Smoke evacuation system

ES 2 245 490 T3

DESCRIPTION

Smoke evacuation system.

1. Field of the invention

The present invention relates to smoke removal and filtering, and more particularly to a smoke evacuation system for use in surgical procedures, including minimally invasive surgical procedures such as laparoscopy, during which a cautery or laser is used. .

two. Description of Related Art

US Patent No. 5,578,000 (Greff et al.) Discloses a smoke evacuation system that includes a trocar that has a working channel, a stopcock or valve that communicates with the channel, a vacuum source wall, a fluid conduit connected between the trocar stopcock and the wall vacuum source, a first filter to apply a first reduction in suction and separate the smoke into its components and a residual gas, and a flow restriction to generate a second reduction in suction. The flow restriction is along a passage formed by the duct, the filter, and the working channel.

Greff et al. They emphasize that the smoke has been manipulated by simply allowing it to escape into the operating room, thus subjecting the surgeon and staff to contaminants. They acknowledge that closed recirculation systems involving two trocars have been used and that probes that are inserted through a trocar have also been used, but that such systems do not adequately solve problems associated with smoke and smoke removal, for example contamination, odor, and impaired visibility of a surgical site.

Other problems inadequately addressed by currently available evacuation systems are pressure loss in the pneumoperitoneum and / or tissue drying, particularly if pressure loss is compensated by increasing insufflation gas flow.

Although the smoke evacuation system described in the Greff et al. may be well suited for the intended purpose, it would be advantageous if the reliance on a remote "in-wall" vacuum source could be eliminated, thus reducing the cost and complexity of the system.

Summary

The present invention provides an improvement over currently known smoke evacuation systems, procedures and techniques, including laparoscopic smoke evacuation systems such as the system described in the Greff et al. Patent.

In one embodiment, the present invention provides a combination of a filter and a generally tubular element according to claim

1.

Other embodiments are defined in independent claims 2 and 4.

An advantage of the present invention is that it eliminates the dependence on a built-in wall vacuum source. It does not require high vacuum suction or the necessary heavy duty filters or the combination of restrictors or reducers and flow filters. In addition, it simplifies smoke evacuation and filtering by eliminating the need for multiple in-line structures (filters, resistors, etc.) to decrease or reduce suction.

Although the present invention can be used in surgical procedures, it can also be used in industry to remove smoke and / or chemicals from workstations. For example, it could be used in conjunction with chip manufacturing stations or electronic equipment to reduce worker exposure to smoke produced when connections are formed. Similarly, it could be used to reduce exposure to corrosive chemicals.

A feature of the present invention is a balanced smoke evacuation system, in which one liter with a relatively low pressure drop performs a filtering function and a flow regulation function, helping to preserve pressure in or within a pressurized surgical site, such as laparoscopy with a pneumoperitoneum, while providing sufficient flow from the site to remove smoke from the site, thus reducing the need for substantial or constant re-inflation of the surgical site.

Another embodiment of the invention includes an elbow member adapted to engage between a trocar and the conduit to position the conduit so as to reduce any potential discomfort to the surgeon and / or staff during an intervention.

An advantage of the system of the present invention is that it provides intraoperative evacuation and filtration of smoke from a pressurized surgical site, for example the abdominal cavity, without requiring suction and without rapidly discharging the pressurizing gas or causing a substantial pressure reduction in the pressurized surgical site. Other advantages are that the invention does not require an operator, continuously removes smoke from the pressurized cavity (once the valve is opened in valved embodiments) to improve unvented visibility, reduces operating time, eliminates surgical smoke from the operating room, thus reducing the health risk from exposure to such smoke, eliminates the need to apply suction to a patient, thus reducing potential tissue damage, and is inexpensive.

Other features and advantages of the present invention will become more apparent with reference to the following description and drawings and the appended claims.

Brief description of the drawings

Figure 1 represents an embodiment of the smoke evacuation system of the present invention.

Figure 2 represents the filter of an embodiment of the present invention.

Figure 3 represents a part of the filter of Figure 2 in cross section.

Figure 4 represents another embodiment of the filter.

Figure 5 depicts a stopcock or connector valve for use in the smoke evacuation system of the present invention.

Figure 6 illustrates, in broadly representative form, a trocar (and obturator) of a type suitable for use with the present invention.

Figure 7 depicts an elbow connector connecting a trocar and a valve connector.

