Device for irrigation and insufflation with blood pressure dependent pressure control

• US 9,901,670 B2
• Filed: 06/12/2015
• Issued: 02/27/2018
• Est. Priority Date: 11/08/2013
• Status: Active Grant

• Current Assignee: Bonvisi AB
• Original Assignee: Bonvisi AB
• Inventors: Mllstam, Anders
• Primary Examiner(s): Osinski, Bradley
• Application Number:
  US14/737,571
• Publication Number:
  US 20150290387A1
• Time in Patent Office: 991 Days
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61M 1/72 Cassettes forming partially or totally the fluid circuit
• 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 13/003 Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: A61M 13/006 with gas recirculation
• CPC Class Codes: A61M 2205/12 with interchangeable cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 3/005 comprising means for injection of two or more media, e.g. by mixing
• CPC Class Codes: A61M 3/0201 Cassettes therefor
• CPC Class Codes: A61M 3/0216 Pressure
• CPC Class Codes: A61M 3/0229 Devices operating in a closed circuit, i.e. recycling the irrigating fluid
• CPC Class Codes: A61M 3/0258 by means of electric pumps
• CPC Class Codes: A61M 3/0283 with at least two inner passageways, a first one for irrigating and a second for evacuating suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92

Abstract

A device for irrigation and/or insufflation during endoscopic surgery/procedures in a body cavity, comprising a first fluid pump device to deliver fluid to the body cavity, a second fluid pump device to move fluid from the body cavity, a control unit connected to the first and/or second fluid pump device, a blood pressure measuring device, wherein the control unit derives a control signal based on a signal from the blood pressure measuring device, and sends the control signal to the first fluid and/or second fluid pump device, wherein the control signal is derived by processing the signal from the blood pressure measuring device using a correlation factor in the device, dependent on the relationship between a blood pressure measurement signal, and a perfusion pressure of the body cavity, wherein the first and/or second fluid pump device controls the pressure in the body cavity based on the control unit'"'"'s control signal.

Claims

1. A device for irrigation and/or insufflation during endoscopic surgery or endoscopic procedures in a body cavity, comprising

a first fluid pump device in fluid connection with the body cavity via a fluid line, wherein the first fluid pump device is adapted to deliver a fluid to the body cavity,

a second fluid pump device in fluid connection with the body cavity via a fluid line, wherein the second fluid pump device is adapted to move a fluid from the body cavity,

a control unit connected to the first fluid pump device and/or the second fluid pump device,

a blood pressure measuring device, connected to the control unit, wherein the blood pressure measuring device is adapted to measure a blood pressure, and deliver a blood pressure measurement signal,

wherein the control unit is adapted to derive a control signal based on the signal from the blood pressure measuring device, wherein the control unit is further adapted to send the control signal to the first fluid pump device and/or the second fluid pump device,

wherein the control signal is derived by processing the signal from the blood pressure measuring device by using a correlation factor stored in the device, wherein the correlation factor is dependent on the relationship between the blood pressure measurement signal and a perfusion pressure of the body cavity,

wherein the first fluid pump device and/or the second fluid pump device is adapted to control the pressure in the body cavity based on said control signal received from the control unit.

2. The device according to claim 1, wherein the control signal is derived by processing the signal from the blood pressure measuring device by using an adjustment factor stored in the device corresponding to a preferred required over- or underpressure versus the perfusion pressure of the body cavity.

3. The device according to claim 2, wherein the control signal is derived by processing the signal from the blood pressure measuring device by using a compensation value stored in the device corresponding to a height level difference between a position for blood measurement and the body cavity.

4. The device according to claim 1, wherein a first fluid pressure measuring device is arranged to measure a deliver pressure Pi, corresponding to a pressure of the fluid delivered to the body cavity.

5. The device according to claim 4, wherein the control unit is adapted to calculate an estimated pressure Pei in the body cavity based on the measured deliver pressure Pi, a static pressure difference between the body cavity and the pressure at the first fluid pressure measuring device Ph, and a pressure drop Pdi in the fluid line between the first fluid pressure measuring device and the body cavity, wherein the control unit is further adapted to compare the control signal which corresponds to an actual target for the deliver pressure DP-at, with the estimated pressure Pei and adjust the first fluid pump device and/or the second fluid pump device to bring Pi to a pressure such that Pei=DP-at.

6. The device according to claim 1, wherein a second fluid pressure measuring device is arranged to measure a pressure of the fluid leaving the body cavity, wherein the second fluid pressure measuring device is connected to the control unit, wherein the control unit is further adapted to receive a fluid pressure measurement signal from the second fluid pressure measuring device and adjust the control signal based on said fluid pressure measurement signal.

