Medical gas insufflator with automatic gas flow control

Details Medical gas insufflator with automatic gas flow control Medical gas insufflator with automatic gas flow control

1995-10-19

1998-09-01

Bockelman, Mark

Surgery

Means for introducing or removing material from body for...

Gas application

600560, A61M 3700

Patent

active

058003819

DESCRIPTION:

BRIEF SUMMARY
CROSS REFERENCE TO RELATED APPLICATIONS

This application is the U.S. national phase of PCT application PCT/FR95/00218 filed 23 Feb. 1995 with a claim to the priority of French 94 02483 itself filed 25 Feb. 1994.
The present invention relates to a medical gas insufflator with automatic gas-flow control used for diagnostic and surgical endoscopy to create by insufflation with a neutral gas an observation cavity and/or surgical space inside a human or animal body.


BACKGROUND OF THE INVENTION

The evolution of diagnostic endoscopy into surgical endoscopy has created new problems that need to be solved by the devices and instruments that are used. Medical insufflators belong to this category of supplies.
Originally conceived for dilating the cavity where the observation will take place and then, more recently, to create an "aseptic operating space," their characteristics have had to be adapted to the therapeutic means used by endoscopic surgeons, means which are naturally opposite to their good functioning (aspirators, vaporizers, fiber-cooling gases, laser-beam guides, neutral-gas electro-surgical devices, etc.) or that demand larger output in order to ventilate the surgical cavity (venting fumes from electro-surgery or lasers . . . )
Because of surgical demand this evolution has always resulted in an increase in the instantaneous gas flows and as a result insufflation pressures that currently reach values of 10,500 to 13,000 Pa (80 to 100 mm Hg) and even more. As a result the devices currently available on the market have safety-shutoff levels (fixed thresholds limiting the insufflation pressure) that are no longer compatible with the conditions required for the safety of the patients. These devices are all of the "pressure-regulating" type. Normally, in order to compensate for minor leaks, they have insufflation cycles that are very short with insufflation gas flows and pressures that are maximized.
Observation shows that during almost 90% of the time in an operation the effective gas flow is less than 3 l/min while under extreme conditions the instantaneous gas flow can reach 12 to 15 l/min.
In general the parameters to be sought or respected are the following: Veress needle to at most a safety threshold (to the best knowledge of applicant there has never been any clinical experimentation to determine this parameter; it seems nonetheless indispensable to remain below the local arterial pressure of 10,500 to 13,000 Pa, that is 80 to 120 mm Hg); (needle or trocar) to input the gas, measure the intracavity pressure, evacuate fumes, or relieve intracavity over pressures; liter/minute.
Different automatic gas insufflation devices which measure the insufflation pressure and the intracavity pressure have already been envisaged. The proposed systems generally combine a measuring device, means for holding the insufflated gas including one or more intermediate reservoirs, and an automatic regulation of the gas flow.
French 2,303,512 (Wiest) or its U.S. equivalent 3,982,533 describe a device for introducing into an abdominal cavity a limited quantity of carbonic gas, CO.sub.2, under pressure contained in a reservoir, using a monitoring system controlling the insufflation and measuring the insufflation pressure, and a system for measuring the static or intracavity pressure. The device requires two Veress needles for insufflation or one dual-passage Veress needle.
German 2,544,467 (Richard wolf GmbH) describes a device for introducing into an abdominal cavity carbonic gas, CO.sub.2, contained in a reservoir under pressure and using an expander, an insufflation conduit controlled by an Electrical valve, and a measuring conduit controlling the opening of this electrical valve. This devices requires two Veress needles for insufflation or one dual-passage Veress needle.
German 2,803,646 (Kurt Semm) relates to a device for introducing into the abdominal cavity carbonic gas, CO.sub.2, using a multistage assembly comprising several intermediate expanders and reservoirs, characterized by a system using multiple paths for mon

REFERENCES:
patent: 3982533 (1976-09-01), Wiest
patent: 4048992 (1977-09-01), Lindemann et al.
patent: 4207887 (1980-06-01), Hiltebrandt et al.
patent: 4676774 (1987-06-01), Semm et al.
patent: 5006109 (1991-04-01), Douglas et al.
patent: 5328458 (1994-07-01), Sekino et al.
patent: 5360396 (1994-11-01), Chan
patent: 5439441 (1995-08-01), Grimsley et al.

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