Figure 8 represents another embodiment of the filter.

Figure 9 represents another embodiment

ES 2 245 490 T3 of the smoke evacuation system of the present invention.

Figure 10 represents another embodiment of the smoke evacuation system of the present invention.

Description

The attached figures represent embodiments of the system of the present invention and its characteristics and components. With respect to the means for holding, mounting, fixing or connecting the components of the present invention to form the apparatus as a whole, unless otherwise specifically described, such means are intended to comprise conventional fasteners such as machine screws. , machine threads, snap rings, hose clamps, such as screw clamps and the like, rivets, nuts and bolts, toggle levers, pins and the like. Components can also be connected by friction fit or by welding or deformation, if appropriate. Unless specifically described or taught otherwise, the materials for making the components of the present invention are selected from appropriate materials, such as metal, metal alloys, natural or synthetic fibers, and the like, and appropriate procedures can be used. manufacturing or production, including casting, extrusion, molding and machining.

Any reference to front and rear, left and right, top and bottom, top and bottom, and horizontal and vertical is intended to facilitate description and not to limit the present invention or its components to any one positional or spatial orientation.

With reference to the figures, particularly Figure 1, the present invention provides a smoke evacuation system 14 for use during surgical procedures. System 14 includes a filter 16 and a generally flexible fluid conduit 18 connected to filter 16. Conduit 18 may be arranged in one or more pieces. System 14, particularly the end of conduit 18, may include an integral or attachable male or female connector (of the type well known in the art) to facilitate connection of conduit 18 to the exhaust port or vent valve of a trocar, or system 14 may include a Leur lock-type valve 17 (see Figure 5) operatively coupled to conduit 18 and may include a generally tubular element 20, such as a typical well known trocar with an exhaust port (not shown).

Referring to Figure 3, the filter 16 comprises a housing 24 with an inlet connector 26 and an outlet connector 28. Staggered barbed-type connectors for hoses may be used, as shown in the figures. In alternative embodiments, the inlet and outlet connectors 26, 28 may take the form of solid or clip-on male or female connectors or valves or connectors of the Leur lock type (of the type well known in the art) to facilitate connection of the filter 16 to the exhaust port or vent valve of a trocar. Likewise, connectors 26, 28, particularly entry connector 26, can be adapted, such as by elongating and providing appropriate ribs or texturing, to be inserted directly into a puncture leading to a pneumoperitoneum (for example). Housing 24 can be made of polypropylene or other suitable material. Housing 24 contains filter media 32, which comprises two thin, flat, circular disc-shaped layers 34, 36. One layer 36, the layer adjacent to outlet connector 28, is formed of 0.2 µm, 200 mg / cm hydrophobic PTFE.² and the other layer 34 is made of a 50% cellulose / carbon fiber blend of 200 g / m². The layers 34, 36 are immediately adjacent to each other and each layer has a large surface area. Together they form a filter media 32 having a surface area that generally corresponds to its filtration area, that is, approximately 7.5 cm², approximately 100 times greater than the 0.635 cm (1/4 inch) cross-sectional area of ​​the depicted conduit 18 lumen. Although a disk-shaped filter is shown, other shapes can be used as long as a pressure drop is achieved for low-pressure, low-flow filtration. The filter 24, one or both layers, may be designed to exhibit a "filter change" color change indicative that the filter's life is over or nearly over. Odor removal layer 34 may be formed of, or incorporate, carbon-based or charcoal-based material, or a diatomaceous earth material or other odor removal or reduction agent may be used.

The filter media 32 is encapsulated in the housing 24. The housing 24 has an inlet manifold 40 and an outlet manifold 42. On each side of the filter media 32, at the respective manifolds, the housing has a plurality of grooves annular 42. Housing 24 may be formed around filter media 32 or may be formed in pieces that are joined together to encapsulate media 32. An alternate button or rivet-type embodiment of the filter 16 is depicted in Figure 4 in which the outlet 28 is substantially reduced to an outlet port 28 '. This embodiment of filter 16 can be worn at the free end of conduit 18 or, in a similar embodiment with a protruding inlet connector suitable to extend through the abdominal wall, it can be directly attached to the abdomen of a patient, for example. for example, through a needle bar or other suitable opening.

