Tubing set and irrigation system comprising tubing set for irrigating body cavity

Abstract

Disclosed herein are components, systems, and methods to maintain a stable pressure within a body cavity. A tubing set may deliver irrigation fluid to a body cavity or remove waste fluid from the body cavity. An irrigation system may include one or both of the tubing sets that deliver irrigation fluid to the body cavity and remove waste fluid from the body cavity. The tubing set includes a primary path from a fluid reservoir to the body cavity via a pump, and a secondary path that bypasses the pump. The secondary path may include a constriction with a reduced internal cross-sectional dimension that is smaller than the internal cross-sectional dimensions of other components of the tubing set.

Description

TUBING SET AND IRRIGATION SYSTEM COMPRISINGTUBING SET FOR IRRIGATING BODY CAVITYCROSS-REFERENCE TO RELATED APPLICATION

[0001] This patent application claims priority of U.S. Patent Application No. 63 / 715,412, filed on November 1 , 2024, the entire disclosure of which is hereby incorporated by reference herein for all purposes.BACKGROUND

[0002] This disclosure pertains to tubing sets and irrigation systems for use during surgical procedures to distend body cavities. More specifically, the disclosure describes embodiments of tubing sets and irrigation systems that include a constriction that maintains stable pressure within a body cavity during a surgical procedure.

[0003] During some endoscopic procedures, a body cavity is irrigated using an irrigation fluid, which may be stored in a fluid reservoir. Irrigation of the body cavity with the irrigation fluid serves multiple purposes, including but not limited to, distending the body cavity, maintaining a clear field of view, etc. The irrigation fluid also has to be withdrawn from the body cavity and disposed (e.g., to a waste fluid collection unit).

[0004] Known irrigation systems include a constriction located along a length of a flexible tubing that establishes a bypass for a pump that moves fluid into / out of the body cavity. The bypass allows excess fluid to return to a fluid source reservoir after passing through the constriction. The bypass tubing of known irrigation systems consists of a soft, resilient plastic material such that a clamp can be used to reduce the diameter of the tubing to form the constriction.

[0005] However, there are challenges associated with known irrigation systems. For example, it may be difficult to achieve a desired size of the constriction. Maintaining a stable cavity pressure within the cavity and minimizing turbulence within the fluid flow are important factors that contribute to a positive outcome for procedures involving fluid flow to distend body cavities. Applying a variable clamp to the flexible tubing may result in a constriction that is larger or smaller than desired for the chosen procedure. Additionally, if the constriction is formed permanently in the flexible tubing, the soft material of the tubing may result in the size of the constriction varying during use (e.g., increasing as the pressure of the fluid within the tubing increases). Variance in the size of the constriction may result in variance of the pressure within the cavity which can negatively impact the outcome for the procedure.

[0006] Tubing extending from the cavity (e.g., from a continuous flow endoscope providing passage into the body cavity) may clutter the surgical space and reduce easeof use / handling of the known irrigation systems. The tubes are typically long and hang low increasing the risk of becoming tangled or creating a tripping hazard. As the number of tubes connected at a given junction of the known irrigation system increases so do the chances of one or more of the tubes disconnecting, leading to reduced patient safety. Further, the constriction positioned within the hanging tubing may result in the constriction coming into contact with the surgeon, the floor, other tubes, or apparatus within the area. This contact my release the clamp or change the size of the constriction formed in the tubing.SUMMARY

[0007] Embodiments described herein relate to a tubing set comprising a junction, a first tubing, a second tubing, a third tubing, and a connector. The first tubing and the second tubing are fluidly connected via the junction, and the third tubing is fluidly connected to the junction via the connector, which comprises a constriction. Some embodiments of the tubing set connect a surgical instrument (e.g., an endoscope) to a fluid chamber. For example, the first tubing may fluidly connect the junction to the surgical instrument, the second tubing may fluidly connect the junction to the fluid chamber along a first path, and the third tubing may fluidly connect the junction to the fluid chamber along a second path.

[0008] Also disclosed herein are embodiments of an irrigation system comprising the tubing set described above and a surgical instrument (e.g., an endoscope), a fluid chamber, a pump, or any combination thereof. The irrigation system may comprise a second tubing set, a second one of the fluid chamber, a second one of the pump, or any combination thereof.

[0009] During some procedures (e.g., endoscopic procedures), a body cavity may be irrigated using an irrigation fluid, which is stored in a fluid chamber / reservoir. Irrigation of the body cavity with the irrigation fluid serves multiple purposes, including but not limited to, distending the body cavity, maintaining a Clear field of vision, removal of solids (e.g., tissue) and / or gases (e.g., bubbles formed in the irrigation fluid) from the body cavity, etc. The irrigation fluid is also withdrawn from the body cavity and disposed (e.g., to a waste fluid collection unit).

[0010] A body cavity can be easily distended in a “static manner” by simply pushing fluid via a single inflow tube inserted into the cavity. In this manner, a desired cavity pressure can be developed and also maintained. For example, a cavity can be distended by pressing on the piston of a syringe filled with fluid with the outlet end of the syringe being connected to the cavity (e.g., by a tube). However, this is not a practicalsolution to distending a body cavity for procedures that result in blood and / or tissue debris being released from the cavity (e.g., from a fragile inner lining of the cavity). The released debris mixes with the distending fluid and results in obscured vision at the surgical site within the body cavity. Thus, continuous flow irrigation is often used to constantly wash away blood and tissue debris and maintain a clear field of view.

[0011] To be effective, an irrigation system used for such procedures should provide continuous and clear visualization and a predictable mechanical stabilization of the body cavity. To achieve these goals, the irrigation system maintains a stable and precise flow rate of irrigation fluid to / from the body cavity. If the body cavity pressure rises above the prescribed safe limits, excessive fluid intravasation may occur or the body cavity may burst. Fluid intravasation is a process by which the irrigation fluid enters into the patient’s body through the cavity walls and may cause damage to the patient.

[0012] Tissues of the body within which the body cavities are formed are not rigid (e.g., they have some element of elasticity). Thus, a distended body cavity may attempt to constantly revert back to its natural, collapsed state by exhibiting physiological contractions of the cavity wall. These contractions typically result in variations in the pressure within the body cavity, and ultimately culminate in irregular movement of the cavity walls. During an endoscopic procedure, the physiological contractions of the cavity wall may result in fluid within the body cavity being expelled. Sudden shifts in the volume of fluid within the cavity may result in large scale movement of the cavity wall.

[0013] Further, the inflow tube, the outflow tube, and the endoscope (of a conventional irrigation system) often move and shake during a procedure, and these movements also result in variations in fluid flow resistance, which manifests in the form of detrimental variations in the pressure within the body cavity. The cavity pressure variations occurring as a result of cavity wall contractions and the mechanical movement of the tubes and the endoscope tend to repeat even if they are corrected once due to the recurring physiological cavity wall contractions and the mechanical movements of the irrigation circuit.

[0014] Thus, some traditional irrigation systems include a tube having a constriction provided between the fluid source / delivery reservoir and the inflow / outflow tube on a path that bypasses the inflow / outflow pump. The tube with the constriction provides a route for excess fluid to bypass the inflow / outflow pump and go back to the fluid source / delivery reservoir, thereby minimizing turbulence inside the body cavity and maintaining the cavity pressure at a stable value despite physiological contractions of the cavity wall.

[0015] Locating the conventional constriction along the length of the tube that bypasses the pump presents several challenges. Because the walls of the tube are soft, the size of the constriction may change during the procedure (e.g., a size of the internal diameter of the constriction may increase as pressure increases thereby expanding the size of the tube). Additionally, the constriction may variable (e.g., formed by a clamp) that enables different sized constrictions to be selected. However, the desired pressure within the body cavity may have a tight range, and the clamp may lack the precision necessary to achieve the desired constriction size that results in the desired body cavity pressure. Further, the bypass tube typically hangs loosely within the area adjacent the patient. This results in movement and contact of the bypass tube and the constriction, which can negatively impact the constriction (e.g., the clamp move and become loose or completely detached from the bypass tube thereby changing the size of the constriction).

