Channel cleaning with modified water

Abstract

Presented herein are techniques for using modified water that facilitate the cleaning of device lumens. The modified water is used to create a chemical action that may act to reduce adhesion between contaminants and a surface of the device lumens. A contaminant detaching cleaning action is used in conjunction with the chemical action to separate the contaminants from the surface of the device lumens to facilitate removal of the contaminants from the device lumens.

Description

CHANNEL CLEANING WITH MODIFIED WATERBACKGROUNDField of the Invention[oooi] The present invention generally relates to techniques for cleaning interior lumens of, for example, medical devices such as endoscopes.Related Art

[0002] There are several different types of systems / devices that include interior conduits / lumens that can need cleaning. The lumens can include, for example, dental lines, food / drink lines, medical lumens, etc.

[0003] A number of different medical devices (medical instruments), in particular, can include interior lumens that can be used to perform diagnostic and / or surgical procedures. For example, an endoscope is a medical device that includes interior lumens that can be used to visually inspect hollow organs or body cavities, deliver / extract fluids, etc. Specially designed endoscopes are used for different examinations, such as bronchoscopy, cystoscopy, gastroscopy, and proctoscopy. Endoscopes, as well as other available diagnostic and / or surgical medical devices are re-useable across multiple patients and, as such, the interior lumens must be cleaned between uses.SUMMARY

[0004] In one aspect, a method is provided herein. The method comprises: delivering one or more modified water flows to a channel of the medical device; and intermittently delivering air flows to the channel with each of the one or more modified water flows.

[0005] In another aspect, a method is provided herein. The method comprises: delivering one or more modified water flows to a channel of a medical device; and delivering one or more contaminant-detaching flows to the channel to interrupt the one or more modified water flows and to cause a contaminant-detaching action with an interior surface of the channel.

[0006] In yet another aspect, a method is provided herein. The method comprises: delivering a flow of modified water to a channel of a medical device to reduce adhesion of contaminants to a wall of the channel; and delivering one or more cleaning shots to the lumen to separate the contaminants from the wall for removal from the channel. In still another aspect, a method isprovided herein. The method comprises: flowing, via a cleaning device, a fluid to a channel of a medical device to clean the medical device; and flowing, via a module, modified water through the cleaning device to self-clean the cleaning device.BRIEF DESCRIPTION OF THE DRAWING

[0007] Embodiments of the present invention are described herein in conjunction with the accompanying drawings, in which:

[0008] FIG. 1 is a schematic diagram illustrating an endoscope with interior lumens that can be cleaned using modified water, in accordance with certain embodiments presented herein.

[0009] FIG. 2 is a flowchart of an example method for cleaning a lumen of a medical device using modified water, in accordance with certain embodiments presented herein.[ooio] FIG. 3A is a schematic diagram illustrating one stage / phase of a process for cleaning a lumen, in accordance with certain embodiments presented herein.[ooii] FIG. 3B is a schematic diagram illustrating another stage / phase of a process for cleaning a lumen, in accordance with certain embodiments presented herein.

[0012] FIG. 4 is a schematic diagram illustrating an example use of modified water with a lumen cleaning system, in accordance with certain embodiments presented herein.

[0013] FIG. 5 is a flowchart of another example method for cleaning a lumen of a medical device using modified water, in accordance with certain embodiments presented herein.

[0014] FIG. 6A is a flowchart of yet another example method for cleaning a lumen of a medical device using modified water, in accordance with certain embodiments presented herein.

[0015] FIG. 6B is a schematic diagram illustrating a stage / phase of a process for cleaning a lumen, in accordance with certain embodiments presented herein.

[0016] FIG. 7 is a flowchart of still another example method for cleaning a lumen of a medical device using modified water, in accordance with certain embodiments presented herein.

[0017] FIG. 8 is a schematic diagram illustrating an example use of modified water with another lumen cleaning system, in accordance with certain embodiments presented herein.

[0018] FIGs. 9, 10, 11A, 1 IB, 12, and 13 are each a schematic diagram illustrating a respective system for cleaning a lumen of a medical device using modified water, in accordance with certain embodiments presented herein.

[0019] FIG. 14 is a schematic diagram of a cleaning device system configured to clean a lumen of a medical device, in accordance with embodiments disclosed herein.

[0020] FIG. 15 is a flowchart of an example method for cleaning a medical device and selfcleaning a cleaning device, in accordance with embodiments disclosed herein.

[0021] FIG. 16 is a block diagram of an example control sub-system for performing techniques discussed herein.DETAILED DESCRIPTION

[0022] Embodiments presented herein are generally related to the use of chemically modified water to facilitate the cleaning of device lumens. Water that has been chemically modified is generally referred to herein as “modified water” and can include, for example, ozonated water (e.g., water that has been treated with ozone gas), plasmon-activated water (“PAW), and / or water treated with other chemistries / formulations. In certain aspects, chemical effects provided by modified water in combination with a contaminant-detaching cleaning action can more thoroughly clean device lumens. As described further below, the modified water can be implemented in the form of apportioned amounts of water (sometimes referred to herein as a “cleaning shot” or “shot”), a turbulent flow of water, an air flow, etc. Additionally or alternatively, the modified water can be used as a flushing flow (e.g., a fluid flow intended to remove already detached contaminants or other matter, rather than detach contaminants by itself) before or after a contaminant-detaching cleaning action is used to clean device lumens (e.g., to remove remnants of contaminants after the contaminant-detaching cleaning action is provided). It should be noted that the techniques discussed herein are not a function of, nor are they bounded to / by, any particular theories. That is, the techniques and benefits discussed herein can be effectuated regardless of the accuracy of any believed underlying theories and are merely provided as possible examples.

[0023] In some embodiments, the modified water reduces coupling of contaminants, such as biofilms / bioburdens, to interior walls of a device lumen. That is, in certain examples, the modified water provides a chemical reaction that weakens attachment of the contaminants to the device lumen. Thus, the contaminants are more readily removable from the device lumen. In this manner, a subsequent contaminant-detaching cleaning action can more easily detach the contaminants from the interior walls for removal from the device lumen, such as by imparting a shear stress onto the contaminants relative to the interior walls.

[0024] In certain embodiments, the contaminant-detaching cleaning action can produce a triboelectric effect to facilitate detachment / removal of biofilms / bioburdens from a device lumen. In general, the triboelectric effect describes electric charge transfer between two objects when they contact or slide against each other. In accordance with embodiments presented herein, the triboelectric effect can result from passing dry air flow through a device lumen at a triggering velocity. In operation, the dry air flow could generate a static charge on the interior walls, which in turn might disrupt the adhesion of the biofilms / bioburdens. More specifically, biofilms / bioburdens can adhere to surfaces through a combination of physical adhesion mechanisms and extracellular polymeric substances (EPS). Altering the surface charge via the triboelectric effect may influence these adhesion forces (e.g., potentially weaken the adhesion and thereby facilitate removal of the biofilms / bioburdens). Alternatively, the triboelectric effect may make the biofilms / bioburdens more attracted to a subsequent flow of modified water or a subsequently applied flushing flow.

[0025] In certain aspects, the combination of a contaminant-detaching cleaning action (e.g., shear stress from contact with the device lumen, triboelectric effect) and the chemical properties (e.g., oxidative properties) of modified water could synergistically enhance removal of the biofilms / bioburdens. For example, the chemical properties of the modified water can reduce adhesion of biofilms / bioburdens to the device lumen, and the contaminant-detaching cleaning action can physically separate the biofilms / bioburdens from the device lumen to enable removal thereof. Indeed, modified water without a contaminant-detaching cleaning action (e.g., even with another cleaning fluid, such as detergent, that does not provide a contaminant-detaching cleaning action) may not provide a sufficient force to separate biofilms / bioburdens from the device lumen, and / or a contaminant-detaching cleaning action without modified water may not as easily / rigorously reduce adhesion of biofilms / bioburdens to the device lumen, such that using one of modified water or contaminant-detaching cleaning action and not the other may not provide desirable removal of biofilms / bioburdens. Thus, the combined usage of modified water and contaminant-detaching cleaning action can improve cleaning of the device lumen as compared to separate usage of modified water or contaminantdetaching cleaning action.

[0026] Moreover, using modified water along with a contaminant-detaching cleaning action can enable reduced concentrations of modified water to be utilized while achieving a desirable cleaning of a device lumen. For example, elevated concentrations of modified water can increase wear of the device lumen and / or involve costly / intensive processes of production.Therefore, reducing concentration of modified water can increase a useful lifespan of the device lumen and / or reduce costs associated with the production of the modified water, providing further benefits associated with cleaning the device lumen.

[0027] As noted, there are a number of different types of systems / devices that include interior conduits / lumens, such as dental lines, food / drink lines, medical lumens, etc., that may need periodic and / or regular cleaning. For ease of description, the techniques presented herein are primarily described with reference to cleaning specific medical lumens, namely the interior lumens of an endoscope. However, it is to be appreciated that the techniques presented herein can also or alternatively be used to clean any type of interior lumen.

[0028] An endoscope is an elongate tubular medical device that may be rigid or flexible and which incorporates an optical or video system and light source. Typically, an endoscope is configured so that one end can be inserted into the body of a patient via a surgical incision or via one of the natural openings of the body. Internal structures near the inserted end of the endoscope can thus be viewed by an external observer.

[0029] As well as being used for investigation, endoscopes are also used to carry out diagnostic and surgical procedures. Endoscopic procedures are increasingly popular as they are minimally invasive in nature and provide a better patient outcome (through reduced healing time and exposure to infection), enabling hospitals and clinics to achieve higher patient turnover.

[0030] FIG. 1 is a schematic diagram of an example endoscope 100 with which aspects of the techniques presented herein can be implemented. As shown, the endoscope 100, similar to most endoscopes, has a long tube-like structure with a distal end / tip 102 at one end for insertion into a patient and an opposing proximal or connector end 104, with a control handle 106 located between the two ends (e.g., generally at the center of the length between connector end 104 and distal end 102). The connector end 104 includes a plurality of connectors that enable the endoscope 100 to be attached to, for example, a light source 108, water source 110, a suction source (not shown in FIG. 1), and a pressurized air source 112. For example, shown in FIG. 1, is a suction port / connector 137, a water-jet (auxiliary) port / connector 139, a water port / connector 141, and an air-port / connector 143. The control handle 106 is held by the operator during the procedure to control the endoscope 100 via valves, which include in this example a suction valve 114, an air / water valve 116, and a biopsy valve 118, and control wheels 120.

[0031] As shown in FIG. 1, the endoscope 100 includes internal channels used either for delivering air and / or water, providing suction or allowing access for forceps and other medical equipment required during the procedure. As such, the distal tip 102 contains the camera lens (not shown in FIG. 1), the exits for the lighting, air, and water, as well as exits for suction and forceps. Some of the internal channels run from one end of the endoscope 100 to the other, while others run via valve sockets at the control handle 106. Some channels bifurcate while and others join from two into one.

[0032] More specifically, shown in FIG. 1 is a biopsy / suction channel 122, an air channel 124, a water channel 126, and a water-jet channel 128. The biopsy / suction channel 122 includes two sections, referred to as proximal section 122A and distal section 122B that are connected via the suction valve 114. The air channel 124 also includes two sections, referred to as proximal section 124A and distal section 124B that are connected via the air / water valve 116. Similarly, the water channel 126 also includes two sections, referred to as proximal section 126A and distal section 126B that are connected via the air / water valve 116. The distal section 126B of the water channel joins to the distal section 124B of the air channel at a location 130 within the distal end 102. The water-jet channel 128 extends directly from the connector end 104 to the distal end 102 (via the control handle 106) but is similarly referred to as having a proximal section 128A and distal section 128B. The proximal sections 122A, 124A, 126A, and 128A of the channels are sometimes referred to as being located within a universal cord section (cord) 132 of the endoscope 100, while the distal sections 122B, 124B, 126B, and 128B of the channels are sometimes referred to as being located within an insertion tube 134 of the endoscope 100. More generally, as used herein, the proximal sections 122A, 124A, 126A, and 128 A are the portions of the channels located between the connector end 104 and a valve (e.g., valve 114 or 116) at the control handle 106 and / or a mid-point of the control handle 106, as applicable. The distal sections 122B, 124B, 126B, and 128B are the portions of the channels located between the valve (e.g., valve 114 or 116) at the control handle 106 and / or a mid-point of the control handle 106, and the distal end 102 of the endoscope 100.

[0033] The high cost of endoscopes means they must be re-used. As a result, because of the need to avoid cross infection from one patient to the next, each endoscope must be thoroughly cleaned and disinfected or sterilized after each use. This involves the cleaning of not only the outer of the endoscope 100, but also cleaning and disinfecting the internal channels / lumens (e.g., channels 122, 124, 126, and 128 of FIG. 1).

[0034] Endoscopes used for colonoscopic procedures are typically between 2.5 and 4 meters long and have one or more lumen channels of diameter of no more than a few millimeters. Ensuring that such long narrow channels are properly cleaned and disinfected between patients presents a considerable challenge. The challenge of cleaning is also made more difficult by the fact that there is not just one configuration / type of endoscope. Indeed, there are a variety of endoscopic devices, each suited to a particular insertion application, such as colonoscopes inserted into the colon, bronchoscopes inserted into the airways, gastroscopes for investigation of the stomach, etc. Gastroscopes, for instance, are smaller in diameter than colonoscopes; bronchoscopes are smaller again and shorter in length while duodenoscopes have a different tip design to access the bile duct.

[0035] A variety of options are available to apply a force that removes biological residues from the lumen, which can be one stage in a cleaning and / or disinfection process. One procedure for cleaning the lumens utilizes small brushes mounted on long, thin, flexible lines. Brushing is the mandated means of cleaning the lumen in some countries. These brushes are fed into the lumens while the endoscope is submerged in warm water and a cleaning solution. The brushes are then pushed / pulled through the length of the lumens in an effort to scrub off the soil / bio burden. Manual back and forth scrubbing is typically required. Water and cleaning solutions are then flushed down the lumens. These flush-brush processes are repeated three times or until the endoscope reprocessing technician is satisfied that the lumen is clean. At the end of this cleaning process, air is pumped down the lumens to dry them. A flexible pull-through device having wiping blades may also be used to physically remove material. A liquid flow through the lumen at limited pressure can also be used.

