Systems, devices, and methods for insufflation of body lumens and cleaning of surgical instruments

Abstract

Embodiments described herein relate to systems and methods of cleaning cameras during surgical procedures. In some embodiments, a controller for initiating a wash sequence can also be configured to control insufflation of a body cavity and / or vacuuming or venting from a body cavity.

Description

Agent’s File Ref. BAYU-007 / 01WO 343337-2060SYSTEMS, DEVICES, AND METHODS FOR INSUFLATTION OF BODY LUMENS AND CLEANING OF SURGICAL INSTRUMENTSCross-Reference to Related Applications

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 698,466, filed September 24, 2024, titled “SYSTEMS, DEVICES, AND METHODS FOR INSUFFLATION OF BODY LUMENS AND CLEANING OF SURGICAL INSTRUMENTS,” the disclosure of which is hereby incorporated by reference in its entirety.Technical Field

[0002] Embodiments described herein relate to systems, devices, and methods for insufflation and instrument cleaning, and in particular, to trocars for cleaning endoscopes and insufflating body lumens.Background

[0003] In many medical procedures, an insufflation device can be used to expand or inflate a body lumen or cavity of a patient with a gas. The expansion of the body cavity can facilitate visualization within the body cavity and / or performance of a surgical procedure within the body cavity. The degree of insufflation of a body cavity, however, may change during the course of a procedure, e.g., due to gas leakage through various orifices of the body cavity and / or instrument channels placed within the body cavity (e.g., endoscope and / or trocar channels). As such, continuous and / or intermittent insufflation through a surgical procedure may be needed to ensure that a body cavity remains sufficiently inflated.

[0004] During surgical procedures, it is also common to use cameras to view the inside of a body cavity. One common example of a camera is an endoscope. The endoscope may be introduced into a patient’s body via a natural orifice or through a small surgical incision. Endoscopes and other cameras can be coupled to or include an imaging system and an illumination system. The imaging system receives image data captured by the endoscope, and the illumination system can be used to provide light to assist in image capture. The three systems work together to give the physician views of the body cavity. During use, however, the tip of an endoscope or other camera may become obscured, e.g., due to smears, residue, debris, condensation, and / or other types of obstructing material. Therefore, there exists a needAgent’s File Ref. BAYU-007 / 01WO 343337-2060 for an efficient way to clean the end of endoscopes and other cameras during a surgical operation.

[0005] It can therefore be useful to have devices for providing insufflation and for instrument cleaning.Summary

[0006] Embodiments described herein relate to systems, devices, and methods for insufflation and for instrument cleaning. In some embodiments, a system can include a trocar designed to clean the end of an imaging device, such as, for example, an endoscope. In some embodiments, the trocar can be positioned in a body cavity (e.g., thoracic cavity, abdominal cavity). In laparoscopic surgery, for example, the trocar penetrates through the thickness of the abdominal or chest wall to provide access for various instruments to the interior of the body. The trocar is designed such that instruments can be inserted into the body interior without the significant loss of insufflation gases used to expand the body cavity. As such, the trocar is configured to create and maintain a working space for those instruments. In some embodiments, an endoscope can be placed through the trocar, and an imaging system receiving signals from the endoscope can display images of the body interior to guide the surgical procedure. In some embodiments, the trocar can include one or more sensors. In some embodiments, the trocar can include a sensor configured to sense an intraluminal pressure of a body cavity. In some embodiments, the trocar can include a sensor for sensing the position of the distal end of an endoscope. The trocar can be configured to deliver quantities of liquid and / or gas to insufflate the body cavity and / or clean the end of the endoscope.

[0007] In some embodiments, a system can include a controller configured to control insufflation of a body cavity and cleaning of an instrument (e.g., an endoscope). The controller can be coupled to one or more trocars. In some embodiments, the controller can be coupled to a first trocar configured to receive an endoscope and a second trocar configured to insufflate the body cavity. The controller can be configured to activate delivery of gas and / or liquid to first and second trocars to clean the endoscope and / or insufflate the body cavity.Brief Description of the Drawings

[0008] The skilled artisan will understand that the drawings primarily are for illustrative purposes and are not intended to limit the scope of the inventive subject matter described herein. The drawings are not necessarily to scale; in some instances, various aspects of the inventive subject matter disclosed herein may be shown exaggerated or enlarged in theAgent’s File Ref. BAYU-007 / 01WO 343337-2060 drawings to facilitate an understanding of different features. In the drawings, like reference characters generally refer to like features (e.g., functionally similar and / or structurally similar elements). Also in the drawings, optional items are shown in dashed lines.[0009| FIG. l is a block diagram of a cleaning system for cleaning an endoscope disposed in a patient’s anatomy (e.g., body lumen or cavity), according to an embodiment.

[0010] FIG. 2 is a block diagram of a controller of a cleaning system, according to an embodiment.

[0011] FIGS. 3A-3C show different configurations of connections between a controller of a cleaning system and one or more trocars disposed in a body lumen, according to various embodiments.

[0012] FIG. 4 is a diagram of a trocar of a cleaning system, according to an embodiment.

[0013] FIGS. 5 A-5B show side views of trocars with pressure sensors, according to various embodiments.

[0014] FIGS. 6A-6C show cross-sectional views of different trocar shafts of cleaning systems, according to various embodiments.

[0015] FIG. 7 is a flow diagram of a method associated with operating cleaning systems, according to an embodiment.

[0016] FIG. 8 is a flow diagram of a method associated with operating cleaning systems, according to an embodiment.

[0017] FIG. 9 is a flow diagram of a method associated with operating cleaning systems, according to an embodiment.

[0018] FIG. 10 is a flow diagram of a method associated with operating cleaning systems, according to an embodiment.Detailed Description

[0019] Embodiments described herein relate to systems, devices, and methods for cleaning imaging devices, such as, for example, endoscopes. Such systems, devices, and methods can be configured to clean the imaging devices while they are positioned within patient anatomy (e.g., a body lumen or cavity), e.g., when they are in use during a surgical procedure. In some embodiments, a cleaning system for cleaning an endoscope can be configured to use gas to propel small, controlled amounts of a liquid into a lumen of a trocar. In some embodiments, the gas can include carbon dioxide (CO2), nitrogen, argon, or any other suitable inert gas or combinations thereof. A liquid such as a wash solution is used to clean a distal end of the imaging devices. In some embodiments, an obturator can be shaped to fit in the trocar.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0020] Endoscopes can vary significantly. Some endoscopes use optical light, while others use infrared. Different endoscopes can also have different sizes and / or configurations. For example, some endoscopes can have a flat distal end, while other endoscopes can have angled or tapered distal ends. Systems and devices described herein can include sensors (e.g., light sensors) that can be configured to detect when an endoscope passes the sensor for a variety of different endoscopes. Once an endoscope is in a position to be cleaned, a bolus of wash solution is ejected onto the endoscope. After the ejection of the wash solution, a line containing the wash solution can be primed with fluid for a subsequent wash sequence. In some embodiments described herein, sensors on the trocar can detect illumination features at the end of the endoscope, thus identifying the precise position of the end of the endoscope, relative to the trocar shaft. The optical window of the endoscope that receives the image is nearly always in close proximity to the illumination features, and therefore, systems as described herein can detect the location of the optical end of the scope that has become soiled by surgical debris. Precisely positioned fluid and gas outlets on the inside of the trocar can then be actuated to provide a precise cleaning burst onto the tip of the endoscope, once the position of the endoscope has been detected by the optical sensors that locate the position of the illumination features.

[0021] Examples of endoscope cleaning systems are described in U.S. Patent Publication No. 2019 / 0125176, filed October 18, 2018, and titled, “Trocars,” U.S. Patent Publication No. 2021 / 0127963, filed November 21, 2019, and titled “Intraoperative Endoscope Cleaning System,” U.S. Patent Publication No. 2021 / 0127964, filed November 21, 2019, and titled “Intraoperative Endoscope Cleaning System,” International Patent Application No. US2023 / 064451 filed March 15, 2023, and titled “Systems, Devices, And Methods For Controlled Fluid Delivery,” International Patent Application No. US2023 / 064448, filed March 15, 2023, and titled “Cleaning Devices And Systems For Surgical Instruments, And Methods Thereof,” and International Patent Application No. US2023 / 064479, filed March 15, 2023, and titled “Robotic Cleaning Devices And Systems For Surgical Instruments, And Methods Thereof’ the disclosure of each of which is hereby incorporated by reference in its entirety. Systems, devices, and methods described herein provide improvements over such cleaning systems, e.g., by improving delivery of liquid and / or gas into a trocar, integrating controller circuitry for insufflation and cleaning together, and / or improving venting of excess gases within a body lumen or cavity via a trocar. Conventional systems may rely on user input or data transmission from other, distinct processors or devices to trigger insufflation, cleaning, venting, etc. As such, conventional systems may be disadvantaged or inhibited by user error,Agent’s File Ref. BAYU-007 / 01WO 343337-2060 processing errors, lag time in data transmission, etc. Contrast this with the systems, methods and devices described herein having integrated insufflation, venting, and / or cleaning systems operably coupled to a controller, thereby enabling prompt, streamlined communication between such systems. For example, the insufflation system described in reference to systems, methods and devices described herein can be controlled, via controller circuitry, based on sensor data associated with a vacuum system, image data associated with an imaging device, sensor data associated with delivery of liquid and / or gas, etc. In one embodiment, for example, the controller described herein can cause the insufflation system to deliver gas of a higher temperature than a temperature within the body lumen based on fog detected by the imaging system and / or humidity detected by a sensor system within the body lumen. In this manner, systems, methods and devices described herein can provide a more transparent, and thus safer, perspective of the body cavity by evaporating moisture from the lens of the endoscope with relatively warm insufflation gas.

