SYSTEM FOR EVACUATING DETACHED TISSUE IN CONTINUOUS FLOW IRRIGATION ENDOSCOPIC PROCEDURES

• US 20080091071A1
• Filed: 10/10/2007
• Published: 04/17/2008
• Est. Priority Date: 10/11/2006
• Status: Active Grant

• Current Assignee: Alka Kumar, Atul Kumar
• Original Assignee: Alka Kumar, Atul Kumar
• Inventors: Kumar, Alka, Kumar, Atul
• Granted Patent: US 9,028,398 B2
• Time in Patent Office: Days
• US Class Current: 600/121
• CPC Class Codes: A61B 1/00068 Valve switch arrangements
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/00094 Suction openings
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61M 1/74 Suction control underwater drainage A61M1/61
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 1/893 with extraction of specific components, e.g. of stem cells
• CPC Class Codes: A61M 2205/3337 Controlling, regulating pressure or flow by means of a valve by-passing a pump
• CPC Class Codes: A61M 3/0202 with electronic control means or interfaces
• CPC Class Codes: A61M 3/0208 before use
• CPC Class Codes: A61M 3/0212 after use
• CPC Class Codes: A61M 3/0216 Pressure
• CPC Class Codes: A61M 3/022 Volume; Flow rate
• CPC Class Codes: A61M 3/0258 by means of electric pumps
• CPC Class Codes: F04B 43/1253 by using two or more rollers as squeezing elements, the rollers moving on an arc of a circle during squeezing

Abstract

A continuous flow irrigation endoscope and a continuous flow irrigation fluid management system, both designed to be compatible to each other and to function as a single system. The endoscope and the fluid management system are synergistic to each other such that both enhance the efficiency of each other. The invented system allows a body tissue cavity to be distended by continuous flow irrigation so that detached tissue pieces and waste fluid present inside a body tissue cavity are continuously automatically evacuated from the tissue cavity without causing the cavity to collapse at any stage and without the need of withdrawing the endoscope of a part of the endoscope from the tissue cavity. No type of feedback mechanism, such as mechanical or electrical, or valve or valve like systems, are incorporated in the endoscope to influence or facilitate the removal of detached tissue pieces or waste fluid in any manner.

Claims

1. A continuous flow irrigation system, comprising:

an endoscope comprising an outer sheath having a longitudinal axis, a distal end and a proximal end;

an inflow port located at the proximal end of the outer sheath, configured to allow fluid to enter the outer sheath;

a tube extending about parallel to the longitudinal axis of the outer sheath, the tube being configured to move in at least one of a linear motion and a rotary motion relative to the longitudinal axis of the outer sheath; and

an outflow port located at a proximal end of the tube;

an inflow pump connected to the inflow port of the endoscope; and

an outflow pump connected to the outflow port of the endoscope.

2. The system of claim 1, wherein at least one of the inflow pump and the outflow pump is a peristaltic pump, piston pump, gear pump or diaphragm pump.

3. The system of claim 1, wherein the inflow pump is connected to a fluid source reservoir, and wherein the system further comprises a second tube having a variable size constriction site provided between the fluid source reservoir and the inflow port of the endoscope, the second tube providing a route for any excess fluid being pumped by the inflow pump to bypass the inflow pump.

4. The system of claim 1, wherein the tube of the endoscope is an inner channel of a surgical instrument and also an evacuation channel for fluid and/or tissue debris from a tissue cavity.

5. The system of claim 4, wherein the surgical instrument is selected from the group consisting of a morcellator, shaver, cutter, electrode and electrosurgical instrument.

6. The system of claim 1, further comprising a pressure transducer for sensing the pressure of fluid entering the inflow port of the endoscope.

7. The system of claim 1, wherein the endoscope further comprises an optical channel, at least a portion of the optical channel being non-parallel to the longitudinal axis of the outer sheath.

8. The system of claim 1, wherein the endoscope further comprises an optical channel about parallel to the longitudinal axis of the outer sheath.

9. The system of claim 1, wherein the outflow port of the endoscope is located outside the outer sheath.

10. A continuous flow irrigation system for an endoscopic procedure, the system comprising:

an endoscope comprising a tubular outer housing having a longitudinal axis, a distal end and a proximal end;

an inflow port located at the proximal end of the tubular outer housing, configured to allow fluid to enter the tubular outer housing;

an optics channel located within the tubular outer housing and comprising a bent region that forms an angle relative to the longitudinal axis of the tubular outer housing;

a movable tube extending about parallel to the longitudinal axis of the tubular outer housing, the movable tube being configured to move in at least one of a linear motion and a rotary motion relative to the longitudinal axis of the tubular outer housing; and

an outflow port located at a proximal end of the movable tube;

a first peristaltic pump connecting a fluid source reservoir to the inflow port of the endoscope via an inflow tube;

a second peristaltic pump connecting a waste fluid reservoir to the outflow port of the movable tube of the endoscope; and

a tube having a controllable constriction site provided between the fluid source reservoir and the inflow port of the endoscope, the tube providing a route for any excess fluid being pumped by the first peristaltic pump to bypass the first peristaltic pump.