[0036] In general, however, only the larger suction / biopsy lumens (e.g., 122 in FIG. 1) can be cleaned by brushing or pull throughs. Air / water channels (e.g., channels 124 and 126) are generally too small for brushes, so these lumens are usually only flushed with water and cleaning solution.

[0037] There has been significant research to show that the method of cleaning with brushes, even when performed as prescribed, may not completely remove biofilm in endoscope lumens. As well as lacking in efficacy, the current manual brushing procedures suffer from other drawbacks. The large number of different endoscope manufacturers and models results in many minor variations of the manual cleaning procedure. This has led to confusion and ultimately poor compliance in cleaning processes.

[0038] The current system of manual brushing is also labor intensive, leading to increased cost. Thus, the current approaches to cleaning and disinfecting the lumens in medical cleaning apparatus are still inadequate and residual microorganisms are now recognized as a significant threat to patients and staff exposed to these devices. For example, there is evidence of bacterial transmission between patients from inadequate cleaning and disinfection of internal structures of endoscopes,, which in turn has led to patients acquiring mortal infections. Between 2010 and 2015 more than 41 hospitals worldwide, most in the U.S., reported bacterial infections linked to the scopes, affecting 300 to 350 patients (http: / / www.modemhealthcare.com / article / 20167415 / NEWS / 167419935). It would be expected that a reduction in the bioburden in various medical devices would produce a concomitant overall reduction in infection rates and mortality.

[0039] In addition, if endoscopes are not properly cleaned and dried, biofdm can build up on the lumen wall. Biofilms start to form when a free-floating microorganism attaches itself to a surface and surrounds itself with a protective polysaccharide layer. The microorganism then multiplies, or begins to form aggregates with other microorganisms, increasing the extent of the polysaccharide layer. Multiple sites of attachment can in time join up, forming significant deposits of biofdm. Once bacteria or other microorganisms are incorporated in a biofdm, they become significantly more resistant to chemical and contaminant-detaching cleaning than they would be in their free-floating state. The organisms themselves are not inherently more resistant, rather, resistance is conferred by the polysaccharide film and the fact that microorganisms can be deeply embedded in the film and isolated from any chemical interaction. Any residual biofdm remaining after an attempt at cleaning quickly returns to an equilibrium state, and further growth of microorganisms within the film continues. Endoscopes lumens are particularly prone to biofilm formation. They are exposed to significant amounts of bioburden, and subsequent cleaning of the long narrow lumens is quite difficult due to inaccessibility and the inability to monitor the cleaning process.

[0040] There is considerable pressure in medical facilities to reprocess endoscopes as quickly as possible. Because endoscopes are cleaned by hand, training and attitude of the technician are important in determining the cleanliness of the device. Residual biofilm on instruments can result in a patient acquiring an endoscope acquired infection. Typically, these infections occur as outbreaks and can have fatal consequences for patients.

[0041] In certain embodiments presented herein, modified water can be used to facilitate cleaning of device lumens (e.g., endoscope lumens). As used herein, modified water refers towater that has been chemically treated, such as ozonated water, PAW, and / or other water treated with other chemistries / formulations. As described further below, the techniques presented herein can use modified water for cleaning device lumens, use modified water in combination with untreated water for cleaning device lumens, and / or use modified water in combination with and / or as a part of a contaminant-detaching cleaning action, such as a slurry (e.g., cleaning shots of a liquid-powder mixture / contaminant-detaching fluidic composition) and / or a fluid applied with a sufficient force or with a particular flow (e.g., turbulent flow), to clean device lumens. Stated differently, in accordance with aspects presented herein, a contaminant-detaching cleaning action could be provided in a variety of manners. In certain examples, a contaminant-detaching cleaning action is provided by flowing a slurry (e.g., a shot of a slurry) through a lumen. In other examples, a contaminant-detaching cleaning action is provided using a flow of a fluid with sufficient force. FIGs. 2, 3A, 3B, and 4 generally describe techniques for use of modified water for cleaning a device lumen.

[0042] More specifically, FIG. 2 illustrates an exemplary method 240 for use of a modified water flow to clean a lumen (e.g., of the endoscope 100). The method 240 begins at 242 where a lumen cleaning device obtains modified water. The modified water can be obtained by a lumen cleaning device in a number of different manners, such as from an external source, created by / in the lumen cleaning device, obtained from an internal storage system, etc.

[0043] In some embodiments, modified water can be formed via a chemical process by infusing water with ozone, such as via ultraviolet light to convert oxygen to ozone, corona discharge to split oxygen molecules, electrolysis to split water molecules into ozone and other reactive oxygen species, and / or proton exchange membrane technology, which can be implemented using one or more products manufactured by Biosure®, to produce high-purity ozone directly into water using a membrane and applying electrical energy to split oxygen atoms from hydrogen atoms and a mechanism (e.g., an electrode with high oxidation ability) to join oxygen atoms to form ozone. As another example, water is purified or treated with cold plasma, such as using a dielectric barrier discharge or atmospheric plasma as cold plasma to interact with water, to transfer reactive oxygen and nitrogen species (e.g., hydroxyl radicals, hydrogen peroxide, nitrate, nitrite, ozone) to the water. Such a process can use oxygen, air, argon, and / or nitrogen.

[0044] The method 240 includes, at 244, flowing modified water through a lumen. In some embodiments, modified water is delivered as a continuous flow through the lumen over a period of time. In additional or alternative embodiments, modified water is delivered as discrete flows,sometimes referred to herein as a “modified water shot.” As described elsewhere herein, the modified water can be delivered with different velocities / flow rates. In addition, in certain examples, the modified water can be retained / held within a lumen for a period of time. The modified water can, in certain examples, produce a chemical reaction with contaminants within the lumen, thereby weakening adhesion of the contaminants to a surface (e.g., a wall) of the lumen and enabling the contaminants to be more readily separated from the surface.

[0045] The method 240 further includes, at 246, intermittently delivering air flows to the lumen. These air flows can be delivered with the modified water or separate from the modified water. For example, in certain examples, pulses of air are delivered periodically or at a selected frequency (e.g., at respective intervals of time). In some arrangements, the air disrupts the flow of modified water to induce a turbulent flow in which portions of the modified water undergo various changes in direction and / or magnitude of flow. Consequently, the modified water imparts a greater force against the contaminants relative to the surface of the lumen. Therefore, after adhesion of the contaminants to the surface has been weakened via the flow of modified water through the lumen (e.g., without delivery of air flows to the lumen), the disrupted flow of modified water effectuated by delivery of air flows to the lumen facilitates separation of the contaminants from the surface. For this reason, intermittently delivering air flows to the lumen improves removal of contaminants from the lumen via the modified water, such as in comparison to flowing modified water through the lumen without delivering air flows to the lumen.

[0046] In some embodiments, the air flows are intermittently delivered to the lumen by repeatedly alternating between delivering pressurized air and suspending delivery of pressurized air. That is, pressurized air is delivered for a first duration of time (e.g., between 5 seconds and 15 seconds) with the modified water, and after the first duration of time has elapsed, delivery of pressurized air is suspended for a second duration of time (e.g., between 1 second and 3 seconds) to flow modified water into the lumen without delivery of air. After the second duration of time has elapsed, pressurized air is delivered again (e.g., for the same or different duration of time). As an example, the modified water and air are delivered at substantially similar pressures (e.g., around 200 kilopascal (kPa) or 29 psi) to facilitate mixture to flow through the lumen. Additionally or alternatively, air is delivered at a higher pressure than that of modified water to facilitate entrainment of air within the modified water. In certain embodiments, the parameters (e.g., duty cycle, amounts, ratio, etc.) controlling delivery of air and / or of modified water can be modified during a cleaning process. For instance, feedbackdata, such as related to a cleaning quality, a flow property of air and / or of modified water, a property of the lumen, and so forth, can be utilized to adjust the parameters accordingly.

[0047] FIG. 3A illustrates the flow of modified water 358 through a lumen 352 to remove contaminants 354 from inner surface / walls 356 of the lumen 352, where the general direction of travel of the modified water 358 is represented by arrows 361. In this example, the modified water 358 is delivered through the lumen 352 to chemically interact with the walls 356 and facilitate removal of the contaminants 354 therefrom. For example, the chemical reaction effectuated by the modified water 358 can reduce adhesion of the contaminants 354 to the walls 356.

[0048] In some embodiments, the modified water 358 is delivered as a continuously flow (e.g., as opposed to intermittently modified water shots). In some embodiments, air flows 360 are intermittently delivered to the lumen 352 with the modified water 358 to interrupt the flow of modified water 358. For instance, the air flows 360 are delivered as pulses (e.g., turbulent pulses) of air through the modified water 358. The air flows 360 disrupt the flow of the modified water 358 through the lumen 352, such as by inducing flow (e.g., turbulent flow) of the modified water 358 toward the walls 356 to impinge against the contaminants 354. As a result, the air flows 360 cause the modified water 358 to physically interact with the contaminants 354 by imparting a force that creates a contaminant-detaching action urging the contaminants 354 to separate from the walls 356. In some cases, the flow of modified water 358 can change configurations during flow through the lumen 352. By way of example, the flow of modified water 358 may be initially concentrated at a center of the lumen 352, and an air flow 360 adjusts a profile of the flow of modified water 358 to cause the modified water 358 to transition to an annular flow (e.g., with the air flow 360 flowing through a center opening of the modified water 358) further downstream of the lumen 352.

[0049] Although FIGs. 2 and 3 A provide examples in which modified water flows continuously through a lumen while air flow is intermittently delivered into the lumen, it should be noted that modified water and air flow can be utilized in any other suitable manner with respect to one another in which the air flow interrupts the modified water flow to provide a contaminant-detaching cleaning action. In one example, air flows continuously through the lumen (e.g., to provide a contaminant-detaching cleaning action), and modified water is intermittently delivered with the air (e.g., to provide intermittent chemical cleaning). In another example, air and modified water are alternately delivered to the lumen. That is, air is delivered without modified water for a first duration of time, and modified water is delivered without airfor a second duration of time separate from the first duration of time (e.g., after the first duration of time has elapsed). Thus, air is interspersed between modified water flows.

[0050] Moreover, although FIGs. 2 and 3A discuss usage of air flow to cause the modified water to provide contaminant-detaching cleaning action, the flow of modified water can be interrupted in a different manner to provide the contaminant detaching cleaning action. For instance, applying a sufficient force to the modified water can induce flow (e.g., turbulent flow) of the modified water 358 to impinge against the contaminants 354. Indeed, any suitable adjusted flow of the modified water 358 to impart a sufficient force against the contaminants 354 can create the contaminant detaching cleaning action via the modified water 358.

[0051] FIG. 3B illustrates another flow of modified water 375 through the lumen 352. In certain examples, FIG. 3A represents one stage / phase of a cleaning process, while FIG. 3B represents another stage / phase of the cleaning process. More specifically, in certain examples, before or after the modified water 358 is delivered through the lumen 352 with intermittent air flows 360 (as in FIG. 3A), the modified water 375 is delivered through the lumen 352 without any air. For instance, the modified water 375 is used for flushing with chemical cleaning over a period of time in which the general direction of travel of the modified water 375 is again represented by arrows 361.

[0052] In one example, the modified water 375 is configured to remove residuals 347 from the lumen 352. The residuals 347 can comprise, for example, some remaining portion of the contaminants 354 that may remain on the walls of the lumens 352 after passage of the modified water 358 with air flows 360 (e.g., the contaminants 354 can break up, a portion of which can remain on the walls 356 of the lumen 352).

[0053] In certain embodiments, the modified water 375 is delivered as a continuous flow (e.g., with a contiguous body). In additional or alternative embodiments, a fluid flow (e.g., air) is interspersed between flows of the modified water 375. That is, the modified water 375 can be delivered intermittently, and adjacent portions of the modified water 375 are at least initially separated by a fluid flow that does not include any modified water 375. For instance, the modified water 375 is pulsed through the lumen 352. However, in some cases, the initially separated portions of modified water 375 can combine downstream in the lumen 352. For example, turbulent flow of the modified water 375 and / or of the fluid flow between adjacent portions of the modified water 375 can cause adjacent portions of the modified water 375 to flow past the intermediate fluid flow and toward one another.

[0054] FIG. 4 is a schematic diagram illustrating an example use of modified water with a lumen cleaning system 470, in accordance with embodiments presented herein. In certain examples, the lumen cleaning system 470 can be implemented as described in co-owned International Patent Publication No. WO2022256871A1, the content of which is hereby incorporated by reference herein. However, it is to be appreciated that the lumen cleaning system 470 could also have other arrangements.

[0055] In the example of FIG. 4, the lumen cleaning system 470 is schematically shown as being fluidically connected to the endoscope 100 using modified water and air. To this end, the lumen cleaning system 470 includes a module 472 for providing modified water to the endoscope 100. For instance, the module 472 is configured to store and / or produce the modified water and direct the modified water toward the endoscope 100. The lumen cleaning system 470 is also configured to interface with an air source 474 via an air line 476 to receive air flows for directing toward the endoscope 100.

[0056] During operation of the lumen cleaning system 470, the module 472 provides modified water to the endoscope 100, and the lumen cleaning system 470 intermittently directs air from the air source 474 to the endoscope 100. Thus, such operation of the lumen cleaning system 470 intermittently delivers air flows to the endoscope 100 with the modified water to provide both a contaminant-detaching cleaning action and a chemical cleaning action for a lumen of the endoscope 100. Additional or alternative operations of the lumen cleaning system 470 include delivering a continuous air flow to the endoscope 100 while intermittently directing modified water to the endoscope 100 and / or alternately directing separate flows of air and modified water to the endoscope 100.

[0057] Although the illustrated lumen cleaning system 470 includes the module 472, in additional or alternative embodiments, the lumen cleaning system 470 is configured to receive modified water from an external source (e.g., an external module fluidly coupled to the lumen cleaning system 470). In further embodiments, the lumen cleaning system 470 is configured to store air therein in addition to or as an alternative to receiving air from the air source 474 via the air line 476.

[0058] In some implementations, a sensor 478 can be incorporated to monitor various parameters during operation of the lumen cleaning system 470, and the lumen cleaning system 470 can adjust delivery of modified water and / or of air to the endoscope 100 based on data received from the sensor 478. For example, such data is associated with a cleanliness of theendoscope 100, a flow property of the modified water and / or of the air, and the like. Thus, the sensor 478 can help the lumen cleaning system 470 operate more suitably to clean the endoscope 100.