[0022] Additionally, insufflation of the body lumen can be important for viewing an interior of the body lumen and / or performing a surgical operation. Without insufflation, the view of endoscopes can be obscured, e.g., by the walls of the body lumen or other nearby tissue. By insufflating the interior of the body lumen, space can be created within the body lumen that allows for a clear view of the body lumen as well as access to and / or maneuverability around a surgical site. In some embodiments, systems, devices and methods can include a controller that can perform wash functions as well as insufflation.

[0023] With the use of an insufflator, monitoring the pressure inside the body lumen is important to ensure sufficient insufflation but to prevent over-pressurizing. In laparoscopic abdominal procedures, for example, the abdominal cavity is generally insufflated with a gas (e.g., carbon dioxide or CO2) to a pressure of around 15 mm Hg. In some embodiments, systems, devices, and methods can include pressure sensors that can facilitate such pressure monitoring.

[0024] FIG. 1 is a block diagram of a system 100 for cleaning an endoscope (also referred to as a “scope”) and insufflation, according to an embodiment. As shown, the system 100 includes a controller 120 that can be coupled to one or more instruments 130a, 130b, 130c (collectively referred to as instruments 130). The controller 120 can also be coupled to a gas source 160 and a liquid source 170, such that the controller 120 can control the delivery of a gas and / or liquid to the instrument(s) 130, e.g., for performing a wash sequence and / or insufflation. Optionally, the controller 120 can also be fluidically coupled to a vacuum sourceAgent’s File Ref. BAYU-007 / 01WO 343337-2060180. Lines depicted in FIG. 1 connecting the various components of system 100 to each other can represent electrical, physical, and / or fluidic couplings.

[0025] The gas source 160 is configured to contain a gas (e.g., for insufflation, propelling or atomizing a liquid, and / or drying). In some embodiments, the gas from gas source 160 can be transported to at least one of the instrument(s) 130 to insufflate the body lumen. In some embodiments, the gas from the gas source 160 can be transported to at least one of the instrument(s) 130 to propel a liquid (e.g., from liquid source 170) into the instrument 130 for cleaning an endoscope. In some embodiments, the gas can include an inert gas. In some embodiments, the gas can include air, CO2, nitrogen, argon, or any combination thereof. The selected gas can be a gas that is commonly used in medical procedures and is safe for delivery into a body lumen or cavity. In some embodiments, the gas source 160 can include a container (e.g., a tank) that houses a volume of pressurized gas. In some embodiments, the gas source 160 can deliver gas at a pressure of between about 20 psi and about 50 psi, including all values and sub-ranges therebetween. The controller 120 controls the delivery of gas from the gas source 160 to the instrument s) 130 when the instruments 130 are disposed in the body lumen.

[0026] The liquid source 170 is configured to contain a liquid (e.g., wash liquid or solution), e.g., for cleaning an endoscope. In some embodiments, the washing fluid can include a saline solution, a buffered solution, a bio-compatible surfactant, and / or any other suitable wash solution, including those described in U.S. Patent Publication No. 2021 / 0127963, incorporated by reference above. The liquid source 170 can be configured to contain a volume of liquid that is sufficient for conducting at least about 5, at least about 10, at least about 50, at least about 100, at least about 500, at least about 1000, at least about 1500, or at least about 2000 wash sequences. For example, the liquid source 170 can include enough liquid for cleaning an endoscope throughout the duration of a surgical procedure.

[0027] The optional vacuum source 180 can be configured to generate a vacuum or suction, e.g., for removing gas and / or liquid from a body lumen. In some embodiments, the vacuum source 180 can be configured to remove gas and / or liquid to maintain the pressure of a body lumen within a predefined range of pressures or below a pressure threshold. In some embodiments, medical devices (e.g., ultrasonic scalpels) operating within the body lumen can generate smoke or other gaseous byproduct that can, in turn, at least partially fill the body lumen or otherwise obscure a perspective of an imaging device disposed therein. In such embodiments, the vacuum source 180 is configured to remove smoke from the body lumen. The vacuum source 180 can be a vacuum pump.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0028] The instrument^ s) 130 can include surgical instruments that can be placed within a patient to provide access into a body lumen or cavity of the patient. In some embodiments, the instrum ent(s) 130 can include one or more trocars. In use, an instrument 130a such as a trocar can be placed in the body lumen or cavity, e.g., with or without an obturator. In some embodiments, the instrument 130a can be used for delivery of gas, e.g., for insufflation. In some embodiments, a second instrument 130b such as a trocar can be placed in the body lumen or cavity and used for a different purpose than instrument 130a. For example, the second instrument 130b can be configured to receive an endoscope, e.g., for viewing an interior of the body lumen. The second instrument 130b can be configured to delivery gas and / or liquid for washing the endoscope. In some embodiments, a third instrument 130c such as a trocar can be placed in the body lumen or cavity and used for a different purpose than instruments 130a, 130b. For example, the third instrument 130b can be configured to vent gases from the body lumen, e.g., via active (vacuum) and / or passive means. In some embodiments, a single instrument 130a can be used for multiple purposes. For example, the instrument 130a can be used for the delivery of liquid and / or gas as well as for venting and / or vacuuming.

[0029] Desirably, a single instrument 130a (e.g., a single trocar) can be used with the controller 120 to provide insufflation and to clean an endoscope. For example, a single trocar can be positioned within a body lumen. The trocar can be coupled to the controller 120 via one or more connectors. In some embodiments, a single connector including one or more liquid lines, gas lines, or electrical lines can couple the trocar to the controller 120. With the trocar positioned within the body lumen, the controller 120 can control delivery of gas via the connector to the trocar to insufflate the body cavity. An endoscope can then be positioned within the trocar (e.g., within a central channel of the trocar) to gain visualization of the body cavity. During a surgical procedure, if the endoscope were to become soiled by surgical debris, then the controller 120 can control delivery of gas and / or liquid via the connector to the trocar to clean the distal end of the endoscope. As such, a single trocar that is coupled via a single connector to the controller 120 can be used to provide insufflation and scope cleaning during a surgical procedure. This desirably reduces the number of instruments and connections within an operating room, as well as reducing the number of steps required for setup during a surgical procedure.

[0030] FIG. 2 is a block diagram of a controller 220 of a system for cleaning (e.g., performing wash sequences) and insufflation, according to an embodiment. As shown, the controller 220 includes a memory 221, a processor 222, a communication interface 224, and an input / output (I / O) device 226.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0031] Memory 221 can be, for example, a random access memory (RAM), a memory buffer, a hard drive, a database, an erasable programmable read-only memory (EPROM), an electrically erasable read-only memory (EEPROM), a read-only memory (ROM), and / or so forth. In some embodiments, memory 221 stores instructions that cause processor 222 to execute modules, processes, machine learning models, and / or functions associated with insufflation, wash sequences, and / or venting or suction. These modules, processes, machine learning models, and / or functions can include, for example, an insufflation control 221a, vacuum control 221b, wash control 221c, and pressure monitoring 22 Id. Insufflation control 221a, vacuum control 221b, wash control 221c, and pressure monitoring 22 Id can be implemented as one or more programs and / or applications that are tied to hardware components (e.g., a processor, I / O device, liquid source, gas source, etc.). The insufflation control 221a controls the delivery of gas to the body lumen. This can be via a series of valve openings and closings. The vacuum control 221b controls removal of gas and / or liquid from the body lumen. The wash control 221c controls delivery of gas and / or liquid to the body lumen, e.g., to clean a distal end of an endoscope. The pressure monitoring 22 Id measures pressure within the body lumen. If the pressure measured by the pressure monitoring 22 Id is above a preset or predetermined value, the vacuum control 221b can activate a vacuum to remove gas and / or liquid from the body lumen.

[0032] In some embodiments, the memory 221 stores one or more models (e.g., Artificial Intelligence (Al) models and / or machine learning (ML) models) trained on data from the memory 221 and / or from an external database (e.g., a patient database). In some embodiments, such data can include images, sensor data, user inputs, etc. The data can be historical data associated with or otherwise including insufflation procedures, endoscope cleaning procedures, trocar operation, or any other surgical procedure described herein. As such, the one or more models stored in the memory 221 can be configured to classify objects, detect anomalies, determine measurements, identify trends, etc., associated with inputs from, for example, the insufflation control 221a, the vacuum control 221b, the wash control 221c, the pressure monitoring 22 Id, etc. In some embodiments, the one or more models can use edge detection algorithms to recognize shapes or segment objects in image data.