[0016] Beneficially, some embodiments of the tubing system disclosed herein comprise a connector with a constriction that fluidly connects a bypass tubing to a junction. This is advantageous over known tubing systems in which the constriction is located along the length of the bypass tubing because the junction and the connector may be positioned such that they are removed from incidental contact / movement to which the long, hanging bypass tubing is susceptible. By utilizing the disclosed tubing set and constriction, such contact / movement is avoided. Additionally, some embodiments of the connector may include a rigid exterior, which resists expansion / contraction due to changing pressures within the tubing system. Thus, the rigid connector advantageously provides a stable size for the constriction, which contrasts with systems in which the constriction is formed within the soft, flexible walls of the tubing, resulting in improved stability of the internal pressure within the body cavity.

[0017] In some embodiments, a tubing set is disclosed. The tubing set comprises a junction, a first tubing, a second tubing, and a connector. The first tubing is fluidly connectable to the junction and comprises a first lumen with a first cross-sectional dimension. The second tubing comprises a second lumen with a second cross-sectional dimension. The connector comprises a constriction with a third cross-sectional dimension that is smaller than the second cross-sectional dimension and the connector is fluidly connectable to the junction and the second tubing.

[0018] In some embodiments of the tubing set, the first tubing forms at least a portion of a first path along which the junction is fluidly connected to a fluid chamber, and the second tubing forms at least a portion of a second path that is separate from the first path, and along which the junction is fluidly connected to the fluid chamber. The constriction is fluidly connectable to the junction and the second tubing such that theconstruction forms a portion of the second path. The first path passes through a pump that moves fluid between the junction and the fluid chamber, and the second path bypasses the pump.

[0019] In some embodiments, an irrigation system is disclosed. The irrigation system comprises the tubing set, a surgical instrument (e.g., an endoscope), a pump, a fluid reservoir, or any combination thereof. The irrigation system may include first and second tubing sets. The first tubing set may be fluidly connected to an inflow channel of the endoscope, and the second tubing set may be fluidly connected to an outflow channel of the tubing set.

[0020] In some embodiments methods of assembling an irrigation system are disclosed. In some cases, the methods comprise the step of fluidly connecting a junction to a fluid reservoir along a first fluid flow path defined by a first lumen of a first tubing, the first lumen having a first cross-sectional dimension, and fluidly connecting the junction to the fluid reservoir along a second fluid flow path defined by a second lumen of a second tubing, the second lumen having a second cross-sectional dimension. The method further includes positioning a connector between the junction and the second tubing such that the connector defines a portion of the second path, wherein the connector comprises a constriction with a third cross-sectional dimension that is smaller than the second cross-sectional dimension.

[0021] In some cases, the disclosure relates to a method of maintaining a pressure within a cavity. The method may comprise the step of moving a fluid from a fluid reservoir through a first lumen of a first tubing to a first junction. The first lumen having a first cross-sectional dimension along its length. The method further comprises moving the fluid from the junction through a connector fluidly connected to the junction and then through a second lumen of a second tubing fluidly connected to the connector. The second lumen has a second cross-sectional dimension along its length, and the connector has a third cross-sectional dimension that is smaller than the second cross- sectional dimension. The method further includes moving the fluid from the junction through a third lumen of a third tubing to a surgical instrument and moving the fluid from the surgical instrument to a cavity.

[0022] Some embodiments of a method of maintaining a pressure within a cavity may comprise moving a fluid from a cavity to a surgical instrument. The method further comprises moving the fluid from the surgical instrument to a junction and moving the fluid from the junction to a fluid reservoir through a first lumen of a first tubing, the first lumen having a first cross-sectional dimension along its length. The method further includes moving the fluid from the junction through a connector fluidly connected to the junctionand then through a second lumen of a second tubing fluidly connected to the connector. The second lumen has a second cross-sectional dimension along its length, and the connector has a third cross-sectional dimension that is smaller than the second cross- sectional dimension.BRIEF DESCRIPTION OF THE DRAWINGS

[0023] In the drawings, identical reference numbers identify similar elements or acts. The sizes and relative positions of elements in the drawings are not necessarily drawn to scale. For example, the shapes of various elements and angles are not necessarily drawn to scale, and some of these elements may be arbitrarily enlarged and positioned to improve drawing legibility. Further, the particular shapes of the elements as drawn, are not necessarily intended to convey any information regarding the actual shape of the particular elements and may have been solely selected for ease of recognition in the drawings. The headings and Abstract of the Disclosure provided herein are for convenience only and do not interpret the scope or meaning of the embodiments.

[0024] Figure 1 is a schematic view of a known irrigation system.

[0025] Figure 2 is a schematic view of another known irrigation system.

[0026] Figure 3 is a schematic view of an outflow portion of an irrigation system comprising a first tubing set.

[0027] Figure 4 is a schematic view of an outflow portion of an irrigation system comprising a second tubing set.

[0028] Figure 5 is a cross-sectional view of a first tubing of the first tubing set.

[0029] Figure 6 is a cross-sectional view of a second tubing of the first tubing set.

[0030] Figure 7 is a cross-sectional view of a third tubing of the first tubing set.

[0031] Figure 8 is a cross-sectional view of a fourth tubing of the first tubing set.

[0032] Figure 9 is a cross-sectional view of a first junction of the first tubing set.

[0033] Figure 10 is a cross-sectional view of a constriction of the first tubing set.

[0034] Figure 11 is a cross-sectional view of the second tubing illustrated in Figure 6, the first junction illustrated in Figure 9, and the constriction illustrated in Figure 10 in a first configuration.

[0035] Figure 12 is a cross-sectional view of the second tubing illustrated in Figure 6, the first junction illustrated in Figure 9, and the constriction illustrated in Figure 10 in a second configuration.

[0036] Figure 13 is a cross-sectional view of the second tubing illustrated in Figure 6, the first junction illustrated in Figure 9, and the constriction illustrated in Figure 10 in a third configuration.

[0037] Figure 14 is a schematic view of an outflow portion of an irrigation system comprising a third tubing set.

[0038] Figure 15 is a schematic view of an outflow portion of an irrigation system comprising a fourth tubing set.

[0039] Figure 16 is a schematic view of an inflow portion of an irrigation system comprising a first tubing set.

[0040] Figure 17 is a schematic view of an inflow portion of an irrigation system comprising a second tubing set.

[0041] Figure 18 is a schematic view of an inflow portion of an irrigation system comprising a third tubing set.

[0042] Figure 19 is a schematic view of an irrigation system.

[0043] Figure 20 is a cross-sectional view of a cartridge of the tubing set.DETAILED DESCRIPTION

[0044] As noted above, methods for maintaining a constant pressure within a body cavity with tubing sets and irrigation systems are known. These known systems include a primary path between a fluid reservoir and the body cavity that passes through a pump, and further include a secondary path between the fluid reservoir and the body cavity that bypasses the pump. To maintain a steady pressure within the body cavity, these known systems require a constriction, which forms a reduced cross-sectional dimension within the secondary path.

[0045] It is desirable to provide a constriction with a precise cross-sectional dimension, selected based on the procedure to be performed using the irrigation system. If an abnormally high pressure develops inside a body cavity during endoscopic surgery, it may cause mechanical rupture of the body cavity and may also lead to dangerous intravasation (a process by which the irrigation fluid enters into the patient’s body system through the cavity walls causing significant danger to the patient’s health. However, the constriction in the known systems is formed along the length of a flexible tubing that forms the secondary path. The flexible tubing may be susceptible to changing size in response to changing pressure (e.g., increasing its outer diameter in response to an increase in internal pressure within the flexible tubing).

[0046] Known irrigation systems are shown in Figure 1 , which is a reproduction of Figure 7 of U.S. Pat. Nos. 8,226,549 and 8,911 ,363, and Figure 2, which is a reproduction of Figure 9 of U.S. Pat. Nos. 8,652,089 and 9,101 ,701. The known irrigation systems include inflow and outflow portions that each comprise a square junction connecting first, second, third, and fourth tubes.