[0059] As noted, the techniques presented herein can use modified water for cleaning device lumens, use modified water in combination with untreated water for cleaning device lumens, and / or use modified water in combination with a contaminant-detaching cleaning action, such as a slurry (e.g., cleaning shots of a liquid-powder mixture / contaminant-detaching fluidic composition), to clean device lumens. While not wishing to be bound by theory, it is believed that the chemical properties of the modified water (e.g., high oxidation potential, reduction properties, etc.) can at least partially destroy / weaken the attachment of biofilms on the walls of the lumen. As a result, the combination of modified water (to at least partially destroy biofilm) and a contaminant-detaching cleaning action, such as a slurry (e.g., to physically remove biofilm), can more thoroughly clean device lumens. Indeed, modified water can be used in combination with any suitable contaminant-detaching cleaning action.

[0060] In the examples of FIGs. 2 and 3A, the delivery of air pulses / pressurized air (e.g., along with, or separate from the modified water flow) provide the contaminant-detaching cleaning action. That is, in the embodiments of FIGs. 2 and 3A, the air pulses / pressurized air are the “contaminant-detaching flows.” However, it is to be appreciated that the contaminantdetaching flows can have other arrangements. For example, in certain examples, a modified water flow itself can be a contaminant-detaching flow that is utilized to provide the contaminant-detaching cleaning action (e.g., by adjusting a flow parameter of the modified water flow). In other embodiments, a liquid-powder mixture flow can be used as a contaminant-detaching flow that is utilized to provide the contaminant-detaching cleaning action. FIGs. 5-13 generally describe use of liquid-powder mixture flows in combination with modified water, in accordance with certain embodiments presented herein.

[0061] More specifically, FIG. 5 illustrates an exemplary method 563 of cleaning a lumen / channel of a medical device using modified water and a contaminant-detaching flow in the form of a liquid-powder mixture flow. The method 563 includes, at 565, delivering modified water through at least a portion of the lumen / channel to be cleaned. The modified water can create a chemical action to reduce adhesion of contaminants to walls of the lumen / channel. At 567, a liquid-powder mixture flow (contaminant-detaching fluidic composition) is delivered through at least a portion of the lumen / channel to interrupt the flow of modified water. The liquid-powder mixture creates a contaminant-detaching action thatphysically separates the contaminants from the walls to remove the contaminants from the lumen / channel, thereby cleaning the lumen / channel. For example, delivering the modified water can loosen the contaminants from the walls and / or weaken the structural integrity of biofilms and bacterial colonies, rendering them more susceptible to a subsequent contaminantdetaching cleaning action. The structurally weakened biofilms and bacteria can thereby be more efficiently removed via the liquid-powder mixture to improve efficacy of the liquidpowder mixture. In such an arrangement, the modified water flow can be considered a “precleaning flow.”

[0062] A liquid-powder mixture flow can safely interact with the lumen / channel to provide a contaminant-detaching cleaning action by imparting a force (e.g., a shear force) onto unwanted matter relative to a surface (e.g., a wall) of the lumen / channel to remove the unwanted matter via physical contact. The liquid-powder mixture (e.g., a contaminant-detaching fluidic composition) is sometimes referred to herein as a “slurry.” The liquid-powder mixture propelled through the lumen / channel removes unwanted matter via physical contact. In accordance with embodiments presented herein, modified water can be used to enhance the efficacy of the liquid-powder mixture.

[0063] Any suitable liquid-powder mixture composition may be implemented. As can be appreciated, the liquid component of the mixture can facilitate the fluidity of the mixture, while the presence of the powder can act to interact with, such as contact, the walls of the target lumen / channel to impart a force that urges contaminants to separate from the walls and thereby clean the lumen / channel. In accordance with certain examples, the powder component of the liquid-powder mixture is present within the mixture in amounts greater than the respective saturation limit within the respective liquid, which can facilitate a cleaning interaction between the mixture and the walls of the lumen / channel.

[0064] In certain embodiments, the liquid-powder mixture comprises mixture of sodium bicarbonate powder and water, where the sodium-bicarbonate is present in an amount greater than the respective saturation level. For example, in a number of embodiments, sodiumbicarbonate can, at certain stages, be present in an amount greater than 10% of the mixture by mass. It has been determined that a mixture of sodium bicarbonate and water can be particularly effective in the disclosed application. Moreover, these constituent components are readily available. However, it would be appreciated that any suitable liquid-powder mixture can be used in alternative examples. One consideration for powder selection may be that it has a Mohs hardness higher than that of a target biofdm / bioburden to facilitate removal of thebiofilm / bioburden from the walls of the lumen / channel, while having a Mohs hardness lower than that of the walls to avoid wear of the walls.

[0065] In some arrangements, the powder in the mixture is present in an amount below the respective saturation of the associated liquid. However, the liquid is delivered to the target lumen / channel prior to complete dissolution of the powder in the liquid. In this way, the undissolved powder can still interact with the target lumen / channel to be cleaned.

[0066] In certain embodiments, the method 563 is repeated one or more times. That is, modified water flows and liquid-powder mixture flows are alternately directed through the lumen / channel. In this manner, the modified water flows can be considered “intra-cleaning flows” in which the modified water is interspersed between contaminant-detaching cleaning actions (e.g., adjacent liquid-powder mixture flows). This roughly contemporaneous application of chemical and contaminant-detaching cleaning actions can provide a multi-modal assault on contaminants, improving the overall efficacy of the cleaning cycle.

[0067] By way of example, there may be a chemical reaction between the modified water and the content of the liquid-powder mixture (e.g., sodium bicarbonate) that enhances the contaminant-detaching cleaning action, such as by combining ozonated modified water with sodium bicarbonate in the liquid-powder mixture to form carbon dioxide and heat to increase a pressure inside the lumen / channel to enhance an overall cleaning action. Furthermore, the modified water could be used as a “post-cleaning flow” for delivery after the liquid-powder mixture flow. For example, the initial cleaning stage can exclusively involve the delivery of liquid-powder mixture flow(s) through the lumen(s), and then this initial stage can be followed by a subsequent flow of modified water. This post-treatment step can ensure thorough cleaning of residual bacterial contaminants. Indeed, modified water can be delivered at any of a number of different stages of a device lumen cleaning cycle, including various combinations of stages.

[0068] Further still, in certain embodiments, air flows can be delivered (e.g., intermittently delivered) with the modified water. For instance, the air flows can change the modified water flow (e.g., to create a turbulent flow) that also enables the modified water to physically interact / abrade with the contaminants and facilitate removal. Thus, both the liquid-powder mixture and the modified water (effectuated by the air flows) can provide the contaminantdetaching cleaning action. It is also to be appreciated that although modified water is described / illustrated in this instance, in some embodiments, regular (unmodified) water can be delivered at the above or other stages of the cleaning cycle.

[0069] FIG. 6A illustrates an exemplary method 668 of cleaning a lumen / channel of a medical device using modified water and liquid-powder mixture. The method 668 begins at 669 with creating, mixing, or otherwise obtaining a liquid-powder mixture having any suitable composition discussed herein. For example, in certain embodiments, a powder is obtained from a cartridge and / or a consumable chamber / container, water is obtained from a tap, and these constituent components are mixed within a holding chamber (or within a consumable chamber itself) proximate (e.g., within days or weeks) to the time of cleaning. This approach may be advantageous insofar as powders such as sodium bicarbonate can be relatively stable and can have a long shelf life and suitable sources of water are readily available. However, in other embodiments, the mixture may be obtained in an already mixed form.

[0070] The method 668 includes at 671 , apportioning the liquid-powder mixture into a suitable amount (e.g., a cleaning shot). The apportioned amount of the liquid-powder mixture can be provided in any of a variety of ways. For example, in certain embodiments, a valve may be used to draw a target amount of liquid-powder mixture from a reservoir (e.g., the holding chamber, consumable chamber). In some embodiments, a self-regulating pressurized system is used to draw a suitable amount of liquid-powder mixture from the reservoir.

[0071] The method 668 also includes, at 673, delivering (e.g., propelling) the apportioned amount of the liquid-powder mixture through at least a portion of a lumen / channel to be cleaned, such as via a carrier fluid (e.g., air, water) that entrains the liquid-powder mixture. The apportioned amount of the liquid-powder mixture is delivered in a manner (e.g., suitable size, suitable velocity, etc.) to provide an appropriate physical interaction between the liquid-powder mixture and the walls of the lumen / channel such that the undissolved powder will physically contact against the walls of the lumen / channel and / or contaminants (e.g., bioburdens) to remove the contaminants from the walls. Delivering discrete amounts of the liquid-powder mixture can be advantageous insofar as the discrete amounts can be delivered periodically at suitable velocities, and the periodic application of the composition can help facilitate the cleaning of the lumen / channel while avoiding clogging / blocking of the lumen / channel. Moreover, the discrete nature of the delivered amounts can facilitate the maintenance of a suitable delivery velocity, which can also aid cleaning. For example, delivering the liquidpowder mixture continuously (and not in discrete, apportioned amounts) might risk clogging or otherwise obstructing the lumen / channel to reduce the velocity at which the liquid-powder mixture flows through the lumen / channel and can thereby impact cleaning efficacy.

[0072] The method 668 can be iterated any number of times to provide any suitable quantity of apportioned amounts of the liquid-powder mixture to facilitate the cleaning of the lumen / channel. In some embodiments, a parameter associated with the apportioned amounts of liquid-powder mixture and / or associated with the delivery apportioned amounts of liquidpowder mixture can be adjusted. In other words, apportioned amounts of liquid-powder mixture having different parameters can be used to clean the lumen / channel. For instance, a size, a composition, a velocity, and the like of apportioned amounts of the liquid-powder mixture can be adjusted. Such an adjustment can be based on feedback data, such as a cleaning efficacy and / or an amount of contaminants. Thus, using apportioned amounts of liquid-powder mixture can enable the usage of liquid-powder mixture to be more readily adjusted to clean the lumen / channel more suitably.

[0073] Moreover, different amounts of liquid-powder mixture may be differently suitable for the different characteristics of lumens / channels to be cleaned. For example, air / water channels within an endoscope are typically amongst the narrowest lumens and, accordingly, may be more suitably cleaned with relatively smaller amounts of a liquid-powder mixture (whereas using larger amounts of a liquid-powder mixture may result in blocking such a narrow lumen). In contrast, the suction / biopsy channels of an endoscope are typically amongst the widest lumens and, accordingly, may be more suitably cleaned with relatively larger amounts of liquid-powder mixture. Accordingly, the amount of liquid-powder mixture apportioned for use in cleaning a given lumen is a function of the geometry of the lumen to be cleaned. It should of course be appreciated that the amount of liquid-powder mixture apportioned can also or alternatively be a function of any of a variety of parameters, including those that relate to the target.

[0074] FIG. 6B illustrates the delivery of one cleaning shot 648 (e.g., an apportioned amount of a liquid-powder mixture) through a lumen 652 to remove contaminants 654 from an inner surface / walls 656 of the lumen 652, where the general direction of travel of the cleaning shot 648 is represented by arrows 661. It is further illustrated that the cleaning shot 648 is delivered through the lumen 652 to physically interact with the inner surface / walls 656 and thereby remove the contaminants 654 therefrom. The cleaning shot 648 can be considered to be entrained within a carrier fluid, represented by arrows 663.

[0075] In general, cleaning shots presented herein, such as the cleaning shot 648, can have different forms / arrangements. For example, in certain embodiments, a cleaning shot presented herein can be a relatively singular / unitary mass (e.g., potentially substantially occluding thelumen while traveling therethrough), which is sometimes referred to herein as a “unitary shot.” However, in other embodiments, a cleaning shot can be an “agglomeration” or “cluster” of smaller masses / groups that travel through the lumen as a loose group (e.g., potentially not occluding the lumen while traveling therethrough), sometimes referred to herein as a “cluster shot.” FIG. 6B schematically illustrates an example in which the cleaning shot 648 is a cluster shot. In certain embodiments, a cleaning shot can transition between different forms during the shot’s life cycle. For example, a cleaning shot could be apportioned (initially created) as a unitary shot, but then transition to a cluster shot. This transition could occur before entering the lumen 652 (e.g., in a delivery chamber) and / or while traveling through the lumen.

[0076] Importantly, it should be appreciated that in certain embodiments, the cleaning shots 648 are delivered through the lumen 652 sequentially (e.g., one-at-a-time). In general, the use of a series of discrete / individual cleaning shots 648, as opposed to a single large flow, can allow the individual cleaning shots 648 to maintain sufficient kinetic energy to pass through the lumen 652 at a rate that allows the particles (powder) within the cleaning shots 648 to advantageously interact with, and remove contaminants 654 from, the inner surface / walls 656.

[0077] Modified water can be used in any suitable manner with respect to the cleaning shots 648 discussed in FIGs. 6A and 6B to provide a chemical cleaning action. In certain embodiments, modified water can be used as at least a portion of the liquid for forming the liquid-powder mixture. In other words, a powder material is mixed within the modified water to create the liquid-powder mixture containing at least the modified water and the powder material, and such a liquid-powder mixture is apportioned for delivery to at least a portion of the lumen 652. In additional or alternative embodiments, modified water is used as the carrier fluid to deliver the cleaning shot 648 to at least a portion of the lumen 652. In further embodiments, a flow of modified water is delivered to the lumen 652 separately from the liquid-powder mixture. That is, modified water without powder material is delivered to the lumen 652 (e.g., before or after a cleaning shot 648 is delivered to the lumen 652), and the cleaning shots of the liquid-powder mixture interrupt the flow of modified water. For example, cleaning shots 648 are interspersed between flows of modified water such that adjacent cleaning shots 648 are at least initially separated by modified water flows that do not contain any powder material. In some circumstances, initially separated cleaning shots 648 can combine downstream in the lumen 652, such as due to turbulent flow of the modified water and / or of the cleaning shots 648. In any case, the modified water weakens adhesion of thecontaminants 654 to the walls 656 to increase efficacy of a contaminant-detaching action provided by the cleaning shot 648.

