply gas and / or the device can be raised above the dew point, preventing condensation of the gas and / or reducing and / or preventing condensation on the medical device (and / or removing any condensation that has already formed by evaporation). The temperature of the supply gas and / or the device (e.g., on or near optical elements such as lenses, or other areas of the device) can also be measured by, for example, thermocouples and / or other sensors, and closed-loop feedback may be provided to the controller to maintain the temperature near the device at or above a predetermined or calculated value, e.g., the dew point. In some embodiments, the system may include one or more humidity sensors. The humidity sensor can provide feedback information to the controller, which in turn controls the heating element, such as a heater plate or heater wire in a tube, to maintain the humidity within a desired parameter, such as a preset range.

[0210] During laparoscopic surgery, some form of electrosurgery / electrocautery / ultrasonic or laser device surgery is generally performed to induce resection or coagulation within the insufflated cavity. This generates surgical smoke, which may increase in concentration over time within the sealed and pressurized peritoneum or other cavities, especially in the absence of significant gas leakage or suction / perfusion. High concentrations of smoke within the insufflated cavity and field of view may significantly impair optical clarity when observing the intraperitoneal space through a camera or lens inserted via a cannula. Without the use of evacuation or suction, the surgeon generally has no choice but to release all or part of the gas from the pneumoperitoneum by degassing and then re-inflate. For example, electrocautery may generate a smoke plume. The smoke plume may move towards the scope / lens, reducing the surgeon's visibility.

[0211] Guided gas flow can advantageously mitigate the effects of concentrated smoke in the insufflated lumen by eliminating non-uniformity of the gas flow around the scope. This helps push the smoke away from the scope and guide the line of sight, improving the surgeon's field of view. Guided gas flow cannulas can prevent the smoke plume from coming into contact with medical equipment by pushing it away.

[0212] Figure 3A schematically shows a surgical cavity in which a cannula 100 is located within a pneumoperitoneal cavity CA, and the scope lens C at the distal end of the scope is inserted through the cannula 100. Surgical smoke S surrounding the scope lens C is also shown. Figure 3B schematically shows the surgical cavity scenario of Figure 3A, with the smoke S being directed away from the scope lens C by an induced gas flow indicated by an arrow. As illustrated, the instruments can be held concentrically, and the gas is guided to be substantially concentric and coaxial with the instruments. The gas travels through the cannula 100 and along the scope, extending around the scope. Figure 3C schematically shows that the cannula may include one, two, or more features for creating a control zone Z that can advantageously reduce or prevent smoke, condensation, or other unwanted media from coming into contact with the target section of the medical instrument, as described elsewhere in this specification. In other words, in some cases, as described herein, a guided gas flow cannula can create a gas barrier or envelope, also referred to as a gas shroud, gas sheath, protective zone, or controlled temperature and humidity area, such that gas flows from the opening through the lumen of the cannula and out the exit. Figure 3D schematically shows a surgical cavity scenario similar to those in Figures 3A-3C. Figure 3D shows a guided gas flow cannula 100 used in conjunction with a second cannula 300. In some cases, the first medical device may include a scope lens C, which can be inserted through the second cannula 300, and the guided gas flow may be introduced through the guided gas flow cannula 100. As shown in Figure 3D, the guided gas flow cannula 100 can provide a guided gas flow, as indicated by the arrow, within the inflated cavity CA, and the guided gas flow can keep smoke S away from the scope lens C inserted through the second cannula 300. In some cases, the induction gas flow cannula 100 can also support a second medical device 301 that can be inserted through the induction gas flow cannula 100, as shown in Figure 3D.

[0213] The guided gas flow cannula may be configured to create a gas envelope that extends distally beyond the end of the medical device and / or over or beyond a portion of the medical device, such as an endoscope lens, sensor, or other element. The formed gas envelope may have any number of potential benefits, including but not limited to maintaining a temperature, humidity, and / or pressure-controlled environment around the shaft (e.g., the distal end of the shaft) and the outlet of an elongated shaft, including maintaining the temperature of the instrument above the dew point, preventing or reducing fogging and / or condensation that forms on the instrument, reducing or preventing smoke, debris, or other unwanted media from coming into contact with the instrument, or guiding smoke, debris, or other unwanted media away from the instrument and / or the lumen outlet so that the gas envelope disperses the smoke plume, substantially surrounding a portion of the instrument (or substantially the entire portion of the instrument placed within the surgical cavity and / or cannula shaft), concentrically surrounding the instrument inside the shaft and / or beyond the shaft outlet distally, extending a predetermined or calculated distance in a desired direction beyond the outlet, and / or maintaining the temperature of the envelope above the dew point.

[0214] The flow separates and diverges from the scope surface at a certain distance from the cannula exit. This distance and the jet divergence angle do not necessarily depend heavily on the scope insertion depth. The distance over which the flow separates and diverges from the scope surface decreases as the flow rate increases. In some embodiments, the gas envelope can be controlled to extend beyond the distal end and / or lumen exit of the medical device by about, just about, or at least about 10 mm, 25 mm, 50 mm, 75 mm, or 100 mm, or more or less than 100 mm, or beyond a range including any two of the aforementioned values. In some configurations, the gas envelope can extend beyond the distal end and / or lumen exit of the medical device by about 10 mm to more than about 100 mm. In some configurations, the gas envelope can extend just about 100 mm beyond the distal end and / or lumen exit of the medical device. The distance the envelope extends can depend on the flow rate of the gas being delivered.

[0215] Surgical air supply systems, for example, can be configured to deliver intermittent (e.g., periodic) and / or constant gas flows. In some embodiments, a constant flow provides a more stable envelope, but intermittent / periodic flows also allow for the formation of an envelope to clear the scope. The flow rate of the delivered gas can be sufficient to maintain a pressurized surgical cavity. The flow rate can be, for example, at least about 2 liters per minute (lpm). In one example, the flow rate provided is at least about 6 lpm. In another example, the flow rate provided is at least about 7 lpm. In yet another example, the flow rate is at least about 10 lpm, or about 10 lpm to about 12 lpm, or about, at least about, or just about 2, 4, 6, 8, 10, 12, 14, 16, 20, 30, 40, 50, 60 lpm, or more or less than 60 lpm, or a range incorporating any two of the aforementioned values. The flow rate can be any suitable flow rate. In one example, the flow rate can reach approximately 40 L / min to over 50 L / min. Furthermore, the flow rate limit is based on the pressure in the surgical cavity. The pressure in the surgical cavity can be defined by regulatory standards, e.g., established clinical practice, and in some cases, it can be up to approximately 50 mmHg. The exemplary flow rates described above may be continuous flow rates. When intermittent flow rates are delivered, the flow rate may vary between upper and lower limits, including the values ​​described for continuous flow rates. Concentric placement of the equipment ensures that the supplying gas remains in contact with the equipment, e.g., the lens of the scope. This contact also allows for defogging of the equipment. Generally, increasing the flow rate of the supplying gas can reduce the required defogging time. Low-temperature dry gas supplied to the cannula while the equipment is held concentrically can also help defogging the lens. Defogging can be improved by heating the gas. This can be achieved by using a humidifier, such as the SH870 humidifier from Fisher & Paykel Healthcare (Auckland, NZ), which can further humidify the gas. Humidifying the gas has the added benefit of reducing cell / tissue damage. Higher flow rates provide an increased distance for the envelope to cover the scope as it is inserted beyond the cannula.The distance between the end of the shaft and the distal end of the scope may be called the insertion depth. The insertion depth may be, for example, about 20 mm to about 100 mm. The insertion depth may be, for example, up to about 80 mm. The clearing time may increase as the insertion depth extends beyond a threshold distance, such as 100 mm in some cases. The flow rate from a flow generator, such as an insufflation device, can be controlled to change the length of the envelope. The flow rate may be controlled by the insufflation device, or there may be a flow control device placed in the gas path, or the humidifier may include a device or structure for controlling the flow rate delivered to the cannula.

[0216] Non-uniform flow along a medical device (sometimes referred to herein as a stagnation zone) can reduce the effectiveness of the protective envelope / protection zone. Non-uniform flow can also hinder the formation of an envelope. Features disclosed herein, in particular, such as induced gas flow vanes, may be especially useful in cannulas with tapered ends. Cannulas with tapered ends are particularly susceptible to the effects of non-uniform flow due to the elongation of one portion or one side of the cannula end. Placing vanes or a series of vanes on the longer portion can help reduce or prevent non-uniform flow. Non-uniform flow can occur when a medical device, such as a scope, rests on a wall at the cannula exit. When a scope rests on a wall, it obstructs the flow surrounding the scope, creating non-uniform flow beyond the cannula exit.

[0217] More detailed examples of the characteristics of induction gas flow cannulas are described below with reference to Figures 4A to 16.

[0218] Example of an induction gas flow cannula shaft Figures 4A to 16 show examples of cannulas having one, two, or more lumens configured to guide gas flow within and / or around or beyond the cannula. As shown in Figures 4A to 4C, the cannula 400 may include a cannula body (not shown) having a distal end integrally formed with or operationally connected to the proximal end of the cannula elongated shaft 402. One, two, or more lumens may be present in both the cannula body and the cannula elongated shaft 402, for example, within the central lumen 404. One, two, or more lumens may extend from openings (not shown) to one, two, or more outlets (for example, located at or near the distal end 408 of the cannula shaft 402) and be in fluid communication with these openings. The lumen 404 may be defined by side walls such as the inner side wall 406 of the cannula shaft 402 (and cannula body). Medical devices 410, such as an endoscope, camera, or other scope device, are also shown, including an elongated shaft of a medical device extending into the lumen 404 of the cannula shaft 402. The free end 408 at the exit of the cannula elongated shaft 402 may have a tapered (or sharp) end 408, a right-angle end, or any other geometric shape. The cannula body or elongated shaft 402 may include a gas inlet port (not shown) coupled to the wall (e.g., the outer wall) of the cannula 400. The gas inlet port may be connected to a gas delivery tube of, for example, a surgical insufflation system (e.g., one of the systems disclosed herein).

[0219] Figure 4B is a cross-sectional view taken along line 4A-4A of Figure 4A, without showing the medical device 410 within the lumen. As shown in Figure 4B, the inner side wall 406 of the cannula shaft 402 may include a medical device guide element 420. The medical device guide element 420 is configured to hold the medical device within the lumen and / or to promote concentricity of the medical device with the lumen 404 of the cannula shaft 402, and to prevent the medical device from contacting the side wall of the lumen.

[0220] In some embodiments, the medical device guide element may include radially spaced ribs and / or fins 420 extending inward from the cannula shaft 402 into the lumen 404. The ribs and / or fins 420 may be oriented substantially along the longitudinal axis of the cannula shaft 402, as shown in Figure 4B, or, in other embodiments, at an angle. The fins 420, ribs, or other structures may extend substantially along part or all of the axial length of the cannula body 402. The fins 420 may be configured to contact the medical device and grip the device substantially concentrically within the lumen 404. In some embodiments, the fins 420, ribs, or other structures may not necessarily contact the medical device during use, but may function as radial limits or restraints to prevent the fins / ribs from contacting the internal sidewalls 406 of the cannula shaft 402, and in some cases to facilitate the centering of the medical device relative to the center of the lumen 404. The fins / ribs 402 can provide gas passages for the supplying gas to move around the scope. Some embodiments may include approximately or at least approximately 2, 3, 4, 5, 6, 7, 8, 9, 10, or more than 10 fins 420, or a range of fins 420 incorporating any of the aforementioned values, and may be spaced regularly or irregularly along the inner circumference of the cannula 400 and / or along the cannula shaft 402, axially and / or longitudinally.

[0221] Figure 4C is a cross-sectional perspective view of the cannula 400 shown in Figures 4A and 4B, illustrating the fins 420 against the inner side wall 406 of the cannula 400 and a medical device (not shown).

[0222] A gas barrier or envelope can be created to shield at least a portion of the medical device 410, such as an endoscope, from the warm, humid environment of the pneumoperitoneum (the cavity insufflated with air), thereby preventing or reducing condensation formation on the scope lens. The gas (flowing in the direction of the arrows shown in Figure 4A) can pass along the gaps between the fins 420 and be guided along the scope to remove fogging / condensation, smoke, or for other applications as described above.

[0223] Figures 4D to 4E illustrate further embodiments of a cannula 490 including ribs / fins 420 that may have features similar to those shown in Figures 4A to 4C above. Figure 4D is a partial cross-sectional view of a cannula, where the elongated shaft is shown in cross-section but the cannula body is not. The cannula may include six ribs spaced equiangled around the cannula shaft, but other numbers of ribs may be used as previously noted. In some cases, the ribs or fins 420 are not spaced equiangled around the cannula shaft. The cannula may include a first rib set 492 and a second rib set 494 spaced axially apart from each other, as seen in Figure 4D. In the illustrated configuration, the first rib set 492 and the second rib set 494 contain the same number of ribs. Alternatively, the first rib set 492 may contain more or fewer ribs than the second rib set 494. In other embodiments, further rib sets (e.g., third, fourth, or more rib sets) are also possible. As shown, a ribless gap 496 may exist between rib set 492 and rib set 494. The gap 496 between rib set 492 and rib set 494 can mix and stabilize the insulated gas. The insulated gas can enter the gas inlet 498 of the cannula 490 perpendicularly or at any other angle as shown. The insulated gas can enter as turbulent flow and bounce / change direction off the walls of the cannula 490. The gap 496 between the two rib sets 492, 494 allows the insulated gas to become more linear and mixed, surrounding the scope when it is placed inside the cannula 490.

[0224] As described above, the rib 420 can serve to stabilize the annular position of the instrument within the cannula 490, limiting annular movement and acting as a limit / stop to restrict the angle of the scope with respect to the longitudinal axis of the shaft / lumen. The rib 420 also serves as a guide when inserting the instrument into the cannula 490. Alternatively, the rib may function as a retainer, concentrically gripping the instrument within the cannula.

[0225] Figure 5A shows another example of a cannula 500 having a cannula elongated shaft 502 and an internal side wall 506 defining a lumen 504, the lumen 504 being configured to house a medical device 410. Figure 5A is a partial longitudinal cross-sectional view. The structure 508 may include an instrument opening configured to contact the medical device 410, for example, on the outer circumference of the structure 508, which can be operationally connected from the internal side wall 506 of the cannula elongated body 502. In some embodiments, the structure 508 may be flexible or semi-rigid. Gas can pass through a small opening or aperture of the structure 508, for example, a gap 509, and may be guided along the medical device 410 (e.g., the scope) to remove fogging, condensation, or other elements along the scope 410 that may obstruct the view of the scope. In other embodiments, each structure 508 may include only one gap 509 or multiple gaps 509 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or more than 10, or a range including any of the aforementioned values). In some embodiments, the structure 508 or a group of structures 508 may be spaced apart along multiple longitudinal heights of the cannula length. In some embodiments, the structure 508 may be mechanically or electronically actuated to open and close reversibly depending on the desired result. Figure 5B is a cross-sectional view taken along line 5A-5A of Figure 5A, with the medical device 410 not shown in the lumen. Figure 5B is a cross-sectional view of the shaft of the cannula 500 of Figure 5A cut above the structure 508, showing the internal side wall 506 defining the lumen. In some cases, a structure 508 is also shown that includes at least one device opening 555 configured to receive and grasp the device 410, which may take the form of a disc or flange and may be centrally located as shown. The structure 508 may be positioned at a predetermined location within the lumen such that the equipment opening 555 is concentric or substantially concentric with the lumen. The structure 508 may include a plurality of gas openings 509. The plurality of gas openings 509 are positioned radially outward with respect to the equipment opening 555 and are configured to concentrically guide the supplied gas around the equipment to form a gas envelope, thereby forming a protective zone and a region of controlled temperature and humidity around the equipment as described above.In some embodiments, the gas openings 509 are arc-shaped or polygonal and are evenly or irregularly arranged around the equipment openings 555. As described above, the structures 508 can be flexible, rigid, or semi-rigid. Figure 5C is a schematic diagram of the cannula 500 of Figures 5A-5B, with selective cutouts showing the structures 508 and related structures as described above. With respect to the embodiments of Figures 4A-4B, 5A-5C, and other embodiments described herein, the gas may be delivered continuously or intermittently (e.g., periodically) through the gas supply source.