[0047] As shown in Figures 1 and 2, a pump 5 pushes fluid into a cavity 18 while a pump 14 simultaneously extracts fluid out of the cavity 18. The fluid is drawn from a fluid source reservoir 1 via a first tube 2 that is connected to a square junction 6. The square junction 6 is a meeting point for four tubes, a first tube 4 connected to the pump 5, a second tube 7, a third tube 9, and a fourth tube 10. One end of the second tube 7 connects with the square junction 6, while another end 11 of the second tube 7 is submerged in the fluid within the fluid source reservoir 1. A pressure transducer 17 is attached at one of the third tube 9 while the other end of the third tube 9 is connected to the square junction 6. The pressure transducer 17 measures the fluid pressure via a column of liquid or air present in the lumen of the third tube 9. The fourth tube 10 is connected to the square junction 6 and defines a flow path into the cavity 18 for the fluid drawn from the fluid source reservoir 1 by the pump 5. The fourth tube 10 may connect the square junction 6 to an inflow port of a continuous flow endoscope (not shown), which delivers the fluid to the cavity 18.

[0048] As shown, the second tube 7 has a constriction 8, located along its length. The second tube 7 establishes a bypass for the pump 5, allowing excess fluid to return to the fluid source reservoir 1 via the second tube 7 after passing through the constriction 8. The second tube 7 consists of a soft, resilient plastic material such that a clamp can be used to reduce the diameter of the second tube 7 to form the constriction 8.

[0049] A square junction 12 of the outflow portion of the known irrigation system is assembled and operates similarly to the inflow portion as described above. The square junction 12 is a meeting point for four tubes, a tube 13 connected to a pump 14, a bypass tube 15 (or as shown in Figure 2 a bypass tube 27), a tube connected to an additional pressure transducer 26 (or as shown in Figure 2 an additional pressure transducer 28), and a tube that delivers fluid from the cavity 18. Waste fluid is transported to a waste fluid collecting container 16 via the tube 13 and the fluid carrying tube 45. The bypass tube 15 has a constriction 25 (or as shown in Figure 2 the bypass tube 27 has a constriction 29), located along its length that can help in reducing the substantially high amplitude pressure variations inside the cavity 18 caused by abnormally large cavity wall contractions.

[0050] However, there are challenges associated with known irrigation systems. For example, it may be difficult to achieve a desired size of the constriction. Maintaining a stable cavity pressure within the cavity and minimizing turbulence within the fluid flow are important factors that contribute to a positive outcome for procedures involving fluid flow to distend body cavities. Applying a variable clamp to the second tube 7 may result in a constriction that is larger or smaller than desired for the chosen procedure. Additionally,if the constriction 8 is formed permanently in the second tube 7, the soft material of the second tube 7 may result in the size of the constriction 8 varying (e.g., increasing as the pressure of the fluid within the second tube increases). Variance in the size of the constriction 8 may result in variance of the pressure within the cavity 18 which can negatively impact the outcome for the procedure.

[0051] The tubes extending from the cavity 18 (e.g., from a continuous flow endoscope providing passage into the cavity 18) may clutter the surgical space and reduce ease of use / handling of the known irrigation system. The tubes are typically long and hang low increasing the risk of becoming tangled or creating a tripping hazard. As the number of tubes connected at a given junction of the known irrigation system increases so do the chances of one or more of the tubes disconnecting, leading to reduced patient safety. Further, the constriction 8 positioned within the hanging second tube 7 may result in the constriction coming into contact with the surgeon, the floor, other tubes, or apparatus within the area. This contact my release the clamp or change the size of the constriction 8 formed in the second tube 7.

[0052] Other known irrigation systems, such as those disclosed in U.S. Patent No. 8,388,570; U.S. Patent No. 9,028,398; and U.S. Patent No. 8,591,464 include a constriction similar to those described in reference to Figures 1 and 2 above, and thus have similar challenges associated with their use.

[0053] Some embodiments of the tubing sets and irrigation systems described herein include a connector that comprises the constriction. The connector may have rigid outer walls or other features that result in a connector that is resistant to changes in cross- sectional dimension due to changes in internal pressure. For example, the rigid outer walls of the connector may be a rigid plastic (e.g., polycarbonate, polyvinyl chloride), metallic, or some other material that maintains a constant shape without elastic deformation.

[0054] Additionally, in conventional sets and irrigation systems, the flexible tubing in which the constriction is formed often hangs loosely such that the tubing is susceptible to incidental contact / movement, which may cause the constriction to be detrimentally removed from the tubing or the tubing to disconnect from other components of the system. In some cases, the disclosed tubing sets and irrigation systems, unlike conventional systems, include the connector that forms the constriction fluidly coupled between a junction and the tubing that forms the secondary path and bypass for the pump. This positioning is advantageous as it removes the connector and constriction from being inadvertently impacted during the procedure.

[0055] Additionally, known tubing sets and irrigation systems form the constriction via a clamp being applied to the flexible tubing and incrementally reducing the cross-sectional dimension of the flexible tubing until a desired cross-sectional dimension is achieved. However, with these clamps, the system have been unable to achieve the precise cross- sectional dimensions desired for certain procedures due to the inaccuracy of the clamps and the flexibility of the tubing. Some embodiments of the connectors disclosed herein include respective constrictions with pre-selected cross-sectional dimensions that correspond to several procedures. These connectors may be included as part of a kit such that one of the connectors may be connected to the tubing set for use in a first procedure, and then a second one of the connectors may replace the first one of the connectors for use in a second procedure.

[0056] In some embodiments, the disclosed tubing set is used to connect an endoscopic instrument to a waste fluid collection unit to remove and dispose of a waste fluid withdrawn from a body cavity during an endoscopic procedure. The tubing set may comprise a junction having at least a first port, a second port and a third port. The tubing set may further comprise a first tubing, which in use during an endoscopic procedure, fluidly connects the first port to the waste fluid collection unit via a pump, thus providing a primary path between the junction and the waste fluid collection unit. The tubing set may further comprise a second tubing, which in use during the endoscopic procedure, extends between the second port and the waste fluid collection unit defining at least a portion of a secondary path that bypasses the pump. The tubing set may comprise a connector that comprises a constriction site with an internal cross-sectional dimension that is smaller than cross-sectional dimensions of the second port and the second tubing.

[0057] The tubing set may further comprise a third tubing, which in use during the endoscopic procedure, extends between the third port and the endoscopic instrument. In some embodiments, the junction may comprise a fourth port that connects to a pressure transducer. In such an embodiment, the tubing set may further comprise a fourth tubing, which during the endoscopic procedure, connects the fourth port to the pressure transducer.

[0058] The tubing set may be a component of embodiments of an irrigation system described herein. The irrigation system may comprise the endoscopic instrument, the waste fluid collection unit, the pump, the pressure transducer, or any combination thereof. The pump may be a positive displacement pump (e.g., an external gear pump, an internal gear pump, a gerotor pump, a lobe pump, a vane pump, or a peristaltic pump).

[0059] In some embodiments, the first tubing may be operably coupled to (e.g., pass through) the peristaltic pump. In some embodiments in which the pump is any of the external gear pump, the internal gear pump, the gerotor pump, the lobe pump, or the vane pump, the first tubing may comprise a fifth tubing and a sixth tubing. The fifth tubing may connect the first port to an inlet port of the pump and the sixth tubing may connect an outlet port of the pump to the waste fluid collecting unit.

[0060] The first port, the second port, the third port, and the fourth port each define an internal cross-sectional dimension that may range from 2 mm to 8 mm. The constriction of the connector may define an internal cross-sectional dimension may range from 0.03 mm to 1.5 mm. Some embodiments of the tubing set and / or the irrigation system may comprise a plurality of connectors having respective constrictions with different sized internal cross-sectional dimensions. For example, different sizes of the constrictions may be adopted to different surgical procedures.

[0061] By way of a non-limiting example, the tubing set may comprise a first connector with a first constriction having an internal cross-sectional dimension configured for use in (e.g., sized for) hysteroscopic surgery, a second connector with a second constriction having an internal cross-sectional dimension configured for use in (e.g., sized for) arthroscopic surgery, a third connector with a third constriction having an internal cross- sectional dimension configured for use in (e.g., sized for) transurethral surgery, a fourth connector with a fourth constriction having an internal cross-sectional dimension configured for use in (e.g., sized for) brain surgery, a fifth connector with a fifth constriction having an internal cross-sectional dimension configured for use in (e.g., sized for) spine surgery, or any combination thereof.