[0078] FIG. 7 illustrates another exemplary method 749 for cleaning a lumen / channel of a medical device, providing further details related to usage of the liquid-powder mixture. The method 749 begins at 751 with the providing of a holding chamber containing a powder. For example, in some embodiments, providing the holding chamber is achieved via a durable chamber configured to receive powder, e.g., via a cartridge. Such a chamber may be considered to be “durable” insofar as it is intended to be operable for the lifetime of the system. In certain embodiments, providing the holding chamber is achieved via a disposable / consumable chamber that inherently includes the powder. Such a disposable / consumable chamber may be provided with sufficient powder to enable multiple cleaning cycles, after which they are “consumed” (depleted). Thereafter, users can obtain additional disposable / consumable chambers that inherently include the powder.

[0079] The method 749 further includes, at 753, adding liquid to the holding chamber to create a fluidic liquid-powder mixture. In certain embodiments, the liquid can be received from a liquid source that is dedicated to servicing the holding chamber. In further embodiments, a liquid source is used both to provide liquid to the holding chamber and to provide liquid to act as a carrier fluid. Such a configuration can enable for a more efficient design. The liquid can include modified water, thereby creating a liquid-mixture that contains the powder and modified water.

[0080] The method 749 further includes, at 755, providing a portion (e.g., a cleaning shot) of the liquid-powder mixture to a delivery chamber. For example, a valve may be used to provide a portion of the liquid-powder mixture to the delivery chamber. In certain embodiments, the size of the portion of the of the liquid-powder mixture provided to the delivery chamber is a function of a characteristic (e.g., a size) of the lumen / channel to be cleaned.

[0081] The method 749 further includes, at 757, delivering the portion of the liquid-powder mixture to the lumen / channel using a carrier fluid. In effect, the liquid-powder mixture can be made to interact with the lumen (e.g., akin to a “brushing” action). The carrier fluid can include modified water in some embodiments. As illustrated, providing a portion of the liquid-powder mixture to the delivery chamber and subsequently delivering the portion of the liquid-powder mixture to the lumen / channel can be iterated a plurality of times to effectuate the cleaning of the lumen / channel.

[0082] Cleaning shots of liquid-powder material can be implemented in a number of different manners with a number of different lumens. For context, one specific example implementation is described with reference to cleaning at least part of the endoscope 100 of FIG. 1.

[0083] More specifically, in one example cleaning process / cycle, one (1) cleaning shot is fired / shot into the water-jet channel 128 via the water-jet connector 138, nine (9) cleaning shots are then fired into the biopsy / suction channel 122 via the suction connector 137, one (1) cleaning shot is then fired into the water-jet channel 128 via the water-jet connector 138, three (3) cleaning shots are then fired into the distal section 122B of the biopsy / suction channel 122 via the biopsy valve 118, one (1) cleaning shot is then fired into the water-jet channel 128 via the water-jet connector 138, and then nine (9) cleaning shots are fired into the biopsy / suction channel 122 via the suction connector 137. The cleaning cycle can further include firing / shooting six (6) cleaning shots into the air channel 124 via the air connector 143 and firing six (6) cleaning shots into the water channel 126 via the water connector 141 (e.g., in parallel). The firing of the cleaning shots within each target lumen can be preceded by, or followed by, a fluid flow. The cleaning shots and fluid flows can be delivered via one, or possible multiple connectors (e.g., one connector for the air pipe and one connector for the air / water bottle).

[0084] In certain examples, approximately 180-200 grams of a slurry could be used to clean a typical flexible GI endoscope. For example, approximately 80-100 grams can be used to clean a relatively large channel (e.g., suction / biopsy channel 122) with 21 shots in total and an approximately 15 second delay between each shot. For a relatively small channel (e.g., air / water channels), the process can use approximately 60-80 grams with 12 shots in total and an approximately 30 second delay between each shot. For other small channels (e.g., water-jet channel 128), the process can use approximately 10-20 grams with 3 shots in total and an approximately 30 second delay between each shot. Again, each of these channels can also receive a subsequent fluid flow (e.g., after each cleaning shot).

[0085] As noted above, cleaning shots are delivered to a target lumen with a velocity that is suitable / sufficient to remove contaminants from the walls of the target lumen. The velocity of the cleaning shots can vary, for example, based on the attributes of the target lumen, the attributes of the liquid-powder mixture (slurry) used to form the shot, etc. In one illustrative example, the shot velocity for a relatively large lumen may be around 1000 mm / second.

[0086] In addition, the cleaning shots can be delivered within specific pressure and fluid flow (air) ranges. In certain examples, the cleaning shots can be delivered with a pressure up to approximately 180 kPa or 26 psi, such as by using air as a carrier fluid, up to approximately 165 kPa or 24 psi, such as by using water as a carrier fluid, etc. Example air flow metrics can include approximately 50 standard liter per minute (SLPM) for a large channel with no load, approximately 11-17 SLPM for a large channel during dosing, approximately 7-10 SLPM for a large channel during full load, approximately 5-7 SLPM for a small channel with no load, and / or approximately 0. 1 SLPM for a small channel during full load. It is to be appreciated that these ranges and values are merely illustrative.

[0087] PIG. 8 is a schematic diagram illustrating an example use of modified water with liquidpowder mixture via a lumen cleaning system 870. In certain examples, the lumen cleaning system 870 can be implemented as described in co-owned International Patent Publication No. WO2022256871A1. However, it is to be appreciated that the lumen cleaning system 870 could also have other arrangements. The lumen cleaning system 870 is schematically shown as being fluidically connected to the endoscope 100.

[0088] The lumen cleaning system 870 includes a holding chamber 877 for creating / housing a liquid-powder mixture, and the lumen cleaning system 870 interfaces with an air source 874 via an air line 872. The illustrated lumen cleaning system 870 also interfaces with a modified water source 879 via a water line 880. A module 876 for providing modified water is disposed between the modified water source 879 and the lumen cleaning system 870 (e.g., along the water line 880). The module 876 is configured to deliver modified water (e.g., apportioned amounts of modified water) to the lumen cleaning system 870 for subsequent delivery to the endoscope 100. The operation of the module 876 can be controlled by the lumen cleaning system 870 and / or a separate control device (not shown in FIG. 8).

[0089] As shown in FIG. 8, the module 876 is placed upstream of the lumen cleaning system 870 system so that modified water can be selectively generated as needed. However, it is to be appreciated that the module 876 could be integrated with, or used with, the lumen cleaning system 870 in different configurations. Similarly, in additional or alternative embodiments, the lumen cleaning system 870 could be integrated with the air source 874 or otherwise configured to produce / store air without having to interface with an external air source 874.

[0090] Operation of the lumen cleaning system 870 enables any suitable manner in which liquid-powder mixture, modified water, and / or air is delivered to the endoscope 100. As anexample, the lumen cleaning system 870 is configured to apportion an amount of the liquidpowder mixture from the holding chamber 877 and deliver the apportioned amount to the endoscope 100. In such an operation, the lumen cleaning system 870 can deliver the modified water to the endoscope 100 before or after the apportioned amount is delivered to the endoscope 100 (e.g., for pre-cleaning flow, post-cleaning flow, intra-cleaning flow). That is, the lumen cleaning system 870 delivers the modified water and the liquid-powder mixture separately from one another. As another example, the lumen cleaning system 870 can utilize modified water to create a portion of the liquid-powder mixture within the holding chamber 877 for subsequent delivery to the endoscope 100. As a further example, the lumen cleaning system 870 utilizes the modified water as a carrier fluid for propelling the liquid-powder mixture to the endoscope 100. In any of these examples, the lumen cleaning system 870 can selectively deliver modified water and / or liquid-powder mixture for providing chemical cleaning action and contaminantdetaching cleaning action, respectively, for the endoscope 100. Similarly, the lumen cleaning system 870 can also selectively deliver air to the endoscope 100, such as before / after an apportioned amount of liquid-powder mixture is delivered to the endoscope 100 and / or as a carrier fluid for propelling the liquid-powder mixture to the endoscope 100. Additionally or alternatively, the lumen cleaning system 870 can deliver air with the modified water to cause the modified water to create the contaminant-detaching cleaning action (e.g., in addition to or as an alternative to the contaminant-detaching cleaning action provided by the liquid-powder mixture).

[0091] In some implementations, a sensor 878 can be incorporated to monitor various parameters during operation of the lumen cleaning system 870, such as in accordance with techniques discussed in International Patent Publication No. WO2024246706A1, the content of which is hereby incorporated by reference herein, and the lumen cleaning system 870 can adjust delivery of modified water, of air, and / or of liquid-powder mixture to the endoscope 100 based on data received from the sensor 878, such as by adjusting a duty cycle and / or an amount associated with the modified water, the air, and / or the liquid-powder mixture being delivered to the endoscope 100. For example, such data is associated with a cleanliness of the endoscope 100, a flow property of the modified water, of the air, and / or of the liquid-powder mixture, and the like. Thus, the sensor 878 can help the lumen cleaning system 870 operate more suitably to clean the endoscope 100.

[0092] It is to be appreciated that systems for cleaning a lumen of a medical device, in accordance with embodiments presented herein, can take any of a number of differentforms / arrangements. For example, in many embodiments, the systems include: a holding chamber for creating / housing a powder and / or liquid-powder mixture, as well as a mechanism for delivering a portion of the liquid-powder mixture to a target lumen. FIGS. 9, 10, 11A, and 1 IB illustrate various aspects of example systems that can be implemented in accordance with embodiments presented herein.

[0093] Referring first to FIG. 9, shown is a system 990 for cleaning a target lumen of a medical device using a liquid-powder mixture, in accordance with embodiments presented herein. More specifically, the system 990 includes a holding chamber 992 for creating / housing a liquidpowder mixture 994. In the illustrated embodiment, the holding chamber 992 is provided with the powder that is used to form the liquid-powder mixture 994. For example, the holding chamber 992 may be a consumable component of the system 990 and may be replaced when its contents have been used. The holding chamber 992 interfaces with an inlet valve 996 for receiving liquid from a liquid source 998. A relief valve 982 can be used to relieve pressure created during creation of the liquid-powder mixture 994. As can be appreciated, the liquidpowder mixture 994 can be created using any suitable constituent components. For example, in certain embodiments, the powder that is provided with the holding chamber 992 is sodium bicarbonate, and the liquid source 998 is a source for water (e.g., modified water, unmodified water). Of course, it can be appreciated that the holding chamber 992 can receive liquid and powder in any of a variety of ways in accordance with embodiments of the invention. For example, in some embodiments, the holding chamber 992 is configured to receive powder from a powder reservoir, e.g., a sodium bicarbonate cartridge. In some embodiments, a pump is used to provide liquid to the holding chamber 992 in lieu of directly using a valve to do so. In some embodiments, the holding chamber 992 may include mechanisms (not illustrated) for facilitating the mixing of the received powder and liquid. For example, a stirring mechanism or an agitation mechanism may be implemented to facilitate mixing.

[0094] The system 990 further includes a delivery mechanism 984 for delivering apportioned amounts (e.g., cleaning shots) of the liquid-powder mixture 994 to the target lumen. In the illustrated embodiment, the delivery mechanism 984 is in the form of an aggregate of a carrier fluid source 986, a first valve 988, and a second valve 964. As can be appreciated, the carrier fluid may be made to flow through the target lumen via the first valve 988, and apportioned amounts of the liquid-powder mixture 994 may be entrained within this carrier fluid flow. It should be noted that any suitable carrier fluid may be implemented. For example, the carrier fluid source 986 may comprise at least one of: air, water (e.g., modified water, unmodifiedwater), ethanol, nitrogen, and carbon dioxide. In the illustrated embodiment, the second valve 964 is configured to implement an apportioned amount of the liquid-powder mixture 994 that is entrained within the carrier fluid. For example, the second valve 964 may be open to the holding chamber 992, and the holding chamber 992 may be pressurized via the liquid source 998 and the inlet valve 996, thereby resulting in delivery of an apportioned amount of the liquid-powder mixture 994 to the delivery mechanism 984 while the second valve 964 is open. Of course, it should be appreciated that any suitable mechanism for implementing the amount to be entrained within the carrier fluid may be applied in accordance with embodiments of the present invention.

[0095] While one system architecture for cleaning a medical device having a lumen has been illustrated, it should be appreciated that the described concepts can be implemented in any of a variety of ways in accordance with embodiments of the invention. For example, in some embodiments, the carrier fluid source is additionally used to create the liquid-powder mixture 994 and, therefore, a separate liquid source (e.g., the liquid source 998) may not be necessary. In some embodiments, a selectable plurality of carrier fluid sources can be implemented. Thus, for instance, in some embodiments, an air source and a water source can each supply carrier fluid for delivery of liquid-powder mixture 994 to the lumen, and the water source may further be used to facilitate the creation of the liquid-powder mixture 994. In some embodiments, the holding chamber 992 may include a discrete pressure source to facilitate the delivery of an apportioned amount of the liquid-powder mixture 994 to the delivery mechanism 984, such that the liquid source does not have to facilitate said delivery.

[0096] In certain embodiments, a separate chamber is implemented to facilitate the propulsion of the liquid-powder mixture through the lumen to be cleaned. For example, FIG. 10 illustrates a system 1090 that includes a holding chamber 1092 for creation / housing of a liquid-powder mixture 1094 and a delivery chamber 1093 for developing the flow (e.g., velocity) ofthe liquidpowder mixture 1094 for subsequent delivery through the lumen. In the illustrated embodiment, a powder source 1091 is coupled to the holding chamber 1092 via a first inlet valve 1082, and a liquid source 1098 is coupled to the holding chamber 1092 via a second inlet valve 1096. The powder source 1091 may be, for example, a cartridge, and the liquid source 1098 may be, for example, a pressure-regulated mains water.

[0097] As noted, the system 1090 also comprises the delivery chamber 1093 for delivery of an apportioned amount of the liquid-powder mixture 1094 to the target lumen to be cleaned. As shown, the delivery chamber 1093 is coupled to each of two carrier fluid sources 1086A and1086B via respective valves 1088A and 1088B. For example, air and water (e.g., modified water, unmodified water) may serve as carrier fluids for the illustrated system 1090. The amount of liquid-powder mixture 1094 to be entrained in the carrier fluid can be controlled by a valve 1064.