[0226] Figures 6A and 6B show further examples of cannulas 600, 610 having a first lumen 604 and a second lumen 629 between the first outer wall 628 and the second inner wall 630 of the elongated cannula 602. The second lumen 629 may be offset from the center of the elongated cannula shaft 602, may be concentric with the first lumen 604 that houses the medical device 410 therein, and / or may be radially outwardly separated from the first lumen 604. The first lumen 604 may be defined by the inner surface of the second inner wall 630. The second lumen 629 may have a relatively straight proximal portion and a curved portion 632 that forms an angled distal end 634 (for example, angled radially inward toward the medical device 310) as shown in Figure 6A, or a straight distal end 636 as shown in Figure 6B. In some embodiments having an angled distal end, the curved portion may form angles of, for example, about 5, 10, 20, 30, 40, 50, 60, 70, 80, or 90 degrees, or angles within a range of values ​​including any two of the aforementioned values ​​or any other natural angle between any of the disclosed values. In some cases, the distal end 634 may be a curved end or a stepped end. The gas flowing from the second lumen 629 may advantageously create a gas barrier or envelope along the medical device to prevent condensation / fogging or other conditions, as described elsewhere in this specification. The second lumen 629 may be connected to a gas supply source (e.g., humidified supply gas), although in some embodiments the supply gas does not flow through the first lumen 604.

[0227] Figures 7A and 7B show further examples of cannula 700 that are somewhat similar to those in Figures 6A and 6B. The second lumen 729 may have a gap between the first outer wall 728 and the second inner wall 730, but does not necessarily have to be concentric around the first lumen 704. The second lumen 729 includes an inlet (not shown) and an outlet port 740 oriented (or obliquely in other embodiments) generally transverse the longitudinal axis of the cannula's elongated shaft, functionally creating a gas blade. In some cases, the outlet port can be located anywhere along the elongated shaft, not just at the distal end. In some embodiments, the outlet port 740 of the second lumen 729 may be oriented laterally as shown, radially inward relative to the elongated shaft of the cannula body 702, and includes a closed or plugged distal end 742 and / or is in fluid communication with the first lumen 704. The gas can be forced across a desired portion of a medical device 410, e.g., an endoscope or other scope lens, to remove or prevent any condensation, smoke, or accumulation of undesirable media on the medical device 410. In some embodiments, the gas can flow continuously or substantially continuously, moving the endoscope lens 488 proximal to the transverse height of the gas blade (e.g., the outlet port 740) to remove fogging and / or condensation. In some embodiments, the outlet port 740 of the second lumen 729 may be marked (e.g., a marking, color, etc.) to allow the operator to better identify the gas blade.

[0228] Figures 8A and 8B show further examples of cannula 800 similar to those in Figures 7A and 7B, except that they have multiple auxiliary lumens (e.g., lumens 829 and 829') (or alternatively, a single concentric lumen relative to the leading of a dual gas blade (e.g., gas exits through exit ports 840, 840')). The gas blades can be spaced regularly or irregularly circumferentially along the transverse height of the cannula body 802, for example, 180 degrees apart as shown (or three gas blades spaced 120 degrees apart, four gas blades spaced 90 degrees apart, etc.). As shown in Figure 8B, the scope lens 488 at or near the distal end of the medical device 410 can be moved proximal to the same height as the transverse height of the gas blades to remove fogging, as described in relation to Figure 7B.

[0229] Figures 9A and 9B show cross-sectional views of another example of a cannula 900 similar in some respects to Figures 7A-7B and 8A-8B, except that a gas blade extends from a series of sidewall ports 940 that are located at a number of regularly or irregularly spaced transverse heights along the elongated cannula shaft 902 and discharge into the first lumen 904 defined by the inner surface of the second inner wall 930, with the second lumen 929 located between the first outer wall 928 and the second inner wall 930 and operationally connectable proximal to the inlet 985, and is defined by the inner surface of the second inner wall 930. In some cases, the series of sidewall ports 940 may be randomly spaced or patterned. Figure 9B is an enlarged view of the shaft of the embodiment shown in Figure 9A. As illustrated, the medical device 410 can be retracted from the surgical site in the appropriate direction (e.g., proximal) and returned into the cannula shaft 902 so that the gas blades remove fogging / condensation from the lens 488. In some embodiments, a subset of the gas blades may be actuated (e.g., via valves) to control the gas flow at different axial heights of the cannula 900.

[0230] Figure 10 shows a partial longitudinal cross-sectional view of another embodiment of the cannula 1000, which delivers warm, humid gas directly to the insufflation / air delivery lumen through a second lumen 1029 located between a first outer wall 1028 and a second inner wall 1030, and radially separated outward from a first lumen 1004 for housing a medical device 410, while bypassing the medical device 410 or a portion thereof (e.g., an endoscope lens) 488. The exit port 1040 may be angled radially outward from the cannula body 1002 and does not communicate with the inner side wall of the first lumen 1030. In other words, the first lumen 1004 for housing the medical device 410 may not, in some cases, be configured to be connected to a source of humidifying gas, and the humidifying gas does not flow within the first lumen 1004. Therefore, the endoscope lens 488 or other desired parts of the medical device 410 are advantageously not directly exposed to warm, humid gases, thereby reducing or preventing fogging.

[0231] Figures 11A and 11B show partial longitudinal cross-sectional views of an embodiment of a cannula that may be similar in some respects to Figure 10, having a first lumen 1104 for housing a medical device 410 therein, the first lumen 1104 defined by the inner surface of an inner wall 1132, and a second lumen 1129 located between the inner wall 1132 and an intermediate wall 1130, configured to be connected to a source of humidified gas flowing into the lumen to be inflated / inflated. In some embodiments, the second lumen 1129 is insulated from the cannula heating element so that the gas is delivered at any desired therapeutic temperature and relative humidity, including parameters described elsewhere herein. In some embodiments, the second lumen 1129 is radially outward from the first lumen 1104. The cannula shaft 1102 may also include a third lumen 1139 between the intermediate wall 1130 and an outer wall 1128. The third lumen 1139 is configured to be connected to a relatively dry gas (e.g., CO2) source to remove condensation / fogging from the medical device 410. The second lumen 1129 can be in direct fluid communication with the first lumen 1104 and may have an outlet port 1140 to the first lumen 1104, as shown in the figure.

[0232] In some embodiments, a third lumen 1139 may be positioned between the first lumen 1104 and the second lumen 1129. In some embodiments, the third lumen is the outermost lumen, and the gas moving through the third lumen 1139 may be guided perpendicularly or at an angle from the outlet of the lumen 1104, which is similar to, but not limited to, the gas guidance described with reference to Figure 10, as opposed to the gas guidance from the end of the shaft. In some embodiments, the second lumen 1129 is isolated from the first lumen 1104 by the third lumen 1139. The second lumen 1129 may be shaped and configured to guide a dry gas around and / or across the medical device 410. In some embodiments, the third lumen 1139 surrounds the first lumen 1104 such that the first lumen 1104 is nested inside the third lumen 1139. In some embodiments, two or more of the first lumen 1104, the second lumen 1129, and / or the third lumen (or only two lumens, or other embodiments including four or more lumens) may be concentric and nested with each other, or non-concentric and non-nested. In some embodiments, the first lumen 1104 has a diameter equal to, greater than, or smaller than the diameter of the second lumen 1129. In some embodiments, the first lumen 1104 has a diameter equal to, greater than, or smaller than the diameter of the third lumen 1139. In some embodiments, the second lumen 1129 has a diameter equal to, greater than, or smaller than the diameter of the third lumen 1139. As shown in Figure 11A, the intermediate wall 1130 may contain a heating element 1131 within the intermediate wall 1130.

[0233] Figures 12A and 12B show cross-sectional views of one embodiment of a cannula 1200 having an elongated shaft 1202 that includes features configured to create a Venturi effect for removing gas from around a medical device 410 or a portion thereof, such as an endoscope lens 488. The Venturi effect is a drop in fluid pressure that occurs when a fluid flows through a restricting section 1166 (or choke point) of a lumen having a reduced inner diameter, such as a second lumen 1129 as shown in Figure 12B. The Venturi effect can create a partial vacuum, causing a pressure loss around the restricting section 1166 in the second outer lumen 1129, and remove low-pressure gas / moisture from the scope lens positioned in the first inner lumen 1104, thus eliminating condensation / fogging. In some embodiments, the reduction in inner diameter in the restricting section is in the range of about, at least about, or just about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% of the unrestricted diameter immediately proximal to the restricting section 1166, or more or less than 90%, or any two of the aforementioned values. The second lumen 1129 may have an increased inner diameter distal to the constricted section, as shown. Figure 12B is a magnified view of the tip of the shaft shown in Figure 12A, showing that the restricting section 1166 of the second lumen 1129 may be created by an increased thickness area such as a bump or projection 1167 on the outer wall 1120.

[0234] Figure 13 shows a partial longitudinal cross-sectional view of one embodiment of the distal end of the medical device 410 within the lumen 1304 of the cannula 1300, formed by the inner side wall 1306 of the cannula 1300, showing that the cannula 1300 is configured to allow a free flow of gas through a first portion 13042 of the lumen 1304 of the cannula 1300, while blocking the flow of gas through a second portion 13041 of the cannula 1300. The gas flow can be blocked, for example, with respect to one or more of half, one-third, one-quarter, or other fractional portions of the lumen 1304 of the cannula 1300 by one, two, or more flexible or semi-rigid flaps 1308, or other elements. Such a configuration can advantageously enable the induced gas flow to remove stagnant zones of unwanted gases (e.g., smoke, condensation / fogging, etc.) from medical devices 410, such as the distal tip 488 of an endoscope (e.g., in the direction of the arrow).

[0235] Figures 14A and 14B show cross-sectional views of one embodiment of the elongated shaft 1402 of the cannula 1400 and the distal end of the medical device 410 within the lumen 1404 of the cannula 1400. Figure 14B is a cross-sectional view taken along line 14A-14A of Figure 14A, where the medical device 410 is not shown within the lumen 1404. The inner side wall 1406 of the lumen 1404 of the cannula 1400 may include an irregular portion 1489 such that the lumen 1404 is not a perfect arc (e.g., circular or elliptical). The irregular portions 1489 may include recesses or other features that extend radially inward into the lumen 1404, are spaced apart from one another axially and / or longitudinally (arranged irregularly and / or randomly at regular intervals along the lumen 1404), and generate turbulent gas flow within the lumen 1404 of the cannula 1400 (in the direction of the arrows). Some embodiments may also include, alternatively or additionally, features such as grooves or slots that extend radially outward from the lumen 1404. These features can also generate turbulent gas flow. Such features can advantageously remove stagnant zones of unwanted gas (e.g., smoke, condensation / fogging, etc.) from a medical device 410, such as the distal tip 488 of an endoscope.

[0236] Figures 15A and 15B show cross-sectional views of an embodiment of the distal end of the elongated shaft 1502 of the cannula 1500, in which the medical device 410 is positioned within the first lumen 1504 of the cannula 1500. The elongated body of the cannula 1502 may include one, two, or more additional spiral-shaped vanes 1530 winding down the elongated shaft 1502. Figure 15B is a cross-sectional view taken along line 15A-15A of Figure 15A, in which the medical device 410 is not shown within the lumen 1504. The helical lumen 1529 may externally tangent to the side wall 1506 of the first lumen 1504, or in some cases may be located within the first lumen 1504 and configured to connect proximal to a gas supply source. The spiral-shaped lumen 1529 may include a distal outlet port 1540 such that the outgoing gas creates a vortex flow pattern along the target location of the medical device 410 (e.g., the distal end of the endoscope 488), favorably creating a gas barrier, eliminating flow non-uniformity, and reducing or preventing fogging, condensation, or other debris on the medical device or a part thereof (e.g., the endoscope lens).

[0237] Figures 16-17 show one embodiment of an endoscopic lens 488 of a medical device (e.g., a scope) 410 within the elongated shaft 1602 and lumen 1604 (e.g., the central lumen is defined by the inner sidewall 1606 of the cannula 1600, as shown) of a cannula 1600, including one or more helical vanes 1608 geometrically configured to create a gas vortex (in the direction of the arrows), which is somewhat similar to those described in relation to Figures 15A-15B. Figure 17 shows a partially cutaway schematic diagram of the cannula 1600. The helical vanes 1608 may be a single spirally wound wall extending in some cases all or substantially all of the length of the lumen 1604. The helical vanes 1608 can restrict the radial movement of the scope. The vanes 1608 may also grasp and hold the scope 410 within the lumen 1604. The gas flow within the lumen 1604 is guided around the scope 410 by the continuous vane 1608. The continuous vane 1608 acts as a guide wall that guides the supplied gas in a vortex along the scope 410. The vortex extends beyond the cannula exit and also creates a gas envelope as described above. In such embodiments, the envelope may be a vortex envelope due to the shape of the vortex / spiral vane 1608 that promotes the vortex flow / vortex.

[0238] In some embodiments, any number of features for facilitating the induction gas flow to a medical device located within it, including but not limited to guide elements (e.g., ribs or fins), gas blades, vanes, limiters, and / or other features described in various embodiments herein, configured to hold the medical device within the lumen and / or to promote the concentricity of the medical device and prevent the medical device from contacting the side walls of the lumen, do not necessarily have to be integrally formed with the cannula, but rather are formed as part of an insert that can be slid into the lumen of the cannula and secured by friction fitting, adhesive, or other means. Figures 18A–18B show one embodiment of a cannula 1800 including an elongated cannula body 1802 in which an induction gas flow insert 1819 is placed, including, for example, a plurality of ribs or fins 1820 described and illustrated above in relation to Figures 4A–4C. A medical device 410 within the insert lumen 1884 is also shown. Figure 18B is a cross-sectional view taken along line 18A-18A in Figure 18A, which better shows the fin 1820. Figure 18C schematically shows a method by which an insert 1819 (e.g., the distal end of the insert) can be placed within the proximal end of a conventional cannula 1800 to form the induced gas flow cannula shown in Figures 18A-18B.

[0239] The guided gas flow cannula described herein can provide the user with optical clarity and enable the maintenance of a clear field of view (e.g., the field of view is not affected by lens fogging, condensation, and smoke). Guided gas flow cannula can minimize and manage surgical smoke resulting from electrosurgery / electrocautery and maintain a stable working space within the pneumoperitoneum. Guided gas flow cannula can minimize surgical time and postoperative complications. In some cases, guided gas flow cannula can be used for other purposes (e.g., electrocautery instruments, gripping devices, etc.).