[0062] Some embodiments of the tubing set may comprise a kit including a plurality of the connectors. For example, the kit may include the first connector configured for use in hysteroscopic surgery, the second connector configured for use in arthroscopic surgery, the third connector configured for use in transurethral surgery, the fourth connector configured for use in brain surgery, the fifth connector configured for use in spine surgery, or any combination thereof. The kit may include multiples of one or more of the first, second, third, fourth, and fifth connectors. Thus, the tubing set may be configured to use in multiple types of surgery (e.g., by swapping one of the connectors for another of the connectors). For example, one of the connectors from the kit may be connected to the tubing set for use in a first procedure, and then another of the connectors from the kit may replace the connector from the first procedure for use in a second procedure.

[0063] In some embodiments, the second port may be fluidly connected to the first tubing at a location between the pump and the waste fluid collecting unit. For example, the first tubing may be dissected into two or more parts (e.g., a seventh tubing and an eighth tubing) both located downstream of the pump. The seventh tubing and the eighth tubing may be coupled by a second junction which comprises a fifth port, a sixth port, and a seventh port.

[0064] The fifth port and the sixth port may couple the seventh tubing with the eighth tubing (e.g., such that the second port is fluidly connected to the seventh port. As used herein “fluidly connected” includes direct connections (with no intervening components along a fluid flow path) and indirect connections (with one or more intervening components between the fluidly connected components along a fluid flow path).

[0065] In some embodiments of the irrigation system (e.g., that comprise an external gear pump, an internal gear pump, a gerotor pump, a lobe pump or a vane pump and the fifth tubing and the sixth tubing), the connector may provide a second path between the first junction and the waste fluid collecting unit bypassing the pump. In some embodiments, the second port may be fluidly connected to the sixth tubing at an intermediate location between the pump and the waste fluid collecting unit. To enable the second port to be fluidly connected to the sixth tubing at the intermediate location, the sixth tubing may be dissected into two parts downstream of the pump into a ninth tubing and a tenth tubing.

[0066] The ninth tubing and the tenth tubing may be coupled by a second junction which comprises a fifth port, a sixth port, and a seventh port. For example, the fifth port and the sixth port may couple the ninth tubing with the tenth tubing and the second port may be fluidly connected to the seventh port. In some embodiments of the tubing set and / or the irrigation system, the first junction may be integrally formed with the first tubing and / or the third tubing. In some embodiments any combination of the tubing that extends from the first junction may be integrally formed.

[0067] Some embodiments of the tubing set comprise a three-way junction, which comprises a first port, a second port, and a third port, and further comprises a four-way junction comprising a fourth port, a fifth port, a sixth port, and a seventh port. The tubing set may further comprise a first tube portion that extends from the first port and is connectable, in operation, to a fluid reservoir containing an irrigation fluid. The tubing set further comprises a second tube portion that extends from the fifth port and is connectable, in operation, to an endoscopic instrument, and further comprises a third tube portion that extends between the second port and the fourth port.

[0068] In operation, a pump, which pumps the irrigation fluid from the fluid reservoir to the endoscopic instrument, may be connected between two ends of the third tube portion. The third port of the three-way junction may be directly joined to the sixth port of the four-way junction. The tubing set may further comprise a constriction site positioned between the third port and the sixth port. The seventh port of the four-way junction may be connectable, in operation, to a pressure sensor which senses pressure of the irrigation fluid. Some exemplary embodiments of the three-way junction may form a “T” junction or a “Y” junction.

[0069] In some cases, the fourth port of the four-way junction may be aligned with the fifth port in a first plane. The sixth port may face away from the seventh port (e.g., with the sixth port positioned within a second plane, and the seventh port positioned within a third plane). The second plane may be substantially parallel to the third plane, the first plane and the second plane may be substantially perpendicular to each other, and the first plane and the third plane may be substantially perpendicular to each other.

[0070] In some embodiments, the fourth port of the four-way junction may line up with the fifth port in a first plane, the sixth port may face away from the seventh port, the sixth port and the seventh port may be positioned in a second plane, and the first plane and the second plane may be substantially perpendicular to each other. The fourth port of the four-way junction may line up with the fifth port in a first plane, the sixth port and the seventh port may be on the same side of the first plane, and the sixth port may be in a second plane. The seventh port may be in a third plane substantially parallel to the second plane. The first plane may be substantially perpendicular to the second plane, and the first plane and the third plane may be substantially perpendicular to each other.

[0071] Referring to Figures 3 and 4, a tubing set 100 may mitigate the chance of discontinuity in flow of an irrigation fluid 117 (e.g., a non-viscous liquid such as saline or glycine) due to accidental disconnection of tubing of the tubing set 100 during a surgical procedure. The tubing set 100 may be specifically adapted to various endoscopic procedures, including but not limited to hysteroscopic, arthroscopic, transurethral, brain, and spine surgeries.

[0072] As shown in Figure 3, an irrigation system 200 that withdraws a waste fluid 111 (e.g., the irrigation fluid 117 optionally with additional liquid, such as blood, or solid, such as tissue, material) from a body cavity 113 during a procedure (e.g., an endoscopic procedure). The irrigation system 200 may comprise the tubing set 100 and a waste fluid collection unit 204, a pump 206, an instrument (e.g., an endoscopic instrument 202), or any combination thereof. The tubing set 100 may fluidly connect two or more of the endoscopic instrument 202, the waste fluid collection unit 204, and the pump 206. Insome embodiments the waste fluid 111 may be transported from the body cavity 113 to the waste fluid collection unit 204 by operation of the pump 206 through the tubing set 100. The irrigation system 200 may further comprises a pressure transducer 208 connected (e.g., fluidly connected) to the tubing set 100.

[0073] As shown, the tubing set 100 may comprise a first junction 102 having multiple ports (e.g., a first port 104, a second port 106, and a third port 108). The tubing set 100 may comprise a first tubing 110 extending between (e.g., fluidly connecting) the first port 104 to the waste fluid collection unit 204 via a pump 206. Thus, the first tubing 110 may define a first or primary fluid flow path between the first junction 102 and the waste fluid collection unit 204. The tubing set 100 may comprise a second tubing 112 extending between (e.g., fluidly connecting) the second port 106 and the waste fluid collection unit 204. Thus, the second tubing 112 may define at least a portion of a second or secondary fluid flow path between the first junction 102 and the waste fluid collection unit 204 that bypasses the pump 206. The tubing set 100 (e.g., the second port 106) may comprise a constriction 114, as described in greater detail below.

[0074] The tubing set 100 may comprise a third tubing 116 extending between (e.g., fluidly connecting) the third port 108 and the endoscopic instrument 202. Some embodiments of the first junction 102 may comprise a fourth port 118 fluidly connected (e.g., by a fourth tubing 120 of the tubing set) to a pressure transducer 208 of the irrigation system 200.

[0075] According to some embodiments, the pump 206 may be a positive displacement pump (e.g., an external gear pump, an internal gear pump, a gerotor pump, a lobe pump, a vane pump, or a peristaltic pump). As shown in Figure 3, the pump 206 may be a peristaltic pump and the first tubing 110 may pass through the peristaltic pump. Other embodiments of the pump 206 may be operably connected to the first tubing 110 such that operation of the pump 206 moves the waste fluid 111 through the first tubing 110.

[0076] As shown in Figure 4 the irrigation system 200 may be similar to the irrigation system 200 described in reference to Figure 3 such that the description of the irrigation system 200 of Figure 3 is applicable to the irrigation system of Figure 4, with significant differences described below. The pump 206 may be an external gear pump, an internal gear pump, a gerotor pump, a lobe pump, or a vane pump. As shown, the first tubing 110 may comprise a fifth tubing 122 and a sixth tubing 124 (e.g., with the fifth tubing 122 fluidly connecting the first port 104 to an inlet port 123 of the pump and the sixth tubing 124 fluidly connecting an outlet port 125 of the pump 206 to the waste fluid collection unit 204).

[0077] Referring to Figures 5 to 13, components of the tubing set 100 may each define an internal cross-sectional dimension. For example, the first tubing 110 may comprise a first lumen 150 extending through a length of the first tubing 110 such that the first lumen 150 establishes a fluid flow path through the first tubing 110 connecting opposite ends of the first tubing 110. As shown in Figure 5, the first lumen 150 may define a first cross- sectional dimension D1 (e.g., measured perpendicular to the length of the first tubing 110). Similarly, the second tubing 112 may comprise a second lumen 152 that defines a second cross-sectional dimension D2, as shown in Figure 6. The third tubing 116 may comprise a third lumen 154 that defines a third cross-sectional dimension D3 (as shown in Figure 7), the fourth tubing 120 may comprise a fourth lumen 156 that defines a fourth cross-sectional dimension D4 (as shown in Figure 8), and so on for any additional tubing of the tubing set 100.