[0098] In general, one example purpose of a delivery chamber presented herein, such as the delivery chamber 1093, is to create an air gap between the holding chamber 1092 and the target lumen to be cleaned. The creation of the air gap provides a location (e.g., the delivery chamber 1093) where apportioned amounts (e.g., cleaning shots) of the liquid-powder mixture 1094 can be accelerated so as to enter the target lumen at a suitable (e.g., selected) velocity. That is, the delivery chamber 1093 provides a region where the system 1090 uses one or more fluids (e.g., air and / or water) to accelerate the apportioned amounts of the liquid-powder mixture 1094. Without the delivery chamber 1093, the apportioned amounts of the liquid-powder mixture 1094 would enter the target lumen with the same speed at which the apportioned amounts of the liquid-powder mixture 1094 exit the holding chamber 1092, which can be too slow to effectively clean the target lumen (e.g., delivery chamber 1093 enables the system 1090 to provide sufficient kinetic energy to propel an apportioned amount of the liquid-powder mixture 1094 through the entire lumen at a desired rate).

[0099] As shown in FIG. 10, the delivery chamber 1093 defines a frustoconical shape, which can be beneficial in a number of respects. For example, such a geometry can aid the flow of an apportioned amount of the liquid-powder mixture 1094, e.g., directing it towards the target lumen. Indeed, the reduced cross-sectional area of the delivery chamber 1093 can increase the speed at which the carrier fluid and the apportioned amount of the liquid-powder mixture 1094 enters the target lumen. Additionally or alternatively, the frustoconical shape may cause the development of a “vortex” or other variable flow (e.g., turbulent flow) of the carrier fluid within the delivery chamber 1093 to provide more desirable flow that can interact with (e.g., impinge against) walls of the target lumen.[ooioo] It can be appreciated that while a certain configuration has been illustrated, systems implementing a discrete delivery chamber can be used in any of a variety of ways in accordance with embodiments of the invention. For example, in some embodiments, the delivery chamber is coupled to a single carrier fluid source.[ooioi] While the embodiment illustrated in FIG. 10 depicts an architecture whereby powder may be provided to a chamber via, for example, a cartridge, in some embodiments, the chambermay be a consumable component, as mentioned previously. In this context, a “consumable component” can be understood to be a component that is not intended to be permanent fixtures of the systems with which they interact. Accordingly, FIG. 11A illustrates a system 1190A for cleaning a target lumen of a medical device with a consumable component and a delivery chamber.

[0102] In particular, the system 1190A includes a holding chamber 1192 in the form of a consumable component that is provided with powder. A liquid-powder mixture 1194 can be created / housed within the holding chamber 1192 using liquid (e.g., modified water, unmodified water) from a first carrier fluid source 1186A. The system 1190A further includes a second carrier fluid source 1186B that may house a gaseous carrier fluid. Similar to the system 1090 of FIG. 10, the system 1190A further includes a delivery chamber 1193 operable to deliver the liquid-powder mixture 1194 to the target lumen for cleaning. In certain embodiments, a pump 1195 is also provided between the holding chamber 1192 and the delivery chamber 1193. The pump 1195 is configured to direct apportioned amounts of the liquid-powder mixture 1194 from the holding chamber 1192 toward the delivery chamber 1193 for subsequent delivery to the target lumen.

[0103] The use of a holding chamber in the form of a consumable component, as shown in FIG. 11A, may be advantageous insofar as it simplifies the design and enhances useroperability. For example, the use of such a configuration can eliminate the need for a discrete powder handling mechanism. Moreover, such a consumable component can be obtained, made to interface with the system 1190A, and once its constituent components within it have been used up by the system 1190A, the consumable component may be disposed of or reprocessed. Subsequently, a user can obtain another consumable component for usage as a holding chamber where further cleaning is required. The use of such consumable components can greatly enhance the efficiency and operability of the system 1190A.

[0104] It should be appreciated that while a specific configuration for a consumable component has been illustrated, embodiments of the invention can be implemented in any of a variety of ways in accordance with embodiments of the invention. For example, in some embodiments, a third interface is included for engagement with a dedicated liquid source for creating the liquidpowder mixture 1194. In some embodiments, respective valves may be integrated with the consumable component. In general, the disclosed concepts can be implemented in any of a variety of ways in accordance with embodiments of the invention.

[0105] Although the illustrated embodiments depict a holding chamber that houses powder that is subsequently hydrated, in some embodiments, a holding chamber is provided with a premade liquid-powder mixture. For example, a holding chamber that houses a powder that is insoluble in a corresponding liquid may be implemented. The insolubility of the powder in the respective liquid may allow the holding chamber to have a suitable shelf life, and therefore may be commercially viable.

[0106] FIG. 11B illustrates another system 1190B for cleaning a target lumen of a medical device with a consumable component and a delivery chamber. The system 1190B is similar to the system 1190A of FIG. 11A and also includes a holding chamber 1192 in the form of a consumable component that is provided with powder, where a liquid-powder mixture 1194 can be created / housed within the holding chamber 1192 using liquid (e.g., modified water, unmodified water) from a first carrier fluid source 1186A. The system 1190B further includes a second carrier fluid source 1186B that may house a gaseous carrier fluid.

[0107] However, unlike the system 1190A of FIG. 11 A, the system 1190B includes two delivery chambers 1193 each operable to deliver the liquid-powder mixture 1194 to a target lumen for cleaning. Also shown in FIG. 1 IB are two pumps 1195 provided between the holding chamber 1192 and a corresponding delivery chamber 1193 to direct apportioned amounts of the liquid-powder mixture 1194 toward the corresponding delivery chambers 1193. In certain examples, the system 1190B can be used to concurrently (e.g., simultaneously, sequentially, etc.) clean two target lumens.

[0108] In certain embodiments, a system presented herein further includes at least one distribution manifold that may couple to a plurality of ports / channels / lumens of the medical device to be cleaned. FIG. 12 illustrates one such example system 1290. For ease of description, the system 1290 will generally be described with reference to endoscope 100 of FIG. 1.

[0109] More specifically, the system 1290 includes a control sub-system 1217 (e.g., a computing device, a computer control), a holding sub-system 1225, and a delivery sub-system 1227. The holding sub-system 1225 includes, among other elements, a holding chamber 1292 for mixing a powder and liquid (e.g., modified water, unmodified water) to form a liquidpowder mixture 1294. The delivery sub-system 1227 comprises, among other elements, a delivery chamber 1293 for creating a flow of fluid to propel an apportioned amount (e.g., a cleaning shot) of the liquid-powder mixture 1294 through at least a portion of a channel, such as the channels 122, 124, 126, or 128, of the endoscope 100. In the illustrated embodiment ofFIG. 12, the delivery chamber 1293 includes an internal volume that can be characterized as having a frustoconical-like shape such that entry of fluid flow from one or more sides will create a flow of the fluid that increases in velocity as the flow approaches a narrow end of the delivery chamber 1293. However, it is to be appreciated that the use of a frustoconical shape, although potentially advantageous, is merely illustrative and that a delivery chamber can have any suitable geometry in accordance with embodiments of the invention. For example, in some embodiments a delivery chamber can have a cylindrical form factor. In several embodiments, a delivery chamber can be characterized as having a hemispherical shape.

[0110] Returning to the example of FIG. 12, a slurry conduit 1289 fluidly connects the holding chamber 1292 to the delivery chamber 1293, and a slurry valve 1262 is preferably provided in the slurry conduit 1289. Of course, it should be appreciated that any suitable configuration that allows for the liquid-powder mixture 1294 to be created, apportioned into an apportioned amount, and delivered at a suitable velocity to a channel of a medical device can be implemented in accordance with embodiments of the invention.[ooni] In the illustrated embodiment of FIG. 12, the delivery chamber 1293 is, in turn, fluidly connectable to at least one of the channels (e.g., 122, 124, 126, or 128) of the endoscope 100. In the illustrated embodiment, a distribution manifold 1229 is provided between the delivery chamber 1293 and the channels so that a channel, or portion of a channel, can be selected for cleaning. In the illustrated embodiment, the delivery chamber 1293 is associated with each of the channels. In other embodiments, one holding chamber provides slurry to each of several delivery chambers, and each of the several delivery chambers is each associated with a single port of a medical device. Of course, it should be appreciated that any suitable configuration that allows an apportioned amount of liquid-powder mixture 1294 to be delivered at a suitable velocity through the channel of a medical device can be implemented in accordance with embodiments of the invention.

[0112] In the illustrated embodiment of FIG. 12, the powder is provided to the holding chamber 1292 from a powder source 1291 (e.g., a cartridge) via a powder conduit 1233. A powder inlet valve 1282 is positioned in the powder conduit 1233 upstream of the holding chamber 1292 inlet to seal the holding chamber 1292 from the powder source 1291, when required. The holding chamber 1292 also includes a relief valve 1235 to allow the escape of any entrapped air during liquid fdling.

[0113] Of course, it can be appreciated from the above description, powder can be provided in any suitable way to form the liquid-powder mixture 1294 (e.g., a slurry) in accordance with embodiments of the invention. For example, in some embodiments, the powder source 1291 may be omitted, and the powder required for the cleaning process is simply placed into the holding chamber 1292 ready for use. In a further embodiment (not shown), the powder for one complete cleaning cycle is placed in the holding chamber 1292 in a pierceable powder pod.

[0114] In the illustrated embodiment, the delivery chamber 1293 includes a primary liquid port 1201 and a primary gas port 1203 for respectively allowing the entry of a liquid (e.g., modified water, unmodified water) from a first liquid supply 1284A and a gas from a first gas supply 1285A, respectively. Similarly, the holding chamber 1292 includes a secondary liquid port 1205 and a secondary gas port 1207, which feed from a second liquid supply 1284B and a second gas supply 1285B, respectively. In the illustrated embodiment, a vibration motor 1209 is provided and positioned proximate the exit of the holding chamber 1292 for promoting the egress of the liquid-powder mixture 1294 or for assisting in the mixing process, if / when needed.

[0115] In addition to the above, the system 1290 of FIG. 12 includes optical sensors 1211 and pressure sensors 1213 for monitoring the operation of the liquid-powder mixture production and / or of the cleaning process. For example, the pressure sensors 1213 may cooperate to detect if the endoscope 100 is connected to the system 1290 and / or sense if there are any blockages in the system 1290. In those circumstances, a fault condition will be generated by the control sub-system 1217 for programmable control of the operation of various control valves 1215, motors, and / or other pumping systems for controlling flow to the channels of the endoscope 100 in accordance with the method of the proposed embodiment of the invention. The control sub-system 1217, which can be integrated with the system 1290 or as a separate computing device, can enable the system 1290 to be programmed to clean the various endoscopes, or other medical devices, available on the market to a sufficient degree to adhere to the various regulatory authority and in an enhanced time to shorten the downtime of the device. The user would simply connect the system 1290 to the endoscope 100 and recall the required cleaning program. Of course, as can be appreciated, any suitable sensors and / or control sub-systems can be implemented to affect the operation of cleaning systems in accordance with embodiments of the present invention.

[0116] Turning specifically now to operation of the system 1290, a first step according to the illustrated embodiment in FIG. 12 may be that one or more target channels of the endoscope100 are flushed with water (e.g., modified water, unmodified water) and / or a combination of gas and water. This may be achieved, for example, by first closing the slurry valve 1262. A flow of gas, such as compressed air, and water are then fed into the delivery chamber 1293 from the primary liquid port 1201 and the primary gas port 1203. The mix of air and water then enters each of the channels through the distribution manifold 1229 to exit through an exit point in the endoscope 100. It can be appreciated that the channels may be flushed sequentially at some phases of a cleaning process and / or the channels may be flushed simultaneously at some phases of a cleaning process. In other embodiments, the step of flushing is omitted, and the process starts with the first substantive cleaning step below.

[0117] As noted, a step in the cleaning process is the obtaining (e.g., the formation) of the liquid-powder mixture 1294. In the example of FIG. 12, the liquid-powder mixture 1294 is formed by providing an amount of powder from the powder source 1291, as well as an appropriate amount of a liquid (e.g., modified water, unmodified water), into the holding chamber 1292, thereby creating the liquid-powder mixture 1294. The liquid may be provided into the holding chamber 1292 from the primary liquid port 1201 in the delivery chamber 1293 feeding up to the holding chamber 1292 after opening the slurry valve 1262 and / or directly from the secondary liquid port 1205. In operation, the powder is mixed with the liquid to create the liquid-powder mixture 1294. The liquid-powder mixture 1294 may form naturally upon introduction of the liquid to the holding chamber 1292, or alternatively, the vibration motor 1209 may be activated to ensure the liquid-powder mixture 1294 is mixed to the desired level. It is noted that it is not proposed that all the powder is dissolved in the liquid. To this end, the non-dissolved powder assists the cleaning function.

[0118] FIG. 12 is described with reference to an embodiment in which the powder is sodium bicarbonate and the liquid is water (e.g., modified water, unmodified water). However, other powders may be used to create the liquid-powder mixture 1294 without departing from the scope of the invention. Similarly, other liquids may be used besides water without departing from the scope of the invention.

[0119] It is to be appreciated that the liquid-powder mixture 1294 can be created in a variety of ways. For example, in one method, all control valves 1215 at the output of the distribution manifold 1229 are initially closed and no gas is being provided to any of the chambers 1292, 1293. The relief valve 1235, the slurry valve 1262, and the primary liquid port 1201 are then opened, allowing water to fill the delivery chamber 1293. When the delivery chamber 1293 is filled, water goes into the holding chamber 1292 through the slurry conduit 1289 and hydratesthe powder from the bottom of the holding chamber 1292. This way, a uniform slurry is formed without the need to use the vibration motor 1209. At some point during the filling of the delivery chamber 1293, the secondary liquid port 1205 may also open to fill the holding chamber 1292 faster, if required. Once the holding chamber 1292 is appropriately filled with water, as determined, for example, by an optical sensor 1211 at the relief valve 1235, the primary and secondary liquid ports 1201, 1205 close.

[0120] The operations of the system 1290 also include apportioning the liquid-powder mixture 1294 and forming a cleaning shot. In one specific example, the control sub-system 1217 closes the slurry valve 1262 and opens at least one of the control valves 1215. The control sub-system 1217 then commands the system 1290 to create a positive pressure difference between the holding chamber 1292 and the delivery chamber 1293 and then to open the slurry valve 1262. The created positive pressure difference pushes a flow of the liquid-powder mixture 1294, already created in the holding chamber 1292, into the delivery chamber 1293. The slurry valve 1262 then closes and stops the flow of the liquid-powder mixture 1294 from the holding chamber 1292 into the delivery chamber 1293, and a cleaning shot of the liquid-powder mixture 1294 is therefore defined.