[0240] A guided gas flow cannula can provide optical clarity within the pneumoperitoneum during surgery by removing fogging, condensation, smoke, and / or other debris on the laparoscopic lens. Optical clarity can be achieved by concentrically holding the medical device (such as a laparoscope) within the guided gas flow cannula through which the supplying gas flows. Concentric holding of the medical device allows the supplying gas to flow over the scope lens, preventing the formation of fogging, condensation, smoke, and / or other debris on the lens of the medical device, such as a laparoscopic device. For example, the supplying gas can form a microenvironment or envelope around the lens, isolating the lens from the pneumoperitoneum gas. The humidity and temperature of the supplying gas can be controlled, thereby allowing the microenvironment or envelope around the lens to be controlled to gas conditions suitable for preventing the formation of fogging, condensation, smoke, and / or other debris. This prevention of fogging, condensation, smoke, and / or other debris may be a desirable outcome for operating room staff performing surgery using laparoscopy.

[0241] Medical devices held concentrically within a cannula can prevent the formation of fogging, condensation, smoke, and / or other debris on medical devices, including the scope lens of a laparoscopic device. For example, condensation or fogging on a scope lens occurs when the lens temperature falls below the dew point temperature at the humidity level carried by the gas. Therefore, fogging occurs when the scope is first inserted or when it is removed and reinserted during surgery, because the scope is cooler than the warm, humid environment of the pneumoperitoneum. Fogging can also occur when the dew point temperature rises due to activities such as electrosurgery.

[0242] Fog or other visual obstructions can impair vision, and when this occurs, the only option is usually to remove and wipe the lens. This can cause the scope to cool down again, and this problem may continue to recur without any other intervention, such as using an anti-fog solution, warming the scope, or using a light at the edge of the lens to warm it.

[0243] As described herein, concentric cannula technology can enable control of the small microenvironment or envelope around the scope lens. This envelope can isolate the scope lens from the warm, humid environment of pneumoperitoneum. Thus, this gas can isolate the scope lens from the surgical environment. If the conditions of the delivered gas are controlled, the environment around the scope can be controlled.

[0244] Inductive gas flow cannulas may involve the use of concentric cannulas that guide gas to form a microenvironment or envelope around the scope lens. Concentric cannulas can utilize medical devices that are surrounded by the cannula during use.

[0245] In some cases, concentric cannulas may incorporate heating technology to either maintain the gas temperature from a humidifier or to further heat the gas to lower its dew point. This can help prevent fogging of the scope lens.

[0246] Concentric cannulas can be equipped with venting capabilities that allow the gas flow to be delivered onto the lens of a medical device without excessively inflating the patient. Venting technology can also be used to maintain the patient at a constant pressure. In some cases, smoke filter technology can be used to filter the vented gas.

[0247] In some cases, flow rates exceeding those required to maintain pressure can also improve optical clarity from a smoke management perspective.

[0248] Concentric cannulas can provide better fogging, condensation, smoke, and / or other debris prevention performance when a specific flow algorithm is used, which can be controlled by a gas supply unit similar to the gas supply unit described with reference to Figure 2.

[0249] Concentric cannulas may require higher flow rates than usual, which can be achieved with tube sets capable of delivering higher flow rates. Systems incorporating concentric cannulas may include reduced limiting sections at gas connections, low-friction tube sets, tube sets with a constant diameter, and / or tube sets with multiple connections.

[0250] Concentric cannulas can have an optimized humidity source. Concentric cannula technology can enable control of the microenvironment or envelope around the scope. An optimized humidity source can enable setting the microenvironment or envelope to parameters favorable for preventing fogging, condensation, smoke, and / or other debris. In some cases, this envelope may be dynamic.

[0251] A concentric cannula may include concentric features, such as ribs or guides, that can be used to concentrically hold the laparoscope within the cannula shaft while still allowing the insufflation gas to pass through the main lumen. Figures 19A–19B, 20A–20B, 21A–21B, and 22A–22B show examples of concentric feature guide elements that may be used. However, concentric feature guide elements are not limited to the examples shown in Figures 19A–19B, 20A–20B, 21A–21B, and 22A–22B, and variations of these features can be effectively used to concentrically hold the scope within the cannula.

[0252] Figures 19A-19B, 20A-20B, 21A-21B, and 22A-22B show vertical and horizontal cross-sectional views of the cannula shaft. Any of the cannula embodiments described herein can be incorporated into any of the features or guide elements described with reference to Figures 19A-19B, 20A-20B, 21A-21B, and / or Figures 22A-22B, and the features or guide elements described in Figures 19A-19B, 20A-20B, 21A-21B, and / or Figures 22A-22B may be used interchangeably with each other or with any other guide elements described herein. Figure 19A shows a vertical cross-sectional view of a cannula wall 1906 having guide elements such as a rib concentric feature 1920. Figure 19B shows a horizontal cross-sectional view of a cannula shaft having a rib concentric feature 1920 with right-angle edges. The rib concentric feature 1920 may have rounded upper and lower edges, as shown in Figure 19A. As shown in Figure 19A, the rib concentric feature 1920 may be elongated and extend along the cannula shaft. Figure 20A shows a vertical cross-sectional view of a cannula wall 2006 having guide elements such as a raised or recessed concentric feature 2020. Figure 20B shows a horizontal cross-sectional view of a cannula shaft having a raised or recessed concentric feature 2020. The raised or recessed concentric feature 2020 may be rounded or hemispherical, as shown in Figures 20A and 20B. Figure 21A shows a vertical cross-sectional view of a cannula wall 2106 having guide elements such as a pin concentric feature 2120. Figure 21B shows a horizontal cross-sectional view of a cannula shaft having a pin concentric feature 2120. The pin concentric feature 2120 may be rounded or have a rounded end, or it may be sharp as shown in Figures 21A-21B, or in some cases the pin concentric feature 2120 may have a tapered edge or end. Figure 22A shows a vertical cross-sectional view of a cannula wall 2206 having a guide element such as a rounded rib concentric feature 2220. Figure 22B shows a horizontal cross-sectional view of a cannula shaft having a rounded rib concentric feature 2220. In some cases the rounded rib concentric feature 2220 may be elongated and extend along the longitudinal axis of the cannula shaft.

[0253] Concentric cannulas can hold medical devices (such as laparoscopes) within a flow of guiding gas within the cannula. Various designs can be used to concentrically hold medical devices within the cannula shaft while allowing the insufflation gas to pass through the main cannula lumen. Examples described herein include features that can be integrated with the cannula so that the concentric feature and the cannula form one complete assembly. Examples of concentric features shown in Figures 19A–19B, 20A–20B, 21A–21B, and 22A–22B illustrate various features that can be used to obtain concentricity of the scope within the cannula shaft, but any structural feature that can concentrically support a medical device within the cannula shaft can also be used. In some cases, the guide element can maintain the medical device concentrically or substantially concentrically within the lumen. In some cases, the guide element can maintain the medical device at 0 degrees or 0–30 degrees relative to the lumen.

[0254] Figures 23A to 23T show an embodiment of cannula 2300 having a guide element at the distal end 2308 of cannula 2300, which includes a flexible feature to assist in the concentricity of the medical device 2310 within cannula 2300. Cannula 2300 may include a cannula body 2312 and an elongated shaft 2302. The elongated shaft 2302 may include a cannula side wall 2306 that forms the lumen 2304 of the cannula. The lumen 2304 may be defined by the inner side wall 2306 of cannula 2300 as shown in Figures 23A to 23T. As described herein, the medical device 2310 may be inserted into the cannula by being introduced through an inlet 2328 at the proximal end of the cannula body and extending toward the distal end 2308 of the elongated shaft 2302 within the lumen 2304 of cannula 2300. As described herein, the terms "inside," "inner wall," "inner circumference," "inner cross section," or "inner portion" relating to a cannula, cannula wall, or insert within a cannula may mean the part of the cannula that faces the interior, including the lumen of the cannula, and the terms "outside," "outer wall," "outer circumference," "outer cross section," or "outer portion" relating to a cannula, cannula wall, or insert within a cannula may mean the part of the cannula that has characteristics opposite to those of the inner portion.

[0255] As shown in Figure 23A, the medical device may be supported by guide elements such as a flexible rib 2320 at the distal end 2308 of the cannula to achieve concentricity of the medical device 2310. The flexible feature rib 2320 may be molded onto the distal end 2308 of the elongated cannula shaft 2302 or attached to the distal end 2308 of the elongated cannula shaft 2302. The flexible feature rib 2320 may be overmolded onto the cannula sidewall 2306. The flexible feature or flexible rib may be flexible or semi-flexible. Figure 23B is a cross-sectional view taken along line 23A-23A in Figure 23A, which better shows the rib 2320.

[0256] Figure 23C shows a schematic diagram of a partial cutout of the cannula shown in Figures 23A and 23B. The features in Figures 23C and 23D may be the same or substantially the same as those shown and described in Figures 23A and 23B, and reference numbers for the same or substantially the same features may share the same reference number. Figure 23D is a cross-sectional view taken along line 23C-23C in Figure 23C, which better shows the rib 2320.

[0257] Figures 23E and 23F show a cannula 2300 having a guide element, such as a flexible pin 2330, at the distal end 2308 of the cannula 2300, in order to achieve concentricity of the medical device 2310. The features of Figures 23E and 23F are similar to those described with reference to Figures 23A to 23D. Therefore, the similar features of Figures 23E and 23F have the same reference numbers as Figures 23A to 23D. The flexible pin 2330 may protrude into the lumen 2304 of the cannula elongated shaft 2302. As shown in Figure 23F, when the medical device 2310 is inserted into the lumen 2304 of the cannula elongated shaft 2302, the medical device 2310 can push aside the flexible pin 2330 or press against the cannula sidewall 2306. Therefore, the flexible pin 2330 pushes back the medical device 2310, holding the medical device 2310 concentrically within the cannula 2300.

[0258] Figures 23G and 23H show schematic partial cutaways of the cannula shown in Figures 23E to 23F. The features of Figures 23G and 23H may be the same or substantially the same as those shown and described in Figures 23E and 23F, and reference numbers for the same or substantially the same features may share the same reference number. Figures 23E and 23G show cannula 2300 with the medical device 2310 not inserted into it. In this configuration, the flexible pin 2330 protrudes radially into the lumen 2304. Figures 23F and 23H show cannula 2300 with the medical device inserted into it. When the medical device 2310 is inserted and maintained concentrically within cannula 2300, the flexible pin is pressed against the cannula sidewall 2306.

[0259] Figures 23I and 23J show a cannula 2300 having a guide element including a flexible or semi-flexible flared fin structure 2340 at the distal end 2308 of the cannula 2300 to obtain concentricity of the medical device 2310. The features of Figures 23I and 23J are similar to those described with reference to Figures 23A to 23D. Therefore, the similar features of Figures 23I and 23J have the same reference numerals as Figures 23A to 23D. Figure 23I shows the cannula 2300 with the flared fin structure 2340, shown without the medical device 2310. The flared fin structure 2340 may be made of thin plastic or another semi-flexible material at the distal end 2308 of the cannula. As shown in Figure 23J, when the medical device 2310 is inserted into the lumen 2304, the medical device 2310 may be pushed beyond the flared fin structure 2340. This deforms and pushes back the medical device 2310, holding it concentrically with the elongated cannula shaft 2302. The fin structure 2340 can expand outward when the medical device 2310 is pushed through the fin structure 2340 of the cannula 2300.

[0260] Figures 23K and 23L show schematic cross-sections of the cannula shown in Figures 23I to 23J. The features in Figures 23K and 23L may be the same or substantially the same as those shown and described in Figures 23I and 23J, and reference numbers for the same or substantially the same features may share the same reference number. Figure 23K shows the cannula 2300 with a flared fin structure 2340, shown without the medical device 2310. As shown in Figure 23L, when the medical device 2310 is inserted into the lumen 2304, the medical device 2310 may be pushed over the flared fin structure 2340. This deforms and pushes back the medical device 2310, concentrically holding it in place by the elongated shaft 2302 of the cannula.

[0261] Figure 23M shows a cannula 2300 having a guide element including a flexible distal projection 2350 at the distal end 2308 of the cannula 2300 in order to obtain concentricity of the medical device 2310. The features of Figure 23M are similar to those described with reference to Figures 23A to 23D. Therefore, the similar features of Figure 23M have the same reference numbers as Figures 23A to 23D. Figure 23M shows a cannula 2300 with a distal projection 2350, with the medical device 2310 inserted into the cannula 2300. The flexible distal projection 2350 can be molded onto the most distal end of the elongated shaft 2302 of the cannula. As shown in Figure 23M, one or more flexible distal projections 2350 can be spaced apart around the exit of the elongated shaft of the cannula at the distal end 2308. The flexible distal end projection 2350 can be overmolded onto the cannula. As shown in Figure 23M, the flexible distal end projection 2350 may include concentric features, such as a pin, at the exit of the elongated shaft 2302 of the cannula 2300, which concentrically holds the medical device 2310 within the flexible distal end of the cannula. As shown in Figure 23M, when the medical device 2310 is inserted into the lumen 2304, the medical device 2310 abuts against one or more flexible distal end projections 2350 that concentrically hold the medical device 2310 within the elongated shaft 2302 of the cannula.

[0262] Figure 23N shows a schematic diagram of a partial cutout of the cannula in Figure 23M. The features in Figure 23N may be the same or substantially the same as those shown and described in Figure 23M, and the reference numbers of the same or substantially the same features may share the same reference number.

[0263] Figure 23O shows a cannula 2300 having a guide element containing a flexible projection 2360 inside the cannula shaft 2302 to achieve concentricity of the medical device 2310. The features of Figure 23O are similar to those described with reference to Figures 23A to 23D. Therefore, the similar features of Figure 23O have the same reference numerals as Figures 23A to 23D. Figure 23O shows the cannula 2300 with the projection 2360, with the medical device 2310 inserted into the cannula 2300. The flexible projection 2360 can be formed inside the elongated cannula shaft 2302. The flexible projection 2360 is similar to the distal end projection 2350 described with reference to Figures 23M and 23N, but the flexible projection 2360 is located within the elongated cannula shaft 2302, while the distal end projection 2350 is located on the most distal end of the elongated cannula shaft 2302. As shown in Figure 23O, one or more flexible projections 2360 may be spaced apart around the periphery of the elongated cannula shaft 2302. The flexible projection 2360 may be molded within the cannula shaft 2302 or overmolded. As shown in Figure 22O, the flexible projection 2350 may include concentric features within the elongated shaft 2302, such as pins that concentrically hold the medical device 2310 within the cannula. As shown in Figure 23O, when the medical device 2310 is inserted into the lumen 2304, the medical device 2310 comes into contact with one or more flexible projections 2360, thereby concentrically holding the medical device 2310 within the elongated cannula shaft 2302.

[0264] Figure 23P shows a schematic diagram of a partial cutaway of the cannula in Figure 23O. The features in Figure 23P may be the same or substantially the same as those shown and described in Figure 23O, and the reference numbers of the same or substantially the same features may share the same reference number. As shown in Figure 23P, one or more flexible projections 2360 may be spaced apart around the periphery of the elongated shaft 2302 of the cannula.

