SURGICAL FLUID MANAGEMENT SYSTEMS AND METHODS

• US 20130172805A1
• Filed: 06/27/2012
• Published: 07/04/2013
• Est. Priority Date: 06/29/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Arqos Surgical, Inc.
• Inventors: Truckai, Csaba, Klein, Kyle, Shadduck, John H., Walker, Michael D., Lesko, Balazs, Germain, Aaron, Orczy-Timko, Benedeck
• Granted Patent: US 9,233,193 B2
• Time in Patent Office: Days
• US Class Current: 604/28
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3205 Excision instruments
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61M 1/74 Suction control underwater drainage A61M1/61
• CPC Class Codes: A61M 1/777 Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• 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 3/0229 Devices operating in a closed circuit, i.e. recycling the irrigating fluid

Abstract

A fluid management system for use with a fluid reservoir includes an inflow pump and an outflow pump. The inflow pump is connectable to a probe for delivering a distention fluid to a body cavity. The outflow pump removes the distention fluid through the same probe, thus establishing a re-circulating volume of distention fluid within the body cavity. The removed fluid is filtered and returned to a fluid reservoir for eventual recycling to the body cavity. A controller adjusts the flow rates of the inflow pump and the outflow pump to maintain a pre-selected fluid pressure or volume within the body cavity.

Claims

1. A fluid management system for use with a fluid reservoir and a probe to re-circulate a distending fluid in a body space or potential space, said system comprising:

an inflow pump connectable to a fluid inflow lumen of the probe for providing an inflow of the distending fluid from the fluid source to the body space or potential space;

an outflow pump connectable to a fluid outflow lumen of the probe for removing fluid from the space and returning the removed fluid to the reservoir;

a filter arrangement for removing waste from the removed fluid before returning the removed fluid to the reservoir and

a controller for adjusting the flow rates of the inflow pump and of the outflow pump to maintain a pre-selected distending fluid pressure and/or volume in the body space or potential space.

2. The fluid management system of claim 1 wherein the controller is configured for operation in a pressure control mode wherein the first and second pumps cooperate to deliver fluid to the space and maintain pressure therein with a predetermined pressure range.

3. The fluid management system of claim 1 wherein the controller is configured for operation in a flow control mode wherein the first and second pumps cooperate to deliver fluid to the space within flow rates selected to control the volume of fluid accumulated in the body space or potential space.

4. The fluid management system of claim 1, further comprising at least one pressure sensor capable of providing a pressure signal indicating fluid pressure in the space or potential space.

5. The fluid management system of claim 4 wherein the pressure sensor is located in the fluid inflow lumen of the probe.

6. The fluid management system of claim 1, wherein the controller periodically or continuously calculates a difference between a fluid volume delivered to the space or potential space and a fluid volume recovered from the space or potential space, wherein the controller can alert the user and/or shut down at least the inflow pump if the difference exceeds a predetermined limit.

7. The fluid management system of claim 1, wherein the controller continuously or periodically compares an inflow pressure from the inflow pump and an outflow pressure at the outflow pump and wherein the controller is further configured to stop at least the inflow pump if two pressure signals differ by more than a predetermined minimum amount.

8. The fluid management device of claim 1, further comprising the probe and a tubing set, wherein the tubing set including at least one pulse dampener.

9. The fluid management device of claim 1, further comprising the probe wherein the probe comprises a windowed outer sleeve and a reciprocating inner cutting sleeve

10. The fluid management device of claim 9, wherein such reciprocation moves the probe between window-open and window-closed configurations;

wherein the system further comprises a window-closing mechanism to move the probe to the window-closed configuration in response to idling of the reciprocation.

11. A method of monitoring delivery and recovery of a distension fluid to detect loss during treatment of a body or potential space, said method comprising:

recording a reference volume of distending fluid contained within a supply container;

flowing distending fluid into the body or potential space;

recovering an outflow a fluid volume in from the space

filtering the recovered distending fluid; and

re-circulating the recovered fluid to the supply container to provide a replenished volume; and

calculating a fluid deficit by subtracting the replenished volume from the initial reference volume.

12. The method of 1 wherein the recording step further comprises recording a system capacity volume and a volume of the body or potential space

13. The method of 12, wherein the recording the system volume includes priming a supply tubing set and a surgical device with the distending fluid.

14. The method of 12, wherein the recording the volume of the body or potential space includes inflowing distending fluid into the body space.

15. The method of 11 wherein the recording step includes calculating the volume of the body space by imaging means.

16. The method of 11, further comprising sealing an access to the body space to prevent the loss of distending fluid into the environment.

17. The method of 16, further comprising capturing fluid loss through the access to the body space and measuring such lost fluid volume.

18. The method of 17, wherein calculating the fluid deficit comprises accounting for the lost fluid volume.

19. The method of 11, wherein a control system monitors and signals a fluid deficit parameter on an intermittent or continuous basis via a user interface.

20. The method of 19, wherein the signal is at least one of visual, aural and tactile.