[0121] It can be appreciated that creating a pressure difference between the holding chamber 1292 and the delivery chamber 1293 can be done in variety of ways. For example, the positive pressure difference can be achieved by controlling the pressure of gas or liquid using pumps, pressure regulators, proportional pressure regulators (PPRs) or electrical pressure regulators (EPRs). For example, in one specific and illustrative arrangement, the gas pressure can be controlled using two PPRs, namely a primary PPR 1219 and a secondary PPR 1221. The primary PPR 1219 is positioned between the first gas supply 1285A and the primary gas port 1203 and controls the gas pressure in the delivery chamber 1293. The secondary PPR 1221 is positioned between the second gas supply 1285B and the secondary gas port 1207 and controls the gas pressure of the holding chamber 1292. The PPRs 1219 and 1221 are controlled by the control sub-system 1217 to create a selectable positive pressure difference between the holding chamber 1292 and the delivery chamber 1293.

[0122] As noted, the system 1290 delivers the cleaning shot (apportioned amount of the liquidpowder mixture 1294) through at least a portion of a channel of the endoscope 100 to be cleaned. Delivery of a cleaning shot into the channel can occur in a variety of ways. For example, before the apportioned liquid-powder mixture 1294 is transferred into the delivery chamber 1293, carrier fluid from the first gas supply 1285A is supplied to the delivery chamber1293 at a regulated pressure using primary PPR 1219. The carrier fluid may create a fluid flow inside the delivery chamber 1293 that propels the apportioned liquid-powder mixture into a selected channel of the endoscope 100 through the distribution manifold 1229, which has already selected one of the control valves 1215 to be opened at this time (e .g . , the cleaning shot is accelerated to the appropriate velocity). That is, the cleaning shot exits the delivery chamber 1293, enters the distribution manifold 1229, and then enters a selected channel of the endoscope 100 at an appropriate velocity. The process may be repeated many times for a channel of the endoscope 100 before the process is performed for a different channel by closing one control valve 1215 and opening another control valve 1215.

[0123] Another technique for delivering a cleaning shot of the liquid-powder mixture 1294 into the target channel in FIG. 12 uses a self-regulating bi-stable process. In such examples, the carrier fluid from the first gas supply 1285A is again supplied to the delivery chamber 1293 at a regulated pressure using the primary PPR 1219. Once the slurry valve 1262 opens, a cleaning shot of the liquid-powder mixture 1294 may transfer into the delivery chamber 1293. It can be appreciated that the transfer of the cleaning shot can happen automatically (e.g., because of gravity) and / or may be assisted by creation of a positive pressure difference between the holding chamber 1292 and the delivery chamber 1293. If used, the positive pressure difference may naturally be brought about by the high flow of air through the endoscope 100 due to the low fluidic resistance of an un-occluded channel. Once this cleaning shot occludes the exit of the delivery chamber 1293, the pressure of the delivery chamber 1293 will increase due to the increased fluidic resistance of the fluidic path downstream of the delivery chamber 1293. As a result, the holding chamber 1292 and the delivery chamber 1293 will settle at a similar pressure, which in turn, stops any additional flow of the liquid-powder mixture 1294 into the delivery chamber 1293. The cleaning shot then proceeds through the selected channel to then exit the endoscope 100. When the cleaning shot of the liquid-powder mixture 1294 exits the endoscope channel, the pressure of the delivery chamber 1293 will drop because of the lower fluidic resistance of the downstream fluidic line and the limited flow rate of the carrier fluid. This will result in a pressure difference between the delivery chamber 1293 and the holding chamber 1292. As a result, another cleaning shot of the liquid-powder mixture 1294 will be drawn from the holding chamber 1292. The newly drawn cleaning shot is again acted upon by the carrier fluid to propel through the delivery chamber 1293, through the distribution manifold 1229, and into a selected channel of the endoscope 100.

[0124] In general, so long as the flow of pressure-regulated gas continues and the supply of the liquid-powder mixture 1294 in the holding chamber 1292 is not depleted, the process will continue automatically with the distribution manifold 1229 selecting which channel will receive the cleaning shot of the liquid-powder mixture 1294. More specifically, once the cleaning shot has cleared through a channel, the control sub-system 1217 can change the states of control valves 1215, and the process is repeated for one or more endoscope channels. In a variation of this, the process may be repeated multiple times through the same channel until a sufficient level of debris removal is achieved before the process is performed for a different channel.

[0125] By selecting the appropriate parameters, such as size of the chambers 1292, 1293, amount of liquid, amount of powder, and / or gas pressure, the system 1290 can self-regulate and prevent endoscope channel blockage while cleaning the endoscope 100. In some embodiments, the size of the cleaning shot can more deliberately be altered by changing the gas pressure, amount of water, amount of powder, size of the chambers 1292, 1293, etc.

[0126] In a variation of the above process according to a further embodiment, the slurry valve 1262 and all control valves 1215 are initially closed. Similar to the previous technique, once the liquid-powder mixture 1294 is formed in the holding chamber 1292 using one of the earlier mentioned processes, a positive pressure difference is created between the holding chamber 1292 and the delivery chamber 1293 using the primary and secondary PPRs 1219, 1221 and / or EPRs. Then, the slurry valve 1262 opens, and the positive pressure difference draws a cleaning shot of the liquid-powder mixture 1294 into the delivery chamber 1293. The slurry valve 1262 then closes and stops the flow of the liquid-powder mixture 1294 from the holding chamber 1292 into the delivery chamber 1293 to define a cleaning shot of the liquid-powder mixture 1294. A pressure-regulated gas, typically compressed air, is then introduced into the delivery chamber 1293 through the primary gas port 1203 to again create a flow of gas. However, unlike the previous method, the cleaning shot is retained in the delivery chamber 1293 until one of the control valves 1215 in the distribution manifold 1229 is opened. After a selectable time, one of the control valves 1215 is opened, and the cleaning shot is propelled at an appropriate velocity into an endoscope channel using pressurized air. By doing so, the cleaning efficiency may be enhanced by providing a better control over the size of the cleaning shot, because the cleaning shot will be fully defined within the delivery chamber 1293 before the cleaning shot will be propelled as a whole rather than being partially propelled. The described high velocity cleaning shots of the liquid-powder mixture 1294 can use, for example, their composition andvelocity created by the pressurized gas, water, or mixture of gas and water in the delivery chamber 1293 to create a strong contaminant-detaching cleaning action across the internal walls of the selected endoscope channel.

[0127] FIG. 13 illustrates another example system 1390 for cleaning a lumen that can incorporate specific elements of the above-described concepts, in accordance with embodiments of the present invention. For ease of description, the system 1390 will generally be described with reference to the endoscope 100 of FIG. 1.

[0128] More specifically, the system 1390 includes a control sub-system 1317 (e.g., a computing device), a holding sub-system 1325, a first delivery sub-system 1327(1), and a second delivery sub-system 1327(2). The holding sub-system 1325 includes, among other elements, a holding chamber 1392 (e.g., a consumable chamber) for mixing a powder and liquid (e.g., modified water, unmodified water) to form a liquid-powder mixture 1394, while each delivery sub-system 1327(1) and 1327(2) comprises, among other elements, a delivery chamber 1393 for creating a flow of fluid to propel an apportioned amount (e.g., a cleaning shot) of the liquid-powder mixture 1394 through at least a portion of a channel, such as the channels 122, 124, 126, or 128, of the endoscope 100. In the illustrated embodiment of FIG. 13, the delivery chambers 1393 each include an internal volume that can be characterized as having a frustoconical-like shape such that entry of fluid flow from one or more sides will create a flow of the fluid that increases in velocity as the flow approaches a narrow end of the delivery chamber 1393. However, it is to be appreciated that the use of a frustoconical shape, although potentially advantageous, is merely illustrative and that a delivery chamber can have any suitable geometry in accordance with embodiments of the invention. For example, in some embodiments a delivery chamber can have a cylindrical form factor. In several embodiments, a delivery chamber can be characterized as having a hemispherical shape.

[0129] As noted above, the holding sub-system 1325 comprises a holding chamber 1392. In this example, the holding chamber 1392 comprises a consumable component initially provided with a powder therein. In additional or alternative embodiments, powder is obtained by the holding chamber 1392 in another suitable manner, such as from a powder source (e.g., a cartridge) via a powder conduit and / or via placement in the holding chamber 1392 (e.g., in a pierceable powder pod). A liquid (e.g., modified water, unmodified water) is introduced into the holding chamber 1392 formixing with the powderto form the liquid-powder mixture 1394. To this end, the holding chamber 1392 includes a secondary liquid port 1305 and a secondary gas port 1307, which feed from a second liquid supply 1384B and a second gas supply 1385B,respectively. In the illustrated embodiment, a vibration motor 1309 is provided and positioned proximate the exit of the holding chamber 1392 exit for promoting the egress of the liquidpowder mixture 1394 or for assisting in the mixing process, if / when needed. The holding chamber 1392 can also include a relief valve 1335 to allow the escape of any entrapped air during liquid fdling.

[0130] As noted, the system 1390 includes two delivery sub-systems 1327(1) and 1327(2). In general, the two delivery sub-systems 1327(1) and 1327(2) are substantially similar. Thus, although the following description is provided with reference to the delivery sub-system 1327(1), it is to be appreciated that this description applies similarly to delivery sub-system 1327(2).

[0131] As shown, the delivery sub-system 1327(1) comprises a pump 1395 and a slurry valve 1362 fluidly connecting the holding chamber 1392 to the delivery chamber 1393. The pump 1395 and slurry valve 1362 are operable to provide / deliver an apportioned amount (a cleaning shot) of the liquid-powder mixture 1394 to the delivery chamber 1393. Of course, it should be appreciated that any suitable configuration that allows for a liquid-powder mixture 1394 to be created, apportioned into an apportioned amount, and delivered at a suitable velocity to a channel of a medical device could be used in accordance with embodiments of the invention.

[0132] In the illustrated embodiment, the delivery chamber 1393 includes one or more primary liquid ports 1301 and one or more primary gas ports 1303 for respectively allowing the entry of a liquid (e.g., modified water, unmodified water) from a first liquid supply 1384A and a gas from a first gas supply 1385A, respectively. The delivery chamber 1393 is, in turn, fluidly connectable to at least one of the channels (e.g., 122, 124, 126, 128, etc.) of the endoscope 100. In the illustrated embodiment, a distribution manifold 1329 is provided between the delivery chamber 1393 and the channels so that a channel, or portion of a channel, can be selected for cleaning. In the illustrated embodiment, the delivery chamber 1393 is associated with each of the channels. In other embodiments, one holding chamber provides slurry to each of several delivery chambers, and each of the several delivery chambers is each associated with a single port of a medical device. Of course, it should be appreciated that any other suitable configuration that allows an apportioned amount of liquid-powder mixture 1394 to be delivered at a suitable velocity through the channel of a medical device can be implemented in accordance with embodiments of the invention.

[0133] In addition to the above, the delivery sub-system 1327(1) includes a pressure sensor 1313 for monitoring the operation of the liquid-powder mixture production and / or of the cleaning process. For example, the pressure sensor 1313 may be used to detect if the endoscope 100 is connected to the system 1390 and / or to sense if there are any blockages in the system 1390. In those circumstances, a fault condition will be generated by the control sub-system 1317 for programmable control of the operation of various control valves 1315, motors, and / or other pumping systems for controlling flow to the channels of the endoscope 100 in accordance with the method of the proposed embodiment of the invention. The control sub-system 1317, which can be integrated with the system 1390 or as a separate computing device, can enable the system 1390 to be programmed to clean the various endoscopes, or other medical devices, available on the market to a sufficient degree to adhere to the various regulatory authority and in an enhanced time to shorten the downtime of the device. The user would simply connect the system 1390 to the endoscope and recall the required cleaning program. Of course, as can be appreciated, any suitable sensors and / or control sub-systems can be implemented to affect the operation of cleaning systems in accordance with embodiments of the present invention.

[0134] Turning specifically now to operation of the system 1390 of FIG. 13, a first step according to the illustrated embodiment in FIG. 13 may be that one or more target channels of endoscope 100 are flushed with water (e.g., modified water, unmodified water) and / or a combination of gas and water. This may be achieved, for example, by first closing the slurry valve 1362. A flow of gas, such as compressed air, and water are then fed into the delivery chamber 1393 from the primary liquid port 1301 and the primary gas port 1303. The mix of air and water then enters each of the channels through the distribution manifold 1329 to exit through an exit point in the endoscope 100. It can be appreciated that the channels may be flushed sequentially at some phases of the cleaning process and / or the channels may be flushed simultaneously at some phases of the cleaning process. In other embodiments, the step of flushing is omitted, and the process starts with the first substantive cleaning step below.

[0135] As noted, a step in the cleaning process is the obtaining (e.g., the formation) of the liquid-powder mixture 1394. In the example of FIG. 13, the liquid-powder mixture 1394 is formed by providing an amount of liquid (e.g., modified water, unmodified water) for mixing with the powder in the holding chamber 1392, thereby creating the liquid-powder mixture 1394. The liquid may be provided into the holding chamber 1392 directly from the secondary liquid port 1305 (or another liquid line). In operation, the liquid is mixed with the powder to create the liquid-powder mixture 1394. The liquid-powder mixture 1394 may form naturallyupon introduction of the liquid to holding chamber 1392, or alternatively, the vibration motor 1309 may be activated to ensure the slurry is mixed to the desired level. It is noted that it is not proposed that all the powder is dissolved in the liquid. To this end, the non-dissolved powder assists the cleaning function.

[0136] FIG. 13 is described with reference to an embodiment in which the powder is sodium bicarbonate and the liquid is water (e.g., modified water, unmodified water). However, other powders may be used to create the liquid-powder mixture 1394 without departing from the scope of the invention. Similarly, other liquids may be used besides water without departing from the scope of the invention.

[0137] The operations of system 1390 also include apportioning the liquid-powder mixture 1394 and forming a cleaning shot. In one specific example, the control sub-system 1317 uses the pump 1395 to provide the cleaning shot to the delivery chamber 1393. In other embodiments (e.g., if the pump 1395 is omitted), the control sub-system 1317 closes the slurry valve 1362 and opens at least one of the control valves 1315. The control sub-system 1317 then commands the system 1390 to create a positive pressure difference between the holding chamber 1392 and the delivery chamber 1393 and then to open the slurry valve 1362. The created positive pressure difference pushes a flow of the liquid-powder mixture 1394, already created in the holding chamber 1392, into the delivery chamber 1393. The slurry valve 1362 then closes and stops the flow of the liquid-powder mixture 1394 from the holding chamber 1392 into the delivery chamber 1393, and a cleaning shot of the liquid-powder mixture 1394 is therefore defined.