[0033] The processor 222 can be any suitable processing device configured to run and / or execute modules, processes, models, and / or functions associated with insufflation, wash sequences, and / or venting or suction. For example, the processor 222 can be configured to execute one or more of insufflation control 221a, vacuum control 221b, wash control 221c, and pressure monitoring 22 Id. In some embodiments, the processor 222 can be configured toAgent’s File Ref. BAYU-007 / 01WO 343337-2060 receive data from one or more sensors disposed along a channel of an instrument (e.g., the instrument s) 130, as described above with respect to FIG. 1), e.g., to detect when an endoscope is being retracted within the trocar for initiating a wash sequence. In some embodiments, the processor 222 can be configured to receive data from a pressure sensor configured to measure a pressure of a body lumen, and to control delivery of gas and / or removal of gas and / or liquids from the body lumen. In turn, the processor 222 can transmit the data (e.g., from the sensors) to one or more models stored in memory 221. The processor 222 can be electrically connected to one or more electrical components (e.g., disposed in one or more instrument(s) 130) via a communication interface 224. For example, the processor 222 can receive data from sensor(s) (not shown). In some embodiments, the processor 222 can receive information from the sensor(s) and based on that information, control the insufflation control 221a, the vacuum control 221b, and / or the wash control 221c. Further, the processor 222 can receive information from the one or more models stored in the memory 221 and based on that information, control the insufflation control 221a, the vacuum control 221b, and / or the wash control 221c.

[0034] The communication interface 224 provide one or more wired and / or wireless connections between the controller 220 and one or more other devices. In some embodiments, the communication interface 224 can include a network interface that can be configured to provide a wireless and / or wired connection to a network, e.g., to enable communication between the controller 220 and a remote device (e.g., a computer, a workstation, a portable device, a mobile device, etc.). In some embodiments, the communication interface 224 can include one or more ports and / or wires for coupling to one or more electrical components of cleaning and / or insufflation system. For example, the communication interface 224 may be configured to receive inputs from or send outputs to one or more electrical components of an instrument (e.g., the instrument(s) 130), a gas source (e.g., gas source 160), and / or a liquid source (e.g., liquid source 170). For example, the processor 222 may determine a quantity (e.g., volume) of gas and / or liquid that needs to be delivered to an instrument, the rate or timing of the gas and / or liquid delivery, the pressure of the gas and / or liquid delivery, and / or other characteristics associated with the transmission of the gas to the instrument. The processor 222, via the communication interface 224, can then control the opening and / or closing of one or more valves or other components to control the delivery of gas and / or liquid to the instrument.

[0035] The I / O device 226 can be configured to communicate to and / or receive information from a user. The VO device 226 can include any suitable input device or output device, such as a screen or display, a touch screen, a keyboard, a button, a switch, one or more signaling lights, a transmitter and / or receiver for transmitting signals to and / or receiving signals from anAgent’s File Ref. BAYU-007 / 01WO 343337-2060 external device, a microphone, a speaker, and the like. In some embodiments, the user may input parameters for operating the controller 220 via the I / O device 226.

[0036] FIGS. 3A-3C show different configurations of couplings between a controller and one or more instruments disposed in a body lumen, according to various embodiments. FIG. 3 A shows a controller 320 with insufflation control 321a, vacuum control 321b, wash control 321c, and pressure monitoring 32 Id. The insufflation control 321a, vacuum control 321b, wash control 321c, and pressure monitoring 32 Id can be similar to the insufflation control 221a, vacuum control 221b, wash control 221c, and pressure monitoring 221d described above. For example, the insufflation control 321a can control supply of a gas for insufflation of the body lumen, the vacuum control 321b can control evacuation of gas and / or liquid from the body lumen, the wash control 321c can control delivery of gas and / or liquid to the body lumen for a wash sequence, and the pressure monitoring 32 Id can monitor the pressure inside the body lumen. As shown in FIG. 3A, the controller 320 can be coupled to a first instrument 330a for implementing the wash control 321c and the pressure monitoring 32 Id. The controller can also be coupled to a second instrument 330b for implementing the insufflation control 321a and the vacuum control 321b. In other words, the controller 320 can control delivery of gas and / or liquid to a first instrument 330a for performing a wash sequence (e.g., to clean a distal end of an endoscope). That same instrument 330a can include a pressure sensor that can provide intraluminal pressure information to the controller 320. The controller 320 can also control delivery of gas to the body lumen via a second instrument 330b and / or removal (e.g., vacuuming) of gas and / or liquid from the body lumen via the second instrument 330b. In some embodiments, the controller 320 can control the delivery of gas and / or liquid to the body lumen or the removal thereof based on pressure information received from the first instrument 330a. In an embodiment, the instruments 330a, 330b can be trocars.

[0037] In some embodiments, the insufflation control and vacuum control can be implemented via different instruments, e.g., two trocars. FIG. 3B shows a controller 320’ with insufflation control 321a’, vacuum control 321b’, wash control 321c’, and pressure monitoring 321d’. The insufflation control 321a’, vacuum control 321b’, wash control 321c’, and pressure monitoring 32 Id’ can be similar to the insufflation control 221a, vacuum control 221b, wash control 221c, and pressure monitoring 22 Id described above. As shown, the controller 320’ can be coupled to a first instrument 330a’ for implementing the wash control 321c’ and the pressure monitoring 321d’, to a second instrument 330b’ for implementing the vacuum control 321b’, and to a third instrument 330c’ for implementing the insufflation control 321a’.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0038] In some embodiments, the insufflation control, vacuum control, wash control, and pressure monitoring can be implemented via the same instrument, e.g., a single trocar. FIG. 3C shows a controller 320” with an insufflation control 321a”, a vacuum control 321b”, a wash control 321c”, and pressure monitoring 32 Id”. The controller 320” can be coupled to a single instrument 330” that is inserted into a body lumen for implementing these functions.

[0039] In some embodiments, a single connector can also be used to couple the controller 320” to the instrument 330” to enable implementation of insufflation, vacuum, and / or wash functions. As depicted in FIG. 3C, the controller 320” can be coupled to the single instrument 330” via a single connector. The connector can include a plurality of lines, such as, for example, a liquid line, a gas line, an electrical line, and / or other lines, can be used to couple the controller 320” to the instrument 330”. The plurality of lines can be independent lines, i.e., lines that are separated from one another, but the plurality of lines can be disposed within a single sheath or outer jacket. In some embodiments, the connector can also include one or more additional layers or materials, including, for example, insulators, shields, etc. to keep the lines separated and / or protected from external elements. The connector can include an instrument connection (e.g., trocar connection) at a first end and a controller connection at a second end. The instrument connection can be configured to couple to the instrument 330” (e.g., by plugging into a port of the instrument), and the controller connection can be configured to couple to the controller 320” (e.g., by plugging into a port of the controller). The plurality of lines can extend from the controller connection to the trocar connection. In use, a surgeon or other individual can connect the controller connection to the controller 320” such that the plurality of lines is coupled to respective lines within the controller 320” and connect the instrument connection to the instrument 330” such that the plurality of lines is coupled to the respective lines within the instrument 330”. Once coupled to the controller 320” and the instrument 330”, the connector can then provide liquid, gas, and / or electrical communication or couplings between the controller 320” and the instrument 330”. By having a single connector that can facilitate multiple couplings, the complexity of setting up the system can be reduced.

[0040] In some embodiments, the instruments 330a, 330b, 330a’, 330b’, 330c’, 330” can be the same or substantially similar to the instruments 130, as described above with reference to FIG. 1. In some embodiments, the insufflation control 321a, 321a’, 321a” can be the same or substantially similar to the insufflation control 221a, as described above with reference to FIG. 2. In some embodiments, the vacuum control 321b, 321b’, 321b” can be the same or substantially similar to the vacuum control 221b, as described above with reference to FIG. 2.Agent’s File Ref. BAYU-007 / 01WO 343337-2060In some embodiments, the wash control 321c, 321c’, 321c” can be the same or substantially similar to the wash control 221c, as described above with reference to FIG. 2. In some embodiments, the pressure monitoring 32 Id, 32 Id’, 32 Id” can be the same or substantially similar to the pressure monitoring 22 Id, as described above with reference to FIG. 2. Thus, certain aspects of the insufflation control 321a, 321a’, 321a”, the vacuum control 321b, 321b’, 321b”, the wash control 321c, 321c’, 321c”, the pressure monitoring 321d, 321d’, 321d”, and instruments 330a, 330b, 330a’, 330b’, 330c’, 330” are not described in greater detail herein.

[0041] While specific numbers of instruments 330a, 330b, 330a’, 330b’, 330c’, 330” are depicted in FIGS. 3A-3C, it can be appreciated that other configurations of couplings between a controller and one or more instruments can be implemented. For example, four instruments, including an instrument that is associated with each of insufflation control, vacuum control, wash control, and pressure monitoring, can be used. In other embodiments, different couplings between a controller and one or more instruments can be implemented, such as where pressure monitoring and insufflation control are implemented via a single instrument, while other functions are implemented via different instruments. Any combination of couplings between a controller and one or more instruments for implementing insufflation control, vacuum control, wash control, and pressure monitoring are contemplated within the present disclosure.