[0265] Figures 23Q and 23R show a cannula 2300 having a guide element including a flexible bellows 2370 at the distal end 2308 of the elongated cannula shaft 2302 in order to achieve concentricity of the medical device 2310. The features of Figures 23Q and 23R are similar to those described with reference to Figures 23A to 23D. Therefore, the similar features of Figures 23Q and 23R have the same reference numerals as Figures 23A to 23D. Figure 23Q shows the cannula 2300 with the flexible bellows 2370, with the medical device 2310 inserted into the cannula 2300. The flexible bellows 2370 may include concentric features such as a pin 2372 attached to a rigid or semi-rigid ring 2374 at the most distal end of the cannula 2300. The ring 2374 is attached to the cannula shaft 2302 via a flexible bellows 2370. The bellows 2370 allows the ring 2374 to move with the medical device 2310, while maintaining the concentricity of the medical device 2310 at the distal end of the cannula 2300. In such a case, the medical device 2310 can be held concentrically in the gas flow within the cannula 2300. As shown in Figures 23Q and 23R, one or more pins 2372 may be spaced around the ring 2374.

[0266] Figures 23S and 23T show schematic diagrams of partial cutouts of the cannula shown in Figures 23Q and 23R. The features of Figures 23S and 23T may be the same or substantially the same as those shown and described in Figures 23Q and 23R, and reference numbers of the same or substantially the same features may share the same reference number.

[0267] Figures 23Q and 23S show a medical device 2310 inserted parallel or substantially parallel to the cannula elongated shaft 2302. In this case, the ring 2374 at the distal end of the bellows 2370 is aligned with the elongated shaft 2302. Figures 23R and 23T show a medical device 2310 inserted at an angle into the cannula elongated shaft 2302. In this case, the ring 2374 at the distal end of the bellows 2370 is offset from the elongated shaft 2302 by causing expansion or contraction of the flexible bellows 2370 or otherwise bending of the flexible bellows 2370, as shown in Figures 23R and 23T. The medical device 2310 can move around at different angles relative to the cannula 2300, and the bellows 2370 and ring 2374 can keep the medical device 2310 concentric in the gas flow within the cannula 2300. The bellows 2370 may be a flexible bellows that allows the pin 2372 on the ring 2374 at the distal end of the cannula to move together with the medical device 2310.

[0268] Figures 24A to 24N show embodiments of cannula 2400 having guide elements within the cannula 2400 that include rigid features to assist in the concentricity of the medical device 2410 within the cannula 2400. Cannula 2400 may include a cannula body 2412 and an elongated shaft 2402. The elongated shaft 2402 may include a cannula side wall 2406 that forms the lumen 2404 of the cannula 2400. The lumen 2404 may be defined by the inner side wall 2406 of the cannula 2400, as shown in Figures 24A to 24N. As described herein, the medical device 2410 may be inserted into the cannula 2400 by being introduced through an inlet 2428 of the cannula body 2412 and extending toward the distal end 2408 of the elongated shaft 2402 within the lumen 2404 of the cannula 2400.

[0269] As shown in Figure 24A, the medical device 2410 may be supported by a guide element including a rigid rib 2420 located at the distal end 2408 of the cannula to achieve concentricity of the medical device 2410. The rigid rib 2420 may be molded onto or overmolded onto the distal end 2408 of the elongated cannula shaft 2402. The rigid rib 2420 concentrically holds the medical device 2410 within the elongated cannula shaft 2302 while allowing the insufflated gas to pass through the cannula lumen 2404. Figure 24B is a cross-sectional view taken along line 24A-24A in Figure 24A, better showing the rib 2420.

[0270] Figure 24C shows a schematic partial cutaway of the cannula shown in Figures 24A and 24B. Figure 24D is a cross-sectional view taken along line 24C-24C in Figure 24C. The features of Figures 24C and 24D may be the same or substantially the same as those shown and described in Figures 24A and 24B, and the same or substantially the same reference numbers may share the same reference number. The cross-sectional view of Figure 24D shows the radially separated ribs 2420 within the cannula 2400.

[0271] As shown in Figure 24E, the medical device 2410 may be supported by a guide element including a non-circular cannula shaft section 2430 at the distal end 2408 of the cannula 2400 in order to achieve concentricity of the medical device 2410. The features of Figures 24E and 24F are similar to those described with reference to Figures 24A to 24D. Therefore, the similar features of Figures 24E and 24F have the same reference numbers as Figures 24A to 24D. The non-circular cannula shaft section 2430 may include a non-circular section at the distal end 2408, thereby concentrically holding the medical device 2410 within the cannula 2400 and allowing gas to pass through the lumen 2404 of the elongated cannula shaft 2402. Figure 24F is a cross-sectional view taken along line 24E-24E in Figure 24E, which better illustrates the configuration of the medical device 2410 within the non-circular cannula shaft section 2430. As shown in Figure 24F, the medical device 2410 is circular, and the non-circular cannula shaft cross section 2430 is non-circular. This creates a gap for the insufflated gas to pass through the cannula lumen 2404.

[0272] Figure 24G shows a schematic diagram of a partial cutaway of the cannula shown in Figures 24E to 24F. The features in Figures 24G and 24H may be the same or substantially the same as those shown and described in Figures 24E and 24F, and reference numbers for the same or substantially the same features may share the same reference number. Figure 24H is a cross-sectional view taken along line 24G-24G of Figure 24H, which better shows the gap for the insufflated gas to pass through the cannula lumen 2404.

[0273] Figure 24I shows a cannula 2400 having guide elements such as a rigid protrusion 2440 at the distal end 2408 of the cannula 2400 in order to obtain concentricity of the medical device 2410. The features of Figures 24I and 24J are similar to the features described with reference to Figures 24A to 24D. Therefore, the similar features of Figures 24I and 24J have the same reference numbers as Figures 24A to 24D. The protrusion 2440 may protrude into the lumen 2404 of the elongated shaft 2402 of the cannula. The protrusion 2440 may be circumferentially spaced apart within the lumen 2404 of the elongated shaft 2402. As shown in Figure 24I, when the medical device 2410 is inserted into the lumen 2404 of the cannula-shaped shaft 2402, the rigid ridge 2440 can concentrically hold the medical device 2410 while allowing the supplying gas to flow through the lumen 2404.

[0274] Figure 24J shows a schematic diagram of a partial cutout of the cannula in Figure 24I. The features in Figure 24J may be the same or substantially the same as those shown and described in Figure 24I, and the reference numbers of the same or substantially the same features may share the same reference number.

[0275] Figures 24K to 24N show a cannula 2400 having a guide element including a swivel structure 2450 at the distal end 2408 of the cannula 2400 to achieve concentricity of the medical device 2410. The features of Figures 24K to 24N are similar to those described with reference to Figures 24A to 24D. Therefore, the similar features of Figures 24K to 24N have the same reference numbers as Figures 24A to 24D. The swivel structure 2450 can rotate when the medical device 2410 is pushed beyond the swivel structure 2450. Thus, the swivel structure 2450 forms a rib 2452 between the medical device 2410 and the cannula shaft side wall 2406. The rib 2452 formed from the swivel structure 2450 can hold the scope concentrically and allow the insufflated gas to pass through the lumen 2404. A fin 2454 may be included on the outside of the swivel structure 2450. The fin 2454 extends when the medical device 2410 is inserted into the cannula 2400 and the rib 2452 is pressed against the internal cannula wall. The fin 2454 can hold the cannula 2400 in place within the patient and helps prevent the cannula 2400 from becoming displaced.

[0276] Figures 24M to 24N show schematic diagrams of partial cutouts of the cannula shown in Figures 24K and 24L. The features of Figures 24M to 24N may be the same or substantially the same as those shown and described in Figures 24K and 24L, and reference numbers of the same or substantially the same features may share the same reference number.

[0277] Figures 24K and 24M show a cannula 2400 without a medical device 2410 inside it. In this configuration, the swivel structure 2450 includes a rib 2452 projecting radially inward from the cannula sidewall 2406 into the lumen 2404. As shown in Figures 24K to 24N, the swivel structure 2450 may be on a swivel axis that, when the medical device 2410 is pushed beyond the swivel structure 2450, rotates the rib 2452 of the swivel structure 2450 out of obstruction, thereby opening the lumen 2404. Once the swivel structure 2450 swivels, the fin 2454 then extends radially outward from the cannula sidewall 2406, as shown in Figures 24L and 24N. Figures 24L and 24N show a medical device 2410 inserted into cannula 2400. The rib 2452 can concentrically hold the medical device 2410 within the elongated cannula shaft 2402 while allowing gas to pass through the lumen 2404. The fin 2454 can form a mechanism to prevent the cannula from being removed from the patient. When the rib 2452 of the swivel structure 2450 is pressed against the inner wall of the cannula, the rib 2452 can create a mechanism between the elongated cannula shaft side wall 2406 and the medical device 2410, concentrically holding the medical device 2410 within the elongated cannula shaft 2402.

[0278] Figures 25A to 25O show embodiments of a cannula 2500 having a guide element including a flexible continuous structure 2520 that extends axially along the elongated shaft 2502 of the cannula 2500 to assist in the concentricity of the medical device 2510 within the cannula 2500. The cannula 2500 may include a cannula body 2512 and an elongated shaft 2502. The elongated shaft 2502 may include a cannula side wall 2506 that forms the lumen 2504 of the cannula 2500. As shown in Figures 25A to 25O, the lumen 2504 may be defined by the inner side wall 2506 of the cannula 2500. As described herein, the medical device 2510 may be inserted into the cannula 2500 by being introduced through an inlet 2528 at the proximal end of the cannula body 2512 and extending toward the distal end 2508 of the elongated shaft 2502 within the lumen 2504 of the cannula 2500.

[0279] As shown in Figure 25A, the medical device 2510 may be supported by a guide element containing flexible continuous ribs 2520 within the elongated shaft 2502 of the cannula 2500 to obtain concentricity of the medical device 2510. The flexible continuous ribs 2520 may be molded continuously along the elongated shaft 2502 of the cannula. The flexible continuous ribs 2520 can concentrically hold the medical device 2510 within the elongated shaft 2502 of the cannula. As shown in Figure 25A, the flexible continuous ribs 2520 may be molded along the length of the elongated shaft 2502. Figure 25B is a cross-sectional view taken along line 25A-25A in Figure 25A, which better shows the flexible continuous ribs 2520 circumferentially spaced around the elongated shaft 2502.

[0280] Figure 25C shows a schematic cross-section of the cannula shown in Figures 25A and 25B. The features in Figures 25C and 25D may be the same or substantially the same as those shown and described in Figures 25A and 25B, and reference numbers for the same or substantially the same features may share the same reference number. Figure 25D is a cross-sectional view taken along line 25C-25C of Figure 25C, better showing the flexible continuous ribs 2520 circumferentially spaced around the elongated shaft 2502. As shown in Figure 25D, the flexible continuous ribs 2520 can concentrically hold the medical device 2510 within the lumen 2504 and allow gas to pass through the lumen 2504.

[0281] In some cases, the flexible continuous guide element along the elongated shaft 2502 of the cannula 2500 may be discrete structures located at one or more points along the elongated shaft 2502. Figure 25E shows several rib sets 2530 along the elongated shaft 2502. As shown in Figure 25E, the flexible continuous structure may be one or more ribs 2530 attached to a flexible ring that can be molded into or inserted into the elongated shaft 2502. One or more ribs 2530 may be flexible. One or more ribs 2530 located at one or more points along the elongated shaft 2502 can concentrically hold the medical device 2510 within the cannula 2500.

[0282] As shown in Figure 25F, the medical device 2510 may be supported by a guide element including a flexible continuous rib 2540 within the elongated shaft 2502 of the cannula 2500 in order to obtain concentricity of the medical device 2510. The flexible continuous rib 2540 may be directly molded into or overmolded onto the elongated shaft 2502 of the cannula. The flexible continuous rib 2540 can concentrically hold the medical device 2510 within the elongated shaft 2502 of the cannula. The flexible continuous rib 2540 may be formed inside the elongated shaft 2502 of the cannula. The flexible continuous rib 2540 may be overmolded onto the elongated shaft 2502 of the cannula.

[0283] Figure 25G shows a schematic diagram of a partial cutout of the cannula in Figure 25F. The features in Figure 25G may be the same or substantially the same as those shown and described in Figure 25F, and reference numbers for the same or substantially the same features may share the same reference number. As shown in Figure 25G, the flexible continuous rib 2540 may be spaced apart around the elongated shaft 2502 to concentrically hold the medical device 2510 within the lumen 2504 and allow gas to pass through the lumen 2504.

[0284] Figure 25H shows an embodiment of a medical device 2510 supported by a guide element including a foam 2550 within the elongated shaft 2502 of a cannula 2500 to achieve concentricity of the medical device 2510. The foam 2550 may be a continuous foam structure extending substantially the entire length of the elongated shaft 2502. The foam 2550 can allow gas to pass through the foam 2550 and the lumen 2504. The foam 2550 can concentrically hold the medical device 2510 within the elongated shaft 2502 of the cannula. The foam 2550 can deform as the medical device is pushed through the elongated shaft 2502, and the restoring force of the foam 2550 can concentrically hold the medical device within the cannula 2500. In some cases, the foam 2550 may be a foam insert. In some cases, as shown in Figure 25H, the foam can surround the medical device 2510 circumferentially once the medical device 2510 is inserted into the cannula 2500. In other cases, one or more foam components can be positioned within the cannula lumen 2504 to concentrically hold the medical device 2510 within the cannula 2500 and can be asked, similar to the ribs described herein.

[0285] As shown in Figures 25I to 25L, in order to obtain concentricity of the medical device 2510, the medical device 2510 may be supported by a guide element including flexible continuous ribs 2560 on an insert 2562 within the elongated shaft 2502 of the cannula 2500. As shown in Figure 25I, the flexible continuous ribs 2560 may be molded onto an insert 2562 which can be attached inside the elongated shaft 2502 of the cannula. The insert 2562 may be permanently or temporarily attached to the elongated shaft 2502 of the cannula. One or more flexible continuous ribs 2560 hold the medical device 2510 concentrically within the elongated shaft 2502 of the cannula. In some cases, the insert 2562 may be attached to the elongated shaft 2502 of the cannula by friction fitting or by other means. The insertion 2562 may be assembled as part of the cannula 2500, or it may be a separate attachment.

[0286] Figure 25J shows a schematic diagram of a partial cutaway of the cannula in Figure 25I. The features in Figure 25J may be the same or substantially the same as those shown and described in Figure 25I, and reference numbers for the same or substantially the same features may share the same reference number. As shown in Figure 25J, the flexible continuous ribs 2560 on the insert 2562 may be spaced apart around the periphery of the insert 2562 to concentrically hold the medical device 2510 within the lumen 2504 and allow gas to pass through the lumen 2504.

[0287] Figure 25K shows cannula 2500 with the flexible continuous rib 2560 and insert 2562 removed from cannula 2500. The features of Figure 25K may be the same or substantially the same as those shown and described in Figure 25I, and reference numbers of the same or substantially the same features may share the same reference number.