[0138] It can be appreciated that creating a pressure difference between the holding chamber 1392 and the delivery chamber 1393 can be done in variety of ways. For example, the positive pressure difference can be achieved by controlling the pressure of gas or liquid using pumps, pressure regulators, PPRs, and / or EPRs. For example, in one specific and illustrative arrangement, the gas pressure can be controlled using two PPRs, namely a primary PPR 1319 and a secondary PPR 1321. The primary PPR 1319 is positioned between the first gas supply 1385A and the primary gas port 1303 and controls the gas pressure in the delivery chamber 1393. The secondary PPR 1321 is positioned between the second gas supply 1385B and the secondary gas port 1307 and controls the gas pressure of the holding chamber 1392. The PPRs 1319 and 1321 are controlled by the control sub-system 1317 to create a selectable positive pressure difference between the holding chamber 1392 and the delivery chamber 1393.

[0139] As noted, the system 1390 delivers the cleaning shot (apportioned amount of the liquidpowder mixture 1394) through at least a portion of a channel of the endoscope 100 to be cleaned. Delivery of a cleaning shot into the endoscope channel can occur in a variety of ways. For example, before the apportioned liquid-powder mixture 1394 is transferred into the delivery chamber 1393, carrier fluid from the first gas supply 1385A is supplied to the delivery chamber 1393 at a regulated pressure using the primary PPR 1319. The carrier fluid may create a fluid flow inside the delivery chamber 1393 that propels the apportioned liquid-powder mixture into a selected channel of endoscope 100 through the distribution manifold 1329, which has already selected one of the control valves 1315 to be opened at this time (e.g., the cleaning shot is accelerated to the appropriate velocity). That is, the cleaning shot exits the delivery chamber 1393, enters the distribution manifold 1329, and then enters a selected channel of the endoscope 100 at an appropriate velocity. The process may be repeated many times for a channel of the endoscope 100 before the process is performed for a different channel by closing one control valve 1315 and opening another control valve 1315.

[0140] Another technique for delivering a cleaning shot of the liquid-powder mixture 1394 into the target channel in FIG. 13 uses a self-regulating bi-stable process. In such examples, the carrier fluid from the first gas supply 1385A is again supplied to the delivery chamber 1393 at a regulated pressure using the primary PPR 1319. Once the slurry valve 1362 opens, a cleaning shot of the liquid-powder mixture 1394 may transfer into the delivery chamber 1393. It can be appreciated that the transfer of the cleaning shot can happen automatically (e.g., because of gravity), may be assisted by the pump 1395, and / or may be assisted by creation of a positive pressure difference between the holding chamber 1392 and the delivery chamber 1393. If used, the positive pressure difference may naturally be brought about by the high flow of air through the endoscope 100 due to the low fluidic resistance of an un-occluded channel. Once this cleaning shot occludes the exit of the delivery chamber 1393, the pressure of the delivery chamber 1393 will increase due to the increased fluidic resistance of the fluidic path downstream of the delivery chamber 1393. As a result, the holding chamber 1392 and delivery chamber 1393 will settle at a similar pressure, which in turn, stops any additional flow of the liquid-powder mixture 1394 into the delivery chamber 1393. The cleaning shot then proceeds through the selected channel to then exit the endoscope 100. When the cleaning shot of the liquid-powder mixture 1394 exits the endoscope channel, the pressure of the delivery chamber 1393 will drop because of the lower fluidic resistance of the downstream fluidic line and the limited flow rate of the carrier fluid. This will result in a pressure difference between thedelivery chamber 1393 and the holding chamber 1392. As a result, another cleaning shot of the liquid-powder mixture 1394 will be drawn from the holding chamber 1392. The newly drawn cleaning shot is again acted upon by the carrier fluid to propel through the delivery chamber1393, through the distribution manifold 1329, and into a selected channel of the endoscope 100.

[0141] In general, so long as the flow of pressure -regulated gas continues and the supply of liquid-powder mixture 1394 in the holding chamber is not depleted, the process will continue automatically with the distribution manifold 1329 selecting which channel will receive the cleaning shot of the liquid-powder mixture 1394. More specifically, once the cleaning shot has cleared through a channel, the control sub-system 1317 can change the states of control valves 1315, and the process is repeated for one or more endoscope channels. In a variation of this, the process may be repeated multiple times through the same channel until a sufficient level of debris removal is achieved before the process is performed for a different channel.

[0142] By selecting the appropriate parameters, such as size of the chambers 1392, 1393, amount of liquid, amount of powder, and / or gas pressure, the system 1390 can self-regulate and prevent endoscope channel blockage while cleaning the endoscope 100. In some embodiments, the size of the cleaning shot can more deliberately be altered by changing the gas pressure, amount of water, amount of powder, size of the chambers 1392, 1393, etc.

[0143] In a variation of the above process according to a further embodiment, the slurry valve 1362 and all control valves 1315 are initially closed. Similar to the previous technique, once the liquid-powder mixture 1394 is formed in the holding chamber 1392 using one of the earlier mentioned processes, a positive pressure difference is created between the holding chamber 1392 and the delivery chamber 1393 using the primary and secondary PPRs 1319, 1321 and / or EPRs. Then, the slurry valve 1362 opens, and the positive pressure difference draws a cleaning shot of the liquid-powder mixture 1394 into the delivery chamber 1393. The slurry valve 1362 then closes and stops the flow of the liquid-powder mixture 1394 from the holding chamber 1392 into the delivery chamber 1393 to define a cleaning shot of the liquid-powder mixture1394. A pressure-regulated gas, typically compressed air, is then introduced into the delivery chamber 1393 through the primary gas port 1303 to again create flow of gas. However, unlike the previous method, the cleaning shot is retained in the delivery chamber 1393 until one of the control valves 1315 in the distribution manifold 1329 is opened. After a selectable time, one of the control valves 1315 is opened, and the cleaning shot is propelled at an appropriate velocity into an endoscope channel using pressurized air. By doing so, the cleaning efficiencymay be enhanced by providing a beter control over the size of the cleaning shot, because the cleaning shot will be fully defined within the delivery chamber 1393 before it will be propelled as a whole rather than being partially propelled. The described high velocity cleaning shots of the liquid-powder mixture 1394 can use, for example, their composition and velocity created by the pressurized gas, water, or mixture of gas and water in the delivery chamber 1393 to create a strong contaminant-detaching cleaning action across the internal walls of the selected endoscope channel.

[0144] It should be appreciated that the systems and methods of cleaning can provide a means to clean the channels of a medical device efficiently. The degree of contamination within the medical device after cleaning can be such that it meets all relevant standards and can be substantially beter than using prior art means. Once the cleaning process is completed, the channels may be rinsed via a flushing process by flowing water and / or gas through each channel in a similar way as that in the cleaning process described above. In certain embodiments, the cleaning process may be substantially automatic after initial setup, and its operation can be very simple for an operator. Advantageously, by using computer control of all the valves, ports, and pumps, the cleaning time can be adjusted in order to minimize the down time of the medical device.

[0145] In certain embodiments, for any of the systems (e.g., the system 990, the system 1090, the system 1190A, the system 1190B, the system 1290, the system 1390) discussed herein, a method of cleaning a lumen of a medical device includes determining the fluidic resistance / impedance (and / or conductance) of the lumen to be cleaned and using the determined fluidic resistance to inform the cleaning methodology. For example, different lumens may have different characteristics such as geometry, etc., and enhancing the cleaning efficacy / efficiency may be a function of these particular characteristics. Fluidic resistance may be a suitable indicator of these characteristics. Generally, fluidic resistance can be understood to relate to how much a lumen restricts flow.

[0146] For example, determining the fluidic resistance of the lumen of the medical device can include flowing a fluid comprising a known specific gravity through the lumen of the medical device and measuring a flow rate and / or a pressure differential of the fluid being flowed through the lumen of the medical device. These parameters can then be used to compute the fluidic resistance of the lumen. Such a method is merely illustrative, and other techniques could alternatively be used to determine the fluidic resistance of a lumen (e.g., determine the fluidic resistance directly from the known dimensions of a lumen).

[0147] The fluidic resistance of the lumen may then be used to control the apportionment of the liquid-powder mixture and / or the delivering of an apportioned amount of the liquid-powder mixture. For example, in one arrangement, a suction / biopsy channel of an endoscope is the lumen to be cleaned. Suction / biopsy channels are relatively larger lumens, and the dimensions of the larger lumens may be used to establish a relatively larger size of the apportioned amount. Conversely, air-water channels of an endoscope relatively smaller lumens, and the dimensions of these smaller lumens may be used to establish a relatively smaller size of the apportioned amount.

[0148] In certain examples, the fluidic resistance of the lumen can be used (e.g., periodically, continually, etc.) to update cleaning parameters (e.g., in real-time) as appropriate to enhance cleaning efficacy. For example, the frequency of the delivery of apportioned amounts can be informed by the determined fluidic resistance. More details around the technique of determining the fluidic resistance of the lumen can be found in U.S. Patent Application No. 2024 / 0260823, the content of which is also hereby incorporated by reference herein.

[0149] In addition to or as an alternative to using modified water to clean lumens / channels of a medical device, modified water can be used in a self-cleaning process. In particular, a cleaning device / system is used to clean lumens / channels of a medical device (e.g., by directing modified water to the lumens / channels), and the self-cleaning process includes cleaning the cleaning device / system itself, such as to place the cleaning device / system in a desirable condition to clean the medical device. In some embodiments, a self-cleaning fluid used during the self-cleaning process has substantially the same composition as a cleaning fluid used to clean the medical device. In additional or alternative embodiments, fluids of different compositions are used during the self-cleaning process of a cleaning device / system and during a cleaning process of the medical device. In either case, the self-cleaning fluid can include modified water.

[0150] FIG. 14 is a schematic diagram of a cleaning device system 1448 illustrating how modified water can be directed into and through an interior 1450 of a cleaning device 1400 during a self-cleaning process. The cleaning device 1400 includes a first interface 1402 (e.g., an adapter interface) with first ports 1404 configured to direct cleaning fluid (e.g., a liquidpowder mixture, modified water) out of the interior 1450 and toward a medical device. The cleaning device 1400 also includes a second interface 1420 (e.g., a cartridge interface) with second ports 1422 configured to fluidly couple to a cleaning fluid source (e.g., a cartridge) that directs cleaning fluid into the interior 1450. Thus, the cleaning device 1400 is configured todirect cleaning fluid from the cleaning fluid source to the medical device to clean the medical device (e.g., to selectively clean certain channels of the medical device).

[0151] In certain embodiments, the cleaning device 1400 includes multiple fluidic interior portions (e.g., fluid paths, interior cleaning engines) that can direct respective flows of the cleaning fluid in different manners. For example, a first fluidic interior portion 1466 (e.g., a large fluidic interior portion, a first fluid path, a first interior cleaning engine) is configured to direct one or more first flows of cleaning fluid having first flow characteristics (e.g., a first pressure, a first speed, a first flow rate), and a second fluidic interior portion 1468 (e.g., a small fluidic interior portion, a second fluid path, a second interior cleaning engine) is configured to direct one or more second flows of cleaning fluid using second flow characteristics (e.g., a second pressure, a second speed, a second flow rate). For instance, the first fluidic interior portion 1466 is configured to direct the one or more first flows of cleaning fluid to a corresponding first part (e.g., first channels) of the medical device that are more suitably cleaned via the first flow characteristics rather than via the second flow characteristics, and the second fluidic interior portion 1468 is configured to direct the one or more second flows of cleaning fluid to a corresponding second part (e.g., second channels) of the medical device that are more suitably cleaned via the second flow characteristics rather than via the first flow characteristics. Thus, the fluidic interior portions 1466, 1468 can direct separate cleaning fluid flows to clean different parts of the medical device more suitably and improve cleaning provided for the medical device. For this reason, separate first ports 1404 can direct the respective cleaning fluid flows from the fluidic interior portions 1466, 1468 toward the medical device, and / or separate second ports 1422 can direct the respective cleaning fluid flows from the cleaning fluid source toward the fluidic interior portions 1466, 1468. Although the illustrated cleaning device 1400 includes two fluidic interior portions 1466, 1468, it should be noted that the cleaning device 1400 can include any suitable quantity of fluidic interior portions in additional or alternative embodiments to direct respective cleaning fluid flows for cleaning a medical device.

[0152] During the self-cleaning process, modified water is directed through different parts of the cleaning device 1400, such as the fluidic interior portions 1466, 1468. In the illustrated embodiment, a module 1476 (e.g., a bottle, an external reservoir, etc.) for providing modified water is fluidly coupled to the cleaning device 1400. In certain embodiments, the cleaning device 1400 includes a mount, a compartment, port, or another feature to enable the module 1476 to attach to the cleaning device 1400 and help fluidly couple the module 1476 to the cleaning device 1400. In additional or alternative embodiments, the cleaning device 1400 isable to circulate modified water without having to utilize a separate, external module 1476. For instance, the cleaning device 1400 could include the module 1476 therein, the cleaning device 1400 could store the modified water therein, and / or the cleaning device 1400 could produce or create the modified water internally.

[0153] In the example of FIG. 14, the cleaning device 1400 includes a self-cleaning module 1456, which includes various fluid lines (not shown), a pump 1457, a tank or reservoir 1458, and any other suitable components to enable modified water to flow through the interior 1450. To initiate the self-cleaning operation, the self-cleaning module 1456 initially receives modified water from the module 1476. The self-cleaning module 1456 then directs the modified water throughout the interior 1450, such as to various fluid lines (e.g., at the first interface 1402, at the second interface 1420), and / or into the tank 1458, such as until a threshold level within the tank 1458 has been reached.

[0154] The self-cleaning module 1456 is then configured to circulate the supply of the modified water throughout the interior 1450 of the cleaning device 1400 to self-clean various parts of the cleaning device 1400. In certain embodiments, the tank 1458 is configured to store some of the modified water during the self-cleaning operation and supply the modified water as needed to ensure that a sufficient amount of modified water is being circulated throughout the interior 1450, such as to enable different amounts of modified water to circulate through the interior 1450 depending on the flow path of the modified water.

