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EP-4355396-B1 - MULTI-PORT, HIGH-FLOW PNEUMOPERITONEUM AND SMOKE EVACUATION DISTRIBUTION DEVICES AND SYSTEMS

EP4355396B1EP 4355396 B1EP4355396 B1EP 4355396B1EP-4355396-B1

Inventors

  • VISCO, Anthony
  • VISCO, Zachary

Dates

Publication Date
20260506
Application Date
20220930

Claims (15)

  1. An insufflation system for creating a high-flow, constant or variable pressure pneumoperitoneum, the system comprising: a gas flow distribution device (10) comprising: a housing (30) defining an insufflation chamber (12); an inlet port (32) on the housing and configured to be connected to an insufflator to provide insufflation gas from the insufflator to the insufflation chamber; and a plurality of outlet ports (36) on the housing configured to be connected to a plurality of insufflation trocars, each outlet port configured to be connected to a dedicated one of the plurality of trocars, to concurrently distribute the insufflation gas from the insufflation chamber to each of the plurality of trocars; characterized in that the housing further comprises an exhaust chamber (14); the insufflation system further comprising at least one exhaust inlet port (50) on the housing and configured to be connected to an exhaust trocar to provide suction and/or evacuate smoke from the exhaust trocar to the exhaust chamber; and an exhaust outlet port (52) on the housing and configured to be connected to an exhaust device to provide exhaust from the exhaust chamber to the exhaust device.
  2. The insufflation system of claim 1 comprising two or more exhaust inlet ports (50) on the housing, each exhaust inlet port configured to be connected to an exhaust trocar.
  3. The insufflation system of claim 1 wherein the inlet port comprises a barb (B) configured to directly engage an inner surface of tubing connected thereto.
  4. The insufflation system of claim 3 wherein the inlet port comprises a luer lock connection (86) configured to receive a luer lock fitting.
  5. The insufflation system of claim 1 wherein each outlet port comprises a barb (B) configured to directly engage an inner surface of tubing connected thereto.
  6. The insufflation system of claim 5 wherein each outlet port comprises a luer lock connection (86) configured to receive a luer lock fitting.
  7. The insufflation system of claim 5 further comprising a plurality of outlet tubes (16), each outlet tube comprising a first end (40) and a second opposite end (42), the first end of each outlet tube configured to be connected to a corresponding one of the outlet ports, the second end of each outlet tube configured to be connected to the dedicated trocar.
  8. The insufflation system of claim 7 wherein the first end of each outlet tube is pressure fit to a corresponding one of the outlet ports such that an inner surface of the outlet tube directly engages a barb (B) on an outer surface of the outlet port.
  9. The insufflation system of claim 7 further comprising a luer lock fitting (44) at the second end of each of the outlet tubes.
  10. The insufflation system of claim 1 further comprising a reservoir (84) in a top of the housing that is sized and configured to receive and hold a sponge comprising surfactant to reduce fogging on a laparoscopic lens.
  11. The insufflation system of claim 1 wherein the housing includes a partition (66) that isolates the insufflation chamber and the exhaust chamber from one another.
  12. The insufflation system of claim 1 further comprising at least one inlet tube (22) each comprising a first end (56) and a second opposite end (58), the first end of each inlet tube configured to be connected to a corresponding one of the at least one exhaust inlet port, the second end of each inlet tube configured to be connected to a dedicated exhaust trocar.
  13. The insufflation system of claim 12 wherein the first end of each inlet tube is pressure fit to a corresponding one of the at least one exhaust inlet port such that an inner diameter of the inlet tube directly engages a barb (B) on an outer surface of the exhaust inlet port.
  14. The insufflation system of claim 13 further comprising a luer lock fitting (44) at the second end of each inlet tube.
  15. An insufflation system for creating a high-flow, constant or variable pressure pneumoperitoneum, the system comprising: an insufflator (34); first and second insufflation trocars (38) in an abdomen of a patient; a gas flow distribution device of claim 1 wherein: the inlet port on the housing is connected to the insufflator to provide insufflation gas from the insufflator to the insufflation chamber; and a first outlet port of the plurality of outlet ports on the housing is connected to the first insufflation trocar and a second outlet port of the plurality of outlet ports on the housing is connected to the second insufflation trocar, to concurrently distribute the insufflation gas from the insufflation chamber to each of the first and second insufflation trocars.