[0078] As shown in Figure 9, the first junction 102 (e.g., the first port 104, the second port 106, the third port 108, the fourth port 118, and / or internal passageways extending therebetween) may comprise a junction lumen 160 that establishes a fluid flow path through the first junction 102. The junction lumen 160 may define a fifth cross-sectional dimension D5. According to some embodiments, the first junction 102 may have a constant cross-sectional dimension (e.g., the fifth cross-sectional dimension D5) through all of the ports (e.g., the first port 104, the second port 106, the third port 108, etc.).

[0079] As shown in Figure 10, the constriction 114 may define a sixth cross-sectional dimension D6. According to some embodiments, the sixth cross-sectional dimension D6 of the constriction 114 may define a minimum cross-sectional dimension of the tubing set 100. For example, the sixth cross-sectional dimension D6 of the constriction 114 may be less than any of the other cross-sectional dimensions of the tubing set 100 (e.g., the first cross-sectional dimension D1, the second cross-sectional dimension D2, the third cross- sectional dimension D3, the fourth cross-sectional dimension D4, the fifth cross-sectional dimension D5, etc.).

[0080] For example, the cross-sectional dimension of any of the components of the tubing set 100 other than the constriction 114 (e.g., the first cross-sectional dimension D1 of the first tubing 110, the second cross-sectional dimension D2 of the second tubing 112, the third cross-sectional dimension D3 of the third tubing 116, the fourth cross- sectional dimension D4 of the fourth tubing 120, the fifth cross-sectional dimension D5 of the first port 104, etc.) may be between 2 mm and 8 mm (e.g., about 5 mm). In some cases, the cross-sectional dimension of any of the components of the tubing set 100 other than the constriction 114 may range from 3 mm to 7 mm, e.g., from 4 mm to 6 mm. In terms of lower limits, the cross-sectional dimension of any of the components of thetubing set 100 other than the constriction 114 may be greater than 2 mm, e.g., greater than 3 mm, greater than 4 mm, greater than 5 mm, greater than 6 mm, or greater than 7 mm. In terms of upper limits, the cross-sectional dimension of any of the components of the tubing set 100 other than the constriction 114 may be less than 8 mm, e.g., less than 7 mm, less than 6 mm, less than 5 mm, less than 4 mm, or less than 3 mm. One or more of the cross-sectional dimension of any of the components of the tubing set 100 other than the constriction 114 may be equal.

[0081] According to some embodiment, the sixth cross-sectional dimension D6 of the constriction 114 may be between 0.03 mm and 1.5 mm (e.g., about 0.75 mm). In some cases, the sixth cross-sectional dimension D6 of the constriction 114 may range from 0.1 mm to 1.25 mm, e.g., from 0.25 mm to 1.00 mm. In terms of lower limits, the sixth cross- sectional dimension D6 of the constriction 114 may be greater than 0.03 mm, e.g., greater than 0.1 mm, greater than 0.5 mm, greater than 0.75 mm, greater than 1.0 mm, or greater than 1.25 mm. In terms of upper limits, the sixth cross-sectional dimension D6 of the constriction 114 may be less than 1.5 mm, e.g., less than 1.25 mm, less than 1.0 mm, less than 0.75 mm, less than 0.5 mm, or less than 0.1 mm.

[0082] The constriction 114 may be positioned within the first junction 102 (e.g., within the second port 106 proximate a location where the second tubing 112 connects to the first junction 102 (e.g., as shown in Figure 11). According to some embodiments, the constriction 114 may be integral with the first junction 102 (e.g., such that the constriction 114 cannot be removed from the first junction 102 without plastically deforming the first junction 102). According to some embodiments, the constriction 114 may be removable with the first junction 102 (e.g., such that the constriction 114 can be removed from the first junction 102 without plastically deforming the first junction 102).

[0083] In some embodiments, the constriction 114 may be positioned at an end of the second tubing 112 (e.g., proximate the location where the second tubing 112 connects to the second port 106 of the first junction 102 (e.g., as shown in Figure 12). According to some embodiments, the constriction 114 may be integral with the second tubing 112 (e.g., such that the constriction 114 cannot be removed from the second tubing 112 without plastically deforming the second tubing 112). According to some embodiments, the constriction 114 may be removable with the second tubing 112 (e.g., such that the constriction 114 can be removed from the second tubing 112 without plastically deforming the second tubing 112).

[0084] In some embodiments, the tubing set 100 may comprise a connector 170 that includes the constriction 114. As shown in Figure 13, the connector 170 may be positioned between (e.g., directly between or indirectly between) the first junction 102(e.g., the second port 106) and the second tubing 112 such that the connector 170 fluidly connects the first junction 102 to the second tubing 112 (e.g., thereby defining a portion of the second path that bypasses the pump 206). According to some embodiments, the constriction 114 may be integral to one or both of the first junction 102 and the second tubing 112 (e.g., such that the connector 170 cannot be separated from the first junction 102 and / or the second tubing 112 without plastically deformation of one or more of the components). According to some embodiments, the connector 170 may be removable / separable from one or both of the first junction 102 and the second tubing 112 (e.g., such that the connector 170 can be removed / separated from the first junction 102 and / or the second tubing 112 without plastically deforming the components).

[0085] Embodiments of the tubing set 100 may comprise a constriction 114 with a sixth internal cross-sectional dimension D6, adopted to one or more surgical procedures. In some embodiments, the tubing set 100 may comprise a plurality of constrictions 114 (e.g., a plurality of the connectors 170) with different values for the sixth internal cross- sectional dimension D6, the different values corresponding to certain procedures (e.g., hysteroscopic surgery, arthroscopic surgery, transurethral surgery, brain surgery, and spine surgery).

[0086] Referring to Figures 14 and 15, embodiments of the irrigation system 200 as shown are similar to the irrigation system 200 described in reference to Figures 3 and 4 such that the description of the irrigation system 200 of Figures 3 and 4 is applicable to the irrigation system of Figures 14 and 15, with significant differences described below. As shown, the pump 206 may be a peristaltic pump, and the second port 106 may be fluidly connected to the first tubing 110 at a location 172 between the peristaltic pump and the waste fluid collection unit 204.

[0087] As shown in Figure 14, the second tubing 110 may be dissected, downstream of the pump 206, into a seventh tubing 126 and an eighth tubing 128. The seventh tubing 126 and the eighth tubing 128 may be fluidly connected by a second junction 130 comprising a fifth port 132, a sixth port 134, and a seventh port 136. The fifth port 132 and the sixth port 134 may couple the seventh tubing 126 with the eighth tubing 128. The second port 106 may be connected to the seventh port 136. For example, the second port 106 may be directly connected to the seventh port 136. In some embodiments the second port 108 may be indirectly connected to the seventh port 136 (e.g., via the second tubing 112, the connector 170, or both). The constriction 114 may be positioned between the second port 106 and the seventh port 136, as shown.

[0088] As shown in Figure 15, the pump 206 may be one of the external gear pump, the internal gear pump, the gerotor pump, the lobe pump or the vane pump. The firsttubing 110 may comprise the fifth tubing 122 and the sixth tubing 124, and the second port 106 may be fluidly connected to the sixth tubing 124 at the location 172 between the pump 206 and the waste fluid collection unit 204. The sixth tubing 124 may be dissected into two parts downstream of the pump 206 into a ninth tubing 138 and a tenth tubing 140. The ninth tubing 138 and the tenth tubing 140 may be coupled by the second junction 130 comprising the fifth port 132, the sixth port 134, and the seventh port 136. The fifth port 132 and the sixth port 134 may fluidly connect the ninth tubing 138 with the tenth tubing 140 and the second port 106 may be fluidly connected to the seventh port 136.