[0155] Modified water can be directed in different manners during the self-cleaning process. That is, various flow paths can be established during the self-cleaning process, such as to selfclean different fluid lines and / or other parts of the interior 1450. To this end, the cleaning device 1400 includes valves 1474 configured to adjust positions to direct the modified water along different flow paths.

[0156] In a first example flow path, the self-cleaning module 1456 is configured to direct modified water to the fluidic interior portions 1466, 1468, and the fluidic interior portions 1466, 1468 direct modified water back to the self-cleaning module 1456. In this manner, modified water circulates between the self-cleaning module 1456 and the fluidic interior portions 1466, 1468 in the first example flow path. For instance, the first example flow path enables the modified water to continuously self-clean the fluidic interior portions 1466, 1468 without significantly depleting a supply of modified water within the interior 1450. In a second example flow path, the self-cleaning module 1456 is configured to direct modified water to the fluidicinterior portions 1466, 1468, and at least one of the fluidic interior portions 1466, 1468 is configured to direct modified water to one of the interfaces 1402, 1420 for discharge from the interior 1450 via corresponding ports 1404, 1422. Thus, the second example flow path enables the fluid lines between the fluidic interior portions 1466, 1468 and the interfaces 1402, 1420 to be cleaned.

[0157] In a third example flow path, the self-cleaning module 1456 is configured to direct modified water to the fluidic interior portions 1466, 1468, and at least one of the fluidic interior portions 1466, 1468 is configured to direct modified water to a drain 1478 for discharge from the interior 1450 without flowing through one of the interfaces 1402, 1420. Therefore, for the second example flow path and the third example flow path, modified water is directed out of the cleaning device 1400, such as for subsequent flow through a medical device, for reprocessing to enable reuse (e.g., in another self-cleaning process), and / or for discard. It should be noted that any other flow path of modified water through the interior 1450 can be utilized to clean the cleaning device 1400. As an example, modified water can circulate between the fluidic interior portions 1466, 1468 to continuously clean the fluidic interior portions 1466, 1468.

[0158] In certain implementations, for each example flow path, modified water can flow through the cleaning device 1400 for a threshold duration of time (e.g., 1-5 minutes, 5-10 minutes, 10-60 minutes, over an hour). Such flow of modified water can sufficiently self-clean the cleaning device 1400 (e.g., by loosening adhesion of contaminants for removal) to enable the cleaning device 1400 to subsequently clean a medical device. In some embodiments, a level of the modified water within the tank 1458 is periodically determined (e.g., compared to a target level) during the self-cleaning operation to ensure that there is a sufficient supply of modified water that can be recirculated through the interior 1450. For example, the level of the modified water in the tank 1458 is determined before initiating a self-cleaning cycle (e.g., for flow of modified water through one of the flow path examples) and / or during a self-cleaning cycle (e.g., at a predetermined frequency, such as every 100-1000 milliseconds). In response to the level of modified water within the tank 1458 being inadequate (e.g., below the target level), the module 1476 can direct additional modified water into the self-cleaning module 1456, such as to fill the tank 1458 (e.g., above the target level).

[0159] The valves 1474 can be manually adjusted in some embodiments to establish the flow path of modified water through the cleaning device 1400. For example, a user (e.g., a technician, an operator) can adjust the position of the valves 1474 to direct the modified waterin different manners, such as along different flow paths for self-cleaning different parts of the cleaning device 1400. Additionally or alternatively, the valves 1474 can be automatically adjusted. To this end, the cleaning device 1400 includes or is communicatively coupled to a control sub-system 1417 configured to adjust the position of the valves 1474.

[0160] In some embodiments, the module 1476 is also configured to provide modified water for cleaning a medical device via the cleaning device 1448. As an example, the module 1476 is configured to provide the modified water to the cleaning device 1448, and the cleaning device 1448 (e.g., the fluidic interior portions 1466, the fluidic interior portions 1468) is then configured to deliver the modified water to the medical device via the first interface 1402 to clean the medical device. In some cases, the modified water is initially circulated through the cleaning device 1448 (e.g., along the second example flow path) to self-clean the cleaning device 1448 before being directed to the medical device to clean the medical device. Thus, the module 1476 can be used to provide (and in some cases, produce / create) modified water to both the cleaning device 1448 and the medical device.

[0161] FIG. 15 illustrates an exemplary method 1570 related to cleaning. At 1572, a medical device (e.g., the endoscope 100) is cleaned via a cleaning device (e.g., the cleaning device 1400). For instance, the cleaning device directs a cleaning fluid, such as modified water, liquidpowder mixture, and / or a flushing liquid, through a channel of the medical device.

[0162] At 1574, modified water flows through the cleaning device to self-clean the cleaning device. By way of example, operation of the cleaning device (e.g., to clean the medical device) produces contaminants within the cleaning device, such as within certain fluid lines. Therefore, it is desirable to self-clean the cleaning device to enable the cleaning device to sufficiently clean another medical device. The modified water flowing through the cleaning device can reduce adhesion of the contaminants to a surface of the cleaning device, thereby enabling the contaminants to be readily removed to self-clean the cleaning device.

[0163] As noted above, a control sub-system (e.g., the control sub-system 1217, the control sub-system 1317, the control sub-system 1417) can be utilized to perform any of the techniques discussed herein. FIG. 16 is a block diagram illustrating an example computing device 1617 configured to operate as a control sub-system, in accordance with certain embodiments presented herein. The computing device 1617 can comprise, for example, an electronic controller, an automation controller, a personal computer, a server computer, a hand-held device, a laptop device, a multiprocessor system, a microprocessor-based system, a cloud-computing system, a programmable consumer electronic (e.g., smart phone), a network computer, a minicomputer, a mainframe computer, a tablet, a remote control unit, a distributed computing environment that includes any of the above systems or devices, and the like. The computing device 1617 can be a single virtual or physical device operating in a networked environment over communication links to one or more remote devices.

[0164] In its most basic configuration, the computing device 1617 includes at least one processing unit 1625 and memory 1627. The processing unit 1625 includes one or more hardware or software processors (e.g., Central Processing Units) that can obtain and execute instructions. Indeed, the processing unit 1625 can be implemented as firmware elements, partially or fully implemented with digital logic gates in one or more application-specific integrated circuits (ASICs), partially or fully in software, etc. The processing unit 1625 is configured to execute the information stored in the memory 1627 to perform various techniques discussed herein. The processing unit 1625 can communicate with and control the performance of other components of the computing device 1617.

[0165] The memory 1627 is one or more software or hardware-based computer-readable storage media operable to store information accessible by the processing unit 1625. The memory 1627 can store, among other things, instructions executable by the processing unit 1625 to implement applications or cause performance of operations described herein, as well as other data. The memory 1627 can be volatile memory (e.g., random access memory (RAM)), non-volatile memory (e.g., read only memory (ROM)), or combinations thereof. The memory 1627 can include transitory memory or non-transitory memory. The memory 1627 can also include one or more removable or non-removable storage devices. In examples, the memory 1627 can include RAM, ROM, Electronically-Erasable Programmable Read-Only Memory (EEPROM), flash memory, optical disc storage, magnetic storage, solid state storage, or any other memory media usable to store information for later access. In examples, the memory 1627 encompasses a modulated data signal (e.g., a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal), such as a carrier wave or other transport mechanism, and includes any information delivery media. By way of example, and not limitation, the memory 1627 can include wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, Radiofrequency (RF), infrared, and / or other wireless media or combinations thereof. In certain embodiments, the memory 1627 comprises control logic 1629 that, when executed, enables the processing unit 1625 to perform aspects of the techniques presented.

[0166] In the illustrated example, the computing device 1617 further includes a network adapter 1631, one or more input devices 1633, and one or more output devices 1635. The computing device 1617 can include other components, such as a system bus, component interfaces, a graphics system, a power source (e.g., a battery), among other components. The network adapter 1631 is a component of the computing device 1617 that provides network access (e.g., access to at least one network 1637). The network adapter 1631 can provide wired or wireless network access and can support one or more of a variety of communication technologies and protocols, such as ETHERNET, cellular, BLUETOOTH, near-field communication, and / or RF, among others. The network adapter 1631 can include one or more antennas and associated components configured for wireless communication according to one or more wireless communication technologies and protocols.

[0167] The one ormore input devices 1633 are devices overwhich the computing device 1617 receives input from a user. The one or more input devices 1633 can include physically- actuatable user-interface elements (e.g., buttons, switches, or dials), touch screens, keyboards, mice, pens, and / or voice input devices, among others input devices. The one or more output devices 1635 are devices by which the computing device 1617 is able to provide output to a user. The output devices 1635 can include a display, a light emitter, one or more speakers, and / or a haptic feedback output device, among other output devices.

[0168] As noted, merely for ease of illustration, the techniques presented herein are primarily described with reference to cleaning a specific type of medical lumen, namely the channels of an endoscope. However, it will be appreciated that the invention is not limited to use with endoscopes or, more generally, to only use with medical devices, or with reference to fluidic composition. As such, it is to be appreciated that the techniques presented herein can be used to in association with the cleaning of lumens of a number of different devices / instruments used in any of a number of different applications, such as dental lines, food / drink lines, other medical lumens, etc.

[0169] Certain aspects of the techniques presented herein have been described with reference to various descriptions of fluid dynamics. It is to be appreciated that these various descriptions are provided for purposes of illustration and that the innovation presented herein works regardless of the believed understanding of the fluid dynamics.

[0170] As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant tosuggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. In general, additional configurations can be used to practice the processes and systems herein and / or some aspects described can be excluded without departing from the processes and systems disclosed herein.

[0171] This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

[0172] As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and / or some aspects described can be excluded without departing from the methods and systems disclosed herein.

[0173] According to certain aspects, systems and non-transitory computer readable storage media are provided. The systems are configured with hardware configured to execute operations analogous to the methods of the present disclosure. The one or more non-transitory computer readable storage media comprise instructions that, when executed by one or more processors, cause the one or more processors to execute operations analogous to the methods of the present disclosure.

[0174] Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosed steps can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.

[0175] Although specific aspects were described herein, the scope of the technology is not limited to those specific aspects. One skilled in the art will recognize other aspects or improvements that are within the scope of the present technology. Therefore, the specific structure, acts, or media are disclosed only as illustrative aspects. The scope of the technology is defined by the following claims and any equivalents therein.

[0176] It is also to be appreciated that the embodiments presented herein are not mutually exclusive and that the various embodiments may be combined with another in any of a number of different manners.

Claims

CLAIMSWhat is claimed is:

1. A method for cleaning a medical device, the method comprising: delivering one or more modified water flows to a channel of the medical device; and intermittently delivering air flows to the channel.

2. The method of claim 1, wherein the delivering one or more modified water flows to the channel of the medical device comprises: delivering one or more ozonated water flows to the channel.

3. The method of claim 1, wherein intermittently delivering air flows to the channel comprises: intermittently delivering air flows to the channel with each of the one or more modified water flows.

4. The method of claim 1, wherein intermittently delivering air flows to the channel comprises: intermittently delivering air flows to the channel separate from the one or more modified water flows.

5. The method of claim 1, further comprising: flushing the channel with at least one modified water flow over a period of time.

6. The method of claim 5, wherein flushing the channel with at least one modified water flow over the period of time is performed before delivering the one or more modified water flows to the channel.

7. The method of claim 1, further comprising: delivering one or more shots of a liquid-powder mixture to the channel.

8. The method of claim 7, wherein delivering one or more shots of the liquid-powder mixture to the channel comprises: mixing a liquid with a powder to form the liquid-powder mixture; andapplying at least one flow of fluid to a portion of the liquid-powder mixture to propel the portion of the liquid-powder mixture through the channel.

9. The method of claim 8, wherein the liquid comprises modified water.

10. The method of claim 1, wherein the delivering one or more modified water flows to the channel of the medical device comprises: delivering one or more plasmon-activated water flows to the channel.

11. The method of claim 1, wherein the medical device comprises an endoscope.

12. The method of claim 1, wherein a cleaning device is used to deliver the one or more modified water flows to the channel, and wherein the method comprises: flowing at least one additional modified water flow through the cleaning device to self-clean the cleaning device.

13. A method, comprising: delivering one or more modified water flows to a channel of a medical device; and delivering one or more contaminant-detaching flows to the channel to interrupt the one or more modified water flows and to cause a contaminant-detaching action with an interior surface of the channel.

14. The method of claim 11, wherein the one or more contaminant-detaching flows comprise one or more air flows.

15. The method of claim 14, wherein the one or more air flows are delivered with the one or more modified water flows to induce turbulent flow of the one or more modified water flows and interrupt the one or more modified water flows.

16. The method of claim 13, wherein the one or more contaminant-detaching flows comprise one or more apportioned amounts of liquid-powder mixture.

17. The method of claim 14, wherein the one or more modified water flows are delivered to the channel of the medical device without powder material.

18. The method of claim 13, wherein the one or more contaminant-detaching flows are interspersed between the one or more modified water flows to interrupt the one or more modified water flows.

19. The method of claim 13, comprising: delivering one or more additional modified water flows after delivering the one or more contaminant-detaching flows to the channel of the medical device.

20. A method, comprising: delivering a flow of modified water to a channel of a medical device to reduce adhesion of contaminants to a wall of the channel; and delivering one or more cleaning shots to the lumen to separate the contaminants from the wall for removal from the channel.

21. The method of claim 20, further comprising: disrupting the flow of modified water to induce a turbulent flow of modified water.

22. The method of claim 21, further comprising: directing an air flow with the flow of modified water to induce the turbulent flow of modified water.

23. The method of claim 20, wherein delivering one or more cleaning shots to the lumen to separate the contaminants from the wall for removal from the channel comprises: directing a liquid-powder mixture to the channel.

24. The method of claim 23, further comprising: apportioning the liquid-powder mixture to an apportioned amount, and wherein directing the liquid-powder mixture to the channel of the medical device comprises directing the apportioned amount of the liquid-powder mixture to the channel.

25. The method of claim 20, further comprising: delivering an additional flow of modified water to the channel of the medical device after delivering one or more cleaning shots.

26. A method, comprising: flowing, via a cleaning device, a fluid to a channel of a medical device to clean the medical device; and flowing, via a module, modified water through the cleaning device to self-clean the cleaning device.

27. The method of claim 26, wherein the fluid flowing to the channel of the medical device includes modified water.

28. The method of claim 27, comprising creating, via the module, modified water flowing to the channel of the medical device and modified water flowing through the cleaning device.

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