Description

Background Laparoscopic surgery is often aided by pneumoperitoneum, or the insufflation of a gas into the body cavity to create a surgical space. While pneumoperitoneum is essential to visibility during surgery, there are some challenges associated with creating and maintaining gas pressure. Pneumoperitoneum is typically created using a single inflow tubing containing carbon dioxide connected to a single laparoscopic trocar using luer lock connections. The available internal capacity of the trocar to carry high-flow gas is further significantly reduced by the introduction of surgical tools (e.g., a laparoscopic or robotic instrument, suction device, camera, etc.) into the trocar as these devices take up the majority of the available internal trocar volume. One current solution is a valveless trocar system that uses outer channels to carry gases around a central trocar sheath. However, this significantly increases the overall size of the valveless trocar, requiring larger skin and fascial incisions that have been associated with an increased risk of postoperative hernia formation. Another drawback of pneumoperitoneum-assisted laparoscopy is the loss of pneumoperitoneum that can occur, particularly during suctioning or during a total hysterectomy when an incision is made in the vagina allowing the rapid escape of gas. This is particularly problematic during robotic surgery, where the trocars are attached to fixed robotic arms. Pressure loss can cause the abdominal wall to drop away, resulting in the trocars becoming malpositioned. US 2014/309583 A1 shows examples of such systems. In light of these and other challenges, there is an ongoing need for improved insufflation systems and methods. Summary The Summary is provided to introduce a selection of concepts that are further described below in the Detailed Description. This Summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used as an aid in limiting the scope of the claimed subject matter. One aspect of the present disclosure provides all that is described and illustrated herein. The present invention is directed to to an insufflation system for creating a high-flow, constant or variable pressure pneumoperitoneum, the system including a gas flow distribution device. The gas flow distribution device includes: a housing defining an insufflation chamber; an inlet port on the housing and configured to be connected to an insufflator to provide insufflation gas from the insufflator to the insufflation chamber; and a plurality of outlet ports on the housing configured to be connected to a plurality of insufflation trocars, each outlet port configured to be connected to a dedicated one of the plurality of trocars, to concurrently distribute the insufflation gas from the insufflation chamber to each of the plurality of trocars, wherein the housing further comprises an exhaust chamber; the insufflation system further comprising at least one exhaust inlet port on the housing and configured to be connected to an exhaust trocar to provide suction and/or evacuate smoke from the exhaust trocar to the exhaust chamber; and an exhaust outlet port on the housing and configured to be connected to an exhaust device to provide exhaust from the exhaust chamber to the exhaust device. In some embodiments, the inlet port includes a barb configured to directly engage an inner surface of tubing connected thereto. The inlet port may include a luer lock connection configured to receive a luer lock fitting. In some embodiments, each outlet port includes a barb configured to directly engage an inner surface of tubing connected thereto. In some embodiments, each outlet port includes a luer lock connection configured to receive a luer lock fitting. In some embodiments, the system further includes a plurality of outlet tubes, each outlet tube including a first end and a second opposite end, the first end of each outlet tube configured to be connected to a corresponding one of the outlet ports, the second end of each outlet tube configured to be connected to the dedicated trocar. The first end of each outlet tube may be pressure fit to a corresponding one of the outlet ports such that an inner surface of the outlet tube directly engages a barb on an outer surface of the outlet port. The system may further include a luer lock fitting at the second end of each of the outlet tubes. In some embodiments, the system further includes a reservoir in a top of the housing that is sized and configured to receive and hold a sponge comprising surfactant to reduce fogging on a laparoscopic lens. In some embodiments, the inlet port and the plurality of outlet ports are on the top of the housing and surround the reservoir. In some embodiments, the housing is circular in shape. In some embodiments, the housing is polygonal in shape. In some embodiments, the housing has a shape of a torus optionally with a flat bottom surface. In some embodiments