[0089] As shown, the second port 106 may directly connect to the seventh port 136. In some embodiments the second port 108 may be indirectly connected to the seventh port 136 (e.g., via the second tubing 112, the connector 170, or both). The constriction 114 may be positioned between the second port 106 and the seventh port 136, as shown. One or more of the first port 104, the second port 106, the third port 108, the fourth port 118, the fifth port 132, the sixth port 134, and the seventh port 136 may have an internal cross-sectional dimension in a range from 2 mm to 8mm as described above.

[0090] In some embodiments the first junction 102 and the second junction 130 may be formed integrally. An advantage of the tubing set 100 is that no tubing has the constriction 114. Instead, the constriction 114 is positioned within the second port 106 or the connector 170. Thus, some embodiments of the tubing set 100 may be devoid of the second tubing 112.

[0091] Referring to Figures 3 to 15, the tubing set 100 is shown operating as an outflow portion of the irrigation system 200. Additional embodiments include any of the tubing set 100 instead forming an inflow portion of the irrigation system 200. For example, the tubing set 100 of the irrigation system 200 may deliver the irrigation fluid 117 to the body cavity 113 during the procedure. The irrigation system 200 may comprise the tubing set 100 and a fluid chamber in the form of a fluid delivery unit (similar to the fluid collection unit 204), a pump (e.g., similar to the pump 206), an instrument (e.g., the endoscopic instrument 202), or any combination thereof.

[0092] The tubing set 100 may fluidly connect two or more of the endoscopic instrument 202, the fluid delivery unit, and the pump. In some embodiments the irrigation fluid 117 may be transported to the body cavity 113 from the irrigation fluid delivery unit by operation of the pump through the tubing set 100. The irrigation system 200 may further comprises a pressure transducer (e.g., similar to the pressure transducer 208) connected (e.g., fluidly connected) to the tubing set 100. Additionally, embodiments of the irrigation system 200 may include a plurality of the tubing set 100.For example, the irrigation system 200 may include a first one of the tubing sets 100 described herein forming an inflow portion of the irrigation system 200 (delivering the irrigation fluid 117 to the body cavity 113), and a second one of the tubing sets 100 described herein forming an outflow portion of the irrigation system 200 (removing the waste fluid 111 from the body cavity 113).

[0093] Referring to Figures 16 to 19, the tubing set 100 may deliver the irrigation fluid 117 irrigation fluid 117 from a fluid chamber (e.g., an irrigation fluid delivery unit 203) to the body cavity 113 during a procedure (e.g., an endoscopic procedure). The irrigation system 200 may comprise the tubing set 100 and the irrigation fluid delivery unit 203, a pump 205, an instrument (e.g., an endoscopic instrument 202), or any combination thereof. The tubing set 100 may fluidly connect two or more of the endoscopic instrument 202, the irrigation fluid delivery unit 203, and the pump 205. In some embodiments the irrigation fluid 117 may be transported from the irrigation fluid delivery unit 203 to the body cavity 113 by operation of the pump 205 through the tubing set 100. The irrigation system 200 may further comprises a pressure transducer 208 connected (e.g., fluidly connected) to the tubing set 100 (e.g., between the endoscope 202 and the pump 205.

[0094] As shown in Figure 16, the tubing set 100 may include a first junction 302 (e.g., in the form of a three-way joint). The first junction 302 may be similar to the first junction 102 as described herein (e.g., comprising a first port 304, a second port 306, and a third port 308). The tubing set 100 may include a second junction 310 (e.g., in the form of a four-way joint. The second junction 310 may be similar to the first junction 102 as described herein (e.g., comprising a fourth port 312, a fifth port 314, a sixth port 316, and a seventh port 318.

[0095] The tubing set 100 may further comprise a first tubing 320 that extends from the first port 304 and is fluidly connectable, in operation, to the irrigation fluid delivery unit 203. The tubing set 100 may further comprise a second tubing 322 that extends from the fifth port 314 and is fluidly connectable, in operation, to the endoscopic instrument 202. The tubing set 100 may further comprise a third tubing 324 that extends between the second port 306 and the fourth port 312. In operation, the pump 205 may be fluidly connected between the two ends of the third tubing 324. According to some embodiments, the third port 308 of the first junction 302 may be directly joined to the sixth port 316 of the second junction 310 such that the constriction 114 is positioned between the third port 308 and the sixth port 316. The pump 205 may be a peristaltic pump, and the third tubing 324 may pass through the pump 205, as shown.

[0096] In some embodiments the seventh port 118 of the second junction 310 is fluidly connectable, in operation, to the pressure transducer 208 which senses pressure of the irrigation fluid 117. The components of the tubing set 100 (e.g., the first port 304, the second port 306, the third port 308, the fourth port 312, the fifth port 314, the sixth port 316, and the seventh port 318 may each have an internal cross-sectional dimension (e.g., diameter) similar to the first, second, third, fourth, and fifth, internal cross-sectional dimensions as described above (e.g., within a range from about 2 mm to 8 mm. The internal cross-sectional dimension (e.g., diameter) of the constriction 114 may range from about 0.03 mm to 1.5 mm, as described above.

[0097] The tubing set 100 may include a plurality of constrictions 114 with different sizes adopted to different surgical procedures. For example, the kit may include a first constriction configured for use in hysteroscopic surgery, a second constriction configured for use in arthroscopic surgery, a third constriction configured for use in transurethral surgery, a fourth constriction configured for use in brain surgery, a fifth constriction configured for use in spine surgery, or any combination thereof.

[0098] According to some embodiments, the first junction 302 may be in the form of a “T” joint or a “Y” joint. The second junction 310 may be constructed such that the fourth port 312 is aligned with the fifth port 314 in a first plane, the sixth port 316 faces away from the seventh port 318, the sixth port 316 is position in the second plane, which is substantially parallel to a third plane within which the seventh port 318 is positioned, or any combination thereof. The first plane may be substantially perpendicular to the second plane, and the first plane may be substantially perpendicular to the third plane.

[0099] As shown in Figure 17, the second junction 310 (e.g. the four-way joint) may be constructed such that the fourth port 312 is aligned with the fifth port 314 in a first plane. The sixth port 316 may face away from the seventh port 318. The sixth port 316 and the seventh port 318 may be positioned in a second plane that is substantially perpendicular to the first plane.

[0100] As shown in Figure 18, the second junction 310 (e.g., the four-way joint) may be constructed such that the fourth port 312 is aligned with the fifth port 314 in a first plane. The sixth port 316 and the seventh port 318 may be on the same side of the first plane. The sixth port 316 may be in a second plane and the seventh port 318 may be in a third plane substantially parallel to the second plane. The first plane and the second plane may be substantially perpendicular to each other, and the first plane and the third plane may be substantially perpendicular to each other.

[0101] The tubing set 100 may include other arrangements of the second junction 310. According to some embodiments, the first junction 302 (e.g., a three-way joint) andthe second junction 310 (e.g., a four-way joint) may be formed integrally with the first tubing 320, the second tubing 322, and the third tubing 324.

[0102] Referring to Figure 19, the irrigation system 200 may include a combination of two or more of the tubing sets 100 as described herein. For example, the irrigation system 200 may include the tubing set 100 as described in reference to Figure 16 operating as the inflow portion of the irrigation system 200 (delivering the irrigation fluid 117 to the body cavity 113 via the endoscopic instrument 202), and the tubing set 100 as described in reference to Figure 3 operating as an outflow portion of the irrigation system 200 (removing the waste fluid 111 from the body cavity 113 via the endoscopic instrument 202). Additional embodiments of the irrigation system 200 include two substantially similar (e.g., exact copies) of one of the tubing sets 100 as described herein, with one operating as the inflow portion of the irrigation system 200 and the other operating as the outflow portion of the irrigation system 200. As shown the irrigation system 200 may include multiple pumps (e.g., the pump 204 and the pump 205), multiple fluid reservoirs (e.g., the irrigation fluid delivery unit 203 and the waste fluid collection unit 204), multiple (e.g., first and second) pressure transducers 208, or any combination thereof.

[0103] Referring to Figure 20, the tubing set 100 of any of the embodiments described herein may include a cartridge 180. The cartridge 180 may be similar to the connector 170 as described herein. The cartridge 180 may include rigid outer walls 182 that resist expansion and contraction resulting from pressure changes within a lumen 184 of the cartridge 180. For example, the rigid outer walls of the cartridge 180 may be a rigid plastic (e.g., polycarbonate, polyvinyl chloride), metallic, or some other material that maintains a constant shape and does not elastically deform.