[0042] FIG. 4 is a diagram of a trocar 430, according to an embodiment. The trocar 430 can be an example of an instrument, e.g., instrument 130, 330a, 330b, etc., and therefore can be structurally and / or functionally similar to other instruments described herein. As shown, the trocar 430 includes a trocar hub 431 and a trocar shaft 432. A trocar channel 433 extends through the trocar shaft 432. One or more sensors 434, an electronic connection 435, one or more liquid / gas ports 436, and / or a liquid / gas connection 437 are integrated into or disposed in the trocar shaft 432. An electrical line 482 can be coupled to the electronic connection 435, while a gas line 462 and a liquid line 472 can be coupled to the liquid / gas connection 437. An optional vent 438 and / or vacuum port 439 can also be integrated into or disposed in the trocar shaft 432. The vacuum port 439 can be coupled to a vacuum source 490.

[0043] The trocar hub 431 is an enlarged portion of the trocar 430 for housing one or more components of the trocar 430. The trocar hub 431 provides a handle for placement of the trocar 430. The trocar shaft 432 is an elongated portion of the trocar 430 and is connected to the trocar hub 431. In use, the trocar hub 431 can be positioned outside of a patient’s body while the trocar shaft 432 (or a substantial majority of the trocar shaft 432) is positioned within the patient’s body.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0044] The trocar hub 431 and the trocar shaft 432 can collectively define the trocar channel 433 for receiving an instrument, e.g., an endoscope, an obturator, etc. In some embodiments, the trocar channel 433 can have a diameter of between about 1 mm and about 10 mm, including all sub-ranges and values there between. For example, the trocar channel 433 can have a diameter of about 3 mm or slightly larger than 3 mm such that the trocar channel 433 is configured to receive an instrument (e.g., endoscope) having up to a 3 mm diameter. In use, the trocar 430 can be positioned within a patient such that the channel 433 extends into a body lumen or cavity. The channel can therefore provide access to a body lumen or cavity, e.g., for positioning one or more instruments within the body lumen or cavity. The trocar 430 can be positioned through an incision in the patient’s body. In some embodiments, an obturator can be positioned within the trocar channel 433 while the trocar is being positioned within the body and then removed after the distal end of the trocar has been positioned within the body lumen or cavity. Other instruments (e.g., endoscopes) can then be positioned within the trocar channel 433 after the obturator has been removed.

[0045] The trocar 430 can form a part of a cleaning system for an endoscope. As such, the trocar 430 can include components that can facilitate a cleaning or wash sequence associated with an endoscope. In particular, the trocar 430 can include one or more ports and / or one or more sensor(s) 434.

[0046] In some embodiments, the trocar 430 can optionally include a liquid / gas connection(s) 437. The liquid / gas connection(s) 437 can be configured to combine a liquid stream and a gas stream into one output stream. The liquid / gas connection(s) 437 receives a feed from the gas line 462 and the liquid line 472. The liquid / gas connection(s) 437 can include a collection of valves and tubes for controlling the delivery of fluid (e.g., gas and / or liquid). In some embodiments, the liquid / gas connection(s) 437 can be integrated into or disposed in a connector that coupled to the trocar 430 instead of being integrated into or disposed in the trocar 430. In such embodiments, the output stream from the liquid / gas connection(s) 437 can be coupled to a liquid / gas port integrated into or disposed in the trocar shaft 432.

[0047] The sensor(s) 434 can detect whether a device (e.g., an obturator, a scope) is in the trocar channel 433 and / or a position and / or orientation of the device within the trocar channel 433. The sensor(s) 434 can trigger liquid and / or gas deployment via the liquid / gas port(s) 436 upon detecting that the device is in a position and / or orientation for cleaning. For example, when a device is retracted into the trocar channel 433 such that at least one sensor 434 detects the device, the sensor(s) 434 can trigger liquid and / or gas deployment. The sensor(s) 434 can be coupled to a controller (e.g., controller 220) via electronic connect! on(s) 435 and electricalAgent’s File Ref. BAYU-007 / 01WO 343337-2060 line 482. As such, the sensor(s) 434 can send signals to the controller for detecting a position and / or orientation of the device. In response to detecting that the device is in a position and / or orientation for cleaning, the controller can trigger delivery of the liquid and / or gas via one or more liquid / gas port(s) 436 into the trocar channel 433. In some embodiments, the trocar 430 can include 1, 2, 3, 4, 5, 6, 7, 9, 10, or at least about 10 sensors 434. For example, in some embodiments, the trocar 430 can include a sensor 434 that can be configured to detect when an instrument (e.g., an endoscope) is close to the sensor (e.g., based on light detected by the sensor being above a predetermined threshold), and in response to detecting the light, the liquid and / or gas delivery can be triggered (e.g., via a controller). In some embodiments, the trocar 430 can include a first sensor that detects when an instrument (e.g., endoscope) is first inserted into the trocar channel 433 and a second sensor that detects when the instrument, having been previously inserted into the trocar channel 433, is being retracted for cleaning. In such embodiments, the first sensor, upon detecting that the instrument is being inserted into the trocar channel 433, can send a signal to a controller to not initiate a wash sequence as the instrument passes by the second sensor. Then with subsequent detection of the instrument by the second sensor (e.g., in response to a retraction of the instrument), the second sensor can send a signal to the controller to initiate the wash sequence. The sensor(s) 434 can include one or more light sensors, photoelectric sensors, pressure sensors, infrared sensors, force sensors, position sensors, piezoelectric sensors, mechanical sensors, etc. In some embodiments, a sensor 434 can detect the pressure in the trocar channel 433 or a pressure of the body lumen. The sensor can be coupled to a controller (e.g., controller 120, 220, 320, etc.) that can receive the pressure information from the pressure sensor, and control insufflation, venting, or suction.

[0048] The electronic connect! on(s) 435 can couple the sensor(s) 434 to the electrical line 482 and other electronic components of a cleaning system (e.g., controller 220). In some embodiments, the electronic connection 435 is configured to provide power to the sensor(s) 434. In some embodiments, the electronic connection 435 is configured to send to and / or receive data from the sensor(s) 434.

[0049] The liquid / gas port(s) 436 eject a gas and / or liquid (e.g., a wash solution and / or an insufflation gas) into the trocar channel 433, e.g., to wash a device such as, for example, an endoscope positioned in the trocar channel. In some embodiments, the liquid / gas port(s) 436 can be angled retrograde or back towards a proximal end of the trocar 430 such that the liquid / gas port(s) 436 eject the gas and / or liquid in a proximal direction, e.g., toward a distal end of an instrument. In some embodiments, the trocar 430 can include a single ejection port that is configured to generate a spray, e.g., for cleaning a distal end of an endoscope. In someAgent’s File Ref. BAYU-007 / 01WO 343337-2060 embodiments, the trocar 430 can include a plurality of ejection ports for generating sprays. In some embodiments, the plurality of ejection portions can be set at different angles and / or orientations to cover a larger region within the trocar channel 433.[0050| In use, a high pressure source of gas can be used to deliver a set volume of liquid (e.g., wash solution) into the trocar channel 433. The high-pressure source of gas and the liquid can be coupled via the gas line 462 and the liquid line 472, respectively, to the liquid / gas connection(s) 437. The liquid / gas connection(s) 437 can combine the high pressure gas with the liquid, and with each wash sequence, allow the high pressure gas to draw and eject a set volume of liquid into the trocar channel 433. In some embodiments, the high pressure gas can be delivered at pressures of at least about 20 psi to at least about 50 psi, including all sub-ranges and values therebetween. For example, in an embodiment, the high pressure gas can be delivered at a pressure of at least about 30 psi, at least about 35 psi, or at least about 40 psi. Each wash sequence can last about 100 to about 500 ms, including all sub-ranges and values therebetween. For example, in an embodiment, the wash sequence can be at least about 100 ms to about 300 ms, including 200 ms.

[0051] The liquid being delivered by the liquid / gas port(s) 436 can include water, a saline solution, a buffered solution, or a bio-compatible surfactant. For example, the liquid or wash solution can include a mixture of water and a surfactant. The mixture can include at least about 10% surfactant, about 15% surfactant, about 20% surfactant, about 25% surfactant, about 30% surfactant, about 35% surfactant, about 40% surfactant, or higher amounts of surfactant to water. In use with cleaning an endoscope, the distal end of the endoscope can be coated with a surfactant solution before being inserted into the trocar channel 433. The wash solution with a percentage of surfactant can then be used to wash the distal end of the endoscope, e.g., in one or more wash sequences when the endoscope is retracted. The presence of the surfactant in the wash solution can build a hydrophobic layer on the distal end of the endoscope, which can reduce fogging, water build-up, and other types of build-up on the distal end of the endoscope.