7. The device according to claim 5 or 6, wherein the control unit is adapted to calculate an estimated pressure Peo in the body cavity based on the measured pressure of the fluid leaving the body cavity Po, the static pressure difference between the body cavity and the pressure at the first fluid pressure measuring device Ph and/or the second fluid pressure measuring device, and a pressure drop Pdo in the fluid line between the body cavity and the second fluid pressure measuring device, wherein the control unit is further adapted to compare Peo with Pei and trigger a corrective action if the difference between Peo and Pei is greater than a threshold value, wherein the threshold value is >

10%.

8. The device according to claim 6, wherein the second fluid pressure measuring device is adapted to measure the pressure of the fluid leaving the body cavity after a certain time period has passed since the second fluid pump device has been set in an non-operating mode whereby the second fluid pump device has stopped moving fluid from the body cavity.

9. The device according to claim 8, whereby the second fluid pressure measuring device is adapted to measure the pressure of the fluid leaving the body cavity in one measurement and/or in several measurements under a time period whereby the mean fluid pressure is calculated.

10. The device according to claim 1, wherein the blood pressure measuring device comprises any one of a non-invasive blood pressure meter, an invasive blood pressure meter signal, or a monitoring equipment associated to endoscopic surgery or procedures.

11. The device according to claim 1, wherein the blood pressure measuring device is integrated in the device or is a separate external module.

12. The device according to claim 1, wherein processing the signal from the blood pressure measuring device by using a correlation factor stored in the device comprises or is defined by multiplying the signal from the from the blood pressure measuring device with the correlation factor stored in the device.

23. The method according to claim 13, further comprising the step of pressurizing the irrigation or insufflation fluid using a first fluid pump device according to claim 1.

13. A method for controlling an irrigation or insufflation fluid pressure in a body cavity of a patient, comprising the steps of:

setting a default target deliver pressure (DP-dt) for the irrigation or insufflation fluid,

measuring a blood pressure, of said patient,

dynamically calculating a true perfusion pressure (PP-t) based on the measured blood pressure by processing a signal from a blood pressure measuring device by using a correlation factor,

automatically adjusting the default target deliver pressure (DP-dt) based on the true perfusion pressure (PP-t) into an actual target for the deliver pressure (DP-at).

14. The method according to claim 13, whereby the default target deliver pressure (DP-dt) corresponds to a normal perfusion pressure (PP-n) in a specific body cavity plus an adjustment factor (A) of 5-15% depending on the specific body cavity to prevent bleeding in the specific body cavity.

15. The method according to claim 14, whereby automatically adjusting the default target deliver pressure (DP-dt) to the actual target for the deliver pressure (DP-at) comprises:

calculating (PP-t+A) and comparing with (DP-dt),

increasing or decreasing (DP-dt) into (DP-at) if (PP-t+A) deviates from (DP-dt).

16. The method according to claim 15, further comprising:

setting a second fluid pump device in a non-operating mode whereby a second fluid pump device stops moving fluid from a body cavity,

measuring the pressure of the fluid leaving the body cavity after a certain time period has passed since the second fluid pump device has been set in a non-operating mode,

comparing (DP-at) with pressure of the fluid leaving the body cavity,

adjusting (DP-at) if deviates from the pressure of the fluid leaving the body cavity.

17. The method according to claim 16, further comprising providing a warning signal if (DP-at) deviates significantly from the pressure of the fluid leaving the body cavity, whereby significantly comprises more than >

10%.

18. The method according to claim 13, further comprising the step:

continuously delivering a fluid deliver pressure to the body cavity according to (DP-at).

19. The method according to claim 13, further comprising the steps:

measuring a delivery pressure Pi, corresponding to the pressure of the fluid delivered to the body cavity,

determining a static pressure difference between the body cavity and the pressure at a first fluid pressure measuring device Ph,

determining a pressure drop Pdi in the fluid line between the first fluid pressure measuring device Ph and the body cavity

calculating Pei=Pi−

Ph−

Pdi,

comparing Pei with the actual target for the deliver pressure (DP-at),

adjusting Pi such that Pei=(DP-at).

20. The method according to claim 19, further comprising the steps:

measuring a pressure of the fluid leaving the body cavity Po,

determining a static pressure difference between the body cavity and the pressure at the first fluid pressure measuring device and/or a second fluid pressure measuring device Ph,

determining a pressure drop Pdo in the fluid line between body cavity and the second fluid pressure measuring device,

calculating Peo=Po−

Ph+Pdo,

comparing Peo with Pei,

triggering a corrective action if the difference between Peo and Pei is greater than a threshold value, wherein the threshold value is >

10%.

21. The method according to claim 13, whereby the actual target for the deliver pressure (DP-at) is dynamically adjusted regularly, based on the measured blood pressure.

22. The method according to claim 21, whereby the actual target for the deliver pressure (DP-at) is dynamically adjusted regularly every 2-5 seconds based on the measured blood pressure.

24. The method according to claim 13, wherein processing the signal from the blood pressure measuring device by using a correlation factor stored in the device comprises or is defined by multiplying the signal from the from the blood pressure measuring device with the correlation factor stored in the device.