[0104] The cartridge 180 may include a first port 186 that fluidly connects to an inlet port of a pump (e.g., the pump 205, the pump 206), and a second port 188 that fluidly connects to an outlet port of the pump. In operation, the cartridge establishes a primary flow path (indicated by solid arrows 190) from a fluid reservoir (e.g., the irrigation fluid delivery unit 203) to the body cavity 113, or vice versa. The cartridge 180 may include the constriction 114 positioned along a secondary flow path (indicated by dashed arrow 192) that bypasses the pump (e.g., from the body cavity 113 to the fluid reservoir, or vice versa. The cartridge may include a third port 194 and a fourth port 196 that connect to tubing that fluidly connects the cartridge 180 to the fluid reservoir and the body cavity, respectively.

[0105] The above description of illustrated embodiments, including what is described in the Abstract, is not intended to be exhaustive or to limit the embodiments to theprecise forms disclosed. Although specific embodiments of and examples are described herein for illustrative purposes, various equivalent modifications can be made without departing from the spirit and scope of the disclosure, as will be recognized by those skilled in the relevant art. The various embodiments described above can be combined to provide further embodiments.

[0106] Many of the methods described herein can be performed with variations. For example, many of the methods may include additional acts, omit some acts, and / or perform acts in a different order than as illustrated or described.

[0107] These and other changes can be made to the embodiments in light of the above-detailed description. In general, in the following claims, the terms used should not be construed to limit the claims to the specific embodiments disclosed in the specification and the claims but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled. Accordingly, the claims are not limited by the disclosure.

Claims

CLAIMS1. A tubing set comprising: a junction; a first tubing fluidly connected to the junction and having a first lumen with a first cross-sectional dimension; a second tubing having a second lumen with a cross-sectional dimension; and a connector fluidly connecting the junction to the second tubing, the connector comprising a constriction with a third cross-sectional dimension that is smaller than the second cross-sectional dimension.

2. The tubing set of claim 1 wherein: the first tubing forms at least a portion of a first path along which the junction is fluidly connected to a fluid chamber; the second tubing forms at least a portion of a second path that is separate from the first path, and along which the junction is fluidly connected to the fluid chamber; and the constriction forms a portion of the second path.

3. The tubing set of claim 2 wherein: the first path passes through a pump that moves fluid between the junction and the fluid chamber; and the second path provides a bypass for the pump.

4. The tubing set of any one of claims 1 to 3, further comprising: a first port of the junction fluidly connected to the first tubing and forming a portion of the first path; and a second port of the junction fluidly connected to the connector and the second tubing and forming a portion of the second path, wherein the first port is fluidly connected to the second port within the junction.

5. The tubing set of claim 1 wherein the junction is a first junction, the tubing set further comprising: a second junction that fluidly connects the first tubing to the second tubing, wherein the connector is positioned between the first junction and the second junction.

6. The tubing set of any one of claims 1 to 5 wherein the first cross-sectional dimension is equal to the second cross-sectional dimension.

7. The tubing set of claim 6 wherein the junction comprises a lumen with a fourth cross-sectional dimension that is equal to the first cross-sectional dimension.

8. The tubing set of any one of claims 1 to 7 wherein the first cross-sectional dimension is in a range between about 2 mm and about 8 mm, the second cross- sectional dimension is in a range between about 2 mm and about 8 mm, and the third cross-sectional dimension is in a range between about 0.03 mm and about 1.5 mm.

9. The tubing set of any one of claims 1 to 8 wherein the connector is a first connector, and the tubing set further comprises: a second connector that fluidly connects the junction to the second tubing, the second connector comprising a second constriction with a fourth cross-sectional dimension that is different than the third cross-sectional dimension.

10. The tubing set of claim 9, further comprising: a third connector that fluidly connects the junction to the second tubing, the third connector comprising a third constriction with a fifth cross-sectional dimension that is different than both the third cross-sectional dimension and the fourth cross-sectional dimension.

11. The tubing set of claim 10 wherein the tubing set is configured such that in use any one of the first connector, the second connector, or the third connector fluidly connects the junction to the second tubing, and each of the first connector, the second connector, and the third connector are removable from between the junction and the second tubing.

12. The tubing set of claim 1 , further comprising: a third tubing fluidly connected to the junction.

13. The tubing set of claim 12, further comprising: a fourth tubing fluidly connected to the junction.

14. The tubing set of any one of claims 1 to 13 wherein the connector comprises a rigid exterior.

15. An irrigation system comprising: a first tubing set as recited in any one of claims 11 and 12; and a second tubing set as recited in any one of claims 11 and 12.

16. The irrigation system of claim 15 wherein the junction of the first tubing set is fluidly connected to the junction of the second tubing set via a fluid path that flows through the third tubing of both the first tubing set and the second tubing set.

17. The irrigation system of any one of claims 15 and 16, further comprising: an endoscope comprising an inflow channel and an outflow channel, wherein the third tubing of the first tubing set fluidly connects the inflow channel to the junction of the first tubing set, and the third tubing of the second tubing set fluidly connects the outflow channel to the junction of the second tubing set.

18. The irrigation system of any one of claims 15 to 17, further comprising: a first fluid chamber fluidly connected to the junction of the first tubing set via both the first tubing of the first tubing set and the second tubing of the first tubing set.

19. The irrigation system of claim 18, further comprising: a second fluid chamber fluidly connected to the junction of the second tubing set via both the first tubing of the second tubing set and the second tubing of the second tubing set.

20. The irrigation system of any one of claims 18 and 19, further comprising: a first pump that moves fluid through the first tubing of the first tubing set.

21. The irrigation system of claim 20 wherein the first pump is a first positive displacement pump.

22. The irrigation system of claim 21 wherein the first positive displacement pump is one of an external gear pump, an internal gear pump, a gerotor pump, a lobe pump, a vane pump, or a peristaltic pump.

23. The irrigation system of claim 22 wherein the first tubing of the first tubing set comprises a fifth tubing of the first tubing set fluidly connecting the first junction and an inlet port of the first pump, and further comprises a sixth tubing of the first tubing set fluidly connecting an outlet port of the first pump with the first fluid chamber.

24. The irrigation system of claim 23 wherein the junction of the first tubing is a first junction, and the first tubing set further comprises: a second junction that fluidly connects the sixth tubing to the second tubing, wherein the connector is positioned between the first junction and the second junction.

25. The irrigation system of any one of claims 20 to 24, further comprising: a second pump that moves fluid through the first tubing of the second tubing set.

26. The irrigation system of claim 25 wherein the second pump is a second positive displacement pump.

27. The irrigation system of claim 26 wherein the second positive displacement pump is one of an external gear pump, an internal gear pump, a gerotor pump, a lobe pump, a vane pump, or a peristaltic pump.

28. The irrigation system of claim 27 wherein the first tubing of the second tubing set comprises a fifth tubing of the second tubing set fluidly connecting the second junction and an inlet port of the second pump, and further comprises a sixth tubing of the second tubing set fluidly connecting an outlet port of the second pump with the second fluid chamber.

29. An irrigation system comprising: a tubing set comprising: a junction; a first tubing that fluidly connects to the junction, the first tubing having a first lumen with a first cross-sectional dimension; a second tubing having a second lumen with a second cross-sectional dimension; a third tubing that fluidly connects to the junction; anda connector that fluidly connects the junction to the second tubing, the connector comprising a constriction with a third cross-sectional dimension that is smaller than the second cross-sectional dimension; and a surgical instrument, a fluid pump, a fluid reservoir, or any combination thereof.

30. The irrigation system of claim 29 wherein the surgical instrument is an endoscope, and the irrigation system comprises the endoscope, the fluid pump, and the fluid reservoir.

31. The irrigation system of claim 30 wherein: the first tubing fluidly connects the connector to the fluid reservoir via the pump; the second tubing fluidly connects the connector to the fluid reservoir bypassing the pump; and the third tubing fluidly connects the connector to the endoscope.