[0052] The optional vent 438 can be fluidically coupled to the trocar channel 433. The vent 438 can be configured to allow for release for gases (e.g., smoke) built up during surgery. The vent 438 can be a passive vent, e.g., an opening that can allow gases to exit the body lumen or cavity via the trocar channel 433 and vent 438. In some embodiments, the vent 438 can include a valve that can be opened and / or closed to allow venting of gases from the body lumen. In some embodiments, the valve can be controlled by a controller (e.g., controller 120, 220, 320, etc.) that receives pressure information from sensor(s) 434 that measure the pressure of the body lumen. For example, the controller can control the valve to open to vent gases fromAgent’s File Ref. BAYU-007 / 01WO 343337-2060 the body lumen when the sensor(s) 434 detects a pressure in the trocar channel 433 that is greater than a preset threshold value. In some embodiments, the threshold value can be between about 10 mmHg and about 20 mmHg, inclusive of all values and ranges therebetween. [0053| The optional vacuum port 439 can be fluidically coupled to the trocar channel 433. The vacuum port 439 can connect the vacuum source 490 to the trocar channel 433, e.g., for generating a vacuum or suction through the trocar channel 433 for removing liquid and / or gas from the body lumen. In some embodiments, activation of the vacuum can be controlled by a controller (e.g., controller 120, 220, 320, etc.) that receives pressure information from sensor(s) 434 that measure the pressure of the body lumen. For example, the vacuum can be activated to remove gas and / or liquid from the body lumen when the sensor(s) 434 detects a pressure in the trocar channel 433 that is greater than a preset threshold value. In some embodiments, the threshold value can be between about 10 mmHg and about 20 mmHg, inclusive of all values and ranges therebetween.

[0054] As described above, an instrument as described herein (e.g., instrument 130, 330a, 330b, etc. or trocar 430) can include one or more pressure sensors. The pressure sensor can be disposed near a distal end of a shaft or at a more proximal location of the instrument. The pressure sensor can be configured to measure intraluminal pressure of a body lumen. FIGS. 5A-5B schematically depict trocars with pressure sensors, according to various embodiments. FIG. 5 A shows a trocar 530 with a pressure sensor 534 disposed in a trocar channel 533. In some embodiments, the pressure sensor 534 can be disposed near a distal end of the trocar channel 533. The pressure sensor 534 is electronically coupled to an electronic connection 535 via an electrical pathway 528. In some embodiments, the trocar 530, the trocar channel 533, the pressure sensor 534, and the electronic connection 535 can be the same or substantially similar to the trocar 430, the trocar channel 433, the sensor 434, and the electronic connection 435, as described above with reference to FIG. 4. Thus, certain aspects of the trocar 530, the trocar channel 533, the pressure sensor 534, and the electronic connection 535 are not described in greater detail herein. The pressure sensor 534 can be disposed within a body lumen when the distal end of the trocar 530 is disposed within the body lumen. As such, the pressure sensor534 can be configured to measure a pressure of the body lumen, and these measurements can be communicated as signals through the electrical pathway 528 ad the electronic connection535 to a controller (e.g., controller 120, 220, 320, etc.). The controller can then use the pressure information to control insufflation, venting, or suction.

[0055] FIG. 5B shows a trocar 530’ with a pressure sensor 534’ disposed outside of a trocar channel 533’. When the distal end of the trocar 530’ is disposed within a body lumen, theAgent’s File Ref. BAYU-007 / 01WO 343337-2060 pressure sensor 534’ can be fluidically coupled to the body lumen via a pressure sensing lumen 529’ and be configured to sense a pressure of the body lumen. In some embodiments, the pressure sensing lumen 529’ can extend along a length of the trocar channel 533’ and open into the trocar channel 533’ near a distal end of the trocar channel 533’. Alternatively, in some embodiments, the pressure sensing lumen 529’ can open into the body lumen (e.g., on an outside surface of the trocar 530’). In some embodiments, the pressure sensing lumen 529’ can run parallel to or substantially parallel to a longitudinal axis of the trocar channel 533’. The sensor 534’ senses the pressure within the body lumen via the fluidic connection between the sensor 534’ and the body lumen. In some embodiments, the trocar 530’, the trocar channel 533’, and the pressure sensor 534’ can be the same or substantially similar to the trocar 430, the trocar channel 433, and the sensor 434, as described above with reference to FIG. 4. Thus, certain aspects of the trocar 530’, the trocar channel 533’, and the pressure sensor 534’ are not described in greater detail herein.

[0056] Various electrical pathways or pressure sensing lumen arrangements can be used to monitor the intraluminal pressure, e.g., using a pressure sensor. FIGS. 6A-6C show cross- sectional views of trocar shafts with different sensing arrangements, according to various embodiments. FIG. 6A shows a trocar shaft 632 with a trocar channel 633 and an electrical line (e.g., a printed circuit board (PCB)) 628 and a liquid and / or gas lumen 604 disposed adjacent to the trocar channel 633. In some embodiments, the trocar shaft 632 and the trocar channel 633 can be the same or substantially similar to the trocar shaft 432 and the trocar channel 433, as described above with reference to FIG. 4. Thus, certain aspects of the trocar shaft 632 and the trocar channel 633 are not described in greater detail herein. Liquid and / or gas can be transported through the liquid / gas lumen 604 for cleaning and / or insufflation. For example, gas can be delivered through the liquid / gas lumen 604 to insufflate the body lumen, and / or gas and liquid can be delivered through the liquid / gas lumen 604 to clean a distal end of an endoscope. In some embodiments, the liquid / gas lumen 604 can also be used for pressure sensing. For example, the liquid / gas lumen can function as a pressure sensing lumen (e.g., similar to the pressure sensing lumen 529’ described above). The liquid / gas lumen 604 can be fluidically coupled to the body lumen (e.g., via trocar channel 633) such that a pressure sensor in fluidic communication with the liquid / gas lumen 604 can sense the pressure in body lumen. In some embodiments, the electrical line 628 can supply power to one or more electrical components (e.g., sensors) disposed within the trocar shafts 632. For example, the electrical line 628 can be coupled to a sensor (e.g., an optical sensor) that can sense when a distal end of an endoscope is within the channel 633 for initiating a wash sequence.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0057] FIG. 6B shows a trocar shaft 632’ with a trocar channel 633’ and electrical lines 628a’, 628b’ and a liquid and / or gas lumen 604’ disposed adjacent to the trocar channel 633’. In some embodiments, the trocar shaft 632’, the trocar channel 633’, and the liquid / gas lumen 604’ can be the same or substantially similar to the trocar shaft 632, the trocar channel 633, and the liquid / gas lumen 604, as described above with reference to FIG. 6A. Thus, certain aspects of the trocar shaft 632’, the trocar channel 633’, and the liquid / gas lumen 604’ are not described in greater detail herein. The electrical line 628a’ can supply power to a first electrical component, while the electrical line 628b’ can supply power to a second electrical component. For example, the electrical line 628a’ can supply power to an optical sensor configured to detect when the distal end of an endoscope is in the trocar channel 633’ and the electrical line 628b’ can supply power to a pressure sensor configured to measure an intraluminal pressure of the body lumen (e.g., similar to that described with respect to FIG. 5 A).

[0058] FIG. 6C shows a trocar shaft 632’ ’ with a trocar channel 633 ” and an electrical line 628”, a liquid and / or gas lumen 604”, and a pressure sensing lumen 629”. In some embodiments, the trocar shaft 632”, the trocar channel 633”, the liquid / gas lumen 604”, and the electrical line 628” can be the same or substantially similar to the trocar shaft 632, the trocar channel 633, the liquid / gas lumen 604, and the electrical line 628 as described above with reference to FIG. 6A. Thus, certain aspects of the trocar shaft 632”, the trocar channel 633 ”, the liquid / gas lumen 604’ ’ , and the electrical line 628 ” are not described in greater detail herein. Liquid and / or gas can be delivered via the liquid / gas lumen 604”, e.g., for washing and / or insufflation. The pressure sensing lumen 629” can be used for pressure measurement. For example, the pressure sensing lumen 629” can be fluidically coupled to the body lumen with a pressure sensor disposed at a proximal end of the pressure sensing lumen 629” (e.g., similar to that described with respect to FIG. 5B).

[0059] FIGS. 7-10 illustrate methods associated with operating cleaning and insufflation systems, according to various embodiments. The methods illustrated in these figures can be performed by a compute device, such as, for example, a controller (e.g., controller 120, 220, 320, etc.) and / or other external device (e.g., a computer, workstation, etc.). FIG. 7 shows a method 700 of setting up a cleaning and insufflation system as described herein. As shown, the method 700 includes positioning a controller (e.g., controller 120, 220, 320, etc.) near a surgical table, at 702. The method 700 optionally includes prefilling a liquid reservoir, at 704. The method 700 further includes connecting lines and / or a tubing set to the controller, at 706, inserting trocar(s) (e.g., trocar 330) into a patient, at 708, connecting lines (e.g., electrical line 482) and / or a tubing set (e.g., gas line 462 and / or liquid line 472) from the controller to theAgent’s File Ref. BAYU-007 / 01WO 343337-2060 trocar(s), at 712, insufflating the body cavity, at 713, and inserting an imaging device (e.g., endoscope) into a trocar, at 714. After setting up the cleaning and insufflating system, one or more additional processes, as illustrated in FIGS. 8, 9, and 10, can be performed. These additional processes can be performed repeatedly (e.g., at periodic intervals or on an as-needed basis) and, in some instances, concurrently and / or sequentially, during a surgical procedure. Once a surgical procedure is completed, the trocar(s) can be removed and the processes can terminate.