System 14 provides a substantially unobstructed fluid flow path through fluid conduit 18 between valve 18 and filter 16 and, when valve 18 is open, between a pressurized surgical site "S" and filter 16. Filter 16 provides flow regulation of a fluid (smoke-carrying insufflation gas) that flows along the fluid flow path as it provides resistance to flow, whereby flow rates in some embodiments range from one (1 ) to four (4) liters / minute and, in other embodiments, range from 1 to 3.8 liters / minute. Filter 16 exhibits or has an associated side-to-side pressure drop of approximately 0.7 to 27 mbar (half (0.5) to twenty (20) mm of mercury), with a pressure drop of approximately 2 being preferred. 7 to 4 mbar (two (2) to three (3) mm of mercury) in another embodiment and a pressure drop of about one (1) mm of mercury being preferred in still another embodiment. The latest pressure drops generally correspond to flow rates of 1.8 liters / minute and 3.6 to 3.8 liters / minute, respectively. Pressures higher than 3

Lower pressure drops and / or pressure drops will produce higher correlative flow rates, and filter 16 may be available in various specifications to suit the patient, function, or intervention involved. The size and length of the fluid conduit or tube 18 can be varied to help provide the desired flow characteristics (approximately 1.0 to 30 liters per minute) in conjunction with the resistance or pressure drop of the filter 16 of the present invention. . In some embodiments, tube 18 may be four to six feet in length, with a length of 1.5 to 3.0 feet (45.7 to 91.4 cm) being preferred. If a 0.365 cm (one-quarter inch) tubing is selected, the lumen of tube 18 would typically be 3 mm in diameter, but inside diameters ranging from 2 to 12 mm can be used. The diameter and length parameters of the tube 18, the size of the trocar (for a preferred example, 3 mm), and the resistance or pressure drop associated with the filter 16 can be relatively adjusted to accommodate different patients, surgical procedures and / or OR settings, provided adequate low pressure, low flow smoke filtering, and odor removal are achieved. The present invention may be accomplished in a fully desirable single-use unit or components thereof, eg the filter or tubing, may be desirable, with another reusable component. Typically, trocar 20 or tubular element to which conduit 18 is coupled, directly or through a port or relief valve, is grounded to eliminate any stray currents.

A method is disclosed for evacuating smoke from a surgical site, particularly a minimally invasive site, such as a laparoscopy with a pneumoperitoneum. For example, to evacuate smoke from a surgical site in the abdominal cavity during a laparoscopic procedure, the method of the present invention comprises the steps of functionally coupling a conduit 18 to the pneumoperitoneum, for example, to the tubular element 21 (Figure 7) that is extends from the pneumoperitoneum, and coupling to conduit 18 a filter 16 that has a low pressure drop across it, whereby there is a substantially unobstructed low volume fluid flow path between the pneumoperitoneum and filter 18 so that particulate material and odor are removed from the fluid. Fluid is induced to flow through conduit 18 and filter 16 by the generally complementary pressure of the pneumoperitoneum insufflation gas and the pressure drop of filter 16. In one embodiment, flow can be controlled, eg, started, stopped, or reduced, by incorporating a valve (such as a Leur block valve (Figure 5) or the like) with conduit 18 or by using a valved trocar or the like.

The apparatus of the present invention can be used in laparoscopic procedures involving pneumoperitoneum, that is, a condition in which air or gas is collected or inflated into the peritoneal cavity, but it can also be used in any other surgical procedure that involves a substantially closed and / or pressurized surgical site, such as thoracoscopy. Referring to Figure 10, in one embodiment, conduit 18 may be equipped with a flow generating device 48, such as an in-line blower or impeller, which may be battery powered, such as some commercially available models for sucking air, smoke, particles and pollutant into the duct for filtration, whereby the invention can be used for "open" surgical procedures. In this embodiment, the selected flow generating device 48 can be located on either side of the filter 16, although its positioning on the outlet side of the filter 16 can protect it from contaminants and, in non-disposable embodiments, extend its useful life. The flow generating device 48 can be incorporated with the filter 16 itself, for example, in the outlet connector. Referring to Figures 9 and 10, for use in open site surgical procedures, the end of the site or entry end of conduit 18 may be expanded, as at 19, and provided with a grid 21. In this embodiment, the expanded end 19 can be inserted, for example partially into a deep wound or connected to the body of a patient near a surgical site (for example, using adhesive, strips, sutures or the like).