[0288] Figure 25L shows a schematic partial cutaway of the cannula of Figure 25K, with the flexible continuous rib 2560 and the insert 2562 removed from the cannula 2500. The features of Figure 25L may be the same or substantially the same as those shown and described in Figure 25I, and reference numbers of the same or substantially the same features may share the same reference number. As shown in Figure 25L, the insert may be hollow cylindrical. As shown in Figure 25L, the flexible continuous rib 2560 on the insert 2562 may be spaced apart around the inner circumference of the insert 2562 to concentrically hold the medical device 2510 within the lumen 2504 and allow gas to pass through the lumen 2504.

[0289] Figures 26A to 26R show an embodiment of a cannula 2600 having a guide element including a rigid continuous structure along the elongated shaft 2602 of the cannula 2600 to assist in the concentricity of the medical device 2610 within the cannula 2600. The cannula 2600 may include a cannula body 2612 and an elongated shaft 2602. The elongated shaft 2602 may include a cannula side wall 2606 that forms the lumen 2604 of the cannula 2600. As shown in Figures 26A to 26R, the lumen 2604 may be defined by the inner side wall 2606 of the cannula 2600. As described herein, the medical device 2610 may be inserted into the cannula 2600 by being introduced through an inlet 2628 at the proximal end of the cannula body 2612 and extending toward the distal end 2608 of the elongated shaft 2602 within the lumen 2604 of the cannula 2600.

[0290] As shown in Figure 26A, the medical device 2610 may be supported by a guide element including a rigid continuous rib 2620 within the elongated shaft 2602 of the cannula 2600 in order to obtain concentricity of the medical device 2610. The rigid continuous rib 2620 may be molded continuously along the elongated shaft 2602 of the cannula. The rigid continuous rib 2620 may be molded directly onto the elongated shaft 2602 of the cannula. The rigid continuous rib 2620 can concentrically hold the medical device 2610 within the elongated shaft 2602. As shown in Figure 26A, the rigid continuous rib 2620 may be molded along the length of the elongated shaft 2602. Figure 26B is a cross-sectional view taken along line 26A-26A of Figure 26A, which better shows the rigid continuous rib 2620 circumferentially spaced around the elongated shaft 2502.

[0291] Figure 26C shows a schematic cross-section of the cannula shown in Figures 26A and 26B. The features in Figures 26C and 26D may be the same or substantially the same as those shown and described in Figures 26A and 26B, and reference numbers for the same or substantially the same features may share the same reference number. Figure 26D is a cross-sectional view taken along line 26C-26C of Figure 26C, which better shows the rigid continuous ribs 2620 circumferentially spaced around the elongated shaft 2602. As shown in Figure 26D, the rigid continuous ribs 2620 can concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0292] As shown in Figures 26E to 26H, the medical device 2610 may be supported by a guide element including a rigid continuous rib 2630 on an insert 2632 within the elongated shaft 2602 of the cannula 2600 in order to obtain concentricity of the medical device 2610. As shown in Figure 26E, the rigid continuous rib 2630 may be molded onto the insert 2632 which can be mounted inside the elongated shaft 2602 of the cannula. The insert 2632 may be permanently or temporarily attached to the cannula sidewall 2606 of the elongated shaft 2602. One or more rigid continuous ribs 2630 can concentrically hold the medical device 2610 within the elongated shaft 2602 of the cannula. In some cases, the insert 2632 may be attached to the elongated shaft 2602 of the cannula by friction fitting or by other means. The insertion 2632 may be assembled as part of the cannula 2600, or it may be a separate attachment.

[0293] Figure 26F shows a schematic diagram of a partial cutaway of the cannula in Figure 26E. The features in Figure 26F may be the same or substantially the same as those shown and described in Figure 26E, and reference numbers for the same or substantially the same features may share the same reference number. As shown in Figure 26F, the rigid continuous ribs 2630 on the insert 2632 may be spaced apart around the insert 2632 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0294] Figure 26G shows cannula 2600 with the rigid continuous rib 2630 and insert 2632 removed from cannula 2600. The features of Figure 26G may be the same or substantially the same as those shown and described in Figure 26F, and reference numbers of the same or substantially the same features may share the same reference number.

[0295] Figure 26H shows a schematic partial cutaway of the cannula of Figure 26G, with the rigid continuous ribs 2630 and the insert 2632 removed from the cannula 2600. The features of Figure 26H may be the same or substantially the same as those shown and described in Figure 26F, and reference numbers of the same or substantially the same features may share the same reference number. As shown in Figure 26H, the insert may be hollow cylindrical. As shown in Figure 26H, the rigid continuous ribs 2630 on the insert 2632 may be spaced around the inner circumference of the insert 2632 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0296] As shown in Figure 26I, the medical device 2610 may be supported by a guide element including a rigid continuous rib 2640 directly molded onto the elongated shaft 2602 of the cannula 2600 to achieve concentricity of the medical device 2610. The rigid continuous rib 2620 may be continuously molded along the length of the elongated shaft 2602 of the cannula. The rigid continuous rib 2640 may be directly molded onto the elongated shaft 2602 of the cannula, or may be formed as part of the elongated shaft 2602 of the cannula. The rigid continuous rib 2640 can concentrically hold the medical device 2610 within the elongated shaft 2602. As shown in Figures 26I and 26J, the rigid continuous rib 2640 may be directly molded onto the cannula along substantially the entire length of the elongated shaft 2602.

[0297] Figure 26J shows a schematic diagram of a partial cutaway of the cannula in Figure 26I. The features in Figure 26J may be the same or substantially the same as those shown and described in Figure 26I, and reference numbers for the same or substantially the same features may share the same reference number. As shown in Figure 26J, the rigid continuous rib 2640 may be spaced apart around the inner circumference of the cannula sidewall 2606 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0298] Figures 26K–26N show a cannula 2600 having a guide element including an adjustable structure 2650 along the length of the cannula 2600 to achieve concentricity of the medical device 2610. The features of Figures 26K–26N are similar to those described with reference to Figures 26A–26D. Therefore, the similar features of Figures 26K–26N have the same reference numbers as Figures 26A–26D. The adjustable structure 2650 may be spring-loaded to allow the adjustable structure 2650 to support and adapt to medical devices 2610 of different sizes. The spring-loaded adjustable structure 2650 can be pushed outward by the medical device 2610 when the medical device 2610 is inserted, and the spring pushes back against the medical device 2610, maintaining the medical device 2610 concentrically within the elongated cannula shaft 2602. The spring-loaded adjustable structure 2650 makes them adjustable. The spring-loaded adjustable structure 2650 can rotate inward and outward from the cannula sidewall 2606 to accommodate different sizes of medical devices 2610.

[0299] Figures 26M to 26N show schematic diagrams of partial cutouts of the cannula shown in Figures 26K and 26L. The features of Figures 26M to 26N may be the same or substantially the same as those shown and described in Figures 26K and 26L, and reference numbers of the same or substantially the same features may share the same reference number.

[0300] Figures 26K and 26M show a cannula 2600 without a medical device 2610 inside it. In this configuration, the adjustable structure 2650 is biased outward toward the lumen 2604 of the cannula's elongated shaft 2602. As shown in Figures 26K to 26N, the adjustable structure 2650 may be on a pivot axis that rotates the adjustable structure 2650 out of the way and opens the lumen 2604 when the medical device 2610 is pushed beyond the adjustable structure 2650. Once the adjustable structure 2650 has rotated, it then moves inward toward the cannula sidewall 2406, as shown in Figures 26L and 26N. Figures 26L and 26N show a medical device 2610 inserted into the cannula 2600. The adjustable structure 2650 can concentrically hold the medical device 2610 within the elongated cannula shaft 2602 while allowing gas to pass through the lumen 2604. As shown in Figures 26M to 26N, the adjustable structure 2650 can be spaced apart around the inner circumference of the cannula sidewall 2606 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0301] As shown in Figures 26O to 26R, the medical device 2610 may be supported by a guide element including a rigid rib 2664 on an insert 2660 extending from the top housing. The rigid rib 2664 may be on the inner surface of the insert extending to the elongated shaft 2602 of the cannula 2600 in order to obtain concentricity of the medical device 2610. As shown in Figure 26O, the rigid rib 2664 may be molded onto the elongated wall 2662 of the insert 2660. The insert 2660 may include at least a portion of the body 2612 of the cannula 2600. As shown in Figures 26O to 26R, the rigid rib 2664 may be located on the insert 2660 including the top portion of the body 2612 of the cannula 2600. Therefore, the rigid ribs 2664 on the insert 2660 can be modified by modifying the insert 2660, including the top housing of the cannula 2600. The insert 2660, including the body 2612 of the cannula 2600, can be detached from the elongated shaft 2602, which can remain in the patient during surgery. The rigid ribs 2664 on the insert 2660 can be detached or modified to adapt to different medical devices 2610, such as scopes or surgical instruments, simply by modifying the body portion 2610 of the cannula 2600. In some cases, as shown in Figure 26O, the insert 2660 may include an elongated shaft 2662 of the insert with rigid ribs 2664 and an aperture 2668 for passing gas through the shaft 2602 of the cannula 2600. The rigid ribs 2664 on the insert 2660 may be used to concentrically hold the medical device 2610 within the elongated cannula shaft 2602. In some cases, the rigid ribs 2664 may be continuous or discontinuous along the insert 2660.

[0302] In some cases, the insert 2660 may be permanently or temporarily attached to the cannula shaft 2602, or may be integrally formed with the cannula shaft 2602. In some cases, the insert 2660 may be attached to the cannula shaft 2602 by friction fitting or by other means. The insert 2660 may be assembled as part of the cannula 2600, or it may be a separate attachment.

[0303] Figure 26P shows a schematic diagram of a partial cutaway of the cannula and implant shown in Figure 26O. The features in Figure 26P may be the same or substantially the same as those shown and described in Figure 26O, and reference numbers for the same or substantially the same features may share the same reference number. As shown in Figure 26P, the rigid ribs 2664 on the implant 2660 may be spaced apart around the elongated shaft 2662 of the implant 2660 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0304] Figure 26Q shows cannula 2600 with the insert 2660 having rigid ribs 2664 removed from cannula 2600. The features in Figure 26Q may be the same or substantially the same as those shown and described in Figure 26O, and reference numbers for the same or substantially the same features may share the same reference number.

[0305] Figure 26R shows a schematic partial cutaway of the cannula of Figure 26Q, with the insert 2660 having rigid ribs 2664 removed from the cannula 2600. The features of Figure 26R may be the same or substantially the same as those shown and described in Figure 26O, and the same or substantially the same reference numbers may share the same reference numbers. As shown in Figure 26R, the insert 2660 may include a top portion 2666 and an elongated shaft portion 2662 extending distally from the top portion 2666. The elongated shaft portion 2662 may be a hollow cylinder having rigid ribs 2664. As shown in Figure 26R, the rigid ribs 2664 on the insert 2660 may be spaced apart around the inner circumference of the elongated shaft 2662 of the insert 2660 to concentrically hold the medical device 2610 within the lumen 2604 and allow gas to pass through the lumen 2604.

[0306] Figures 27A to 27T show an embodiment of a cannula 2700 having a non-circular inner cross-section of the cannula sidewall 2706 along an elongated shaft 2702 that functions as a guide element within the cannula 2700 to assist the concentricity of the medical device 2710 within the cannula 2700. The cannula 2700 may include a cannula body 2712 and an elongated shaft 2702. The elongated shaft 2702 may include a cannula sidewall 2706 that forms the lumen 2704 of the cannula 2700. As shown in Figures 27A to 27T, the lumen 2704 may be defined by the inner sidewall 2706 of the cannula 2700. As described herein, the medical device 2710 may be inserted into the cannula 2700 by being introduced through the inlet 2728 at the proximal end of the cannula body 2712 and extending toward the distal end 2708 of the elongated shaft 2702 within the lumen 2704 of the cannula 2700.

[0307] As shown in Figure 27A, the medical device 2710 may be supported by a non-circular inner section 2720 of the cannula sidewall 2706 along the elongated shaft 2702, which acts as a guide element within the cannula 2700 to achieve concentricity of the medical device 2710. Since the medical device may be circular or substantially circular, the non-circular inner section 2720 may be designed to maintain the medical device 2710 concentrically within the lumen 2704 while having an air gap 2726 for gas to pass through the lumen 2704. The air gap 2726 may be a region formed between the outer surface of the medical device 2710 and the non-circular inner section 2720 of the elongated shaft. Figure 27B is a cross-sectional view taken along line 27A-27A of Figure 27A, better showing the non-circular inner section 2720 and air gap 2726 with the medical device 2710 inserted into the elongated shaft 2702. For example, a hexagonal cross-sectional shape can be used. As shown in Figure 27B, the non-circular inner cross-section 2720 of the cannula side wall 2706 allows the medical device 2710 to be held concentrically while allowing gas to pass through the lumen 2704. The non-circular inner cross-section 2720 can be located in any part of the cannula wall of the elongated shaft 2702 of the cannula 2700.

[0308] Figure 27C shows a schematic partial cross-section of the cannula shown in Figures 27A and 27B. The features in Figures 27C and 27D may be the same or substantially the same as those shown and described in Figures 27A and 27B, and reference numbers for the same or substantially the same features may share the same reference number. Figure 27C shows a non-circular inner section 2720 extending around the inner circumference of the elongated shaft 2702. Figure 27D is a cross-sectional view taken along line 27C-27C in Figure 27C, which better shows the non-circular inner section 2720 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27D, the non-circular inner section 2720 can concentrically hold the medical device 2710 within the lumen 2704, allowing gas to pass through the lumen 2704.

[0309] As shown in Figures 27E to 27F, the medical device 2710 may be supported by a non-circular inner section 2730 of the cannula sidewall 2706 along the elongated shaft 2702 of the cannula 2700 to obtain concentricity of the medical device 2710. As shown in Figure 27E, the non-circular inner section 2730 maintains a non-circular cross-sectional shape over the entire or substantially entire length of the elongated shaft of the cannula. Since the medical device may be circular or substantially circular, the non-circular inner section 2730 may be designed to maintain the medical device 2710 concentrically within the lumen 2704 while having an air gap for gas to pass through the lumen 2704. Figure 27F is a cross-sectional view taken along line 27E-27E in Figure 27E, better showing the non-circular inner section 2720 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27F, the non-circular inner cross-section 2730 of the cannula side wall 2706 allows the medical device 2710 to be held concentrically while allowing gas to pass through the lumen 2704.

[0310] Figure 27G shows a schematic partial cutaway of the cannula shown in Figures 27E–27F. Features in Figures 27G and 27H may be the same or substantially the same as those shown and described in Figures 27E and 27F, and reference numbers for the same or substantially the same features may share the same reference number. Figure 27G shows a non-circular inner section 2730 extending around the inner circumference of the elongated shaft 2702 and extending over the entire or substantially the entire length of the cannula elongated shaft. Figure 27H is a cross-sectional view taken along line 27G–27G of Figure 27G, which better shows the non-circular inner section 2730 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27H, the non-circular inner section 2730 can concentrically hold the medical device 2710 within the lumen 2704 and allow gas to pass through the lumen 2704.