[0060] In greater detail, at 702, the controller is positioned near a surgical table. The controller, as described with reference to FIGS. 1 and 2, can control operation of a cleaning and insufflation system. Optionally, at 704, a liquid reservoir coupled to the controller can be pre-filled with a liquid. In some embodiments, the liquid reservoir can be filled with wash solution. In some embodiments, the wash solution can include a saline solution, a buffered solution, a bio-compatible surfactant, and / or any of the wash solutions described in U.S. Patent Publication No. 2021 / 0127963, incorporated above by reference. In some embodiments, a liquid source from a wall connection or a pre-filled liquid reservoir may be used, and therefore this pre-filling step can be omitted.

[0061] At 706, one or more connectors including one or more lines (e.g., fluid and / or electrical lines) can be connected to the controller. For example, as depicted in FIGS. 3A-3C, multiple different arrangement of lines can connect the controller to one or more instruments or trocars. In FIG. 3A, one or more connectors including a liquid line, a gas line, and an electrical line can couple the controller to a first trocar (e.g., first instrument 330a) and one or more connectors including a gas line and a vacuum line can couple the controller to a second trocar (e.g., second instrument 330b). In FIG. 3B, one or more connectors including a liquid line, a gas line, and an electrical line can couple the controller to a first trocar (e.g., first instrument 330a’), a connector including a vacuum line can couple the controller to a second trocar (e.g., second instrument 330b’), and a connector including a gas line can couple the controller to a third trocar (e.g., third instrument 330c’). In FIG. 3C, one or more connectors including a liquid line, a gas line, an electrical line, and a vacuum line can couple the controller to a single trocar (e.g., trocar 330”). It can be appreciated that other couplings between the controller and one or more trocars or instruments can also be used. Each connector can have a first end (e.g., a controller connection) that can be coupled to the controller and a second end (e.g., a trocar connection) that can be coupled to a respective trocar, and therefore provide fluidic coupling and / or electrical communication between the controller and the respective trocar. At 706, the controller connection of the one or more connectors can be connected toAgent’s File Ref. BAYU-007 / 01WO 343337-2060 the controller. The controller can also be fluidically coupled to a pressurized gas supply, e.g., via tubing. In some embodiments, the gas can include CO2, nitrogen, argon, or any other inert gas or combinations thereof. In some embodiments, the controller can also be fluidically coupled to an external liquid reservoir or liquid source. Alternatively, in some embodiments, the connector may include an onboard reservoir and therefore a separate coupling to an external liquid reservoir may not be required.[00621 At 708, one or more trocars is inserted into the patient. In some embodiments, an obturator can be used to facilitate insertion of the trocars into the patient’s body lumen. For example, an obturator including a penetrating tip can be placed within a channel of the trocar to provide a penetrating end that can be inserted through the body wall into the body lumen. After insertion of the trocar(s) into the body lumen, the obturator can be removed. At 712, one or more connectors including one or more lines (e.g., fluid and / or electrical lines) can be connected to the trocar(s). For example, a trocar connection of the one or more connectors described above with respect to 706 can be coupled to one or more ports disposed on the trocar(s). The trocar connections can include an electrical connection, a gas and / or liquid connection, and / or a vacuum connection, which can mate with an electrical port, a gas / liquid port, and / or a vacuum port disposed in the trocar(s), respectively. Once the connector and the trocar are coupled, the liquid reservoir, the gas source, and / or the vacuum source can be fluidically coupled to the trocar(s), e.g., to enable gas and / or liquid delivery for insufflation and / or washing or suctioning for pressure managem ent / control.

[0063] At 713, the body lumen or cavity can be insufflated, e.g., by the controller controlling delivery of gas into the body lumen via a trocar. At 714, the imaging device (e.g., an endoscope) can be inserted into a channel of a trocar. As described above with respect to FIGS. 3A-3C, a single trocar can be used for insufflation and for providing a channel for an imaging device, or multiple trocars (e.g., first and second trocars) can be used for insufflation and for providing a channel for an imaging device. The imaging device can then be positioned within a trocar channel for the duration of a surgical procedure, e.g., to provide visualization of a surgical site.

[0064] After setting up the controller, trocar(s), and endoscope, one or more processes as depicted in FIGS. 8-10 can be implemented. As depicted in FIG. 8, a method 800 of performing a wash sequence (e.g., once a trocar of the cleaning and insufflation system has been positioned within the body cavity and an imaging device has been positioned within the trocar) can be implemented. Optionally, at 852, an image data feed from the imaging device can be monitored for fouling. At 854, depending on the image data feed, a compute device such as the controllerAgent’s File Ref. BAYU-007 / 01WO 343337-2060220 or an external processor operatively coupled to the controller 220 can determine whether the imaging device requires cleaning. For example, the processor 222 can transmit the image data feed to one or more models stored in the memory 221. In turn, one or models stored in the memory 221 can analyze the image data feed and determine one or more outputs. The processor 222 can receive the outputs from the memory 221 and determine whether the imaging device requires cleaning based on the outputs (e.g., debris and / or smoke detection).[00651 If no cleaning is required, the imaging device continues to be monitored, at 852. If yes, a user (e.g., surgeon or medical assistant) can be alerted to wash the imaging device, at 856. In some embodiments, the compute device can automatically detect fouling of the imaging device based on the image feed and trigger an alert or a wash sequence. The method 800 further includes detecting that the endoscope has been retracted a predetermined distance within the trocar lumen, at 858, and the initiation of a wash sequence, at 860. The method 800 optionally includes a drying and / or de-fogging sequence, at 862. The method 800 further includes priming the liquid and gas lines for the next wash sequence, at 864.

[0066] In greater detail, optionally, at 852, the image data feed from the imaging device is monitored and a determination is made as to whether the image device requires cleaning, at 854. In some embodiments, the determination of whether the image device requires cleaning can be made by the user. In some embodiments, the determination can be made automatically by a compute device (e.g., a controller such as, for example, controller 120, 220 and / or a processor associated with an imaging system). For example, light captured by the imaging device can be monitored and if the capture does not exceed a predetermined threshold, an alert can be generated and / or wash sequence initiated.

[0067] At 856, the user may be alerted to wash the imaging device, e.g., via a sound, light flashing, etc. At 858, the controller of the cleaning system can detect that the imaging device has been retracted a predetermined distance within the trocar lumen, e.g., by a user after being alerted to wash the imaging device. Once the imaging device has been retracted by the predetermined distance, the wash sequence ensues, at 860. The detecting can be done using a sensor (e.g., sensor(s) 434) that is configured to monitor an amount of light within the trocar channel. The sensor can be configured to send a signal to the controller in response to detecting an amount of light that is greater than a predefined threshold. Alternatively, the sensor can be configured to send a stream of data to the controller, and the controller can be configured to determine when the sensor data is indicative of light being greater than a predefined threshold. The predefined threshold can be selected to capture when the imaging device is sufficiently close to an ejection port of the trocar (e.g., liquid / gas port 436) to deliver a liquid and / or gasAgent’s File Ref. BAYU-007 / 01WO 343337-2060 spray. For example, the predefined threshold of light can be representative of when the imaging device and therefore its illumination is sufficiently close to the sensor, which can be positioned next to the ejection port.[0068| At 860, the wash sequence ensues. The wash sequence includes ejecting a spray of liquid to clean the distal end of the imaging device. In some embodiments, the wash sequence can include ejecting a preset or predetermined volume of liquid into the trocar lumen. In some embodiments, the liquid can include the wash solution. In some embodiments, the liquid can be propelled or ejected into a trocar channel using a pressurized gas, as described above. The pressurized gas can atomize or aerosolize the liquid while ejecting the liquid into the channel. Once the wash sequence is complete, an optional drying / de-fogging sequence can ensue, at 862. In some embodiments, the drying / defogging sequence can include ejecting gas into the trocar lumen without liquid. The gas can aid in drying liquid droplets off the imaging device. The gas can be free or substantially free of moisture content. In some embodiments, the ejection of gas can automatically follow the ejection of a preset volume or bolus of liquid, e.g., because the pressurized gas is used to carry and push the liquid out of the ejection port first before ejecting out of the ejection port. At 864, the liquid line can be primed for the next wash sequence. In other words, the liquid line is filled with wash solution.

[0069] After setting up the controller, trocar(s), and endoscope, a method 900 for monitoring and adjusting pressure within the body lumen can also be implemented, as depicted in FIG. 9. The method 900 can include monitoring pressure of the body cavity, at 902. In some embodiments, the controller 220 can monitor pressure of the body cavity by monitoring sensor data from a pressure sensor or image data from an endoscope. For example, the controller 220 can detect smoke byproduct (e.g., generated by a medical device operating within the body lumen) based on the image data. In some embodiments, smoke can increase the pressure within the body lumen.