32. The irrigation system of claim 31 wherein the tubing set is a first tubing set, the junction is a first junction, the connector is a first connector, the constriction is a first constriction, the fluid pump is a first fluid pump, and the fluid reservoir is a first fluid reservoir, the irrigation system further comprising: a second tubing set comprising: a second junction; a fourth tubing that fluidly connects to the second junction, the fourth tubing having a fourth lumen with a fourth cross-sectional dimension; a fifth tubing having a fifth lumen with a fifth cross-sectional dimension; a sixth tubing that fluidly connects to the second junction; and a second connector that fluidly connects the second junction to the fifth tubing, the second connector comprising a constriction with a sixth cross-sectional dimension that is smaller than the fifth cross-sectional dimension; and a second fluid pump; and a second fluid reservoir.

33. The irrigation system of claim 32 wherein: the fourth tubing fluidly connects the second connector to the second fluid reservoir via the second pump; the fifth tubing fluidly connects the second connector to the second fluid reservoir bypassing the second pump; andthe sixth tubing fluidly connects the second connector to the endoscope.

34. A method of assembling an irrigation system, the method comprising: fluidly connecting a junction to a fluid reservoir along a first fluid flow path defined by a first lumen of a first tubing, the first lumen having a first cross-sectional dimension; fluidly connecting the junction to the fluid reservoir along a second fluid flow path defined by a second lumen of a second tubing, the second lumen having a second cross-sectional dimension; positioning a connector between the junction and the second tubing such that the connector defines a portion of the second path, wherein the connector comprises a constriction with a third cross-sectional dimension that is smaller than the second cross- sectional dimension.

35. The method of claim 34 wherein fluidly connecting the junction to the fluid reservoir along the first fluid flow path comprises operably coupling the first tubing to a pump such that the pump is operable to move fluid through the first tubing along the first fluid flow path.

36. The method of claim 35 wherein fluidly connecting the junction to the fluid reservoir along the second fluid flow path comprises bypassing the pump with the second tubing.

37. The method of any one of claims 34 to 36, further comprising: fluidly connecting the junction to an endoscope along a third fluid flow path defined by a third lumen of a third tubing.

38. The method of claim 37, further comprising: fluidly connecting a second junction to a second fluid reservoir along a fourth fluid flow path defined by a fourth lumen of a fourth tubing, the fourth lumen having a fourth cross-sectional dimension; fluidly connecting the second junction to the second fluid reservoir along a fifth fluid flow path defined by a fifth lumen of a fifth tubing, the fifth lumen having a fifth cross- sectional dimension; positioning a second connector between the second junction and the fifth tubing such that the second connector defines a portion of the fifth path, wherein the secondconnector comprises a second constriction with a sixth cross-sectional dimension that is smaller than the fifth cross-sectional dimension.

39. The method of claim 38 wherein fluidly connecting the second junction to the second fluid reservoir along the fourth fluid flow path comprises operably coupling the fourth tubing to a second pump such that the second pump is operable to move fluid through the fourth tubing along the fourth fluid flow path.

40. The method of claim 39 wherein fluidly connecting the second junction to the second fluid reservoir along the fifth fluid flow path comprises bypassing the second pump with the fifth tubing.

41. The method of claim 40, further comprising: fluidly connecting the second junction to the endoscope along a sixth fluid flow path defined by a sixth lumen of a sixth tubing.

42. The method of any one of claims 34 to 41 , further comprising: fluidly connecting the first junction to a first pressure transducer; fluidly connecting the second junction to a second pressure transducer; or fluidly connecting the first junction to a first pressure transducer, and fluidly connecting the second junction to a second pressure transducer.

43. A method of maintaining a pressure within a cavity, the method comprising: moving a fluid from a fluid reservoir through a first lumen of a first tubing to a first junction, the first lumen having a first cross-sectional dimension along its length; moving the fluid from the junction through a connector fluidly connected to the junction and then through a second lumen of a second tubing fluidly connected to the connector, the second lumen having a second cross-sectional dimension along its length, and the connector having a third cross-sectional dimension that is smaller than the second cross-sectional dimension; moving the fluid from the junction through a third lumen of a third tubing to a surgical instrument; moving the fluid from the surgical instrument to the cavity.

44. The method of claim 43, further comprising: moving the fluid from the second tubing to the fluid reservoir; ormoving the fluid from the second tubing to the first tubing at a location between the fluid reservoir and the junction.

45. The method of any one of claims 43 and 44 wherein the junction is a first junction, the fluid reservoir is a first fluid reservoir, the connector is a first connector, and the constriction is a first constriction, the method further comprising: moving the fluid from the cavity to the surgical instrument; moving the fluid from the surgical instrument to a second junction; moving the fluid from the second junction to a second fluid reservoir through a fourth lumen of a fourth tubing, the fourth lumen having a fourth cross-sectional dimension along its length; moving the fluid from the second junction through a second connector fluidly connected to the second connector and then through a fifth lumen of a fifth tubing fluidly connected to the second connector, the fifth lumen having a fifth cross-sectional dimension along its length, and the second connector having a sixth cross-sectional dimension that is smaller than the fifth cross-sectional dimension.

46. The method of claim 45, further comprising: moving the fluid from the fifth tubing to the second fluid reservoir; or moving the fluid from the fifth tubing to the fourth tubing at a location between the second fluid reservoir and the second junction.

47. The method of any one of claims 45 and 46, further comprising: delivering the fluid through a first channel of the surgical instrument to the cavity; and removing the fluid from the cavity through a second channel of the surgical instrument.

48. The method of any one of claims 43 to 47, further comprising: passing the first tubing through a pump; and moving the fluid through the first tubing via the pump.

49. A method of maintaining a pressure within a cavity, the method comprising: moving a fluid from the cavity to a surgical instrument; moving the fluid from the surgical instrument to a junction;moving the fluid from the junction to a fluid reservoir through a first lumen of a first tubing, the first lumen having a first cross-sectional dimension along its length; moving the fluid from the junction through a connector fluidly connected to the junction and then through a second lumen of a second tubing fluidly connected to the connector, the second lumen having a second cross-sectional dimension along its length, and the connector having a third cross-sectional dimension that is smaller than the second cross-sectional dimension.

50. The method of claim 49, further comprising: moving the fluid from the second tubing to the fluid reservoir; or moving the fluid from the second tubing to the first tubing at a location between the fluid reservoir and the junction.

51. A tubing set that connects an endoscopic instrument to a waste fluid collection unit to dispose of a waste fluid withdrawn from a body cavity during an endoscopic procedure, the tubing set comprising: a first junction having at least a first port, a second port, and a third port; a first tubing extending between the first port and the endoscopic instrument; a second tubing fluidly connecting the second port to the waste fluid collection unit 204 via a pump, thus providing a first path between the first junction and the waste fluid collection unit 204; the third port providing a second path between the first junction and the waste fluid collection unit, the second path bypassing the pump; and the third port comprises a constriction with an internal cross-sectional dimension smaller than an internal cross-sectional dimension of each of the first port, the second port, the first tubing, and the second tubing.

52. A tubing set that connects a fluid reservoir to an endoscopic instrument via a pump, the tubing set comprising: a) a three-way joint comprising a first port, a second port, and a third port; i) a four-way joint comprising a fourth port, a fifth port, a sixth port, and a seventh port; ii) a first tubing that extends from the first port and is fluidly connectable, in operation, to the fluid reservoir; iii) a second tubing that extends from the fifth port and is fluidly connectable, in operation, to the endoscopic instrument;iv) a third tubing that extends between the second port and the fourth port, in operation, the pump being operably connected between first and second ends of the third tubing; v) the third port of the three-way joint being directly joined to the sixth port of the four-way joint; and vi) a constriction positioned between the third port and the sixth port.

53. An irrigation system that irrigates a body cavity during an endoscopic procedure, the irrigation system comprising: a) a fluid reservoir, a pump and an endoscope connected to one another by a tubing set, the tubing set comprising: i) a three-way joint comprising a first port, a second port, and a third port; ii) a four-way joint comprising a fourth port, a fifth port, a sixth port, and a seventh port; iii) a first tubing that extends from the first port and is fluidly connectable to the fluid reservoir; iv) a second tubing that extends from the fifth port and is fluidly connectable, in operation, to the endoscopic instrument; v) a third tubing that extends between the second port and the fourth port, in operation, the pump being operably connected between two ends of the third tubing; vi) the third port of the three-way joint being directly joined to the sixth port of the four-way joint; and vii) a constriction positioned between the third port and the sixth port.

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