[0311] As shown in Figures 27I to 27J, the medical device 2710 can be supported by a non-circular inner cross-section 2740 of the cannula sidewall 2706 along the elongated shaft 2702, which acts as a guide element within the cannula 2700 to achieve concentricity of the medical device 2710. The non-circular inner cross-section 2740 maintains its non-circular cross-sectional shape only for a portion of the elongated shaft length. Figure 27I shows the portion of the cannula shaft having the non-circular inner cross-section 2740 midway along the elongated shaft length. This positioning allows the medical device 2710 to be held concentrically within the cannula elongated shaft 2702, while the gas flow can rejoin the circulating flow after passing the portion of the cannula elongated shaft 2702 with the non-circular cross-section 2740. As shown in Figure 27I, the circular portion of the cross-section at the distal end 2708 of the elongated shaft 2702 allows the gas to be consolidated into a single flow stream after passing the non-circular cross-section 2740. Since the medical device may be circular or substantially circular, the non-circular inner cross-section 2740 may be designed to have an air gap for gas to pass through the lumen 2704 while maintaining the medical device 2710 concentrically within the lumen 2704. Figure 27J is a cross-sectional view taken along line 27I-27I in Figure 27I, better showing the non-circular inner cross-section 2740 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27J, the non-circular inner cross-section 2740 of the cannula sidewall 2706 allows the medical device 2710 to be held concentrically while allowing gas to pass through the lumen 2704.

[0312] Figure 27K shows a schematic partial cutaway of the cannula shown in Figures 27I–27J. Features in Figures 27K and 27L may be the same or substantially the same as those shown and described in Figures 27I and 27J, and reference numbers for the same or substantially the same features may share the same reference number. Figure 27K shows a non-circular inner section 2740 that extends around the inner circumference of the elongated shaft 2702 and extends only to a portion of the length of the cannula elongated shaft. Figure 27L is a cross-sectional view taken along line 27K–27K in Figure 27K, which better shows the non-circular inner section 2740 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27L, the non-circular inner section 2740 can concentrically hold the medical device 2710 within the lumen 2704 and allow gas to pass through the lumen 2704.

[0313] As shown in Figures 27M to 27N, the medical device 2710 may be supported by a cannula elongated shaft 2702 having non-circular inner and outer sections 2750, which function as guide elements for achieving concentricity of the medical device 2710. The non-circular inner and outer sections 2750 can maintain a non-circular cross-sectional shape for only a portion of the elongated shaft length, or for the entire length of the elongated shaft or substantially the entire length. Since the medical device may be circular or substantially circular, the non-circular inner and outer sections 2750 may be designed to maintain the medical device 2710 concentrically within the lumen 2704 while having an air gap for gas to pass through the lumen 2704. Figure 27N is a cross-sectional view taken along line 27M-27M in Figure 27M, better showing the non-circular inner and outer sections 2750 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27N, the non-circular inner and outer cross-sections 2750 of the cannula sidewall 2706 allow the medical device 2710 to be held concentrically while allowing gas to pass through the lumen 2704. The outer non-circular cross-section can closely resemble the inner non-circular cross-section, thereby providing a uniform wall thickness to the cannula shaft wall. In some cases, the uniform wall thickness of the elongated cannula shaft can facilitate molding during the manufacture of the cannula.

[0314] Figure 27O shows a schematic partial cutaway of the cannula shown in Figures 27M to 27N. The features in Figures 27O and 27P may be the same or substantially the same as those shown and described in Figures 27M and 27N, and reference numbers for the same or substantially the same features may share the same reference number. Figure 27O shows non-circular inner and outer sections 2750 extending around the periphery of the elongated shaft 2702 and along the length of the cannula elongated shaft. Figure 27P is a cross-sectional view taken along line 27O-27O of Figure 27O, which better shows the non-circular inner and outer sections 2750 with the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27P, the non-circular inner and outer sections 2750 can concentrically hold the medical device 2710 within the lumen 2704 and allow gas to pass through the lumen 2704.

[0315] As shown in Figures 27Q to 27R, the medical device 2710 may be supported by a cannula elongated shaft 2702 having guide elements such as a non-circular internal section insert 2760 to achieve concentricity of the medical device 2710. The non-circular internal section insert 2760 may be of a length spanning a portion of the elongated shaft length, or may be equal to or substantially equal to the elongated shaft length. Since the medical device may be circular or substantially circular, the non-circular internal section insert 2760 may be designed to maintain the medical device 2710 concentrically within the lumen 2704 while having an air gap for gas to pass through the lumen 2704. Figure 27R is a cross-sectional view taken along line 27Q-27Q in Figure 27Q, better showing the non-circular internal section insert 2760 inserted into the elongated shaft 2702 with the medical device 2710. As shown in Figure 27R, the non-circular internal section insert 2760 can concentrically hold the medical device 2710 while allowing gas to pass through the lumen 2704. The non-circular internal section insert 2760 can be permanently or temporarily attached to the cannula sidewall 2706.

[0316] Figure 27S shows a schematic cross-section of the cannula shown in Figures 27Q–27R. Features in Figures 27S and 27T may be the same or substantially the same as those shown and described in Figures 27Q and 27R, and reference numbers for the same or substantially the same features may share the same reference number. Figure 27S shows a non-circular internal section insert 2760 extending around the inner circumference of the elongated shaft 2702 and along the length of the cannula elongated shaft. Figure 27T is a cross-sectional view taken along line 27S–27S of Figure 27S, better showing the various layers of the non-circular internal section insert 2760 between the inner surface of the cannula sidewall 2706 and the medical device 2710 inserted into the elongated shaft 2702. As shown in Figure 27T, the non-circular internal section insert 2760 can concentrically hold the medical device 2710 within the lumen 2704 and allow gas to pass through the lumen 2704. As shown in Figures 27S and 27T, the outer surface of the non-circular inner cross section insert 2760 may contact the inner surface of the cannula sidewall 2706.

[0317] Figures 28A to 28Q show an embodiment of cannula 2800 having a guide element within the body 2812 of cannula 2800, which includes a flexible structure to assist the concentricity of the medical device 2810 within cannula 2800. Cannula 2800 may include a cannula body 2812 and an elongated shaft 2802. The elongated shaft 2802 may include a cannula side wall 2806 that forms the lumen 2804 of cannula 2800. As shown in Figures 28A to 28Q, the lumen 2804 may be defined by the inner side wall 2806 of cannula 2800. As described herein, the medical device 2810 may be inserted into the cannula 2800 by being introduced through the inlet 2828 at the proximal end of the cannula body 2812 and extending toward the distal end 2808 of the elongated shaft 2802 within the lumen 2804 of the cannula 2800.

[0318] The body of the cannula may include an opening formed therein. A shaft may extend from the body and may include an outlet. The lumen terminates at the outlet and is positioned to be in fluid communication with the opening. The shaft and / or body may include guide elements protruding from the inner surface of the shaft and / or body. The guide elements may be configured to hold the device received in the lumen so that the medical device does not physically come into contact with the inner surface of the shaft and / or body.

[0319] In some cases, the body may have a seal configured to prevent leakage of the insufflation gas when the medical device is inserted or before the device is inserted. In some cases, one or more seals may be used. In some cases, a first seal and a second seal may be used. In some cases, a guide element within the body of the cannula may be located proximal to the first seal. In some cases, a guide element within the body may be located distal to the second seal. In some cases, a guide element within the body may be located between the first seal and the second seal. In some cases, the guide element is integrated with the first seal and / or the second seal.

[0320] In some cases, the body may include a first sealing structure positioned to limit gas leakage and a second sealing structure for providing an instrument seal when a medical device is inserted into the lumen. The first sealing structure may be a seal configured to form a seal on the cannula when the medical device is not present in the cannula. The second sealing structure may be an instrument seal configured to form a seal around the medical device inserted into the cannula. In some cases, a guide element within the body may be located proximal to the first sealing structure. In some cases, a guide element within the body may be located distal to the second sealing structure. In some cases, a guide element within the body may be located between the first and second sealing structures. In some cases, a guide element may be integrated with the first and / or second sealing structures.

[0321] As shown in Figure 28A, the medical device 2810 may be supported by guide elements such as a flexible disc 2820 within the body 2812 of the cannula 2800 to assist in the concentricity of the medical device 2810. The flexible structure 2820 within the body 2812 can hold the medical device 2810 concentrically within the cannula 2800 and allow gas to pass through the cannula lumen 2804. The flexible structure 2820 may have a plate or other fixing structure 2822 for clamping the flexible structure 2820 within the body 2812 of the cannula 2800. The flexible structure 2820 may include an aperture 2824 to allow gas to pass through the lumen 2804. Figure 28B is a cross-sectional view taken along line 28A-28A of Figure 28A, showing the flexible structure 2820 with the medical device 2810 inserted into the cannula 2800.

[0322] Figure 28C shows a schematic partial cutaway of the cannula shown in Figures 28A and 28B. The features in Figures 28C and 28D may be the same or substantially the same as those shown and described in Figures 28A and 28B, and reference numbers for the same or substantially the same features may share the same reference number. Figure 28C shows a flexible structure 2820 extending around the inner circumference of the cannula body 2812. Figure 28D is a cross-sectional view taken along line 28C-28C in Figure 28C, showing the flexible structure 2820 with the medical device 2810 inserted into the elongated shaft 2802. As shown in Figure 28D, the flexible structure 2820 can concentrically hold the medical device 2810 within the cannula 2800, allowing gas to pass through the lumen 2804.

[0323] Figure 28E shows a cannula 2800 in which a medical device 2810 is supported by a guide element within the body 2812 of the cannula 2800, which includes a seal 2830 to assist in the concentricity of the medical device 2810. The body 2812 of the cannula 2800 may include a proximal end 2814 having an inlet 2828. The seal 2830 may be located at the inlet 2828 of the proximal end 2814 of the body 2812. In some cases, the seal 2830 can make the inlet 2828 more rigid and can help hold the medical device 2810 concentrically within the cannula 2800. In some cases, this can be achieved by using an O-ring as the seal 2830 at the inlet 2828. The seal 2830 may be located proximal to a gas inlet 2829, thereby allowing gas to pass through the lumen 2804. In some cases, the seal 2830 can function as a sealing structure to prevent gas leakage.

[0324] Figure 28F shows a schematic diagram of a partial cutout of the cannula shown in Figure 28E. The features of Figure 28F may be the same or substantially the same as those shown and described in Figure 28E, and reference numbers of the same or substantially the same features may share the same reference number. Figure 28F shows a seal 2830 extending around the inner circumference of the inlet 2828. The seal 2830 may be made of a rigid material that can hold the medical device 2810 more securely within the inlet 2828 than if the seal 2830 were not present within the inlet.

[0325] Figures 28G and 28H show a cannula 2800 having a guide element within the body 2812 of the cannula 2800, which includes a flexible fin 2840 to support the medical device 2810 and assist in the concentricity of the medical device 2810. The flexible fin 2840 is positioned within the body 2812 and extends radially inward within the body 2812 of the cannula 2800, allowing the medical device 2810 to be held concentrically within the cannula 2800. The fin 2840 can deform when the medical device 2810 is pushed beyond the fin 2840. The fin can push back the medical device 2810, thereby allowing the medical device 2810 to be held concentrically within the cannula body 2812 and the elongated shaft 2802. Figures 28I and 28J show schematic cutaways of the cannula in Figures 28G and 28H. The features shown in Figures 28I and 28J may be the same or substantially the same as those shown and described in Figures 28G and 28H, and reference numbers for the same or substantially the same features may share the same reference number. Figures 28I and 28J show flexible fins 2840 spaced circumferentially around the cannula body 2812. One or more flexible fins 2840 may be positioned within the cannula body 2812.

[0326] Figures 28G and 28I show a first configuration of the fin 2840 when the medical device 2810 is not inserted into the cannula 2800. In this configuration, as shown in Figures 28G and 28I, the fin 2840 is located within the cannula body 2812 and extends radially inward within the cannula body 2812. Figures 28H and 28J show a second configuration of the fin 2840 when the medical device 2810 is inserted into the cannula 2800. The fin 2840 is pushed aside by the medical device 2810 as it is inserted beyond the fin 2840. As shown in Figures 28H and 28J, the fin can push back the medical device 2810 and hold the medical device 2810 concentrically within the cannula 2800.

[0327] Figure 28K shows a cannula 2800 in which the medical device 2810 is supported by a guide element including a flexible pin 2850 inserted into the body 2812 of the cannula 2800 to assist in the concentricity of the medical device 2810. The flexible pin 2850 may be inserted into the opening 2852 of the body 2812 to hold the medical device 2810 concentrically within the cannula 2800. The flexible pin 2850 may be mounted on a ring 2854. The ring 2854 helps to hold the flexible pin 2850 together and keep them inserted within the cannula 2800. The flexible pin 2850 can maintain the medical device 2810 concentrically within the cannula 2800. Figure 28L shows a schematic cutaway of the cannula in Figure 28K. The features in Figure 28L may be the same or substantially the same as those shown and described in Figure 28K, and reference numbers for the same or substantially the same features may share the same reference number. Figure 28L shows a ring 2854 arranged circumferentially around the outer surface of the cannula body 2812, with flexible pins 2850 extending radially inward within the cannula body 2812 through an opening 2852. One or more flexible pins 2850 may be arranged within the cannula body 2812. In some cases, the ring 2854 may cover only a portion or a portion of the outer surface of the cannula body, or it may completely surround the outer surface of the cannula body in the circumferential direction.

[0328] Figure 28M shows the ring 2854 removed from the cannula 2800. The features of Figure 28M may be the same or substantially the same as those shown and described in Figure 28K, and reference numbers of the same or substantially the same features may share the same reference number. As shown in Figure 28M, the ring 2854 can support the flexible pin 2850. In some cases, the ring 2854 may be flush with the outer surface of the cannula body 2812.

[0329] Figure 28N shows a cannula 2800 in which a medical device 2810 is inserted into the body 2812 of the cannula 2800 and supported by a guide element including a flexible disc 2860 to assist in the concentricity of the medical device 2810. The flexible disc 2860 may be mounted under seals 2872, 2874 within the cannula body. The flexible disc 2860 can hold the medical device 2810 concentrically within the cannula 2800. The flexible disc 2860 may be constructed to deform as the medical device 2810 is pushed through the flexible disc 2860, and thus the flexible disc 2860 can push back or pull back the medical device 2810 and hold the medical device 2810 concentrically within the cannula 2800. The flexible disc 2860 may have an aperture 2864 to allow gas to pass through the cannula lumen 2804. The flexible disc 2860 may have a plate or other fixing structure 2862 for clamping the flexible disc 2860 within the body 2812 of the cannula 2800. The flexible disc 2860 may be positioned within the body 2812 of the cannula 2800. As shown in Figure 28N, the flexible disc 2860 may be clamped between the plate 2862 and the proximal portion of the elongated shaft 2866 of the cannula.

[0330] Figure 28O shows a schematic diagram of a partial cutaway of the cannula shown in Figure 28N. The features of Figure 28O may be the same or substantially the same as those shown and described in Figure 28N, and reference numbers of the same or substantially the same features may share the same reference number. Figure 28O shows a flexible disc 2860 having an aperture 2864, which is positioned within the cannula body 2812 and fixed within the cannula body 2812 by a plate 2862 and the proximal portion of the elongated cannula shaft 2866.