11. The system of claim 10, wherein the fluid source reservoir contains a non-viscous physiologic fluid maintained at atmospheric pressure or a pressure greater than the atmospheric pressure.

12. The system of claim 10, wherein the movable tube of the endoscope is an inner channel of a surgical instrument selected from the group consisting of morcellator, shaver, cutter, electrode and electrosurgical instrument.

13. The system of claim 10, wherein the movable tube of the endoscope is an inner channel of a ball electrode.

14. The system of claim 10, wherein the endoscopic procedure is selected from the group consisting of hysteroscopic fibroid morcellation, trans uretheral prostate morcellation, hysteroscopic polyp morcellation, hysteroscopic septoplasty, hysteroscopic adhesiolysis, trans uretheral morcellation of bladder tumors, and arthroscopy.

15. A method of continuous flow irrigation during an endoscopic procedure, comprising the steps of:

providing a continuous flow irrigation endoscope in the vicinity of a tissue cavity, the endoscope comprising an outer sheath having a longitudinal axis, a distal end and a proximal end;

an inflow port located at the proximal end of the outer sheath, configured to allow fluid to enter the outer sheath;

a tube extending about parallel to the longitudinal axis of the outer sheath, the tube being configured to move in at least one of a linear motion and a rotary motion relative to the longitudinal axis of the outer sheath; and

an outflow port located at a proximal end of the tube;

connecting the inflow port of the endoscope to a fluid source via an inflow pump for pumping fluid from the fluid source at a controlled inflow rate into the inflow port of the endoscope and the tissue cavity, wherein the inflow rate is the flow rate of the inflow pump; and

connecting the outflow port of the endoscope to an outflow pump for removing waste fluid from the tissue cavity at a controlled outflow rate, wherein the outflow rate is the flow rate of the outflow pump.

16. The method of claim 15, further comprising the step of providing a second tube having a controllable constriction site between the inflow port of the endoscope and the fluid source reservoir such that the second tube provides a route for any excess fluid being pumped by the inflow pump or due to the physiologic contraction of walls of the body cavity, therefore avoiding turbulence inside the body cavity and maintaining a stable pressure inside the body cavity.

17. The method of claim 15, wherein the endoscopic procedure is selected from the group consisting of hysteroscopic fibroid morcellation, trans uretheral prostate morcellation, hysteroscopic polyp morcellation, hysteroscopic septoplasty, hysteroscopic adhesiolysis, trans uretheral morcellation of bladder tumors, and arthroscopy.

18. The method of claim 15, wherein the inflow rate and the outflow rate are simultaneously increased or decreased without altering the pressure inside the tissue cavity.

19. A method of controlling pressure variations within a body tissue cavity during an endoscopic procedure, comprising the steps of:

providing a continuous flow irrigation endoscope at least partially within a tissue cavity, the endoscope comprising only an outer sheath without an inner sheath, the outer sheath having a longitudinal axis, a distal end and a proximal end;

an inflow port located at the proximal end of the outer sheath, configured to allow fluid to enter the outer sheath;

a tube extending about parallel to the longitudinal axis of the outer sheath; and

an outflow port located at a proximal end of the tube;

providing an inflow peristaltic pump in communication with the inflow port of the endoscope, to provide fluid into the tissue cavity;

providing an outflow peristaltic pump in communication with the outflow port of the endoscope, to remove fluid from the tissue cavity through the tube of the endoscope;

selecting an outflow rotational speed for the outflow peristaltic pump;

selecting a maximum flow rate at which fluid enters the tissue cavity and, based on the maximum flow rate, selecting an inflow rotational speed for the inflow peristaltic pump;

activating the inflow peristaltic pump and the peristaltic outflow pump, to allow fluid to flow through the inflow port of the endoscope and into the tissue cavity, and from the tissue cavity through the outflow port of the endoscope, so that pressure inside the tissue cavity rises to a set pressure cavity; and

maintaining the set pressure cavity for a period of time.

20. The method of claim 19, wherein the step of maintaining the set pressure cavity for a period of time is achieved by simultaneously increasing the inflow rotational speed and the outflow rotational speed by same numerical amount.

21. The method of claim 19, wherein the step of maintaining the set pressure cavity for a period of time is achieved by simultaneously decreasing the inflow rotational speed and the outflow rotational speed by same numerical amount.

22. The method of claim 19, wherein the set pressure cavity is independently maintained from the inflow rotational speed and the outflow rotational speed.

23. The method of claim 19, further comprising the step of providing a constriction tube having a controllable constriction site between the inflow port of the endoscope and the inflow pump such that the constriction tube provides a route for any excess fluid being pumped by the inflow pump or due to the physiologic contraction of walls of the body cavity, therefore avoiding turbulence inside the body cavity and maintaining a stable pressure inside the body cavity.

24. The method of claim 23, further comprising the step of gradually reducing the diameter of the controllable constriction site to a fixed diameter until the set pressure cavity is achieved.

25. The method of claim 19, wherein the tube of the endoscope is an inner channel of a surgical instrument selected from the group consisting of morcellator, shaver, cutter, electrode and electrosurgical instrument.