[0070] At 904, the controller can determine whether the pressure is above a higher threshold value (e.g., based on the image data and / or the sensor data). If, however, the pressure has not increased above the higher threshold, the method 900 can continue to monitor the pressure within the body lumen. If yes, a vent or vacuum is activated, at 906. Optionally, the method 900 can also include changing one or more parameters associated with insufflation operation (e.g., pause insufflation, reduce insufflation time, etc.), at 908. The method 900 can then continue to monitor the pressure in the body lumen. At 910, the controller can determine whether the pressure is below a lower threshold value (e.g., based on the image data and / or the sensor data). If not, the method 900 can continue to monitor the pressure within the bodyAgent’s File Ref. BAYU-007 / 01WO 343337-2060 lumen. If yes, the method 900 can optionally include closing a vent and / or deactivating a vacuum, at 912. The method 900 can also include changing one or more parameters associated with insufflation operation (e.g., activate insufflation, increase insufflation time, etc.), at 914. The method 900 can then continue to monitor the pressure in the body lumen.

[0071] In greater detail, the pressure inside the body cavity is monitored, e.g., by a compute device such as the controller or an external processor operatively coupled to the controller, at 902. In some embodiments, the pressure can be monitored based on data captured by a pressure sensor located in the body cavity (e.g., at a distal tip of a trocar, as described above). In some embodiments, the pressure can be monitored based on data captured by a pressure sensor in fluidic communication with the body cavity (e.g., via a pressure sensing lumen, as described above). At 904 and at 910, the pressure can be compared against a higher threshold value and a lower threshold value, e.g., to determine whether the pressure falls within a preset range between those two values. In some embodiments, the higher threshold can be between about 10 mmHg to about 20 mmHg, inclusive of all values and ranges therebetween. In some embodiments, the lower threshold can be about 3 mmHg to about 10 mmHg, inclusive of all values and ranges therebetween. While both a higher or upper threshold value and a lower threshold value are described with respect to FIG. 9, it can be appreciated that only a higher or upper pressure value may be monitored, in some embodiments.

[0072] In response to detecting a pressure higher than the higher or upper threshold pressure (904: YES), the compute device can activate venting and / or vacuum, at 906. In some embodiments, the venting can be passive, e.g., through an opening in the trocar that is fluidically coupled to the body lumen. In some embodiments, the venting can be active, e.g., via vacuum or suction (e.g., using vacuum source 180). In some embodiments, activating the venting and / or vacuuming can include opening one or more valves to fluidically couple the body lumen to an outside environment and / or a vacuum source. In some embodiments, activating the venting and / or vacuuming can include activating (e.g., supplying power to) a vacuum source. At 908, the method 900 optionally includes changing the insufflation operation. For example, insufflation of the body lumen may involve constantly and / or periodically delivering gas into the body lumen. In response to detecting a pressure higher than the higher threshold pressure, delivery of gas for insufflation can be paused (e.g., for a predefined period of time) and / or delivery of gas for insufflation can be provided at a lower gas flow rate or pressure or for shorter periods of time. Changing these operational parameters of the insufflation can facilitate reducing the pressure inside the body lumen.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0073] In response to detecting a pressure below the lower threshold (910: NO), the method 900 can include closing a vent or deactivating a vacuum, at 912. Closing a vent can prevent leakage of gas from within the body lumen, thereby avoiding further pressure decrease. Deactivating the vacuum can also avoid further pressure decrease. At 914, the method 900 includes changing the insufflation operation to increase the pressure inside the body lumen. In some embodiments, the changing can include increase the amount or rate of gas delivery. In some embodiments, the changing can include increasing the amount of time during which gas is being delivered or shortening the intervals between insufflation periods.

[0074] After setting up the controller, trocar(s), and endoscope, a method 1000 for adjusting insufflation based on amount or frequency of washing can be implemented, as depicted in FIG. 10. The method 1000 includes monitoring (e.g., via an endoscope and / or one or more sensors) an amount or frequency of implementing a wash sequence, at 1002, optionally adjusting venting or vacuum operation based on a frequency or amount of washing (e.g., based on image data from the endoscope and / or sensor data from the one or more sensors), at 1004, and adjusting insufflation based on frequency or amount of washing (e.g., based on image data from the endoscope and / or sensor data from the one or more sensors), at 1006. The method 1000 can make continuous and / or repeated adjustments during a surgical procedure.

[0075] In greater detail, a compute device can monitor an amount or frequency of wash sequences, at 1002. This monitoring can be used to determine how much wash solution and / or gas may be entering the body lumen during the wash sequences. With greater frequency of wash sequences, a larger amount of wash solution and gas can enter the body lumen and therefore increase the pressure inside the body lumen. At 1004, the method 1000 optionally includes adjusting a venting or vacuum based on frequency or amount of washing. For example, if the washing is occurring at a high frequency, a vent can be opened or a vacuum can be activated to remove gases or liquids from the body lumen. At 1006, the method 1000 can also include adjusting the insufflation based on the frequency or amount of washing. For example, if the washing is occurring at a high frequency, the insufflation or gas delivery can be paused and / or delivered for shorter periods of time (or less gas can be delivered due to a slower gas flow rate and / or gas pressure) to prevent or reduce the risk of over-pressure within the body lumen. Conversely, the insufflation or gas delivery can be increased if washing is infrequent.

[0076] Various concepts may be embodied as one or more methods, of which at least one example has been provided. The acts performed as part of the method may be ordered in any suitable way. Accordingly, embodiments may be constructed in which acts are performed inAgent’s File Ref. BAYU-007 / 01WO 343337-2060 an order different than illustrated, which may include performing some acts simultaneously, even though shown as sequential acts in illustrative embodiments. Put differently, it is to be understood that such features may not necessarily be limited to a particular order of execution, but rather, any number of threads, processes, services, servers, and / or the like that may execute serially, asynchronously, concurrently, in parallel, simultaneously, synchronously, and / or the like in a manner consistent with the disclosure. As such, some of these features may be mutually contradictory, in that they cannot be simultaneously present in a single embodiment. Similarly, some features are applicable to one aspect of the innovations, and inapplicable to others.

[0077] In addition, the disclosure may include other innovations not presently described. Applicant reserves all rights in such innovations, including the right to embodiment such innovations, file additional applications, continuations, continuations-in-part, divisionals, and / or the like thereof. As such, it should be understood that advantages, embodiments, examples, functional, features, logical, operational, organizational, structural, topological, and / or other aspects of the disclosure are not to be considered limitations on the disclosure as defined by the embodiments or limitations on equivalents to the embodiments. Depending on the particular desires and / or characteristics of an individual and / or enterprise user, database configuration and / or relational model, data type, data transmission and / or network framework, syntax structure, and / or the like, various embodiments of the technology disclosed herein may be implemented in a manner that enables a great deal of flexibility and customization as described herein.

[0078] All definitions, as defined and used herein, should be understood to control over dictionary definitions, definitions in documents incorporated by reference, and / or ordinary meanings of the defined terms.

[0079] As used herein, in particular embodiments, the terms “about” or “approximately” when preceding a numerical value indicates the value plus or minus a range of 10%. Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that stated range is encompassed within the disclosure. That the upper and lower limits of these smaller ranges can independently be included in the smaller ranges is also encompassed within the disclosure, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the disclosure.Agent’s File Ref. BAYU-007 / 01WO 343337-2060

[0080] The phrase “and / or,” as used herein in the specification and in the embodiments, should be understood to mean “either or both” of the elements so conjoined, i.e., elements that are conjunctively present in some cases and disjunctively present in other cases. Multiple elements listed with “and / or” should be construed in the same fashion, i.e., “one or more” of the elements so conjoined. Other elements may optionally be present other than the elements specifically identified by the “and / or” clause, whether related or unrelated to those elements specifically identified. Thus, as a non-limiting example, a reference to “A and / or B”, when used in conjunction with open-ended language such as “comprising” can refer, in one embodiment, to A only (optionally including elements other than B); in another embodiment, to B only (optionally including elements other than A); in yet another embodiment, to both A and B (optionally including other elements); etc.

[0081] As used herein in the specification and in the embodiments, “or” should be understood to have the same meaning as “and / or” as defined above. For example, when separating items in a list, “or” or “and / or” shall be interpreted as being inclusive, i.e., the inclusion of at least one, but also including more than one, of a number or list of elements, and, optionally, additional unlisted items. Only terms clearly indicated to the contrary, such as “only one of’ or “exactly one of,” or, when used in the embodiments, “consisting of,” will refer to the inclusion of exactly one element of a number or list of elements. In general, the term “or” as used herein shall only be interpreted as indicating exclusive alternatives (i.e., “one or the other but not both”) when preceded by terms of exclusivity, such as “either,” “one of,” “only one of,” or “exactly one of.” “Consisting essentially of,” when used in the embodiments, shall have its ordinary meaning as used in the field of patent law.

[0082] As used herein in the specification and in the embodiments, the phrase “at least one,” in reference to a list of one or more elements, should be understood to mean at least one element selected from any one or more of the elements in the list of elements, but not necessarily including at least one of each and every element specifically listed within the list of elements and not excluding any combinations of elements in the list of elements. This definition also allows that elements may optionally be present other than the elements specifically identified within the list of elements to which the phrase “at least one” refers, whether related or unrelated to those elements specifically identified. Thus, as a non-limiting example, “at least one of A and B” (or, equivalently, “at least one of A or B,” or, equivalently “at least one of A and / or B”) can refer, in one embodiment, to at least one, optionally including more than one, A, with no B present (and optionally including elements other than B); in another embodiment, to at least one, optionally including more than one, B, with no A presentAgent’s File Ref. BAYU-007 / 01WO 343337-2060(and optionally including elements other than A); in yet another embodiment, to at least one, optionally including more than one, A, and at least one, optionally including more than one, B (and optionally including other elements); etc.[0083| In the embodiments, as well as in the specification above, all transitional phrases such as “comprising,” “including,” “carrying,” “having,” “containing,” “involving,” “holding,” “composed of,” and the like are to be understood to be open-ended, i.e., to mean including but not limited to. Only the transitional phrases “consisting of’ and “consisting essentially of’ shall be closed or semi-closed transitional phrases, respectively, as set forth in the United States Patent Office Manual of Patent Examining Procedures, Section 2111.03.