[0331] Figure 28P shows a cannula 2800 in which a medical device 2810 is supported by a guide element that includes a supportive seal 2870 at the proximal end 2814 of the body 2812 of the cannula 2800 to assist in the concentricity of the medical device 2810. The proximal end 2814 of the cannula 2800 may include seals or sealing structures 2872, 2874 used to seal around the medical device and cover the inside of the cannula. The sealing structures may be a first sealing structure positioned to limit gas leakage and a second sealing structure for providing an instrument seal when the medical device is inserted into the lumen. The first sealing structure may be a seal configured to form a seal on the cannula when the medical device is not inside the cannula. The second sealing structure may be an instrument seal configured to form a seal around the medical device inserted into the cannula. In some cases, the seal or sealing structure 2872 may be the first seal, and the seal or sealing structure 2874 may be the second seal. In other cases, the seal or sealing structure 2872 may be a second seal, and the seal or sealing structure 2874 may be a first seal. In some cases, both the seal or sealing structure 2872 and the seal or sealing structure 2874 may be seals configured to form a seal on the cannula when no medical device is present in the cannula. In some cases, both the seal or sealing structure 2872 and the seal or sealing structure 2874 may be device seals. The cannula body 2812 may incorporate semi-rigid seals, such as a support seal 2870, used to concentrically hold the medical device 2810 within the cannula 2800. The support seal 2870 may be included in conjunction with the other seals 2872, 2874 within the cannula body 2812.

[0332] Figure 28Q shows a schematic diagram of a partial cutout of the cannula shown in Figure 28P. The features in Figure 28Q may be the same or substantially the same as those shown and described in Figure 28P, and reference numbers for the same or substantially the same features may share the same reference number. Figure 28Q shows a support seal 2870 located between seals 2872 and 2874 within the cannula body 2812.

[0333] Figures 29A to 29M show embodiments of a cannula 2900 having guide elements that include rigid features within the body 2912 of the cannula 2900 to assist in the concentricity of the medical device 2910 within the cannula 2900. The cannula 2900 may include a cannula body 2912 and an elongated shaft 2902. The elongated shaft 2902 may include a cannula side wall 2906 that forms the lumen 2904 of the cannula 2900. As shown in Figures 29A to 29M, the lumen 2904 may be defined by the inner side wall 2906 of the cannula 2900. As described herein, the medical device 2910 may be inserted into the cannula 2900 by being introduced through an inlet 2928 at the proximal end of the cannula body 2912 and extending toward the distal end 2908 of the elongated shaft 2902 within the lumen 2904 of the cannula 2900.

[0334] The body of the cannula may include an opening formed therein. A shaft may extend from the body and may include an outlet. The lumen terminates at the outlet and is positioned to be in fluid communication with the opening. The shaft and / or body may include guide elements protruding from the inner surface of the shaft and / or body. The guide elements may be configured to hold the device received in the lumen so that the medical device does not physically come into contact with the inner surface of the shaft and / or body.

[0335] In some cases, the body may have a seal configured to prevent leakage of the insufflation gas when the medical device is inserted or before the device is inserted. In some cases, one or more seals may be used. In some cases, a first seal and a second seal may be used. In some cases, a guide element within the body of the cannula may be located proximal to the first seal. In some cases, a guide element within the body may be located distal to the second seal. In some cases, a guide element within the body may be located between the first seal and the second seal. In some cases, the guide element is integrated with the first seal and / or the second seal.

[0336] In some cases, the body may include a first sealing structure positioned to limit gas leakage and a second sealing structure for providing an instrument seal when a medical device is inserted into the lumen. The first sealing structure may be a seal configured to form a seal on the cannula when the medical device is not present in the cannula. The second sealing structure may be an instrument seal configured to form a seal around the medical device inserted into the cannula. In some cases, a guide element within the body may be located proximal to the first sealing structure. In some cases, a guide element within the body may be located distal to the second sealing structure. In some cases, a guide element within the body may be located between the first and second sealing structures. In some cases, a guide element may be integrated with the first and / or second sealing structures.

[0337] As shown in Figure 29A, the medical device 2910 may be supported by guide elements including rigid features such as ribs 2920 within the body 2912 of the cannula 2900 to assist in the concentricity of the medical device 2910. The ribs 2920 within the body 2912 can concentrically hold the medical device 2910 within the cannula 2900 and allow gas to pass through the cannula lumen 2904. As shown in Figure 29A, the ribs 2920 within the body 2912 may be molded into the body 2912 of the cannula 2900. Figure 29B is a cross-sectional view taken along line 29A-29A of Figure 29A, showing the ribs 2920 within the body 2912 with the medical device 2910 inserted into the cannula 2900. The ribs 2920 within the body 2912 of the cannula may be radially separated around the inner circumference of the body 2912. The ribs 2920 within the main body 2912 allow the medical device 2910 to be held concentrically within the cannula 2900, while also allowing gas to pass through the lumen 2904.

[0338] Figure 29C shows a schematic partial cutaway of the cannula shown in Figures 29A and 29B. The features in Figures 29C and 29D may be the same or substantially the same as those shown and described in Figures 29A and 29B, and reference numbers for the same or substantially the same features may share the same reference number. Figures 29C and 29D show ribs 2920 within the body 2912, radially separated around the inner circumference of the cannula body 2912. Figure 29D is a cross-sectional view taken along line 29C-29C in Figure 29C, showing the ribs 2920 within the body 2912 with the medical device 2910 inserted into the cannula 2900. As shown in Figure 29D, the ribs 2920 within the body 2912 can concentrically hold the medical device 2910 within the cannula 2900, allowing gas to pass through the lumen 2904.

[0339] As shown in Figure 29E, the medical device 2910 may be supported by guide elements that include rigid features, such as a rigid disc 2930 molded into the body 2912 of the cannula 2900, to assist in the concentricity of the medical device 2910. The rigid disc 2930 within the body 2912 can concentrically hold the medical device 2910 within the cannula 2900. The rigid disc 2930 may include an aperture 2932 to allow gas to pass through the lumen 2904 of the cannula. The body 2912 may be formed with the rigid disc 2930 molded into the body 2912.

[0340] Figure 29F shows a schematic diagram of a partial cutout of the cannula shown in Figure 29E. The features of Figure 29F may be the same or substantially the same as those shown and described in Figure 29E, and the reference numbers of the same or substantially the same features may share the same reference number. Figure 29F shows a rigid disk 2930 within the body 2912 extending around the inner circumference of the cannula body 2912.

[0341] As shown in Figures 29G and 29H, the cannula 2900 may include a guide element, such as a seal 2940, at the proximal end 2914 of the body 2912 of the cannula 2900 to assist in the concentricity of the medical device 2910. The seal 2940 at the proximal end 2914 of the body 2912 can hold the medical device 2910 concentrically within the cannula 2900. The seal 2940 at the proximal end 2914 of the body 2912 can be reinforced by clamping the seal 2940 closer to the inlet 2928 located at the proximal end 2914 of the cannula body 2900. The medical device 2910 can be inserted through the inlet 2928. Clamping the seal 2940 closer to the opening reduces the mobility of the seal 2940, thereby limiting the lateral movement of the medical device 2910 within the seal 2940. This can help to concentrically hold the medical device 2910 within the cannula 2900. Figure 29G shows a cannula without a medical device inserted, with the seal 2940 extending across the entire inlet 2928. Figure 29H shows cannula 2900 with the medical device 2910 inserted through the inlet 2928 located at the proximal end 2914 of the cannula body 2912. The seal 2940 can be clamped adjacent to, substantially adjacent to, or next to the medical device, thereby restricting the movement of the medical device 2910 and concentrically holding the medical device within the cannula 2900. In some cases, other seals may be used, including but not limited to one or more seals or sealing structures similar to the first and second seals or sealing structures 2872 and 2874 described with reference to Figures 28P and 28Q.

[0342] Figure 29I shows a schematic diagram of a partial cutaway of the cannula shown in Figures 29G and 29H. The features in Figure 29I may be the same or substantially the same as those shown and described in Figures 29G and 29H, and reference numbers for the same or substantially the same features may share the same reference number. Figure 29I shows a seal 2940 within the body 2912 extending around an opening 2928 surrounding a medical device 2910 within the cannula 2902.

[0343] As shown in Figure 29J, the cannula 2900 may include guide elements, such as rigid features 2950, ​​located above or proximal to seals or sealing structures 2952, 2954 at the proximal end 2914 of the body 2912 of the cannula 2900, to assist in the concentricity of the medical device 2910. The sealing structures may be a first sealing structure positioned to limit gas leakage, and a second sealing structure for providing an instrument seal when the medical device is inserted into the lumen. The first sealing structure may be a seal configured to form a seal on the cannula when the medical device is not present in the cannula. The second sealing structure may be an instrument seal configured to form a seal around the medical device inserted into the cannula. In some cases, seals or sealing structures 2952 may be the first seal, and seals or sealing structures 2954 may be the second seal. In other cases, seals or sealing structures 2952 may be the second seal, and seals or sealing structures 2954 may be the first seal. In some cases, both the seal or sealing structure 2952 and the seal or sealing structure 2954 may be seals configured to form a seal on the cannula when no medical device is present inside the cannula. In some cases, both the seal or sealing structure 2952 and the seal or sealing structure 2954 may be device seals.

[0344] A rigid feature 2950 at the nearest end of the main body 2912 can concentrically hold the medical device 2910 within the cannula 2900. The rigid feature 2950 can form an interlocking channel 2956 aligned with the cannula inlet 2928, through which the medical device 2910 is inserted. The interlocking channel 2956 of the rigid feature 2950 can concentrically hold the medical device 2910 within the cannula 2900. In some cases, the rigid feature 2950 can seal the medical device 2910 once it is inserted into the cannula 2900.

[0345] Figure 29K shows a schematic diagram of a partial cutaway of the cannula in Figure 29J. Features in Figure 29K may be the same or substantially the same as those shown and described in Figure 29J, and reference numbers of the same or substantially the same features may share the same reference number. Figure 29K shows a rigid feature 2950 on the proximal end 2914 of the cannula 2900. As shown in Figure 29K, the rigid feature 2950 may extend proximal to the proximal surface 2914 of the cannula 2900. As shown in Figure 29K, the rigid feature 2950 may be a hollow cone-shaped feature with an interlocking channel. In some cases, the rigid feature 2950 may be a tubular, hollow cylindrical, hollow cone-shaped, or any other shape feature with a channel. In some cases, the rigid feature 2950 may be removable or interchangeable. For example, the rigid feature 2950 may be interchangeable with a different rigid feature to adapt to medical devices 2910 of different shaft sizes. In some cases, the rigidity feature 2950 is permanent or semi-permanent.

[0346] Figure 29L shows a medical device 2910 inserted into a cannula 2900, where the medical device 2910 can be held within the cannula 2900 with two or more guide elements creating two or more contact points within the cannula body 2912. In some cases, rigid features can be used above or proximal to one or more seals within the cannula body, and rigid features can be used below or distal to the seals within the cannula body. In such cases, the cannula 2900 can have two contact points with the medical device 2910, providing support for the medical device 2910 at two points along the length of the cannula 2900. All combinations of the aforementioned flexible and rigid features can be included in this design and can be used in any combination to concentrically hold the medical device 2910 within the cannula 2900. As shown in Figure 29L, the cannula body 2912 may have a first contact point above the seal of the cannula. As described with reference to Figures 29J and 29K, the first contact point may be an interlocking channel. The second contact point on the medical device 2910 may be a rigid disc 2962 below the seal within the cannula body. As described with reference to Figures 29E and 29F, the rigid disc 2962 may have an opening 2964 to allow gas to pass through the cannula lumen 2904. As an example, Figure 29L shows the use of a rigid feature 2960 above or proximal to the seals 2952, 2954 at the proximal end 2914 of the cannula body 2912, in conjunction with the rigid disc 2962 within the cannula body 2912, for concentrically holding the medical device 2910 within the cannula 2900. As shown in Figure 29L, both contact points may occur within the cannula body 2912.

[0347] Figure 29M shows a schematic diagram of a partial cutout of the cannula in Figure 29L. The features in Figure 29M may be the same or substantially the same as those shown and described in Figure 29L, and the reference numbers of the same or substantially the same features may share the same reference number. Figure 29K shows a rigid feature 2960 on the proximal end 2914 of the cannula 2900 and a rigid disk 2962 within the cannula body 2912. The rigid feature 2960 may be similar to the rigid feature 2950 described with reference to Figures 29J and 29K, and the rigid disk 2962 may be similar to the rigid disk 2930 described with reference to Figures 29E and 29F.

[0348] Figures 30A to 30H show embodiments of a cannula 3000 having two or more guide elements at its proximal end 3014 and distal end 3008, which include flexible features to assist in the concentricity of the medical device 3010 within the cannula 3000. The cannula 3000 may include a cannula body 3012 and an elongated shaft 3002. The elongated shaft 3002 may include a cannula side wall 3006 that forms the lumen 3004 of the cannula 3000. As shown in Figures 30A to 30H, the lumen 3004 may be defined by the inner side wall 3006 of the cannula 3000. As described herein, the medical device 3010 can be inserted into the cannula 3000 by being introduced through the inlet 3028 of the proximal end 3014 of the cannula body 3012 and extending toward the distal end 3008 of the elongated shaft 3002 within the lumen 3004 of the cannula 3000.

[0349] As shown in Figure 30A, the medical device 3010 may be supported by any combination of guide elements having the flexible features described in the embodiments above. This combination of flexible features allows the medical device 3010 to be held concentrically within the cannula 3000. In some cases, two contact points within the cannula 3000 can maintain better concentricity than a single point of concentricity. As shown in Figure 30A, the first contact point may be obtained by a flexible feature such as a flexible disc 3020 that can be attached to or molded onto the body 3012 of the cannula 3000. The flexible disc 3020 may include an opening 3022 to allow gas to pass through the lumen 3004. The flexible disc 3020 may include a plate 3024 for securing the flexible disc 3020 within the body 3012 of the cannula 3000. Additionally, a second contact point can be obtained at the distal end 3008 of the elongated shaft 3002 by a flexible concentric rib 3030 molded onto the cannula elongated shaft 3002. The flexible rib 3026 may be similar to and include any of the features of flexible ribs described in other embodiments herein. The flexible disc 3020 and the flexible concentric rib 3026 allow the medical device 3010 to be held concentrically within the cannula 3000, while allowing gas to pass through the lumen 3004.

[0350] Figure 30B is a cross-sectional view taken along line 30A-30A in Figure 30A, showing the flexible disc 3020 within the body 3012 into which the medical device 3010 is inserted into the cannula 3000. The flexible disc 3020 within the body 3012 can concentrically hold the medical device 3010 within the cannula 3000, while allowing gas to pass through the opening 3022 and the lumen 3004. As shown in Figure 30B, the flexible disc 3020 can surround the medical device 3010 in the circumferential direction.

[0351] Figure 30C is a cross-sectional view taken along line 30A'-30A' in Figure 30A, showing the ribs 3026 within the elongated shaft into which the medical device 3010 is inserted in the cannula 3000. The ribs 3026 within the elongated shaft 3002 allow the medical device 3010 to be held concentrically within the cannula 3000, while allowing gas to pass through the lumen 3004. As shown in Figure 30C, the ribs may be radially separated around the inner circumference of the cannula sidewall 3006 at the proximal end of the elongated shaft 3002.

[0352] Figure 30D shows a schematic partial cutaway of the cannula in Figure 30A. The features in Figures 30D, 30E, and 30F may be the same or substantially the same as those shown and described in Figures 30A, 30B, and 30C, and reference numbers for the same or substantially the same features may share the same reference number. Figure 30E is a cross-sectional view taken along line 30D-30D in Figure 30D, showing the flexible disc 3020 within the body 3012 into which the medical device 3010 is inserted in the cannula 3000. Figure 30F is a cross-sectional view taken along line 30D'-30D' in Figure 30D, showing the rib 3026 on the cannula sidewall 3006 within the elongated shaft 3002 into which the medical device 3010 is inserted in the cannula 3000.

