Insufflation Pressure Conditioning for Stable TAMIS Cavity Pressure
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Existing insufflation systems for surgical procedures, such as TAMIS, experience pressure fluctuations due to pulsing gas supply and leakage, leading to tissue billowing and difficulty in laparoscopic surgery.
Innovation Solution
A pressure conditioning apparatus is used to stabilize insufflation gas flow by incorporating a reservoir and flow restrictor to maintain a continuous flow, compensating for pressure losses due to leakage and absorption, and a sealing apparatus to create a closed volume within the body conduit.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If pulsing insufflation pump is used to inflate the rectum, then the insufflation gas is supplied in pulses, but pressure fluctuations occur causing tissue billowing
Solution Approach 1:
The reservoir is pre-filled with insufflation gas before the surgical procedure begins. This preliminary action ensures that gas is already available in the reservoir to compensate for pressure fluctuations during pulsing insufflation, thereby reducing tissue billowing while maintaining high productivity.
Solution Approach 2:
The reservoir acts as an intermediary between the pulsing insufflation pump and the rectum. It buffers the pulsed gas supply by releasing gas during the decay phase of each pulse, smoothing out pressure fluctuations and preventing tissue billowing while allowing the pump to operate at high productivity.
2Object-generated harmful factors
If smoke evacuation port is constantly open to encourage CO2 flow, then smoke is evacuated effectively, but pressure loss increases
Solution Approach 1:
The system uses pressure sensing to detect when pressure drops due to open smoke evacuation. The insufflation pump responds by increasing gas supply during these periods, and the reservoir compensates for the additional loss. This feedback mechanism ensures continuous smoke evacuation while maintaining stable pressure at the surgical site.
Solution Approach 2:
The system dynamically adjusts insufflation parameters by allowing the reservoir volume and pressure to change in response to smoke evacuation demands. When the smoke evacuation port is open, the reservoir compensates for increased gas flow requirements, maintaining adequate pressure despite the increased loss through the open port.
3Measurement precision
If CO2 is supplied in pulses with pressure measurements, then the insufflation machine can monitor pressure, but pressure drops due to leakage and absorption
Solution Approach 1:
The reservoir is pre-filled with excess gas to cushion against anticipated pressure losses from leakage and absorption. This beforehand cushioning ensures that even when the pump is not actively supplying gas during measurement phases, the reservoir maintains adequate pressure to prevent rectal wall contraction and ensure reliable surgical conditions.
Solution Approach 2:
The reservoir ensures continuous gas availability to the rectum, bridging the gaps between pulsed insufflation cycles. This continuity of useful action maintains stable pressure despite the intermittent nature of pump operation, ensuring reliable pressure measurement and preventing pressure drops from leakage and absorption.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The apparatus maintains a substantially constant pressure at the surgical site, reducing tissue billowing and enhancing surgical precision by minimizing pressure fluctuations.
Implementation Method 1
The reservoir is fluidly coupled to the inlet fluid conduit and the outlet fluid conduit... absorb energy from a relatively high flow output from an insufflator and provide a lower, but more continuous flow to the surgical field
Implementation Method 2
condition a pulsed or discontinuous insufflation gas flow to provide a substantially continuous insufflation gas flow that can have a flow rate that varies responsive to pressure losses at an inlet from a zero pressure differential state between pulses of an insufflation pump and backpressure reduction at an outlet due to leakage and absorption by tissue at a surgical site
Data Source
AI summary
Pressure conditioning systems for supplying insufflation gas to an open-ended body conduit such as a rectal cavity during a transanal minimally invasive surgery (TAMIS) procedure can reduce billowing of walls of the body conduit. A pressure conditioning system can include a pressure storage component, an accumulator, and a flow restrictor. The pressure storage component can include a variable volume reservoir that is biased to a relatively low volume state. The flow restrictor can include insufflation tubing with a restrictor plate having a relatively low diameter orifice. The pressure storage component, accumulator, and flow restrictor can be fluidly connected in various orders in series or as side branches from a gas flow conduit. Despite a pulsed or otherwise discontinuous insufflation gas flow and leakage and absorption from the body conduit, the pressure conditioning system can maintain a constant pressure within the body conduit.