[0084] As used in this specification, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, the term “a member” is intended to mean a single member or a combination of members, “a material” is intended to mean one or more materials, or a combination thereof.

[0085] The term “substantially” when used in connection with “cylindrical,” “linear,” and / or other geometric relationships is intended to convey that the structure so defined is nominally cylindrical, linear or the like. As one example, a portion of a support member that is described as being “substantially linear” is intended to convey that, although linearity of the portion is desirable, some non-linearity can occur in a “substantially linear” portion. Such nonlinearity can result from manufacturing tolerances, or other practical considerations (such as, for example, the pressure or force applied to the support member). Thus, a geometric construction modified by the term “substantially” includes such geometric properties within a tolerance of plus or minus 5% of the stated geometric construction. For example, a “substantially linear” portion is a portion that defines an axis or center line that is within plus or minus 5% of being linear.

[0086] As used herein, the term “set” and “plurality” can refer to multiple features or a singular feature with multiple parts. For example, when referring to a set of devices, the set of devices can be considered as one device with multiple portions, or the set of devices can be considered as multiple, distinct devices. Thus, a set of portions or a plurality of portions may include multiple portions that are either continuous or discontinuous from each other. A plurality of particles or a plurality of materials can also be fabricated from multiple items that are produced separately and are later joined together (e.g., via mixing, an adhesive, or any suitable method).

[0087] While specific embodiments of the present disclosure have been outlined above, many alternatives, modifications, and variations will be apparent to those skilled in the art.Agent’s File Ref. BAYU-007 / 01WO 343337-2060Accordingly, the embodiments set forth herein are intended to be illustrative, not limiting. Various changes may be made without departing from the spirit and scope of the disclosure. Where methods and steps described above indicate certain events occurring in a certain order, those of ordinary skill in the art having the benefit of this disclosure would recognize that the ordering of certain steps may be modified and such modification are in accordance with the variations of the invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. The embodiments have been particularly shown and described, but it will be understood that various changes in form and details may be made.

Claims

Agent’s File Ref. BAYU-007 / 01WO 343337-2060Claims1. An apparatus, comprising: a fluid delivery system configured to deliver liquid and gas to one or more instruments disposed within a body cavity of a patient; a controller operatively coupled to a fluid delivery system, the controller configured to: control the fluid delivery system to deliver a volume of liquid and gas via a fluid channel to a distal end of an endoscope disposed within the body cavity to remove visual obstructions from the distal end of the endoscope; and control the fluid delivery system to deliver a volume of gas into the body cavity to insufflate the body cavity.

2. The apparatus of claim 1, further comprising a trocar fluidly coupled to the fluid delivery system, the trocar having a distal end that is insertable into the body cavity, the trocar defining a channel for receiving an instrument from the one or more instruments such that the instrument can be extended into the body cavity, the trocar including at least one port configured to deliver gas and liquid into the channel of the trocar.

3. The apparatus of claim 2, wherein the trocar further includes a pressure sensor, the controller further being operatively coupled to the pressure sensor, the controller being configured to: receive sensor data from the pressure sensor and to monitor a pressure of the body cavity; and in response to determining that the pressure of the body cavity is greater than a predetermined threshold, control the fluid delivery system to pause or reduce the delivery of the volume of gas for insufflating the body cavity.

4. The apparatus of claim 1, wherein the controller is further configured to monitor a frequency or amount of the delivery of the volume of liquid and gas for cleaning the distal end of the endoscope and to adjust the delivery of the volume of gas for insufflating the body cavity based on the frequency or amount of the delivery of the volume of liquid and gas.Agent’s File Ref. BAYU-007 / 01WO 343337-20605. An apparatus, comprising: a trocar having a distal end that is insertable into a body cavity of a subject, the trocar defining a channel for receiving an instrument such that the instrument can be extended into the body cavity, the trocar including at least one port configured to deliver gas and liquid into the channel of the trocar; a fluid delivery system including a gas source and a liquid source, the fluid delivery system being fluidically coupled to the trocar; and a controller operatively coupled to the trocar and the fluid delivery system, the controller configured to: control the fluid delivery system to deliver a volume of liquid and gas into the channel to clean a distal end of the instrument in response to the instrument being retracted into the channel; and control the fluid delivery system to deliver a volume of gas into the body cavity for insufflating the body cavity.

6. The apparatus of claim 5, wherein the trocar includes: a first port configured to deliver the volume of gas into the body cavity to insufflate the body cavity; and a second port configured to deliver the volume of liquid and gas into the channel to clean the distal end of the instrument.

7. The apparatus of claim 6, further comprising a connector configured to couple the controller to the trocar, the connector including: at least one gas line configured to establish fluidic coupling between the gas source and the first and second ports; and a liquid line configured to establish fluidic coupling between the liquid source and the second port.

8. The apparatus of claim 7, wherein the connector further includes: a trocar connection configured to couple to the trocar; and a controller connection configured to couple to the controller.Agent’s File Ref. BAYU-007 / 01WO 343337-20609. The apparatus of claim 5, wherein the trocar further includes a pressure sensor, the controller further being operatively coupled to the pressure sensor, the controller being configured to: receive sensor data from the pressure sensor and to monitor a pressure of the body cavity; and in response to determining that the pressure of the body cavity is greater than a predetermined threshold, control the fluid delivery system to pause or reduce the delivery of the volume of gas for insufflating the body cavity.

10. The apparatus of claim 5, wherein the controller is further configured to monitor a frequency or amount of the delivery of the volume of liquid and gas for cleaning the distal end of the instrument and to adjust the delivery of the volume of gas for insufflating the body cavity based on the frequency or amount of the delivery of the volume of liquid and gas.

11. An apparatus, comprising: a first trocar defining a first channel for receiving an instrument, the first trocar having a distal end that is insertable into a body cavity of a subject, the first trocar including an ejection port configured to eject a volume of liquid and gas into the first channel to clean a distal end of the instrument; a second trocar defining a second channel configured to deliver a volume of gas for insufflating the body cavity, the second trocar including a distal end that is insertable into the body cavity; a fluid delivery system including a gas source and a liquid source, the fluid delivery system being fluidically coupled to the first and second trocars; and a controller operatively coupled to the first and second trocars and the fluid delivery system, the controller configured to: control the fluid delivery system to deliver the volume of liquid and gas in response to the instrument being retracted into the first channel; and control the fluid delivery system to deliver the volume of gas for insufflating the body cavity.

12. The apparatus of claim 11, further comprising a pressure sensor disposed in at least one of the first or second trocars,Agent’s File Ref. BAYU-007 / 01WO 343337-2060 the controller further being operatively coupled to the pressure sensor, the controller being configured to: receive sensor data from the pressure sensor and to monitor a pressure of the body cavity; and in response to determining that the pressure of the body cavity is greater than a predetermined threshold, control the fluid delivery system to pause or reduce the delivery of the volume of gas for insufflating the body cavity.

13. The apparatus of claim 12, wherein the pressure sensor is disposed in the first trocar.

14. The apparatus of claim 13, wherein the pressure sensor is disposed near the distal end of the first trocar.

15. The apparatus of claim 13, wherein the pressure sensor is disposed at a proximal end of the first trocar, the pressure sensor being operatively coupled to a pressure sensing lumen that extends into the body cavity.

16. The apparatus of claim 11, wherein the instrument is an endoscope, the controller further being configured to: receive image data from the endoscope; and control the fluid delivery system to pause or reduce the delivery of the volume of gas for insufflating the body cavity based on the image data.

17. The apparatus of claim 16, wherein the controller is configured to detect smoke in the body cavity based on the image data.

18. The apparatus of claim 11, wherein the controller is further configured to monitor a frequency or amount of the delivery of the volume of liquid and gas for cleaning the distal end of the instrument and to adjust the delivery of the volume of gas for insufflating the body cavity based on the frequency or amount of the delivery of the volume of liquid and gas.

19. The apparatus of claim 18, wherein the instrument is an endoscope, wherein the controller is configured to monitor the frequency or amount of the delivery of the volume of liquid and gas by:Agent’s File Ref. BAYU-007 / 01WO 343337-2060 receiving image data from the endoscope; and determining the frequency or amount of the delivery of the volume of liquid and gas based on the image data.

20. The apparatus of claim 11, wherein the second trocar defines a third channel configured for receiving an endoscope, wherein the controller is further configured to: receive image data from the endoscope; and control the fluid delivery system to increase or decrease the delivery of the volume of liquid and gas via the first trocar based on the image data.

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