[0353] As shown in Figure 30G, the medical device 3010 may be supported by a combination of guide elements having either flexible or rigid characteristics as described in the embodiments above. This combination of flexible and / or rigid characteristics allows the medical device 3010 to be concentrically held within the cannula 3000 at at least two contact points within the cannula. In some cases, two contact points within the cannula 3000 can maintain better concentricity than a single point of concentricity. The two contact points may be disk 3030 and rib 3036, similar to disk 3020 and rib 3026 described with reference to Figures 30A to 30F, but disk 3030 and rib 3036 may be either flexible or rigid. In some cases, both the disc 3030 and the rib 3036 can be flexible, both the disc 3030 and the rib 3036 can be rigid, or one of the disc 3030 and the rib 3036 can be flexible and the other of the disc 3030 and the rib 3036 can be rigid. Figure 30H shows a schematic diagram of a partial cutout of the cannula in Figure 30G. The features in Figure 30H can be the same or substantially the same as those shown and described in Figure 30G, and reference numbers of the same or substantially the same features may share the same reference number.

[0354] Figures 31A to 31H show embodiments of a cannula 3100 having two or more guide elements at its proximal end 3114 and distal end 3108, including rigid features to assist in the concentricity of the medical device 3110 within the cannula 3100. The cannula 3100 may include a cannula body 3112 and an elongated shaft 3102. The elongated shaft 3102 may include a cannula side wall 3106 that forms the lumen 3104 of the cannula 3100. As shown in Figures 31A to 31H, the lumen 3104 may be defined by the inner side wall 3106 of the cannula 3100. As described herein, the medical device 3110 can be inserted into the cannula 3100 by being introduced through the inlet 3128 of the proximal end 3114 of the cannula body 3112 and extending toward the distal end 3108 of the elongated shaft 3102 within the lumen 3104 of the cannula 3100.

[0355] As shown in Figure 31A, the medical device 3110 can be supported by any combination of guide elements having the rigid features described in the embodiments above. This combination of rigid features allows the medical device 3110 to be held concentrically within the cannula 3100. In some cases, two contacts within the cannula 3100 can maintain better concentricity than a single point of concentricity. Figure 31A shows a cannula having two points of connect with a medical device, with one contact on the cannula body 3112 and one contact on the elongated shaft 3102. As shown in Figure 31A, rigid features such as a rigid rib 3120 that can be attached to or molded onto the body 3112 of the cannula 3100 form a first contact with the medical device 3110. The distal end 3008 may include a rigid rib 3122 attached to or molded onto the elongated cannula shaft 3102, forming a second contact point with the medical device 3130. The rigid rib 3122 may be similar to, and include, any of the features of a rigid rib described in other embodiments of this specification. The rigid ribs 3120 and 3122 allow the medical device 3110 to be held concentrically within the cannula 3100, while allowing gas to pass through the lumen 3104.

[0356] Figure 31B is a cross-sectional view taken along line 31A-31A of Figure 31A, showing the rigid ribs 3120 within the body 3112, with the medical device 3110 inserted into the cannula 3100. The rigid ribs 3120 within the body 3112 allow the medical device 3110 to be held concentrically within the cannula 3100, while allowing gas to pass through the lumen 3104. The rigid ribs 3120 may be circumferentially spaced around the inner wall of the body 3112 of the cannula 3100.

[0357] Figure 31C is a cross-sectional view taken along line 31A'-31A' in Figure 31A, showing the rigid ribs 3122 within the elongated shaft 3102, with the medical device 3110 inserted into the cannula 3100. The rigid ribs 3122 within the elongated shaft 3102 allow the medical device 3110 to be held concentrically within the cannula 3100, while allowing gas to pass through the lumen 3104. As shown in Figure 30C, the rigid ribs 3122 may be circumferentially spaced around the inner wall of the proximal end of the elongated shaft 3102.

[0358] Figure 31D shows a schematic partial cutaway of the cannula in Figure 31A. The features in Figures 31D, 31E, and 31F may be the same or substantially the same as those shown and described in Figures 31A, 31B, and 31C, and reference numbers for the same or substantially the same features may share the same reference number. Figure 31E is a cross-sectional view taken along line 31D-31D in Figure 31D, showing a rigid rib 3120 within the body 3112, with the medical device 3110 inserted into the cannula 3100. Figure 31F is a cross-sectional view taken along line 31D'-31D' in Figure 31D, showing a rigid rib 3122 within the elongated shaft 3102, with the medical device 3110 inserted into the cannula 3100. As shown in Figures 31D, 31E, and 31F, the rigid ribs 3120 are radially spaced around the inner circumference of the cannula body, and the rigid ribs 3126 are radially spaced around the inner circumference of the cannula shaft 3102.

[0359] As shown in Figure 31G, the medical device 3110 may be supported by a combination of guide elements having either flexible or rigid characteristics as described in the embodiments above. This combination of flexible and / or rigid characteristics allows the medical device 3110 to be concentrically held within the cannula 3100 at at least two contact points within the cannula. In some cases, two contact points within the cannula 3100 can maintain better concentricity than a single point of concentricity. The two contact points may be ribs 3130 and ribs 3132, similar to ribs 3120 and ribs 3122 described with reference to Figures 31A to 31F, but ribs 3130 and ribs 3132 may be either flexible or rigid. In some cases, both rib 3130 and rib 3132 can be flexible, both rib 3130 and rib 3132 can be rigid, or one of rib 3130 and rib 3132 can be flexible and the other of rib 3130 and rib 3132 can be rigid. Figure 31H shows a schematic diagram of a partial cutout of the cannula in Figure 31G. The features in Figure 31H can be the same or substantially the same as those shown and described in Figure 31G, and the reference numbers of the same or substantially the same features may share the same reference number.

[0360] Any of the embodiments described herein may be modified to include additional features, but not limited to, one or more discharge passages defined within the cannula. For example, any of the cannulas described herein may include one, two, or more additional passages / lumens defining a discharge passage for discharging gas / smoke from the surgical lumen. The discharge lumen may be, for example, concentric with, offset from, or share a common lumen with respect to the gas supply lumen and / or instrument-holding lumen. The cannula may include a filter built into the cannula for filtering the gas delivered to the cannula. The filter may also be in fluid communication with the discharge passage (if any) so that the discharged gas / smoke is filtered. A heating element may be located within the cannula to heat the cannula lumen, thereby raising the dew point of the gas within the cannula. The heating element or a portion of a second heating element may be located within the discharge passage to prevent or at least reduce condensation within the discharge passage. Furthermore, a heating element or another heating element may be positioned in contact with the filter to prevent or at least reduce condensation within the filter.

[0361] term Examples of medical gas delivery systems and related components and methods have been described with reference to the figures. The figures show various systems and modules and the connections between them. Various modules and systems can be combined in various configurations, and the connections between various modules and systems may represent physical or logical links. The representations in the figures are presented to clearly illustrate the principles, and details regarding the division of modules or systems are provided to facilitate explanation rather than to elaborate on separate physical embodiments. The examples and figures are for illustrative purposes only and do not limit the scope of the invention as described herein. For example, the principles herein may be applied not only to surgical humidifiers but also to other types of humidification systems, including respiratory humidifiers.

[0362] The examples described herein illustrate concentric cannulas used in combination with a scope to concentrically support the scope. However, in some cases, cannulas may be used to concentrically hold other medical devices, such as surgical instruments. Furthermore, the terms “concentric,” “concentrically,” and / or “substantially concentric,” or any variation thereof, as used herein, may also refer to a slight axial offset between the cannula and the medical device. In some cases, for example, the axial offset may include an offset of 0 to 30 degrees.

[0363] The examples described herein refer to the reduction of fogging or condensation on medical devices. However, other obstructions or complex elements to visibility can be prevented or reduced. Where the methods, procedures, and devices described herein refer to the reduction of fogging or condensation, it should be understood that these methods, procedures, and devices can also reduce or prevent fogging, condensation, unwanted debris, and / or other visual obstructions.

[0364] As used herein, the term “processor” broadly means any suitable device, logic block, module, circuit, or combination of elements for executing instructions. For example, controller 8 may include any conventional general-purpose single or multi-chip microprocessor such as a Pentium® processor, MIPS® processor, PowerPC® processor, AMD® processor, ARM® processor, or ALPHA® processor. Furthermore, controller 122 may include any conventional dedicated microprocessor such as a digital signal processor or microcontroller. The various illustrative logic blocks, modules, and circuits described in relation to the embodiments disclosed herein can be implemented or run with a general-purpose processor, a digital signal processor (DSP), an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA), or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to implement the functions described herein, or with pure software within a main processor. For example, a logic module may be a software-implemented functional block that does not utilize any additional and / or specialized hardware elements. The controller may be implemented as a combination of computing devices, for example, a combination of a DSP and a microprocessor, a combination of a microcontroller and a microprocessor, multiple microprocessors, one or more microprocessors in use with a DSP core, or any other such configuration.

[0365] While specific embodiments and examples are disclosed herein, the subject matter of the present invention extends beyond the particularly disclosed embodiments to other alternative embodiments and / or uses, as well as their modifications and equivalents. Therefore, the scope of the claims or embodiments appended herein is not limited to any particular embodiment described herein. For example, in any method or process disclosed herein, the actions or operations of the method or process can be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as a number of separate operations in a manner that may be useful for understanding a particular embodiment. However, the order of description should not be interpreted as suggesting that these operations are order-dependent. Furthermore, the structures described herein may be embodied as integrated components or as separate components. For the purpose of comparing various embodiments, specific aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily achieved by any particular embodiment. Therefore, for example, various embodiments may be implemented in a manner that achieves or optimizes one or more of the benefits taught herein, without necessarily achieving other embodiments or benefits that may also be taught or proposed herein.

[0366] As used herein, conditional statements such as “can,” “could,” “might,” “may,” and “e.g.,” unless otherwise stated or understood in the context in which they are used, are generally intended to convey that certain embodiments include certain features, elements, and / or states, while other embodiments do not include those features, elements, and / or states. Therefore, such conditional statements are not generally intended to suggest that one or more embodiments require any particular feature, element, and / or state. As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having,” or any other variations thereof, include non-exclusive inclusion. For example, a process, method, article, or apparatus that includes a list of elements is not necessarily limited to those elements and may include other elements not expressly listed or specific to such process, method, article, or apparatus. Furthermore, the term “or” is used in its inclusive sense (rather than its exclusive sense), for example, when used to connect a list of elements, so that the term “or” means one, some, or all of the elements in the list. Conjunctions such as “at least one of X, Y, and Z” are generally understood, in the context in which they are used, to indicate that an item, term, etc., may be one of X, Y, or Z, unless otherwise noted. Thus, such conjunctions do not generally suggest that a particular embodiment requires the presence of at least one X, at least one Y, and at least one Z, respectively. As used herein, the terms “about” or “approximately” may mean that a value is within ±10%, ±5%, or ±1% of the stated value.

[0367] The methods and processes described herein may be embodied in software code modules executed by one or more general-purpose and / or dedicated computers, and may be partially or fully automated through such modules. The term “module” means logic embodied in hardware and / or firmware, or a set of software instructions, preferably with entry and exit points, written in a programming language such as C or C++. Software modules may be compiled and linked into an executable program, installed in a dynamically linked library, or written in an interpreted programming language such as BASIC, Perl, or Python. It will be understood that software modules may be callable from other modules or from themselves, and / or may be called in response to detected events or interrupts. Software instructions may be incorporated into firmware such as erasable programmable read-only memory (EPROM). Furthermore, it will be understood that hardware modules may include connected logic units such as gates and flip-flops, and / or programmable units such as programmable gate arrays, application-specific integrated circuits, and / or processors. The modules described herein may be implemented as software modules, but may also be represented in hardware and / or firmware. Furthermore, in some embodiments, modules may be compiled separately, while in other embodiments, modules may represent a subset of instructions from separately compiled programs and may not have interfaces available to other logic program units.

[0368] In certain embodiments, code modules may be implemented and / or stored in any type of computer-readable medium or other computer storage device. In some systems, data (and / or metadata) entered into the system, data generated by the system, and / or data used by the system may be stored in any type of computer data repository, such as a relational database and / or a flat file system. Any of the systems, methods, and processes described herein may include interfaces configured to enable interaction with users, operators, other systems, components, programs, etc.

[0369] It should be emphasized that many variations and modifications may be made to the embodiments described herein, and these elements should be understood as particularly acceptable examples. All such modifications and variations are included in the scope of this disclosure and are protected by the following claims. Furthermore, nothing in the foregoing disclosure implies that any particular component, characteristic, or process step is necessary or essential.

Claims

1. A surgical cannula, The proximal end of the surgical cannula has an opening that can receive a medical instrument, It is equipped with a long shaft, The elongated shaft has a proximal end, a distal end, a longitudinal axis extending between the proximal and distal ends of the elongated shaft, and a side wall defining a lumen terminating at the outlet of the distal end of the elongated shaft. The outer cross-section of the aforementioned elongated shaft has a single and constant diameter. A gas inlet is provided at the proximal end of the elongated shaft, and this gas inlet can be connected to a gas source and is in fluid communication with the lumen of the elongated shaft. The inlet is in fluid communication with the outlet via the lumen, The portion of the elongated shaft including the distal end is configured to be inserted into the surgical cavity. The lumen is configured to receive medical instruments, At the distal end of the elongated shaft, the first cross-section of the lumen in a plane perpendicular to the longitudinal axis of the elongated shaft has a hexagonal shape and functions as a guide element that concentrically holds the medical instrument within the elongated shaft. At a second position excluding the distal end of the elongated shaft, the second cross-section of the lumen perpendicular to the longitudinal axis has a second cross-sectional shape, and the second cross-sectional shape is circular. The outer cross-section of the elongated shaft is circular between the distal end and the proximal end. The proximal end of the elongated shaft is provided with a gas inlet that can be connected to a gas source and is in fluid communication with the lumen of the elongated shaft. A surgical cannula characterized by the following features.

2. The second cross-section forms a cross-sectional area larger than the cross-sectional area of ​​the first cross-section. The surgical cannula according to claim 1.

3. The first cross section is configured to provide a gap for a gas, such as an air supply gas, to pass through the lumen when a medical instrument having a circular cross section is received inside a surgical cannula. A surgical cannula according to claim 1 or 2.

4. The guide element extends longitudinally along a portion of the length of the elongated shaft. A surgical cannula according to any one of claims 1 to 3.

5. It includes a first seal configured to prevent the supply gas from leaking through the inlet, A surgical cannula according to any one of claims 1 to 4.

6. The medical device is provided with a second seal positioned to form a seal around the medical device when the medical device is received inside the surgical cannula. A surgical cannula according to claim 5,

7. Includes a heating element for heating the lumen, A surgical cannula according to any one of claims 1 to 4.

8. A surgical cannula system for supplying insufflation gas to a surgical cavity, A surgical cannula according to any one of claims 1 to 7, A medical instrument for insertion into the aforementioned surgical cannula, A surgical cannula system comprising a gas supply device for supplying the aforementioned air supply gas to the gas inlet of the surgical cannula.

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